EXAM 1 OB

The nursing instructor is teaching students about the importance of active listening when communicating with clients. She informs them that which result might occur if the nurse does not listen?

Critical information may be missed.

Which finding would the nurse expect to find in a client with endometriosis?

Dyspareunia

Which action would the nurse include in a primary prevention program in the community to help reduce the incidence of HIV infection?

Educate clients on how to practice safe sex.

A woman has been diagnosed with trichomoniasis and asks the nurse when it would be safe to resume sexual activity. How should the nurse respond?

"After treatment you must be symptom free to resume sexual activity."

A nurse is providing care to a postpartum woman, her partner, and their neonate and is assessing their preparedness for discharge. Which question(s) would be appropriate for the nurse to ask? Select all that apply.

"How comfortable are you with feeding your neonate?" "Can you tell me who will be at home to help you out." "Tell me how you plan to get rest once you are at home."

A couple comes to the clinic for a fertility evaluation. The male partner is to undergo a semen analysis. After teaching the partner about this test, which client statement indicates that the client has understood the instructions?

"I have to abstain from sexual activity for about 2 to 5 days before the sample."

After teaching a pregnant woman about using complementary and alternative medicine (CAM) therapies, the nurse determines that the teaching was successful based on which client statement?

"I need to talk with my provider before I try using any therapy."

A pregnant client tells her nurse that she is interested in arranging a home birth. After educating the client on the advantages and disadvantages of a home birth, which statement would indicate that the client understood the information?

"I want to have more control, but I am concerned if an emergency would arise."

A nurse is conducting a class for a group of young adult women interested in contraception. As part of the class, the nurse asks the group about their understanding about contraception and pregnancy. Which statement(s) would cause the nurse to address it as a misconception. Select all that apply.

"If you douche after having sex, you will not get pregnant." "You cannot get pregnant if you have your menstrual period." "Pregnancy cannot happen if my male partner pulls out before ejaculating." "I cannot get pregnant if I am breastfeeding."

A client asks the nurse, "I read an article on the internet that was talking about integrative medicine. What is that?" Which response by the nurse would be most appropriate?

"It means that mainstream medical therapies and complementary and alternative therapies are combined based on scientific evidence for being effective."

A nurse is discussing the changes in the breast that occur after birth to a group of pregnant women. One woman says, "My friend who was breastfeeding told me that at first, her breast milk was dark yellow." Which response by the nurse would be appropriate?

"That is called colostrum. It is rich in antibodies and proteins."

When developing a teaching plan for a couple who are considering contraception options, the nurse would include which statement?

"The best contraceptive is one that you will use correctly and consistently."

A woman is diagnosed with gonorrhea. The client asks why she needs to take two medications. How should the nurse respond? Select all that apply.

"The medicines are needed to kill the bacteria causing the infection." "The medications help prevent the spread of the bacteria to your female organs." "The medications will stop the bacteria before it can cause complications."

A perinatal nurse is interviewing a group of women in the community about health care services. Assessment of these services reveals that many of them are being underutilized. Which statement from the women would assist the nurse in identifying potential reasons for this underutilization? Select all that apply.

"The services are hard to get to by public transportation." "The clinic is only open during the morning hours." "The staff seems to look down on us when we do come in." "You need insurance to go to the clinic."

A client with genital herpes simplex infection asks the nurse, "Will I ever be cured of this infection?" Which response by the nurse would be most appropriate?

"There is no cure, but drug therapy helps to reduce symptoms and recurrences."

A woman has been prescribed doxycycline to treat a chlamydia infection. What instruction(s) should the nurse give this client? Select all that apply.

"You must take all the 7 days of the medication." If the symptoms do not go away after the medication, you will need to return to the health care provider." "If you suspect you have another infection, you need to see the health care provider right away."

A 22-year-old woman comes to the clinic for an evaluation. Assessment findings are as follows: age of first intercourse: 15 years; intrauterine contraception inserted 2 months ago; monogamous partner; use of condoms for sexual activity; cigarette smoking since age 16, approximately 1/2 to 1 pack per day; oral temperature 100.4°F (38°C). The woman is diagnosed with pelvic inflammatory disease (PID). Which information from the woman's assessment would the nurse evaluate as increasing the woman's risk for this condition? Select all that apply.

-Age of first intercourse -Intrauterine contraceptive device insertion -Cigarette smoking -22 years of age

A hospital nurse is considering changing roles to become a home health nurse. What skill(s) will be important for this nurse to possess to be successful in the new role? Select all that apply.

-Be able to work with less structure -Have good assessment skills -Have good critical thinking skills -Understand that not all environments will be desirable

A nursing group is examining their hospital's maternal outcomes for the previous 5 years. Which identified factors have contributed to the decline in the maternal mortality rate? Select all that apply.

-Increased participation of women in prenatal care -Use of ultrasound to detect disorders -Closer monitoring for complications associated with hypertension of pregnancy -Better management of hemorrhage and infection

The nursing instructor is teaching a class on labor and birth. She lists the advantages of a home birth and then lists which disadvantages of home births? Select all that apply.

-Limited availability of pain medication -Danger to mother if emergency arises -Danger to baby if emergency arises

The nursing student demonstrates an understanding of what is included in postpartum home visits when the student identifies which actions? Select all that apply.

-Monitoring the physical and emotional well-being of the family members -Identifying potential or developing complications for the mother and newborn -Bridging the gap between discharge and ambulatory follow-up for mothers and their newborns

A nurse educator is preparing for a class discussion on the high mortality rate in the 17th and 18th centuries. Which information would the nurse likely include in the discussion? Select all that apply.

-Women giving birth often died from dehydration. -Exhaustion during labor occurred, resulting in death

A nurse is preparing an in-service program for a group of newly hired nurses about trends in care for pregnant women. When describing events of the past decade, the nurse would state that the average length of stay in the hospital for vaginal births is:

24 to 48 hours or less.

A client states that she is to have a test to measure bone mass to help diagnose osteoporosis. The nurse would most likely plan to prepare the client for:

A DEXA scan

The nurse is reviewing the process of egg maturation and ovulation with a client. What occurs during ovulation in the ovarian cycle that the nurse should include in the teaching session with the client?

About day 14, a surge of hormones cause the ovum to burst through the ovary.

The nurse is making a home visit to a client who had a cesarean birth 3 days ago. Assessment reveals that the client is reporting intermittent pain, rating it as 8 on a scale of 1 to 10. She states, "I'm pretty tired. And with this pain, I haven't been drinking and eating like I should. The medication helps a bit but not much. My mom has been helping with the baby." Her incision is clean, dry, and intact. The nurse would identify which problem as the priority for this client?

Acute pain

A woman comes to the clinic because she has been unable to conceive. When reviewing the woman's history, the nurse would least likely identify which factor as a possible risk?

Age of 25 years

A nurse is assessing a client for possible risk factors for chlamydia and gonorrhea. Which factor would the nurse identify?

Age under 25 years

A client with trichomoniasis is to receive metronidazole. What should the nurse instruct the client to avoid while taking this drug?

Alcohol

A nurse is describing the structure and function of the reproductive system to an adolescent health class. How would the nurse describe the secretion of the seminal vesicles?

Alkaline

The nurse is developing a plan of care for a client who is receiving aggressive drug therapy for treatment of HIV. The goal of this therapy is to:

Improve survival rates.

When teaching a group of postmenopausal women about hot flashes and night sweats, the nurse would address which primary cause?

Estrogen deficiency

A nurse is describing the hormones involved in the menstrual cycle to a group of young adult clients who are planning to get pregnant. The nurse determines the teaching was successful when the group identifies the follicle-stimulating hormone as being secreted by the:

Anterior pituitary gland.

A pregnant woman is to undergo an invasive procedure to evaluate the status of her fetus. To ensure informed consent, which action would be the priority responsibility of the nurse providing care to this woman?

Asking relevant questions to determine the client's understanding.

A group of nurses are discussing the reasons for the United States' low rankings for infant and maternal mortality and what impact they could make on these mortality rates in their practice. Which action could nurses implement to reduce these rates?

Assuring early and adequate prenatal care

A pregnant client is to undergo a procedure. Prior to the procedure, a nurse determines that informed consent has been obtained from the client, offering protection for the client based on which principle?

Autonomy

A client is receiving ceftriaxone as treatment for gonorrhea. What would be most important for the nurse to emphasize to the client?

Avoid alcohol consumption.

Which instruction should the nurse give to a client with genital herpes to help control the infection?

Avoid sexual contact until sores heal.

A young adult woman who is HIV-positive is receiving anti-retroviral therapy (ART) and is having difficulty with adherence. To promote adherence, which area would be most important for the nurse to assess?

Beliefs and education

When integrating the principles of family-centered care into the birthing process, the nurse would base care upon which belief?

Birth results in changes in relationships.

A 40-year-old pregnant client tells her nurse that she would like to give birth in a birthing center because she wants several friends and family members to be there and will have more freedom at the center. What would be the most important factor for the nurse to point out when discussing this option with the client?

Birthing centers do not always have pediatricians on staff if the newborn has special needs.

A nurse is preparing a breast cancer presentation for a health forum. Which fact would the nurse expect to address in this presentation?

Breast cancer is more advanced in Black women when found.

The nurse instructs the new parent about some health promotion strategies that could significantly improve their infant's health and chance of survival. These strategies will include which action(s)? Select all that apply.

Breastfeeding Placing infant on back to sleep Joining a parental support groups

A nurse will be educating a client about contraceptives. Which contraceptive method(s) will the nurse include as a mechanical barrier method? Select all that apply.

Condom Cervical cap Cervical sponge Diaphragm

Assessment of a female client reveals a thick, white vaginal discharge. The client also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has:

Candidiasis.

A female adolescent is diagnosed with gonorrhea. When developing the plan of care for this adolescent, the nurse would expect that she would also receive treatment for:

Chlamydia

A group of nurses are attending an in-service program on sexually transmitted infections (STIs). The group demonstrates understanding of the information when they identify which infection as the most commonly reported bacterial STI in the United States?

Chlamydia

A nurse is preparing a presentation for a group of young adults about the sexual response cycle. Place the events in the sequence that they would occur. Use all options.

Desire Excitement Plateau Orgasm Resolution

When preparing a teaching plan for a group of women during their first pregnancy, the nurse reviews how maternity care has changed over the years. Which information would the nurse include when discussing events occurring in the 20th century?

Development of birthing centers

The nurse is assessing a 13-year-old girl. Which event would the nurse expect to have occurred first?

Development of breast buds

A nurse is asked to be a guest speaker for a parents' meeting at the local middle school. Part of the presentation is to focus on the events girls will experience when going through puberty. Place the events in the order that the nurse would address them, from first to last. Use all options.

Development of the breast Appearance of pubic hair Appearance of axillary hair Growth spurt Menstruation

The nurse discusses various contraceptive methods with a client and her partner. Which method would the nurse explain as being available only by prescription?

Diaphragm

A nurse is teaching a new mother about self-care measures. Which action would the nurse do as the final step in this process?

Document the teaching and effectiveness.

A nurse is preparing a presentation for a group of women at the clinic who have been diagnosed with genital herpes. Which factors would the nurse expect to include as possible precipitating factors for a recurrent outbreak? Select all that apply.

Exposure to ultraviolet light Use of corticosteroids Emotional stress Sexual intercourse

The nurse would recommend the use of which supplement as a primary prevention strategy to prevent neural tube defects in the future offspring of pregnant women?

Folic acid

A nurse is teaching a group of adolescent girls about the menstrual cycle. The nurse would integrate information about which hormones as being predominant during the cycle? Select all that apply.

GnRH, FSH, LH

A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection?

Gonorrhea

A nurse is reviewing a journal article about vaccines used to prevent STIs. The nurse would expect to find information about vaccines for which STIs? Select all that apply.

HPV HAV HBV

Cost containment in the health care field has become a sought-after necessity because of rising costs and the influence of managed care. Nurses are instrumental in assisting with cost containment of health care by prioritizing which strategy?

Health promotion

A client with syphilis did not receive treatment and has now progressed into the tertiary stage of the disorder. Which symptoms would the nurse expect the client to exhibit?

Heart disease and inflammation of the aorta, eyes, brain, CNS, and skin

When developing a teaching plan for a community group about HIV infection, which group would the nurse identify being most vulnerable for HIV infection?

Heterosexual women

The nurse is developing a plan of care for a client who is receiving antiretroviral therapy (ART) for treatment of HIV. What would the nurse identify as the goal of this therapy?

Improve morbidity and mortality rates

A nurse is reviewing the statistical outcomes related to fetal deaths nationwide and notes that the numbers have changed over the last several decades. The best explanation would be:

Improved prenatal care has reduced the numbers of fetal deaths.

When discussing contraceptive options, the nurse would recommend which option as being the most reliable?

Intrauterine system

A nurse is conducting a class for a group of female adolescents about the structures of the female reproductive tract. The nurse determines that the teaching was successful when the class identifies which structure as containing sweat and sebaceous glands?

Labia majora

An expectant mother states that she read that more black mothers die in childbirth than do white mothers. When responding to her questions about the reasons for this, the nurse accurately states that which is the major reason for the high maternal mortality rate?

Lack of prenatal care.

When describing the hormones involved in the menstrual cycle, a nurse identifies which hormone as responsible for initiating the cycle?

Luteinizing hormone

A 20-year-old client with a 28-day cycle reports ovulation on May 10. When would the nurse expect the client's next menses to most likely begin?

May 24

When reviewing the medical record of a client diagnosed with endometriosis, the nurse would identify which finding as a risk factor for this woman?

Menstrual cycles of 24 days

After teaching a group of adolescents about female reproductive development, the nurse determines that teaching was successful when the adolescents identify menarche as a client's first:

Menstrual period.

A woman is diagnosed with a vaginal infection. After teaching the client about measures to reduce her risk, the nurse determines that the client needs additional teaching when she states which factor as increasing her risk?

Menstruation

When teaching a group of female adolescents about reproduction and reproductive organs, the nurse describes the vulva. Which structure(s) would the nurse identify as being included? Select all that apply.

Mons pubis, labia, clitoris

The nurse who is working with women, children, and families knows the importance of using good communication, both verbal and nonverbal. Which actions are examples of nonverbal communication? Select all that apply.

Nodding attending to others active listening

The vagina is at risk for infection because of its location and because it opens to the outside of the body. What is a protective mechanism of the vagina to keep it from becoming infected?

Normal vaginal pH is acidic (4 to 5), which protects from infection.

The nurse is assessing a 12-year-old girl who has had her first menses. When reviewing the client's history, which event would the nurse expect to have most likely occurred last?

Onset of menses

With sexual stimulation the penis becomes erect. What is the physiologic cause of an erection?

Penile sinuses fill up with blood.

The nurse is preparing an outline for a class on the physiology of the male sexual response. Which event would the nurse identify as occurring first?

Penile vasodilation

A nurse is conducting an orientation program for a group of newly hired nurses. As part of the program, the nurse is reviewing the issue of informed consent. The nurse determines that the teaching was effective when the group identifies which situation as a violation of informed consent?

Performing a procedure on a 15-year-old without parental consent.

The nurse is preparing to meet with a couple who have requested counseling concerning family planning. The nurse will prioritize which topics for discussion?

Possible genetic abnormalities

A nurse working at a women's health center is engaged in secondary prevention activities. With which activity(ies) would the nurse be involved? Select all that apply.

Pregnancy testing Breast examinations Osteoporosis screening

A client is questioning the nurse about the various options for contraception. When explaining the implantable form, the nurse should point out it contains which form of contraception?

Progestin

A nurse is conducting a presentation for a group of young adults who are considering childbearing. As part of the class, the nurse describes semen as consisting of sperm and which substance(s)? Select all that apply.

Prostatic fluid Seminal fluid Mucus from accessory glands

A nurse at a local community clinic is developing a program to address STI prevention. What would the nurse least likely include in the program?

Recommending screening for symptomatic individuals

After explaining the function of the seminal vesicles to a class, the instructor determines the need for additional teaching when the students identify which action as a function of the seminal vesicles?

Reduces sperm motility

A nurse is assessing a 49-year-old client who has come to the clinic for her annual physical exam. The client tells the nurse, "I usually sleep about 8 hours a night without any problems but there are some nights where I wake up drenched in perspiration. And some days I feel on edge for no apparent reason." Additional assessment reveals use of a vaginal lubricant during sexual intercourse. The client also reports occasional flatus without constipation or bloating and continuation of her menstrual cycle every 32 days with a moderate flow. The nurse suspects that the client may be perimenopausal based on which finding(s)? Select all that apply.

Reports of night sweats Unexplained irritability Use of vaginal lubrication

A woman is diagnosed with premenstrual dysphoric disorder. To address the woman's behavioral symptoms, which class of agents would the nurse anticipate needing to be addressed in the woman's teaching plan?

Selective serotonin reuptake inhibitors (SSRIs)

A nurse is teaching a group of adolescent males about the male reproductive system. The nurse determines that the teaching was successful when the group identifies which activity(ies) as a function of the testes? Select all that apply.

Sperm production Testosterone production

A woman who is using an intrauterine system for contraception comes to the clinic. When assessing the woman, which finding(s) would alert the nurse to a possible complication? Select all that apply.

String length shorter than on initial visit Reports of abdominal pain Oral temperature of 101°F (38.3°C)

A woman comes to the clinic reporting that she has little sexual desire. As part of the client's evaluation, the nurse would anticipate the need to evaluate which hormone level?

Testosterone

A child needs a consent form signed for a minor surgical procedure. Which statement accurately describes the responsibility of the physician or nurse when obtaining the consent?

The nurse is responsible for determining that the parents or legal guardians understand what they are signing by asking them pertinent questions.

A public health nurse is developing programs to educate parents on infant mortality. Which complication(s) should the nurse include in the education? Select all that apply.

Tricuspid atresia Anencephaly Spina bifida

The nurse is giving a presentation about chlamydia to a group of adult women. The nurse would emphasize the need for annual screening for this infection in all sexually active women younger than which age?

Under 25

The nurse is reviewing the process of oocyte maturation and ovulation with a client. What occurs during the follicular phase of the ovarian cycle that the nurse should include in the teaching session?

Under the influence of follicle-stimulating hormone, several follicles begin to ripen, and the ovum with each begins to mature.

A woman comes to the clinic reporting vaginal discharge. The nurse suspects trichomoniasis based on which symptoms? Select all that apply

Urinary frequency Yellow/green discharge

What is the most important consideration for the nurse when communicating with an adolescent about sexually transmitted infections (STI)?

Use communication techniques that are direct and nonjudgmental

After teaching a group of students about premenstrual syndrome, the instructor determines that additional teaching is needed when the group identifies which finding as a prominent assessment finding?

Weight loss

A nurse is teaching a local women's group about women's health care and changes that have occurred. When describing women's health care today, which statement would the nurse likely include?

Women make almost 80% of all health care decisions.

The nurse is providing care to a pregnant woman who speaks a different language from that of the nurse. When communicating with this client, the nurse demonstrates best practice by which action?

arranging for an interpreter to be present during any communication