Exam 2

A clients oncologist has just finished explaining the diagnostic workup results to her, and she still has questions. The woman states, The physician says I have a slow-growing cancer. Very few cells are dividing. How does she know this? What is the name of the test that gave the health care provider this information? a. Tumor ploidy b. S-phase index c. Nuclear grade d. Estrogen-receptor assay

b. S-phase index

Which statement regarding the structure and function of the placenta is correct? a. Produces nutrients for fetal nutrition b. Secretes both estrogen and progesterone c. Forms a protective, impenetrable barrier to microorganisms such as bacteria and viruses d. Excretes prolactin and insulin

b. Secretes both estrogen and progesterone

A woman who is 16 weeks pregnant asks the nurse, Is it possible to tell by ultrasound if the baby is a boy or girl yet? What is the best answer? a. A babys sex is determined as soon as conception occurs. b. The baby has developed enough to enable us to determine the sex by examining the genitals through an ultrasound scan. c. Boys and girls look alike until approximately 20 weeks after conception, and then they begin to look different. d. It might be possible to determine your babys sex, but the external organs look very similar right now.

b. The baby has developed enough to enable us to determine the sex by examining the genitals through an ultrasound scan.

With regard to the assessment of female, male, or couple infertility, the nurse should be aware of which important information? a. The couples religious, cultural, and ethnic backgrounds provide emotional clutter that does not affect the clinical scientific diagnosis. b. The investigation will take several months and can be very costly. c. The woman is assessed first; if she is not the problem, then the male partner is analyzed. d. Semen analysis is for men; the postcoital test is for women.

b. The investigation will take several months and can be very costly.

An unmarried young woman describes her sex life as active and involving many partners. She wants a contraceptive method that is reliable and does not interfere with sex. She requests an intrauterine device (IUD). Which information is most important for the nurse to share? a. The IUD does not interfere with sex. b. The risk of pelvic inflammatory disease will be higher with the IUD. c. The IUD will protect you from sexually transmitted infections. d. Pregnancy rates are high with the IUD.

b. The risk of pelvic inflammatory disease will be higher with the IUD.

The lactational amenorrhea method (LAM) of birth control is popular in developing countries and has had limited use in the United States. As breastfeeding rates increase, more women may rely upon this method for birth control. Which information is most important to provide to the client interested in using the LAM for contraception? a. LAM is effective until the infant is 9 months of age. b. This popular method of birth control works best if the mother is exclusively breastfeeding. c. Its typical failure rate is 5%. d. Feeding intervals should be 6 hours during the day.

b. This popular method of birth control works best if the mother is exclusively breastfeeding.

4. The Centers for Disease Control and Prevention (CDC) recommends which therapy for the treatment of the HPV? a. Miconazole ointment b. Topical podofilox 0.5% solution or gel c. Two doses of penicillin administered intramuscularly (IM) d. Metronidazole by mouth

b. Topical podofilox 0.5% solution or gel

Which test is performed around the time of ovulation to diagnose the basis of infertility? a. Hysterosalpingogram b. Ultrasonography c. Laparoscopy d. Follicle-stimulating hormone (FSH) level

b. Ultrasonography

The nurse working with clients who have infertility concerns should be aware of the use of leuprolide acetate (Lupron) as a gonadotropin-releasing hormone (GnRH) agonist. For which condition would this medication be prescribed? a. Anovulatory cycles b. Uterine fibroids c. Polycystic ovary disease (PCOD) d. Luteal phase inadequacy

b. Uterine fibroids

The nurse should be aware that a pessary is most effective in the treatment of which disorder? a. Cystocele b. Uterine prolapse c. Rectocele d. Stress urinary incontinence

b. Uterine prolapse

Fennel, dong quai

b. Uterotonic

A woman is 15 weeks pregnant with her first baby. She asks how long it will be before she feels the baby move. What is the nurses best answer? a. You should have felt the baby move by now. b. Within the next month, you should start to feel fluttering sensations. c. The baby is moving; however, you cant feel it yet. d. Some babies are quiet, and you dont feel them move.

b. Within the next month, you should start to feel fluttering sensations.

A woman inquires about herbal alternative methods for improving fertility. Which statement by the nurse is most appropriate when informing the client on which herbal preparations may improve ovulation induction therapy? a. You should avoid nettle leaf, dong quai, and vitamin E while you are trying to get pregnant. b. You may want to try black cohosh or phytoestrogens. c. You should take vitamins E and C, selenium, and zinc. d. Herbs have no bearing on fertility.

b. You may want to try black cohosh or phytoestrogens.

A woman who has a seizure disorder and takes barbiturates and phenytoin sodium daily asks the nurse about the pill as a contraceptive choice. What is the nurses best response? a. Oral contraceptives are a highly effective method, but they have some side effects. b. Your current medications will reduce the effectiveness of the pill. c. Oral contraceptives will reduce the effectiveness of your seizure medication. d. The pill is a good choice for a woman of your age and with your personal history.

b. Your current medications will reduce the effectiveness of the pill.

Which statements regarding the HPV are accurate? (Select all that apply.) HPV infections: a. are thought to be less common in pregnant women than in women who are not pregnant. b. are thought to be more common in pregnant women than in women who are not pregnant. c. were previously called genital warts. d. were previously called herpes. e. may cause cancer.

b. are thought to be more common in pregnant women than in women who are not pregnant. c. were previously called genital warts. e. may cause cancer.

The pancreas forms in the foregut during the 5th to 8th week of gestation. A client with poorly controlled gestational diabetes asks the nurse what the effects of her condition will be on the fetus. What is the best response by the nurse? Poorly controlled maternal gestational diabetes will: a. produce fetal hypoglycemia. b. result in a macrocosmic fetus. c. result in a microcosmic fetus. d. enhance lung maturation.

b. result in a macrocosmic fetus

16. Which statement related to the condition of endometriosis is most accurate? a. Endometriosis is characterized by the presence and growth of endometrial tissue inside the uterus. b. It is found more often in African-American women than in Caucasian or Asian women. c. Endometriosis may worsen with repeated cycles or remain asymptomatic and disappear after menopause. d. It is unlikely to affect sexual intercourse or fertility.

c. Endometriosis may worsen with repeated cycles or remain asymptomatic and disappear after menopause.

7. Which condition is the most life-threatening virus to the fetus and neonate? a. Hepatitis A virus (HAV) b. Herpes simplex virus (HSV) c. Hepatitis B virus (HBV) d. Cytomegalovirus (CMV)

c. Hepatitis B virus (HBV)

Which statement regarding the term contraceptive failure rate is the most accurate? a. The contraceptive failure rate refers to the percentage of users expected to have an accidental pregnancy over a 5-year span. b. It refers to the minimum rate that must be achieved to receive a government license. c. The contraceptive failure rate increases over time as couples become more careless. d. It varies from couple to couple, depending on the method and the users.

d. It varies from couple to couple, depending on the method and the users.

Which precaution should the nurse take while caring for a client who is undergoing internal radiation therapy for cervical cancer? a. Wear gloves when assessing the cervical intracavity implant. b. Instruct the client to urinate in the lead-lined bedpan or hat every 2 hours. c. Prepare the client for an enema before inserting the implant. d. Limit staff or visitor exposure to 30 minutes or less in an 8-hour period.

d. Limit staff or visitor exposure to 30 minutes or less in an 8-hour period.

17. Which alteration in cyclic bleeding best describes bleeding that occurs at any time other than menses? a. Oligomenorrhea b. Menorrhagia c. Leiomyoma d. Metrorrhagia

d. Metrorrhagia

Which statement regarding gamete intrafallopian transfer (GIFT) is most accurate? a. Semen is collected after laparoscopy. b. Women must have two normal fallopian tubes. c. Ovulation spontaneously occurs. d. Ova and sperm are transferred to one tube.

d. Ova and sperm are transferred to one tube.

Group B Streptococcus (GBS) is part of the normal vaginal flora in 20% to 30% of healthy pregnant women. GBS has been associated with poor pregnancy outcomes and is an important factor in neonatal morbidity and mortality. Which finding is not a risk factor for neonatal GBS infection? a. Positive prenatal culture b. Preterm birth at 37 weeks or less of gestation c. Maternal temperature of 38 C or higher d. Premature rupture of membranes (PROM) 24 hours or longer before the birth

d. Premature rupture of membranes (PROM) 24 hours or longer before the birth

Which client is most at risk for fibroadenoma of the breast? a. 38-year-old woman b. 50-year-old woman c. 16-year-old girl d. 27-year-old woman

c. 16-year-old girl

At a routine prenatal visit, the nurse explains the development of the fetus to her client. At approximately ____ weeks of gestation, lecithin is forming on the alveolar surfaces, the eyelids open, and the fetus measures approximately 27 cm crown to rump and weighs approximately 1110 g. The client is how many weeks of gestation at todays visit? a. 20 b. 24 c. 28 d. 30

c. 28

The measurement of lecithin in relation to sphingomyelin (lecithin/sphingomyelin [L/S] ratio) is used to determine fetal lung maturity. Which ratio reflects fetal maturity of the lungs? a. 1.4:1 b. 1.8:1 c. 2:1 d. 1:1

c. 2:1

11. The nurse should understand the process by which the HIV infection occurs. Once the virus has entered the body, what is the time frame for seroconversion to HIV positivity? a. 6 to 10 days b. 2 to 4 weeks c. 6 to 12 weeks d. 6 months

c. 6 to 12 weeks

In the acronym BRAIDED, which letter is used to identify the key components of informed consent that the nurse must document? a. B stands for birth control. b. R stands for reproduction. c. A stands for alternatives. d. I stands for ineffective.

c. A stands for alternatives.

Ginger

c. Antiinflammatory

A pregnant woman at 25 weeks of gestation tells the nurse that she dropped a pan last week and her baby jumped at the noise. Which response by the nurse is most accurate? a. That must have been a coincidence; babies cant respond like that. b. The fetus is demonstrating the aural reflex. c. Babies respond to sound starting at approximately 24 weeks of gestation. d. Let me know if it happens again; we need to report that to your midwife.

c. Babies respond to sound starting at approximately 24 weeks of gestation.

What is the drug of choice for the treatment of gonorrhea? a. Penicillin G b. Tetracycline c. Ceftriaxone d. Acyclovir

c. Ceftriaxone

3. Which sexually transmitted infection (STI) is the most commonly reported in American women? a. Gonorrhea b. Syphilis c. Chlamydia d. Candidiasis

c. Chlamydia

A womans cousin gave birth to an infant with a congenital heart anomaly. The woman asks the nurse when such anomalies occur during development. Which response by the nurse is most accurate? a. We dont really know when such defects occur. b. It depends on what caused the defect. c. Defects occur between the third and fifth weeks of development. d. They usually occur in the first 2 weeks of development.

c. Defects occur between the third and fifth weeks of development.

Breast pain occurs in many women during their perimenopausal years. Which information is a priority for the nurse to share with the client? a. Breast pain is an early indication of cancer. b. Pain is almost always an indication of a solid mass. c. Distinguishing between cyclical and noncyclical pain is important. d. Breast pain is most often treated with narcotics.

c. Distinguishing between cyclical and noncyclical pain is important.

The nurse is having her first meeting with a couple experiencing infertility. The nurse has formulated the nursing diagnosis, Deficient knowledge, related to lack of understanding of the reproductive process with regard to conception. Which nursing intervention does not apply to this diagnosis? a. Assess the current level of factors promoting conception. b. Provide information regarding conception in a supportive manner. c. Evaluate the couples support system. d. Identify and describe the basic infertility tests.

c. Evaluate the couples support system.

A couple comes in for an infertility workup, having attempted to achieve pregnancy for 2 years. The woman, 37 years of age, has always had irregular menstrual cycles but is otherwise healthy. The man has fathered two children from a previous marriage and had a vasectomy reversal 2 years ago. The man has had two normal semen analyses, but the sperm seem to be clumped together. What additional testing is needed? a. Testicular biopsy b. Antisperm antibodies c. FSH level d. Examination for testicular infection

c. FSH level

A woman has arrived for her preoperative testing appointment. She is scheduled for a myomectomy the following day. What condition would require the client to undergo this procedure for symptom relief? a. Numerous small fibroid tumors b. Bartholin cysts c. Fibroid tumors near the outer wall of the uterus with a uterine size no larger than at 12 weeks of gestation d. Leiomyomas (also known as fibroid tumors) in a uterus larger than 14 weeks of gestation

c. Fibroid tumors near the outer wall of the uterus with a uterine size no larger than at 12 weeks of gestation

13. Which STI does not respond well to antibiotic therapy? a. Chlamydia b. Gonorrhea c. Genital herpes d. Syphilis

c. Genital herpes

A couple is attempting to cope with an infertility problem. They want to know what they can do to preserve their emotional equilibrium. What is the nurses most appropriate response? a. Tell your friends and family so that they can help you. b. Talk only to other friends who are infertile, because only they can help. c. Get involved with a support group. Ill give you some names. d. Start adoption proceedings immediately, because adopting an infant can be very difficult.

c. Get involved with a support group. Ill give you some names.

A nurse is providing breast care education to a client after mammography. Which information regarding fibrocystic changes in the breast is important for the nurse to share? a. Fibrocystic breast disease is a disease of the milk ducts and glands in the breasts. b. It is a premalignant disorder characterized by lumps found in the breast tissue. c. Healthy women with fibrocystic breast disease find lumpiness with pain and tenderness in varying degrees in the breast tissue during menstrual cycles. d. Lumpiness is accompanied by tenderness after menses.

c. Healthy women with fibrocystic breast disease find lumpiness with pain and tenderness in varying degrees in the breast tissue during menstrual cycles.

Which procedure falls into the category of micromanipulation techniques of the follicle? (Select all that apply.) a. Intrauterine insemination b. Preimplantation genetic diagnosis c. Intracytoplasmic sperm injection (ISCI) d. Assisted hatching e. IVF-ET

c. Intracytoplasmic sperm injection (ISCI) d. Assisted hatching

A woman has a breast mass that is not well delineated and is nonpalpable, immobile, and nontender. Which condition is this client experiencing? a. Fibroadenoma b. Lipoma c. Intraductal papilloma d. Mammary duct ectasia

c. Intraductal papilloma

An infertile woman is about to begin pharmacologic treatment. As part of the regimen, she will take purified FSH (Metrodin). The nurse instructs her that this medication is administered in the form of what? a. Intranasal spray b. Vaginal suppository c. Intramuscular (IM) injection d. Tablet

c. Intramuscular (IM) injection

If consistently and correctly used, which of the barrier methods of contraception has the lowest failure rate? a. Spermicides b. Female condoms c. Male condoms d. Diaphragms

c. Male condoms

Which statement regarding the development of the respiratory system is a high priority for the nurse to understand? a. The respiratory system does not begin developing until after the embryonic stage. b. The infants lungs are considered mature when the L/S ratio is 1:1, at approximately 32 weeks of gestation. c. Maternal hypertension can reduce maternal-placental blood flow, accelerating lung maturity. d. Fetal respiratory movements are not visible on ultrasound scans until at least 16 weeks of gestation.

c. Maternal hypertension can reduce maternal-placental blood flow, accelerating lung maturity.

The nurse provides education to a client about to undergo external radiation therapy. Which statement by the client reassures the nurse that the teaching has been effective? a. I am using ointment to keep my skin from drying out. b. I wash the irradiated area with deodorant soap. c. My diet is high in protein, and I drink at least 2000 ml of fluid a day. d. I wash off the markings for the radiation site after each treatment.

c. My diet is high in protein, and I drink at least 2000 ml of fluid a day.

Which diagnostic test is used to confirm a suspected diagnosis of breast cancer? a. Mammogram b. Ultrasound c. Needle-localization biopsy d. Magnetic resonance imaging (MRI)

c. Needle-localization biopsy

18. Management of primary dysmenorrhea often requires a multifaceted approach. Which pharmacologic therapy provides optimal pain relief for this condition? a. Acetaminophen b. Oral contraceptive pills (OCPs) c. Nonsteroidal antiinflammatory drugs (NSAIDs) d. Aspirin

c. Nonsteroidal antiinflammatory drugs (NSAIDs)

1. Which condition is the least likely cause of amenorrhea in a 17yearold client? a. Anatomic abnormalities b. Type 1 diabetes mellitus c. Obesity d. Pregnancy

c. Obesity

14. Which statement concerning cyclic perimenstrual pain and discomfort (CPPD) is accurate? a. Premenstrual dysphoric disorder (PMDD) is a milder form of PMS and more common in young women. b. Secondary dysmenorrhea is more intense and more medically significant than primary dysmenorrhea. c. PMS is a complex, poorly understood condition that may include any of a hundred symptoms. d. The causes of PMS have been well established.

c. PMS is a complex, poorly understood condition that may include any of a hundred symptoms.

Having a genetic mutation may create an 85% chance of developing breast cancer in a womans lifetime. Which condition does not increase a clients risk for breast cancer? a. BRCA1 or BRCA2 gene mutation b. Li-Fraumeni syndrome c. Paget disease d. Cowden syndrome

c. Paget disease

When caring for clients with neoplasms of the reproductive system, the nurse must begin by assessing the womans knowledge of the disorder, its management, and prognosis. This assessment should be followed by a nursing diagnosis. Which diagnosis fails to address the psychologic effect of these disorders? a. Anxiety, related to surgical procedures b. Disturbed body image, as a result of changes in anatomy c. Risk for injury, related to lack of skill for self-care d. Interrupted family processes

c. Risk for injury, related to lack of skill for self-care

A couple arrives for their first appointment at an infertility center. Which of the following is a noninvasive test performed during the initial diagnostic phase of testing? a. Hysterosalpingogram b. Endometrial biopsy c. Sperm analysis d. Laparoscopy

c. Sperm analysis

A woman will be taking oral contraceptives using a 28-day pack. What advice should the nurse provide to protect this client from an unintended pregnancy? a. Limit sexual contact for one cycle after starting the pill. b. Use condoms and foam instead of the pill for as long as the client takes an antibiotic. c. Take one pill at the same time every day. d. Throw away the pack and use a backup method if two pills are missed during week 1 of her cycle.

c. Take one pill at the same time every day.

Which client would be an ideal candidate for injectable progestins such as Depo-Provera (DMPA) as a contraceptive choice? a. The ideal candidate for DMPA wants menstrual regularity and predictability. b. The client has a history of thrombotic problems or breast cancer. c. The ideal candidate has difficulty remembering to take oral contraceptives daily. d. The client is homeless or mobile and rarely receives health care.

c. The ideal candidate has difficulty remembering to take oral contraceptives daily.

A client arrives for her initial prenatal examination. This is her first child. She asks the nurse, How does my baby get air inside my uterus? What is the correct response by the nurse? a. The babys lungs work in utero to exchange oxygen and carbon dioxide. b. The baby absorbs oxygen from your blood system. c. The placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream. d. The placenta delivers oxygen-rich blood through the umbilical artery to the babys abdomen.

c. The placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream.

The nurse is providing contraceptive instruction to a young couple who are eager to learn. The nurse should be cognizant of which information regarding the natural family planning method? a. The natural family planning method is the same as coitus interruptus or pulling out. b. This contraception method uses the calendar method to align the womans cycle with the natural phases of the moon. c. This practice is the only contraceptive method acceptable to the Roman Catholic Church. d. The natural family planning method relies on barrier methods during the fertility phases.

c. This practice is the only contraceptive method acceptable to the Roman Catholic Church.

4. Which statement(s) might the nurse appropriately include when teaching a client about calcium intake for osteoporosis? (Select all that apply.) a. You should try to increase your protein intake when you are taking calcium. b. It is best to take calcium in one large dose. c. Tums are the most soluble form of calcium. d. You should take calcium with vitamin D because the vitamin D helps your body better absorb calcium. e. Its okay to take calcium if you have had a history of kidney stones.

c. Tums are the most soluble form of calcium. d. You should take calcium with vitamin D because the vitamin D helps your body better absorb calcium.

A woman who has just undergone a first-trimester abortion will be using oral contraceptives. To protect against pregnancy, the client should be advised to do what? a. Avoid sexual contact for at least 10 days after starting the pill. b. Use condoms and foam for the first few weeks as a backup. c. Use another method of contraception for 1 week after starting the pill. d. Begin sexual relations once vaginal bleeding has ended.

c. Use another method of contraception for 1 week after starting the pill.

After a mastectomy, which activity should the client be instructed to avoid? a. Emptying surgical drains twice a day and as needed b. Lifting more than 4.5 kg (10 lb) or reaching above her head until given permission by her surgeon c. Wearing clothing with snug sleeves to support the tissue of the arm on the operative side d. Immediately reporting inflammation that develops at the incision site or in the affected arm

c. Wearing clothing with snug sleeves to support the tissue of the arm on the operative side

Which woman is at the greatest risk for psychologic complications after hysterectomy? a. 55-year-old woman who has been having abnormal bleeding and pain for 3 years b. 46-year-old woman who has had three children and has just been promoted at work c. 62-year-old widow who has three friends who have had uncomplicated hysterectomies d. 19-year-old woman who had a ruptured uterus after giving birth to her first child

d. 19-year-old woman who had a ruptured uterus after giving birth to her first child

Some of the embryos intestines remain within the umbilical cord during the embryonic period. What is the rationale for this development of the gastrointestinal system? a. Umbilical cord is much larger at this time than it will be at the end of pregnancy. b. Intestines begin their development within the umbilical cord. c. Nutrient content of the blood is higher in this location. d. Abdomen is too small to contain all the organs while they are developing.

d. Abdomen is too small to contain all the organs while they are developing.

1. Syphilis is a complex disease that can lead to serious systemic illness and even death if left untreated. Which manifestation differentiates primary syphilis from secondary syphilis? a. Fever, headache, and malaise b. Widespread rash c. Identified by serologic testing d. Appearance of a chancre 2 months after infection

d. Appearance of a chancre 2 months after infection

The nurse providing care in a womens health care setting must be knowledgeable about STIs. Which STIs can be successfully treated? a. HSV b. AIDS c. Venereal warts d. Chlamydia

d. Chlamydia

Which structure is responsible for oxygen and carbon dioxide transport to and from the maternal bloodstream? a. Decidua basalis b. Blastocyst c. Germ layer d. Chorionic villi

d. Chorionic villi

9. Which risk factor would the nurse recognize as being frequently associated with osteoporosis? a. African-American race b. Lowprotein intake c. Obesity d. Cigarette smoking

d. Cigarette smoking

Male fertility declines slowly after age 40 years; however, no cessation of sperm production analogous to menopause in women occurs in men. What condition is not associated with advanced paternal age? a. Autosomal dominant disorder b. Schizophrenia c. Autism spectrum disorder d. Down syndrome

d. Down syndrome

Nurses should be cognizant of what information with regard to the noncontraceptive medical effects of combination oral contraceptives (COCs)? a. COCs can cause TSS if the prescription is wrong. b. Hormonal withdrawal bleeding is usually a little more profuse than in normal menstruation and lasts a week for those who use COCs. c. COCs increase the risk of endometrial and ovarian cancers. d. Effectiveness of COCs can be altered by some over-the-counter medications and herbal supplements.

d. Effectiveness of COCs can be altered by some over-the-counter medications and herbal supplements.

Black cohosh root

d. Estrogen-like luteinizing hormone suppressant

Although remarkable developments have occurred in reproductive medicine, assisted reproductive therapies are associated with numerous legal and ethical issues. Nurses can provide accurate information about the risks and benefits of treatment alternatives to enable couples to make informed decisions about their choice of treatment. Which concern is unnecessary for the nurse to address before treatment? a. Risks of multiple gestation b. Whether or how to disclose the facts of conception to offspring c. Freezing embryos for later use d. Financial ability to cover the cost of treatment

d. Financial ability to cover the cost of treatment

13. Which system responses would the nurse recognize as being unrelated to prostaglandin (PGF2) release? a. Systemic responses b. Gastrointestinal system c. Central nervous system d. Genitourinary system

d. Genitourinary system

Which contraceptive method best protects against STIs and the HIV? a. Periodic abstinence b. Barrier methods c. Hormonal methods d. Same protection with all methods

Barrier methods

What is the most basic information that a nurse should be able to share with a client who asks about the process of conception? a. Ova are considered fertile 48 to 72 hours after ovulation. b. Sperm remain viable in the womans reproductive system for an average of 12 to 24 hours. c. Conception is achieved when a sperm successfully penetrates the membrane surrounding the ovum. d. Implantation in the endometrium occurs 6 to 10 days after conception.

d. Implantation in the endometrium occurs 6 to 10 days after conception.

3. Nafarelin (Synarel) is used to treat mildtosevere endometriosis. What instruction or information should the nurse provide to a client regarding nafarelin administration? a. Nafarelin stimulates the secretion of gonadotropin-releasing hormone (GnRH), thereby stimulating ovarian activity. b. It should be administered by intramuscular (IM) injection. c. Nafarelin should be administered by a subcutaneous implant. d. It can cause the client to experience some hot flashes and vaginal dryness.

d. It can cause the client to experience some hot flashes and vaginal dryness.

Which nonpharmacologic contraceptive method has a failure rate of less than 25%? a. Standard days variation b. Periodic abstinence c. Postovulation d. Coitus interruptus

Standard days variation

A postmenopausal woman has been diagnosed with two leiomyomas (fibroids). Which clinical finding is most commonly associated with the presence of leiomyomas? a. Abnormal uterine bleeding b. Diarrhea c. Weight loss d. Acute abdominal pain

a. Abnormal uterine bleeding

12. The female athlete triad includes which common menstrual disorder? a. Amenorrhea b. Dysmenorrhea c. Menorrhagia d. Metrorrhagia

a. Amenorrhea

Which information regarding amniotic fluid is important for the nurse to understand? a. Amniotic fluid serves as a source of oral fluid and a repository for waste from the fetus. b. Volume of the amniotic fluid remains approximately the same throughout the term of a healthy pregnancy. c. The study of fetal cells in amniotic fluid yields little information. d. A volume of more than 2 L of amniotic fluid is associated with fetal renal abnormalities.

a. Amniotic fluid serves as a source of oral fluid and a repository for waste from the fetus.

The client has undergone hysteroscopic uterine ablation to destroy a number of smaller fibroids. The nurse is preparing to provide discharge instructions. Which information is a priority for the patient and should be included in the teaching plan? (Select all that apply.) a. Analgesics and nonsteroidal antiinflammatory drugs can be used for pain control. b. Vaginal discharge is to be expected for 5 to 7 days. c. Sexual activity can be resumed after 48 hours. d. Next menstrual period will be irregular. e. Provider should be notified if heavy bleeding occurs.

a. Analgesics and nonsteroidal antiinflammatory drugs can be used for pain control. d. Next menstrual period will be irregular. e. Provider should be notified if heavy bleeding occurs.

A woman exhibits symptoms that may lead to a possible diagnosis of polycystic ovary syndrome (PCOS). While completing the initial assessment of the client, which clinical finding would the nurse not anticipate? a. Anorexia b. Hirsutism c. Irregular menses d. Infertility

a. Anorexia

2. Which suggestions are appropriate for a client who complains of hot flashes? (Select all that apply.) a. Avoid caffeine. b. Drink a glass of wine to relax. c. Wear layered clothing. d. Drink ice water. e. Drink warm beverages for their calming effect.

a. Avoid caffeine. c. Wear layered clothing.

9. On vaginal examination of a 30-year-old woman, the nurse documents the following findings: profuse, thin, grayish-white vaginal discharge with a fishy odor and complaints of pruritus. Based upon these findings, which condition would the nurse suspect? a. Bacterial vaginosis b. Candidiasis c. Trichomoniasis d. Gonorrhea

a. Bacterial vaginosis

10. A perimenopausal client has arrived for her annual gynecologic examination. Which preexisting condition would be extremely important for the nurse to identify during a discussion regarding the risks and benefits of hormone therapy? a. Breast cancer b. Vaginal and urinary tract atrophy c. Osteoporosis d. Arteriosclerosis

a. Breast cancer

3. Which medications can be taken by postmenopausal women to treat and/or prevent osteoporosis? (Select all that apply.) a. Calcium b. NSAIDs c. Fosamax d. Actonel e. Calcitonin

a. Calcium c. Fosamax d. Actonel e. Calcitonin

The various systems and organs of the fetus develop at different stages. Which statement is most accurate? a. Cardiovascular system is the first organ system to function in the developing human. b. Hematopoiesis originating in the yolk sac begins in the liver at 10 weeks of gestation. c. Body changes from straight to C-shape occurs at 8 weeks of gestation. d. Gastrointestinal system is mature at 32 weeks of gestation.

a. Cardiovascular system is the first organ system to function in the developing human.

What is the most common reproductive tract cancer associated with pregnancy? a. Cervical b. Uterine c. Ovarian d. Fallopian tube

a. Cervical

Many factors, male and female, contribute to normal fertility. Approximately 40% of cases of infertility are related to the female partner. Which factors are possible causes for female infertility? (Select all that apply.) a. Congenital or developmental b. Hormonal or ovulatory c. Tubal or peritoneal d. Uterine e. Emotional or psychologic

a. Congenital or developmental b. Hormonal or ovulatory c. Tubal or peritoneal d. Uterine

A woman has preinvasive cancer of the cervix. Which modality would the nurse discuss as an available option for a client with this condition? a. Cryosurgery b. Colposcopy c. Hysterectomy d. Internal radiation

a. Cryosurgery

Congenital disorders refer to those conditions that are present at birth. These disorders may be inherited and caused by environmental factors or maternal malnutrition. Toxic exposures have the greatest effect on development between 15 and 60 days of gestation. For the nurse to be able to conduct a complete assessment of the newly pregnant client, he or she should be knowledgeable regarding known human teratogens. Which substances might be considered a teratogen? (Select all that apply.) a. Cytomegalovirus (CMV) b. Ionizing radiation c. Hypothermia d. Carbamazepine e. Lead

a. Cytomegalovirus (CMV) b. Ionizing radiation d. Carbamazepine e. Lead

11. Dysfunctional uterine bleeding (DUB) is defined as excessive uterine bleeding without a demonstrable cause. Which statement regarding this condition is most accurate? a. DUB is most commonly caused by anovulation. b. DUB most often occurs in middle age. c. The diagnosis of DUB should be the first consideration for abnormal menstrual bleeding. d. Steroids are the most effective medical treatment for DUB.

a. DUB is most commonly caused by anovulation.

A woman is 16 weeks pregnant and has elected to terminate her pregnancy. Which is the most common technique used for the termination of a pregnancy in the second trimester? a. Dilation and evacuation (D&E) b. Methotrexate administration c. Prostaglandin administration d. Vacuum aspiration

a. Dilation and evacuation (D&E)

Fibrocystic changes in the breast most often appear in women in their 20s and 30s. Although the cause is unknown, an imbalance of estrogen and progesterone may be the cause. The nurse who cares for this client should be aware that treatment modalities are conservative. Which proven modality may offer relief for this condition? a. Diuretic administration b. Daily inclusion of caffeine in the diet c. Increased vitamin C supplementation d. Application of cold packs to the breast as necessary

a. Diuretic administration

Which statement regarding emergency contraception is correct? a. Emergency contraception requires that the first dose be taken within 72 hours of unprotected intercourse. b. Emergency contraception may be taken right after ovulation. c. Emergency contraception has an effectiveness rate in preventing pregnancy of approximately 50%. d. Emergency contraception is commonly associated with the side effect of menorrhagia.

a. Emergency contraception requires that the first dose be taken within 72 hours of unprotected intercourse.

Which condition is the most common malignancy of the reproductive system? a. Endometrial cancer b. Cervical cancer c. Ovarian cancer d. Vulvar and vaginal cancer

a. Endometrial cancer

7. A client complains of severe abdominal and pelvic pain around the time of menstruation. This pain has become progressively worse over the last 5 years. She also complains of pain during intercourse and has tried unsuccessfully to become pregnant for the past 18 months. To which condition are these symptoms most likely related? a. Endometriosis b. PMS c. Primary dysmenorrhea d. Secondary dysmenorrhea

a. Endometriosis

Researchers have found a number of common risk factors that increase a womans chance of developing a breast malignancy. It is essential for the nurse who provides care to women of any age to be aware of which risk factors? (Select all that apply.) a. Family history b. Late menarche c. Early menopause d. Race e. Nulliparity or first pregnancy after age 40 years

a. Family history d. Race e. Nulliparity or first pregnancy after age 40 years

Which term best describes the conscious decision concerning when to conceive or avoid pregnancy as opposed to the intentional prevention of pregnancy during intercourse? a. Family planning b. Birth control c. Contraception d. Assisted reproductive therapy

a. Family planning

1. Which sexual behaviors are associated with exposure to an STI? (Select all that apply.) a. Fellatio b. Unprotected anal intercourse c. Multiple sex partners d. Dry kissing e. Abstinence

a. Fellatio b. Unprotected anal intercourse c. Multiple sex partners

Relating to the fetal circulatory system, which special characteristics allow the fetus to obtain sufficient oxygen from the maternal blood? (Select all that apply.) a. Fetal hemoglobin (Hb) carries 20% to 30% more oxygen than maternal Hb. b. Fetal Hb carries 40% to 50% more oxygen than maternal Hb. c. Hb concentration is 50% higher than that of the mother. d. Fetal heart rate is 110 to 160 beats per minute. e. Fetal heart rate is 160 to 200 beats per minute.

a. Fetal hemoglobin (Hb) carries 20% to 30% more oxygen than maternal Hb. c. Hb concentration is 50% higher than that of the mother. d. Fetal heart rate is 110 to 160 beats per minute.

A woman in labor passes some thick meconium as her amniotic fluid ruptures. The client asks the nurse where the baby makes the meconium. What is the correct response by the nurse? a. Fetal intestines b. Fetal kidneys c. Amniotic fluid d. Placenta

a. Fetal intestines

5. A client exhibits a thick, white, lumpy, cottage cheeselike discharge, along with white patches on her labia and in her vagina. She complains of intense pruritus. Which medication should the nurse practitioner order to treat this condition? a. Fluconazole b. Tetracycline c. Clindamycin d. Acyclovir

a. Fluconazole

The nurse is responsible for providing health teaching regarding the side effects of COCs. These side effects are attributed to estrogen, progesterone, or both. Which side effects are related to the use of COCs? (Select all that apply.) a. Gallbladder disease b. Myocardial infarction and stroke c. Hypotension d. Breast tenderness and fluid retention e. Dry skin and scalp

a. Gallbladder disease b. Myocardial infarction and stroke d. Breast tenderness and fluid retention

Chemotherapy with multiple drug agents is used in the treatment of recurrent and advanced breast cancer with positive results. Which side effects would the nurse anticipate for the client once treatment has begun? (Select all that apply.) a. Hair loss b. Severe constipation c. Anemia d. Leukopenia e. Thrombocytopenia

a. Hair loss c. Anemia d. Leukopenia e. Thrombocytopenia

10. Which viral sexually transmitted infection is characterized by a primary infection followed by recurrent episodes? a. Herpes simplex virus 2 (HSV-2) b. HPV c. HIV d. CMV

a. Herpes simplex virus 2 (HSV-2)

6. Which symptom described by a client is characteristic of premenstrual syndrome (PMS)? a. I feel irritable and moody a week before my period is supposed to start. b. I have lower abdominal pain beginning on the third day of my menstrual period. c. I have nausea and headaches after my period starts, and they last 2 to 3 days. d. I have abdominal bloating and breast pain after a couple days of my period.

a. I feel irritable and moody a week before my period is supposed to start.

A 23-year-old primiparous client with inconsistent prenatal care is admitted to the hospitals maternity unit in labor. The client states that she has tested positive for the HIV. She has not undergone any treatment during her pregnancy. The nurse understands that the risk of perinatal transmission can be significantly decreased by a number of prophylactic interventions. Which interventions should be included in the plan of care? a. Intrapartum treatment with antiviral medications b. Cesarean birth c. Postpartum treatment with antiviral medications d. Avoidance of breastfeeding e. Pneumococcal, HBV, and Haemophilus influenzae vaccine

a. Intrapartum treatment with antiviral medications b. Cesarean birth d. Avoidance of breastfeeding

To provide adequate care, the nurse should be cognitive of which important information regarding infertility? a. Is perceived differently by women and men. b. Has a relatively stable prevalence among the overall population and throughout a womans potential reproductive years. c. Is more likely the result of a physical flaw in the woman than in her male partner. d. Is the same thing as sterility.

a. Is perceived differently by women and men.

The nurse is reviewing the educational packet provided to a client about tubal ligation. Which information regarding this procedure is important for the nurse to share? (Select all that apply.) a. It is highly unlikely that you will become pregnant after the procedure. b. Tubal ligation is an effective form of 100% permanent sterilization. You wont be able to get pregnant. c. Sterilization offers some form of protection against STIs. d. Sterilization offers no protection against STIs. e. Your menstrual cycle will greatly increase after your sterilization.

a. It is highly unlikely that you will become pregnant after the procedure. d. Sterilization offers no protection against STIs.

What is the correct name describing a benign breast condition that includes dilation and inflammation of the collecting ducts? a. Mammary duct ectasia b. Intraductal papilloma c. Chronic cystic disease d. Fibroadenoma

a. Mammary duct ectasia

Counseling and education are critical components of the nursing care of women with herpes infections. Clients should be taught to identify triggers that might result in a herpes attack. Which factors are possible triggers for a recurrence? (Select all that apply.) a. Menstruation b. Trauma c. Febrile illness d. Soap e. Ultraviolet light

a. Menstruation b. Trauma c. Febrile illness e. Ultraviolet light

Cellulitis with or without abscess formation is a fairly common condition. The nurse is providing education for a client whose presentation to the emergency department includes an infection of the breast. Which information should the nurse share with this client? (Select all that apply.) a. Nipple piercing may be the cause of a recent infection. b. Treatment for cellulitis will include antibiotics. c. Streptococcus aureus is the most common pathogen. d. Obesity, smoking, and diabetes are risk factors. e. Breast is pale in color and cool to the touch.

a. Nipple piercing may be the cause of a recent infection. b. Treatment for cellulitis will include antibiotics. d. Obesity, smoking, and diabetes are risk factors.

The nurse should be familiar with the use of the five Ps as a tool for evaluating risk behaviors for STIs and the HIV. Which components would the nurse include in her use of the five Ps as an assessment tool? (Select all that apply.) a. Number of partners b. Level of physical activity c. Prevention of pregnancy d. Protection from STIs e. Past history

a. Number of partners b. Level of physical activity d. Protection from STIs e. Past history

A woman has chosen the calendar method of conception control. Which is the most important action the nurse should perform during the assessment process? a. Obtain a history of the womans menstrual cycle lengths for the past 6 to 12 months. b. Determine the clients weight gain and loss pattern for the previous year. c. Examine skin pigmentation and hair texture for hormonal changes. d. Explore the clients previous experiences with conception control.

a. Obtain a history of the womans menstrual cycle lengths for the past 6 to 12 months.

2. The human papillomavirus (HPV), also known as genital warts, affects 79 million Americans, with an estimated number of 14 million new infections each year. The highest rate of infection occurs in young women, ages 20 to 24 years. Prophylactic vaccination to prevent the HPV is now available. Which statement regarding this vaccine is inaccurate? a. Only one vaccine for the HPV is available. b. The vaccine is given in three doses over a 6-month period. c. The vaccine is recommended for both boys and girls. d. Ideally, the vaccine is administered before the first sexual contact.

a. Only one vaccine for the HPV is available.

The nurse caring for a pregnant client is evaluating his or her health teaching regarding fetal circulation. Which statement from the client reassures the nurse that his or her teaching has been effective? a. Optimal fetal circulation is achieved when I am in the side-lying position. b. Optimal fetal circulation is achieved when I am on my back with a pillow under my knees. c. Optimal fetal circulation is achieved when the head of the bed is elevated. d. Optimal fetal circulation is achieved when I am on my abdomen.

a. Optimal fetal circulation is achieved when I am in the side-lying position.

A probable cause for increasing infertility is the societal delay in pregnancy until later in life. What are the natural reasons for the decrease in female fertility? (Select all that apply.) a. Ovulation dysfunction b. Endocrine dysfunction c. Organ damage from toxins d. Endometriosis e. Tubal infections

a. Ovulation dysfunction c. Organ damage from toxins d. Endometriosis e. Tubal infections

Which woman has the highest risk for endometrial cancer? a. Postmenopausal woman with hypertension b. Woman who has an intrauterine device (IUD) c. Client who has been on birth control for 15 years d. Perimenopausal woman who has a cystocele

a. Postmenopausal woman with hypertension

5. A 21yearold client complains of severe pain immediately after the commencement of her menses. Which gynecologic condition is the most likely cause of this clients presenting complaint? a. Primary dysmenorrhea b. Secondary dysmenorrhea c. Dyspareunia d. Endometriosis

a. Primary dysmenorrhea

The most conservative approach for early breast cancer treatment involves lumpectomy followed by which procedure? a. Radiation b. Adjuvant systemic therapy c. Hormonal therapy d. Chemotherapy

a. Radiation

5. Nurses are in an ideal position to educate clients who experience PMDD. What self-help activities have been documented as helpful in alleviating the symptoms of PMDD? (Select all that apply.) a. Regular exercise b. Improved nutrition c. Daily glass of wine d. Smoking cessation e. Oil of evening primrose

a. Regular exercise b. Improved nutrition d. Smoking cessation e. Oil of evening primrose

A client is scheduled for surgery after a recent breast cancer diagnosis. The nurse is discussing the procedure with the client. To allay her fears, which explanation best describes a skin-sparing mastectomy? a. Removal of the breast, nipple, and areola, leaving only the skin b. Removal of the breast, nipple, areola, and axillary node dissection c. Incision on the outside of the breast, leaving the nipple intact d. Removal of both breasts in their entirety

a. Removal of the breast, nipple, and areola, leaving only the skin

What kind of fetal anomalies are most often associated with oligohydramnios? a. Renal b. Cardiac c. Gastrointestinal d. Neurologic

a. Renal

1. A client has requested information regarding alternatives to hormonal therapy for menopausal symptoms. Which current information should the nurse provide to the client? (Select all that apply.) a. Soy b. Vitamin C c. Vitamin K d. Vitamin E e. Vitamin A

a. Soy d. Vitamin E

The client is undergoing treatment for ovarian cancer. Which common nutritional problems are related to gynecologic cancers and the treatment thereof? (Select all that apply.) a. Stomatitis b. Constipation c. Increased appetite d. Diarrhea e. Nausea and vomiting

a. Stomatitis b. Constipation d. Diarrhea e. Nausea and vomiting

An essential component of counseling women regarding safe sex practices includes a discussion regarding avoiding the exchange of body fluids. The most effective physical barrier promoted for the prevention of STIs and HIV is the condom. To educate the client about the use of condoms, which information related to condom use is the most important? a. Strategies to enhance condom use b. Choice of colors and special features c. Leaving the decision up to the male partner d. Places to carry condoms safely

a. Strategies to enhance condom use

What important, immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy? a. The blood pressure (BP) cuff should not be applied to the affected arm. b. Venipuncture for blood work should be performed on the affected arm. c. The affected arm should be used for intravenous (IV) therapy. d. The affected arm should be held down close to the womans side.

a. The blood pressure (BP) cuff should not be applied to the affected arm.

With regard to the treatment plan for a pregnant woman with gynecologic cancer, which statement about timing or type of treatment is correct? a. The fetus is most at risk during the first trimester. b. The fetus is most at risk during the second trimester. c. The fetus is most at risk during the third trimester. d. Surgery is more risky than chemotherapy in the first trimester.

a. The fetus is most at risk during the first trimester.

In vitro fertilizationembryo transfer (IVF-ET) is a common approach for women with blocked fallopian tubes or with unexplained infertility and for men with very low sperm counts. A husband and wife have arrived for their preprocedural interview. Which explanation regarding the procedure is most accurate? a. The procedure begins with collecting eggs from your wifes ovaries. b. A donor embryo will be transferred into your wifes uterus. c. Donor sperm will be used to inseminate your wife. d. Dont worry about the technical stuff; thats what we are here for.

a. The procedure begins with collecting eggs from your wifes ovaries.

An infertility specialist prescribes clomiphene citrate (Clomid, Serophene) for a woman experiencing infertility. She is very concerned about the risk of multiple pregnancies. What is the nurses most appropriate response? a. This is a legitimate concern. Would you like to discuss further the chances of multiple pregnancies before your treatment begins? b. No one has ever had more than triplets with Clomid. c. Ovulation will be monitored with ultrasound to ensure that multiple pregnancies will not happen. d. Ten percent is a very low risk, so you dont need to worry too much.

a. This is a legitimate concern. Would you like to discuss further the chances of multiple pregnancies before your treatment begins?

Which condition would be inappropriate to treat with exogenous progesterone (human chorionic gonadotropin)? a. Thyroid dysfunction b. Recent miscarriage c. PCOD d. Oocyte retrieval

a. Thyroid dysfunction

A group of infections known collaboratively as TORCH infections are capable of crossing the placenta and causing serious prenatal effects on the fetus. Which infections are included in this group of organisms? (Select all that apply.) a. Toxoplasmosis b. Other infections c. Roseola d. Clostridium e. Herpes simplex

a. Toxoplasmosis b. Other infections e. Herpes simplex

An expectant couple attending childbirth classes have questions regarding multiple births since twins run in the family. What information regarding multiple births is important for the nurse to share? a. Twinning and other multiple births are increasing because of the use of fertility drugs and delayed childbearing. b. Dizygotic twins (two fertilized ova) have the potential to be conjoined twins. c. Identical twins are more common in Caucasian families. d. Fraternal twins are the same gender, usually male.

a. Twinning and other multiple births are increasing because of the use of fertility drugs and delayed childbearing.

Valerian, wild yam

a. Uterine antispasmodic

A new mother asks the nurse about the white substance covering her infant. How should the nurse explain the purpose of vernix caseosa? a. Vernix caseosa protects the fetal skin from the amniotic fluid. b. Vernix caseosa promotes the normal development of the peripheral nervous system. c. Vernix caseosa allows the transport of oxygen and nutrients across the amnion. d. Vernix caseosa regulates fetal temperature.

a. Vernix caseosa protects the fetal skin from the amniotic fluid.

Which development related to the integumentary system is correct? a. Very fine hairs called lanugo appear at 12 weeks of gestation. b. Eyelashes, eyebrows, and scalp hair appear at 28 weeks of gestation. c. Fingernails and toenails develop at 28 weeks of gestation. d. By 32 weeks, scalp hair becomes apparent.

a. Very fine hairs called lanugo appear at 12 weeks of gestation.

Clients treated for syphilis with penicillin may experience a Jarisch-Herxheimer reaction. Which clinical presentation would be unlikely if a client is experiencing this reaction? a. Vomiting and diarrhea b. Headache, myalgias, and arthralgia c. Preterm labor d. Jarisch-Herxheimer in the first 24 hours after treatment

a. Vomiting and diarrhea

The health history and physical examination cannot reliably identify all persons infected with HIV or other blood-borne pathogens. Which infection control practice should the nurse use when providing eye prophylaxis to a term newborn? a. Wear gloves. b. Wear mouth, nose, and eye protection. c. Wear a mask. d. Wash the hands after medication administration.

a. Wear gloves.

A client has been prescribed adjuvant tamoxifen therapy. What common side effect might she experience? a. Weight gain, hot flashes, and blood clots b. Vomiting, weight loss, and hair loss c. Nausea, vomiting, and diarrhea d. Hot flashes, weight gain, and headaches

a. Weight gain, hot flashes, and blood clots

Although reported in small numbers, toxic shock syndrome (TSS) can occur with the use of a diaphragm. If a client is interested in this form of conception control, then the nurse must instruct the woman on how best to reduce her risk of TSS. Which comment by the nurse would be most helpful in achieving this goal? a. You should always remove your diaphragm 6 to 8 hours after intercourse. Dont use the diaphragm during menses, and watch for danger signs of TSS, including a sudden onset of fever over 38.4 C, hypotension, and a rash. b. You should remove your diaphragm right after intercourse to prevent TSS. c. Its okay to use your diaphragm during your menstrual cycle. Just be sure to wash it thoroughly first to prevent TSS. d. Make sure you dont leave your diaphragm in for longer than 24 hours, or you may get TSS.

a. You should always remove your diaphragm 6 to 8 hours after intercourse. Dont use the diaphragm during menses, and watch for danger signs of TSS, including a sudden onset of fever over 38.4 C, hypotension, and a rash.

A woman asks the nurse, What protects my babys umbilical cord from being squashed while the babys inside of me? What is the nurses best response? a. Your babys umbilical cord is surrounded by connective tissue called Whartons jelly, which prevents compression of the blood vessels. b. Your babys umbilical cord floats around in blood and amniotic fluid. c. You dont need to be worrying about things like that. d. The umbilical cord is a group of blood vessels that are very well protected by the placenta.

a. Your babys umbilical cord is surrounded by connective tissue called Whartons jelly, which prevents compression of the blood vessels.

A newly married couple plans to use the natural family planning method of contraception. Understanding how long an ovum can live after ovulation is important to them. The nurse knows that his or her teaching was effective when the couple responds that an ovum is considered fertile for which period of time? a. 6 to 8 hours b. 24 hours c. 2 to 3 days d. 1 week

b. 24 hours

Which benefit regarding FAMs makes it an appealing choice for some women? a. Adherence to strict recordkeeping b. Absence of chemicals and hormones c. Decreased involvement and intimacy of partner d. Increased spontaneity of coitus

b. Absence of chemicals and hormones

Leiomyomas (also known as fibroid tumors) are benign tumors arising from the muscle tissue of the uterus. Which information related to these tumors is accurate? (Select all that apply.) a. Are rapid growing b. Are more common in African-American women c. Are more common in women who have never been pregnant d. Obesity is a risk factor with leiomyomas e. Become malignant if left untreated

b. Are more common in African-American women c. Are more common in women who have never been pregnant d. Obesity is a risk factor with leiomyomas

The maternity nurse is cognizant of what important structure and function of the placenta? a. As the placenta widens, it gradually thins to allow easier passage of air and nutrients. b. As one of its early functions, the placenta acts as an endocrine gland. c. The placenta is able to keep out most potentially toxic substances, such as cigarette smoke, to which the mother is exposed. d. Optimal blood circulation is achieved through the placenta when the woman is lying on her back or standing.

b. As one of its early functions, the placenta acts as an endocrine gland.

8. Which treatment regime would be most appropriate for a client who has been recently diagnosed with acute pelvic inflammatory disease (PID)? a. Oral antiviral therapy b. Bed rest in a semi-Fowler position c. Antibiotic regimen continued until symptoms subside d. Frequent pelvic examination to monitor the healing progress

b. Bed rest in a semi-Fowler position

The prevalence of urinary incontinence (UI) increases as women age, with more than one third of the women in the United States suffering from some form of this disorder. The symptoms of mild-to-moderate UI can be successfully decreased by a number of strategies. Which of these should the nurse instruct the client to use first? a. Pelvic floor support devices b. Bladder training and pelvic muscle exercises c. Surgery d. Medications

b. Bladder training and pelvic muscle exercises

Macromastia, or breast hyperplasia, is a condition in which women have very large and pendulous breasts. Breast hyperplasia can be corrected with a reduction mammoplasty. Which statement regarding this procedure is themost accurate? a. Breast reduction surgery is covered by insurance. b. Breastfeeding might be difficult. c. No sequelae after the procedure is known. d. Pain in the back and shoulders may not be relieved.

b. Breastfeeding might be difficult.

Postabortion instructions may differ among providers regarding tampon use and the resumption of intercourse. However, education should be provided regarding serious complications. When should the woman who has undergone an induced abortion be instructed to return to the emergency department? (Select all that apply.) a. Fever higher than 39 C b. Chills c. Foul-smelling vaginal discharge d. Bleeding greater than four pads in 2 hours e. Severe abdominal pain

b. Chills c. Foul-smelling vaginal discharge e. Severe abdominal pain

Guidelines for breast cancer screening continue to evolve as new evidence is generated. Which examination or procedure and frequency would be recommended for a 31-year-old asymptomatic client? (Select all that apply.) a. Annual mammography b. Clinical breast examination every 3 years c. Annual MRI d. Breast self-examination e. Mammography every 3 years

b. Clinical breast examination every 3 years d. Breast self-examination

A client in late middle age who is certain she is not pregnant tells the nurse during an office visit that she has urinary problems, as well as sensations of bearing down and of something in her vagina. What condition would the nurse suspect based upon this report? a. Pelvic relaxation b. Cystoceles and/or rectoceles c. Uterine prolapse d. Genital fistulas

b. Cystoceles and/or rectoceles

Which ovarian neoplasm is described as a growth that contains hair, teeth, and sebaceous secretions? a. Ovarian fibroma b. Dermoid cyst c. Uterine polyp d. Follicular cyst

b. Dermoid cyst

Nurses, certified nurse-midwives, and other advanced practice nurses have the knowledge and expertise to assist women in making informed choices regarding contraception. A multidisciplinary approach should ensure that the womans social, cultural, and interpersonal needs are met. Which action should the nurse first take when meeting with a new client to discuss contraception? a. Obtain data about the frequency of coitus. b. Determine the womans level of knowledge concerning contraception and her commitment to any particular method. c. Assess the womans willingness to touch her genitals and cervical mucus. d. Evaluate the womans contraceptive life plan.

b. Determine the womans level of knowledge concerning contraception and her commitment to any particular method.

Women who have undergone an oophorectomy, have ovarian failure, or a genetic defect may be eligible to receive donor oocytes (eggs). Which statements regarding oocyte donation are accurate? (Select all that apply.) a. Donor is inseminated with semen from the parent. b. Donor eggs are fertilized with the male partners sperm. c. Donors are under 35 years of age. d. Recipient undergoes hormonal stimulation. e. Ovum is placed into a surrogate.

b. Donor eggs are fertilized with the male partners sperm. c. Donors are under 35 years of age. d. Recipient undergoes hormonal stimulation.

Significant advances have been made with most reproductive technologies. Which improvement has resulted in increased success related to preimplantation genetic diagnosis? a. Embryos are transferred at the cleavage stage. b. Embryos are transferred at the blastocyst stage. c. More than two embryos can be transferred at a time. d. Two cells are removed from each embryo.

b. Embryos are transferred at the blastocyst stage.

What information is important for the nurse to include in planning for the care of a woman who has had a vaginal hysterectomy? a. Expect to be fully recovered in 4 to 6 weeks. b. Expect no changes in her hormone levels. c. Expect surgical menopause. d. Take tub baths to aid in healing.

b. Expect no changes in her hormone levels.

A married couple is discussing alternatives for pregnancy prevention and has asked about fertility awareness methods (FAMs). Which response by the nurse is most appropriate? a. Theyre not very effective, and it is very likely that youll get pregnant. b. FAMs can be effective for many couples; however, they require motivation. c. These methods have a few advantages and several health risks. d. You would be much safer going on the pill and not having to worry.

b. FAMs can be effective for many couples; however, they require motivation.

Which statement concerning neurologic and sensory development in the fetus is correct? a. Brain waves have been recorded on an electroencephalogram as early as the end of the first trimester (12 weeks of gestation). b. Fetuses respond to sound by 24 weeks of gestation and can be soothed by the sound of the mothers voice. c. Eyes are first receptive to light at 34 to 36 weeks of gestation. d. At term, the fetal brain is at least one third the size of an adult brain.

b. Fetuses respond to sound by 24 weeks of gestation and can be soothed by the sound of the mothers voice.

A client is concerned because she has been experiencing some milky, sticky breast discharge. Which nonmalignant condition is exhibited with this finding? a. Relative inflammatory lesion b. Galactorrhea c. Mammary duct ectasia d. Breast infection

b. Galactorrhea

14. Five different viruses (A, B, C, D, and E) account for almost all cases of hepatitis infections. Which statement regarding the various forms of hepatitis is most accurate? a. Vaccine exists for hepatitis C virus (HCV) but not for HBV. b. HAV is acquired by eating contaminated food or drinking polluted water. c. HBV is less contagious than HIV. d. Incidence of HCV is decreasing.

b. HAV is acquired by eating contaminated food or drinking polluted water.

6. Which laboratory testing is used to detect the human immunodeficiency virus (HIV)? a. HIV screening b. HIV antibody testing c. Cluster of differentiation 4 (CD4) counts d. Cluster of differentiation 8 (CD8) counts

b. HIV antibody testing

12. A 25-year-old single woman comes to the gynecologists office for a follow-up visit related to her abnormal Papanicolaou (Pap) smear. The test revealed that the client has the HPV. The woman asks, What is that? Can you get rid of it? Which is the best response for the nurse to provide? a. Its just a little lump on your cervix. We can just freeze it off. b. HPV stands for human papillomavirus. It is a sexually transmitted infection that may lead to cervical cancer. c. HPV is a type of early human immunodeficiency virus. You will die from this. d. You probably caught this from your current boyfriend. He should get tested for this.

b. HPV stands for human papillomavirus. It is a sexually transmitted infection that may lead to cervical cancer.

15. To assist a client in managing the symptoms of PMS, what should the nurse recommend based on current evidence? a. Diet with more body-building and energy foods, such as carbohydrates b. Herbal therapies, yoga, and massage c. Antidepressants for symptom control d. Discouraging the use of diuretics

b. Herbal therapies, yoga, and massage

8. Which menopausal discomfort would the nurse anticipate when evaluating a woman for signs and symptoms of the climacteric? a. Headaches b. Hot flashes c. Mood swings d. Vaginal dryness with dyspareunia

b. Hot flashes

A 48-year-old woman has just had a hysterectomy for endometrial cancer. Which statement alerts the nurse that further teaching is needed? a. I cant wait to go on the cruise that I have planned for this summer. b. I know that the surgery saved my life, but I will miss having sexual intercourse with my husband. c. I have asked my daughter to come and stay with me next week after I am discharged from the hospital. d. Well, I dont have to worry about getting pregnant anymore.

b. I know that the surgery saved my life, but I will miss having sexual intercourse with my husband.

Importantly, the nurse must be aware of which information related to the use of IUDs? a. Return to fertility can take several weeks after the device is removed. b. IUDs containing copper can provide an emergency contraception option if inserted within a few days of unprotected intercourse. c. IUDs offer the same protection against STIs as the diaphragm. d. Consent forms are not needed for IUD insertion.

b. IUDs containing copper can provide an emergency contraception option if inserted within a few days of unprotected intercourse.

4. While interviewing a 31-year-old woman before her routine gynecologic examination, the nurse collects data about the clients recent menstrual cycles. Which statement by the client should prompt the nurse to collect further information? a. My menstrual flow lasts 5 to 6 days. b. My flow is very heavy. c. I have had a small amount of spotting midway between my periods for the past 2 months. d. The length of my menstrual cycles varies from 26 to 29 days.

b. My flow is very heavy.

A male client asks the nurse why it is better to purchase condoms that are not lubricated with nonoxynol-9 (a common spermicide). Which response by the nurse is the most accurate? a. The lubricant prevents vaginal irritation. b. Nonoxynol-9 does not provide protection against STIs as originally thought; it has also been linked to an increase in the transmission of the HIV and can cause genital lesions. c. The additional lubrication improves sex. d. Nonoxynol-9 improves penile sensitivity.

b. Nonoxynol-9 does not provide protection against STIs as originally thought; it has also been linked to an increase in the transmission of the HIV and can cause genital lesions.

The client and her partner are considering male sterilization as a form of permanent birth control. While educating the client regarding the risks and benefits of the procedure, which information should the nurse include? (Select all that apply.) a. Sterilization should be performed under general anesthesia. b. Pain, bleeding, and infection are possible complications. c. Pregnancy may still be possible. d. Vasectomy may affect potency. e. Secondary sex characteristics are unaffected.

b. Pain, bleeding, and infection are possible complications. c. Pregnancy may still be possible. e. Secondary sex characteristics are unaffected.

A health care provider performs a clinical breast examination on a woman diagnosed with fibroadenoma. How would the nurse explain the defining characteristics of a fibroadenoma? a. Inflammation of the milk ducts and glands behind the nipples b. Thick, sticky discharge from the nipple of the affected breast c. Lumpiness in both breasts that develops 1 week before menstruation d. Single lump in one breast that can be expected to shrink as the woman ages

d. Single lump in one breast that can be expected to shrink as the woman ages

Which client should the nurse refer for further testing? a. Left breast slightly smaller than right breast b. Eversion (elevation) of both nipples c. Faintly visible bilateral symmetry of venous network d. Small dimple located in the upper outer quadrant of the right breast

d. Small dimple located in the upper outer quadrant of the right breast

A man smokes two packs of cigarettes a day. He wants to know if smoking is contributing to the difficulty he and his wife are having getting pregnant. Which guidance should the nurse provide? a. Your sperm count seems to be okay in the first semen analysis. b. Only marijuana cigarettes affect sperm count. c. Although smoking has no effect on sperm count, it can give you lung cancer. d. Smoking can reduce the quality of your sperm.

d. Smoking can reduce the quality of your sperm.

A client currently uses a diaphragm and spermicide for contraception. She asks the nurse to explain the major differences between the cervical cap and the diaphragm. What is the most appropriate response by the nurse? a. No spermicide is used with the cervical cap, so its less messy. b. The diaphragm can be left in place longer after intercourse. c. Repeated intercourse with the diaphragm is more convenient. d. The cervical cap can be safely used for repeated acts of intercourse without adding more spermicide later.

d. The cervical cap can be safely used for repeated acts of intercourse without adding more spermicide later

A nurse is providing education to a support group of women newly diagnosed with breast cancer. It is important for the nurse to discuss which factor related to breast cancer with the group? a. Genetic mutations account for 50% of women who will develop breast cancer. b. Breast cancer is the leading cause of cancer death in women. c. In the United States, 1 in 10 women will develop breast cancer in her lifetime. d. The exact cause of breast cancer remains unknown.

d. The exact cause of breast cancer remains unknown.

What is the importance of obtaining informed consent for a number of contraceptive methods? a. Contraception is an invasive procedure that requires hospitalization. b. The method may require a surgical procedure to insert a device. c. The contraception method chosen may be unreliable. d. The method chosen has potentially dangerous side effects.

d. The method chosen has potentially dangerous side effects.

Which statement is the most complete and accurate description of medical abortions? a. Medical abortions are performed only for maternal health. b. They can be achieved through surgical procedures or with drugs. c. Medical abortions are mostly performed in the second trimester. d. They can be either elective or therapeutic.

d. They can be either elective or therapeutic.

15. A 21-year-old client exhibits a greenish, copious, and malodorous discharge with vulvar irritation. A speculum examination and wet smear are performed. Which condition is this client most likely experiencing? a. Bacterial vaginosis b. Candidiasis c. Yeast infection d. Trichomoniasis

d. Trichomoniasis

A client has just returned from a uterine artery embolization (UAE) procedure. Before her discharge, a discussion concerning the symptoms that require a call to the provider postprocedure is very important. Which symptom would reassure the client that the procedure went well with no reason to call the provider? a. Temperature of 39 C b. Swelling or hematoma at the puncture site c. Abnormal vaginal discharge d. Urinary frequency

d. Urinary frequency

2. When a nurse is counseling a woman for primary dysmenorrhea, which nonpharmacologic intervention might be recommended? a. Increasing the intake of red meat to replace blood loss b. Reducing the intake of diuretic foods, such as peaches and asparagus c. Temporarily substituting physical activity for a sedentary lifestyle d. Using a heating pad on the abdomen to relieve cramping

d. Using a heating pad on the abdomen to relieve cramping

A healthy 60-year-old African-American woman regularly receives health care at her neighborhood clinic. She is due for a mammogram. At her first visit, her health care provider is concerned about the 3-week wait at the neighborhood clinic and made an appointment for her to have a mammogram at a teaching hospital across town. She did not keep her appointment and returned to the clinic today to have the nurse check her blood pressure. What is the most appropriate statement for the nurse to make to this client? a. Do you have transportation to the teaching hospital so that you can get your mammogram? b. Im concerned that you missed your appointment; let me make another one for you. c. Its very dangerous to skip your mammograms; your breasts need to be checked. d. Would you like me to make an appointment for you to have your mammogram here?

d. Would you like me to make an appointment for you to have your mammogram here?

A woman is using the basal body temperature (BBT) method of contraception. She calls the clinic and tells the nurse, My period is due in a few days, and my temperature has not gone up. What is the nurses mostappropriate response? a. This probably means that youre pregnant. b. Dont worry; its probably nothing. c. Have you been sick this month? d. You probably didnt ovulate during this cycle.

d. You probably didnt ovulate during this cycle.

A woman who is 8 months pregnant asks the nurse, Does my baby have any antibodies to fight infection? What is the most appropriate response by the nurse? a. Your baby has all the immunoglobulins necessary: immunoglobulin G (IgG), immunoglobulin M (IgM), and immunoglobulin A (IgA). b. Your baby wont receive any antibodies until he is born and you breastfeed him. c. Your baby does not have any antibodies to fight infection. d. Your baby has IgG and IgM.

d. Your baby has IgG and IgM.

Chaste tree fruit

e. Decreases prolactin levels