Maternity PrepU Chapters 1-9

A postmenopausal client is told at her routine gynecological exam that the primary care provider has found a cyst on her right ovary. The nurse notices that this does not cause worry for this client. What should the nurse and/or care provider tell this client?

"After menopause a mass on an ovary is not a cyst and should be considered cancerous until proven otherwise."

A client is waiting for the results of an endometrial biopsy for suspected endometrial cancer. She wants to know more about endometrial cancer and asks the nurse about the available treatment options. Which treatment information should the nurse give the client?

Surgery involves removal of the uterus, fallopian tubes, and ovaries; adjuvant therapy is used if relevant.

A woman with ovarian cancer has been told that she is in stage III of the cancer. The nurse is reviewing the information with her. Which statement would help in the woman's understanding of stage III ovarian cancer?

The growth has spread to the lymph nodes and other areas/organs in the abdominal cavity.

A pregnant client comes to the local health clinic for her scheduled prenatal visit. On her chart, the nurse notices that the client indicated that she resides in an extended family situation. Which arrangement would validate this information?

She lives with her grandmother, her uncle, her mother, and her younger sister.

A small amount of breast milk is obtained for culture and sensitivity testing from a client with mastitis. The nurse would expect the results to identify which organism as the most likely cause?

Staphylococcus aureus

While performing a clinical breast examination, the nurse notes a firm and rubbery nodule that is well circumscribed and moves freely. How should the nurse counsel the client?

"It's most likely a fibroadenoma, but we may need to do a biopsy."

A 19-year-old pregnant client presents to the office for the third time this week. While completing the client's admission, the nurse screens for abuse. The client responds, "I have already told you twice this week I am not being abused. Why do you keep asking me these questions?" What is the nurse's best response?

"We screen all clients for abuse during every visit."

A nurse is describing the cycle of violence to a group of women at a community clinic. The nurse determines that the women have understood the information when they identify which phase as usually lasting the longest?

tension building

Which statement made by a nursing student would best indicate that her education on family-centered care was fully understood?

"Childbirth affects the entire family, and relationships will change."

A client has been recently diagnosed with genital herpes and asks, "Why am I having so many recurring outbreaks of the infection?" What is the nurse's best response?

"Stress-reducing strategies may help prevent the outbreaks."

A young client desires to know her risk of developing breast carcinoma. She has a positive family history of breast carcinoma. The nurse would suggest that she should undergo which diagnostic test?

BRCA-1 genetic marker

The nurse is teaching a client about fertility and the various phases of the menstrual cycle. The nurse should point out that ovulation usually occurs on which day of a 28-day cycle?

14

A male client has undergone a semen analysis for evaluation of fertility. The nurse understands that which sperm count would suggest infertility?

18 million/mL

A nurse is conducting a class for a local woman's group about recommendations for a Pap smear. One of the participants asks, "At what age should a woman have her first Pap smear?" The nurse responds by stating that a woman should have her first Pap smear at which age?

21

A client who has recently given birth arrives in a health care facility wanting to know ways to prevent sudden infant death syndrome (SIDS) in her infant. Which instructions should the nurse provide to address the concern?

Place the infant on his or her back to sleep.

The nursing instructor is teaching about Bartholin cysts and informs the students that Bartholin cysts are the most common cystic growth in the vulva. She describes this type of cyst as being:

a swollen, fluid-filled, sac-like structure.

Assessment of a client reveals evidence of a cystocele. The nurse interprets this as:

bulging of the bladder into the vagina

After teaching a group of adolescent girls about female reproductive development, the nurse determines that teaching was successful when the girls state that menarche is defined as a woman's first:

Menstrual Period

The nursing instructor is teaching a session comparing the various steps of the nursing process. The instructor determines the session is successful when the students correctly choose which step as the first one?

Assessment

The United States ranks 50th in the world for maternal mortality and 41st among industrialized nations for infant mortality rate. Which factor would need to be addressed as having the greatest impact on decreasing these rates?

Assuring early and adequate prenatal care

An 18-year-old female client who is sexually active asks the nurse for information on barrier contraceptives. Which contraceptive should the nurse say is a mechanical barrier contraceptive?

Cervical Cap

An instructor is preparing a teaching plan for a group of students about reproductive structures and sexual arousal. Which female reproductive structure would the instructor include?

Clitoris

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.

The nurse providing family-centered care in a hospital setting reflects on the focus of the health care provided in today's society. Which statement best describes the current definition of health?

Health is a state of complete physical, mental, and social well-being

A national campaign to improve the health of the people in the United States has as one of its goals to "eliminate health disparities." What is the name of this national campaign?

Healthy People 2020

The primary care provider has prescribed estrogen replacement therapy (ERT) for a menopausal woman who has been diagnosed with pelvic organ prolapse (POP). The client asks the nurse why she needs to be on hormones. Which would be the nurse's best response?

Hormone replacement will increase blood perfusion and the elasticity of the vaginal wall.

A woman with Puerto Rican heritage is 30 weeks pregnant and has been hospitalized for premature contractions for the past 5 days. She has lost 3 pounds since admission because she "can't find food that tastes like what she eats at home." When documenting her progress, which nursing diagnosis would be most appropriate at this time?

Imbalanced nutrition: less than body requirements related to unmet cultural food preferences

A nurse who is conducting sessions on preventing the spread of sexually transmitted infections (STIs) discovers that there is a very high incidence of hepatitis B in the community. Which measure should the nurse take to ensure the prevention of the disease?

Instruct people to get vaccinated for hepatitis B.

A client presents with vulvar itching and diffuse green vaginal discharge. Upon evaluation, she is prescribed metronidazole. What is the paramount nursing intervention in discharge planning?

Instruct the client not to drink alcohol with this treatment.

A woman is crying because she just recently received the results of her biopsies, and they confirm that she has invasive breast cancer. Which response by the nurse is the most appropriate?

Listen to the woman talk, and remain silent for a while

A client reports pain on one side of the abdomen. On further questioning, the nurse discovers that the pain occurs routinely around 2 weeks before menstruation. The client has not missed a period, and she exercises regularly. Which cause is most likely?

Pain during ovulation

A 24-year-old female client with a family history of cervical cancer is in the office. For which test should the nurse prepare the client to detect early stages of cervical cancer?

Papanicolaou test

More nurses are stepping into the role of the advanced practice nurse. Which nurse's role would be to provide care for children under the age of 18?

Pediatric nurse practitioner

The nurse is reviewing with a group of high school students that the hypothalamus, pituitary gland, and gonads all contribute to hormonal regulation of the female reproductive system. Based on this information, what is the specific hormone that functions primarily during pregnancy?

Progesterone

After teaching a group of pregnant women about breastfeeding, the nurse determines that the teaching was successful when the group identifies which hormone as important for the production of breast milk after birth?

Prolactin

A 13-year-old boy has begun showing signs of puberty, including appearance of axillary and facial hair, as well as a change in his voice. He asks the nurse what exactly is causing these changes in his body. The nurse should mention which primary hormone that is responsible for these changes?

Testosterone

A 16-year-old child is admitted to the hospital for treatment after a motor vehicle crash. Review of the child's record reveals that the child is an emancipated minor. What does this mean?

The child has the legal right to consent to and make decisions for treatment.

A nurse is caring for a client who has given birth. The client reports that her breast milk is dark yellow. Which information should the nurse give to the client regarding the situation?

The yellow fluid is colostrum and is rich in maternal antibodies.

A nurse is caring for a client who was raped at gunpoint. The client does not want any photos taken of her injuries. The client also does not want the police to be informed about the incident even though state laws require reporting life-threatening injuries. Which intervention should the nurse perform to document and report the findings of the case?

Use direct quotes and specific language.

A nurse is caring for a client who has just given birth to a baby. Which information should the nurse give the client regarding hepatitis B vaccination for the baby?

Vaccine consists of a series of three injections given within 6 months.

Which statement is false regarding screening for intimate partner violence in women?

Women tend to fit a profile of abuse, and victims tend to share similar physical characteristics.

The nurse at a fertility clinic determines the risk factors for clients using oral contraceptives. Which client would be at highest risk for heart attack or stroke related to use of these contraceptives?

a 38-year-old woman who smokes

In which client would the nurse suspect cancer

a 45-year-old with thickening in one breast with nipple irritation and retraction and a pink discharge

The nurse has assessed several clients who have arrived for routine appointments. The nurse predicts the health care provider will prioritize a bone density scan for which client?

a 55-year-old Caucasian smoker, family history of osteoporosis

A 36-year-old was diagnosed with uterine fibroids (leiomyomas). The nurse teaches the client to expect which clinical manifestation?

abnormal uterine bleeding

Which medication is used to suppress viral load of the HSV-2 infection?

acyclovir

The nurse considers the contraceptive class at the college dormitory to be effective when the students understand that the effectiveness of oral contraceptives (OCs) can be decreased if they take:

antibiotics

When teaching a group of young adult women about the cycle of violence, the nurse would describe which behavior as eventually disappearing as the violence becomes accelerated over time?

apologies for the pain and abuse

A nurse is required to assess a client reporting unusual vaginal discharge for bacterial vaginosis. For which classic manifestation of this condition should the nurse assess?

characteristic "stale fish" odor

A nurse is conducting an intake interview with a new client who wishes to become pregnant. The client has a history of seizures and is on antiepileptics. Which measure should the nurse advocate for the client to take to prevent adverse effects on the fetus?

discussing her medication regimen with her health care provider to determine if her medications need to be changed

The nurse who counsels women who suffer from abuse understands that abuse can come in which different forms? Select all that apply.

emotional abuse physical abuse financial abuse sexual abuse

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

estrogen deficiency

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

gonorrhea

The nurse is reviewing the history and physical exam of a woman who has come to the clinic for a routine physical. Which factor would the nurse identify as increasing the client's risk for breast cancer?

hx of ovarian cancer

During labor, the nurse performs frequent cervical assessments. This would be considered the use of what type of space?

intimate space

A client comes to the genitourinary clinic with very mild symptoms of pelvic organ prolapse (POP) that has just started in the last several days. What would be the treatment of choice for this client?

kegel exercises

An expectant mother states that she read that more African American infants than white infants die before age 1. In response to her questions about the reasons for this, the nurse accurately responds that the major reason for the high infant mortality rate is:

lack of prenatal care

A nurse has just assisted in the birth of a premature neonate. The nurse recognizes that which factor, when associated with prematurity, is a leading cause of death in neonates?

low birth weight

The nurse is providing care to a client who has had surgery as treatment for breast cancer. The nurse would be alert for the development of which complication?

lymphedema

During a clinical breast examination, the nurse palpates a well-defined, firm, mobile lump in a 60-year-old woman's left breast. The nurse notifies the primary care provider. What would the nurse anticipate the care provider to prescribe next?

mammogram

The nurse would refer a client, age 54, for follow up for suspected endometrial carcinoma if she reports which information?

onset of painless, red postmenopausal bleeding

A woman and her partner have been trying to conceive for over 2 years without success. Ultrasound imaging reveals scarring of her fallopian tubes, which appears to be the primary cause of subfertility. What is the most likely cause of the scarring?

pelvic inflammatory disease

What is the medication of choice for early syphilis?

penicillin G benzathine

When assessing a client, a nurse determines that the client has a rectocele based on which finding?

sagging of the rectum, which pushes against or into the posterior vaginal wall

The nurse was teaching a college student how to properly take the prescribed combination oral contraceptive (COC). The nurse determines the session is successful when the client correctly chooses which instruction to follow when taking the COC?

same time of day, each day

A woman is admitted for repair of cystocele and rectocele. She has nine living children. In taking her health history, what would the nurse expect to find?

stress incontinence with feeling of low abdominal pressure

Which nursing plan is a good example of how to incorporate cultural diversity perferences into the L & D unit?

supplying long-sleeved gowns and head scarves for a woman of Middle East descent

A nurse knows the importance of assessing a client's community because:

the health of a person is influenced by the health of the community.

A breast tumor is most likely found in what part of the breast?

the upper outer quadrant

The nurse is reviewing with a new client the diagnosis of polycystic ovarian syndrome (PCOS). Which long-term health problems would the nurse review as a risk with this syndrome?

type 2 diabetes