NUR 365 Exam 1

The nurse is educating a group of women on health promotion and risks from obesity. Which conditions are women at higher risk for due to obesity? Select all that apply. 1.Sleep apnea 2.Type 2 diabetes 3.Breast cancer 4.Osteoporosis 5.Pregnancy complications

1.Sleep apnea 2.Type 2 diabetes 3.Breast cancer 5.Pregnancy complications

The nurse notices a client's husband commonly interrupts her and rarely lets her answer questions when asked. which is the priority action by the nurse? 1.Tell the husband he needs to leave the room for the remainder of the appointment. 2.Document the findings in the client's record. 3.Ask the husband why he is answering the questions for his wife. 4.Call security and have them escort the husband off the premises.

2.Document the findings in the client's record. rationale: It is important to document this behavior in the client's record. The next time the nurse has the opportunity to speak with the client alone, he/she should screen for abuse. 1, 3, & 4: This would not be an appropriate response of the nurse and could intensify the suspected abuse.

The nurse meets with a couple that was diagnosed with infertility after two years of trying to get pregnant. They are scheduled to have a gamete intrafallopian transfer (GIFT) done. Which fertility condition should the nurse expect to be an indication for this couple's need for assisted fertility technology? 1. The man not having any vas deferens 2.The man had an unsuccessful vasectomy reversal 3.The woman having bilaterally blocked fallopian tubes 4.Having a history of failed infertility treatment for anovulation

4. Having a history of failed infertility treatment for an-ovulation. RAtionale: Having a history of failed infertility treatment for anovulation is an indication for GIFT. 1 & 2 Testicular sperm aspiration is the assisted fertility technology for men without any vas deferens. 3 Embryonic transfer is a procedure used to unblock fallopian tubes.

luteal phase of ovarian cycle

begins after ovulation and lasts for 14 days.

follicular phase of ovarian cycle

begins the first day of menstruation and lasts 12 to 14 days.

ovulatory phase

begins when estrogen levels peak and ends with the release of the oocyte.

During a prenatal appointment, the nurse assesses the client's blood pressure and obtains a reading of 152/94 mmHg. The nurse should assess for which additional symptoms? Select all that apply. 1.Facial edema 2.Dyspnea 3.Vision changes 4.Severe headache 5.Pelvic pressure

1. facial edema 3. vision changes 4. severe headache rationale: these are found in pts w/ hypertensive disorders

When assessing the newborn, the nurse notes two vessels in the umbilical cord. What should the nurse do next? 1.Call the pediatrician. 2.Start an IV on the infant. 3.Check the infant's pulse oximetry. 4.Listen to the infant's heart sounds.

1. call the pediatrician rationale: Due to the risk of cardiovascular disease, calling the pediatrician is important in order to let the doctor know what is going on.

what type of inheritance is hemophillia?

x-linked

A gravid female has bacterial vaginosis. Which pregnancy complication would the nurse educate the client to watch for? 1.Preterm labor 2.Oligohydramnios 3.Placenta abruption 4.Polyhydramnios

1, preterm labor

A nurse in a fertility clinic is caring for a client who has been trying to conceive. Which symptoms does the nurse teach the client to note as presumptive signs of pregnancy? Select all that apply. 1.Amenorrhea 2.Nausea and vomiting 3.Skin hyperpigmentation 4.Positive urine test 5.Breast changes

1. Amenorrhea 2. Nausea and vomitting 4. positive urine test 5. breast changes rationale: These are presumptive signs because they could have causes outside of pregnancy and are not diagnostic. 3 & 4. are probable signs

A woman who is being prepped for preimplantation testing worries because she is unsure of what the procedure entails. Which statement by the nurse best describes preimplantation testing? 1."A cell from the developing fetus will be removed for genetic testing prior to the transferring of the in-vitro embryo into your uterus." 2."Both you and your partner will be tested to identify who carries one copy of a gene mutation." 3."Screening will be done to detect genetic disorders that can be treated early in life." 4."This test allows for the early detection of genetic disorders, such as hemophilia."

1."A cell from the developing fetus will be removed for genetic testing prior to the transferring of the in-vitro embryo into your uterus." rationale: Preimplantation testing detects genetic changes in embryos that were created using assisted reproductive techniques.

A pregnant client arrives at the clinic for her first prenatal appointment with her mother. When evaluating the mother-daughter relationship, which components are important for the nurse to assess? Select all that apply. 1.The mother's reaction to her daughter's pregnancy 2.The number of times the mother has been married 3.The mother's willingness to reminisce about her own childbirth 4.How many miscarriages the mother has had 5.The age of the mother when she gave birth to her daughter

1.The mother's reaction to her daughter's pregnancy 3.The mother's willingness to reminisce about her own childbirth rationale: A woman's relationship to her mother is an important determinant of adaptation to motherhood. A negative reaction from the mother could negatively affect the daughter's view of the pregnancy. The mother's willingness to reminisce with her daughter about her own childbirth is an important component of the woman's relationship with her mother. 2. Divorce is not a component that could affect adaptation to motherhood. 4. The number of miscarriages the mother experienced is not one of the four components important to the mother-daughter relationship. 5. The age of the mother she gave birth to her daughter is not one of the four components important to the mother-daughter relationship.

The nurse is seeing a woman at 18 weeks gestation for an assessment due to an increased risk for intrauterine growth restriction. To which drug or chemical should the nurse be concerned the mother has been exposed? Select all that apply. 1.Alcohol 2. Angiotensin-converting enzyme (ACE) inhibitors 3. Carbamazepine (anticonvulsants) 4.Cocaine 5.Warfarin (coumadin)

2 ACE inhibitors, 3 anticonvulsants, 4 cocaine Rationale: 1 Drinking alcohol during pregnancy increases the risk for fetal alcohol syndrome (FAS). With FAS, newborn symptoms include low birth weight, microcephaly, mental retardation, unusual facial features, and cardiac defects. 5 Taking coumadin while pregnant increases the risk for spontaneous abortion, fetal demise, fetal or newborn hemorrhage, and central nervous system abnormalities, no intrauterine growth restriction.

The nurse is reviewing pre-operative instructions with a patient with stage III breast cancer who is scheduled for a simple mastectomy. Which statement by the patient indicates that she understands the procedure? 1. "They will remove the lump in my breast." 2. "They will remove all of the breast tissue, the nipple, and the areola." 3. "They will remove all of the breast tissue and several axillary lymph nodes." 4. "They will remove all of the breast tissue, the nodes, and the lining of my chest wall."

2. "They will remove all of the breast tissue, the nipple, and the areola."

The nurse is admitting a client who is 10-weeks pregnant. An ultrasound has been scheduled and the client asks the nurse why this test is necessary. which are the appropriate responses from the nurse? Select all that apply. 1."To determine the sex of your baby." 2."To verify your gestational age." 3."To make sure the baby has a strong heartbeat." 4."To make sure the baby is inside your uterus and not in the fallopian tube." 5. "To see if you are carrying more than one baby."

2. "To verify your gestational age." 3."To make sure the baby has a strong heartbeat." 4."To make sure the baby is inside your uterus and not in the fallopian tube." 5."To see if you are carrying more than one baby."

A pregnant mother who was exposed to teratogens is now admitted with a diagnosis of fetal growth restriction. In order for this medical diagnosis to be made, the nurse would determine the mother was mostly likely exposed to teratogens during which period? 1.Before getting pregnant 2.After 13 weeks of gestation 3.During the period of organogenesis 4.During the first 8 weeks of gestation

2. After 13 weeks of gestation Rationale: Exposure to teratogens after 13 weeks of gestation may cause fetal growth restriction. 3 & 4 Exposure to teratogens during the period of organogenesis or during the first 8 weeks of gestatopm can cause gross structural defects.

When discussing family dynamics with a client who is G1P0, the client tells the nurse she currently lives with her husband, whom has no other children. The nurse recognizes this as which type of family structure? 1.Extended family 2.Nuclear family 3.Dyad family 4.Typical family

3. a dyad family rationale: A dyad family is a couple living alone without children. A G1P0 woman is pregnant with her first child. 1. An extended family includes three generations. 2. A nuclear family is a father, mother, and child living together. 4. not a type

A client asks the nurse about the importance of preconception counseling. In responding, the nurse states that preconception counseling helps women lessen risky behaviors and eliminate exposure to harmful substances. Which statement made by the nurse about contraception cessation would be included in the preconception counseling? 1."Women taking contraception up to a month before pregnancy will be better able to conceive and date the pregnancy." 2."Women using hormonal contraception need to discontinue its use at least one menstrual period before conception." 3."It may take several months or up to a year to conceive after discontinuing Depo-Provera." 4."Women using an intrauterine device (IUD) will have it removed during labor."

3."It may take several months or up to a year to conceive after discontinuing Depo-Provera." rationale: It may take a woman several months or up to a year to conceive after discontinuing Depo-Provera. 1. Continuing with contraception a month before pregnancy is not safe and will not aid in facilitating conception and dating the pregnancy. 2. Women using hormonal contraception need to discontinue its use few months instead of a month before conception. 4. An intrauterine device (IUD) should be removed before the woman becomes pregnant.

The nurse is teaching a 16-year-old girl about the human papillomavirus (HPV) vaccine. Which statement by the teen indicates more teaching is needed? 1.The vaccine will help prevent cervical cancer." 2."The vaccine will help prevent genital warts." 3.I will need to get three doses of the vaccine." 4.I don't need to have a Pap test if I am fully vaccinated."

4.I don't need to have a Pap test if I am fully vaccinated."

Using Naegele's Rule, calculate the estimated due date (EDD) if the woman's last menstrual period (LMP) was June 11.

March 18

nuclear family

Mother, father and children living as a unit

Newborn screening

detects genetic disorders that can be treated early in life.

dyad family

husband and wife or other couple living alone without children

dxa score below -2.5

indicates osteoporosis

dxa score above -1

normal bone density

dxa score of exactly -1

osteopenia, at risk for osteoporosis

endometrial biopsy

performed to assess the response of the uterus to hormonal signals that occur during the cycle. The biopsy is performed at the end of the menstrual cycle in the clinical or medical office.

hysterosalpingogram

radiological examination that provides information about the endocervical canal, uterine cavity, and fallopian tubes. Under fluoroscopic observation, dye is slowly injected through the cervical canal into the uterus. This examination can detect tubal problems such as adhesions or occlusions and uterine abnormalities, such as fibroids, bicornate uterus, and uterine fistulas.

para

total births after 20 wks (live or stillbirth)

Gamete intrafallopian transfer (GIFT) is used for

unexplained infertility

embryo transfer is used for

used for bilaterally blocked fallopian tubes.

laparoscopy

uses an instrument called a laparoscope to visualize and inspect the ovaries, fallopian tubes, and uterus for abnormalities, such as endometriosis and scarring.

A nurse is caring for a 30-year-old G4P2 client. She arrives at the clinic for her first prenatal visit with her husband and stepchildren. When discussing family adaptation, what developmental tasks should be included? Select all that apply. 1. Delegating household chores and tasks after the baby is born 2. Purchasing diapers, wipes, bottles, and other baby care items 3. Reorienting of relationships with relatives 4. Expanding communication to meet emotional needs 5. Preparing a birth plan that includes all members of the family

1. Delegating household chores and tasks after the baby is born 2. Purchasing diapers, wipes, bottles, and other baby care items 3. Reorienting of relationships with relatives 4. Expanding communication to meet emotional needs

After assessing a woman who had an in vitro fertilization done, the nurse documented "readiness for enhanced knowledge." Which statement made by the woman would have prompted the nurse to document "readiness for enhanced knowledge"? 1. "My eggs were harvested and fertilized in a laboratory before being inserted into my uterus." 2. "Sperm that was removed from the semen was deposited directly into my cervix via a catheter." 3. "A zygote was placed into my fallopian tube via laparoscopy 1 day after the oocyte was retrieved from me." 4. "The sperm and my oocytes were mixed outside of my body and then placed into the fallopian tube via laparoscopy."

1. "My eggs were harvested and fertilized in a laboratory before being inserted into my uterus." Rationale: In vitro fertilization is a procedure in which eggs are harvested and fertilization occurs outside the body in a laboratory.

he nurse knows that which health issues are reported more frequently in women who are obese? Select all that apply. 1.Endometrial cancer 2.Sexually transmitted infections 3.Abnormal menstrual cycle 4.Infertility 5.Osteoporosis

1. Endometrial cancer 3.Abnormal menstrual cycle 4.Infertility rationale: these are reported more in obese women

A nurse is caring for a 16-week pregnant client whose obstetrical history includes 5-year-old twins born at 38 weeks gestation and an abortion at 24-weeks after the twins were born. How would the nurse document the client's obstetrical status? 1.G3P2 2.G3P3 3.G2P3 4.G3P4

1. G3P2 Rationale: Client has 3 pregnancies, a term delivery of twins counted as 1 para and an abortion at 24-weeks counted as another para. Gravida and Para (G/P) is a two-digit system to denote pregnancy and birth history. While Gravida refers to the total number of times a woman has been pregnant, Para refers to the number of births after 20-week gestation whether live or stillbirth.

A nurse is caring for a client from another country during her first pregnancy. which information is important for the nurse to understand regarding the client's view of obstetric care practiced in North America? 1.It is safe and effective. 2.It is strange and confusing. 3.It is expensive and unnecessary. 4.It is new and different.

2. It is strange and confusing rationale: Mainstream models of obstetric care can present a strange and confusing picture to many women from different ethnic backgrounds. This includes protocols, an unfamiliar environment, and health care providers who only speak English.

The nurse is caring for a pregnant client with bipolar affective disorder. Which information is important for the nurse to understand regarding mental health disorders in pregnancy? Select all that apply. 1.Mental health issues during pregnancy always create problems for the pregnant woman. 2.The client may show difficulty with taking on the maternal role. 3.It is the role of the social worker to collaborate with community agencies and psychiatric facilities. 4.Prenatal depression and anxiety can negatively affect the growing fetus. 5.Psychiatric medications are not safe for pregnant women to take and should be discontinued right away.

2. The client may show difficulty with taking on the maternal role. 4. Prenatal depression and anxiety can negatively affect the growing fetus. rationale: taking on the maternal role and transitioning to parenthood are potential areas of concern when caring for clients with mental health issues. Depression and anxiety exert biochemical influences that significantly impact the developing fetus and contribute to adverse birth outcomes. 1. Mental health issues during pregnancy can create problems for the woman, but do not always do so. 3.Nurses need to be aware of community mental health resources and be able to collaborate with other members of the multidisciplinary care team. 5. Some psychiatric medications are safe to take during pregnancy.

female client with a history of breast cancer reports hot flashes and night sweats. Which treatment option would the nurse question if included in her plan of care? 1. Low-dose antidepressants 2. Oral estrogen 3. Avoid alcohol, hot beverages, and spicy foods 4. Biofeedback Rationales

2. oral estrogen rationale: oral estrogen is contraindicated w/ a history of breast cancer

A 12-week gestation client is reporting frequent urination and is concerned about urinary tract infection (UTI). Which response by the nurse would be most therapeutic? 1."Urinary tract infections are common in pregnancy." 2."Most women experience frequent urination during pregnancy." 3."Your health care provider will order a urine test for urinary tract infection." 4."Would you like to discuss why you might be feeling these symptoms?"

4. "would you like to discuss why you might be feeling these symptoms?" rationale: The response is therapeutic. Frequent urination in pregnancy is primarily due to systemic hormonal changes of pregnancy and weight of the growing uterus on the bladder.

Edinburgh Postnatal Depression Scale (EPDS)

Screening test used to identify depression during pregnancy or in the postpartum period

The nurse is reviewing a client's prenatal lab results and notes the white blood cell (WBC) count as 15,000 mm3. How would the nurse interpret that finding? 1.The client has an active infection. 2.This is a normal increase due to pregnancy. 3.The client is immunosuppressed. 4.This is a normal decrease due to pregnancy.

2.This is a normal increase due to pregnancy. rationale: Pregnancy hormones can cause an increase in WBC count, similar to elevations seen with physiological stress/exercise.

proliferative phase of uterine cycle

refers to the estrogen-induced thickening of the endometrium

couvade syndrome

somatic symptoms experienced by the father during pregnancy simulating those of the pregnant mother sympathetic syndrome

testicular sperm aspiration

sperm are asapirated or extracted directly from the testicles. Sperm are then microinjected into the harvested eggs of the female partner when vasectomy reversal is unsuccessful.

A client reports decreased interest in sexual activity during her pregnancy. Which statements made by the nurse are true regarding sexual interest and activity during pregnancy? Select all that apply. 1."All of the changes happening in your body can affect your sexual desires and responses." 2."You may find yourself wanting to have sex more often as the end of the pregnancy draws near." 3."Sometimes pregnant women feel more beautiful and desirable as the pregnancy advances." 4."It is important for us to discuss how your sexual desire and activity is being affected by the pregnancy." 5."During the second trimester, you may see an even further decrease in your sexual interest."

1."All of the changes happening in your body can affect your sexual desires and responses." 3."Sometimes pregnant women feel more beautiful and desirable as the pregnancy advances." 4."It is important for us to discuss how your sexual desire and activity is being affected by the pregnancy." rationale: Physiological changes during pregnancy affect the body's hormones, as well as the woman's sexual desires, responses, and practices.Some women feel more beautiful and desirable with advancing pregnancy.There should be open communication between clinicians and clients about sexual activity during pregnancy. This may help alleviate women's fears and reassure those who want to be sexually active. 2. A woman's sexual interest typically declines in the third trimester. 5. Sexual desire typically increases during the second trimester for most women.

A nurse is caring for a 30-year-old G4P2 client. She arrives at the clinic for her first prenatal visit with her husband and stepchildren. When discussing family adaptation, what developmental tasks should be included? Select all that apply. 1.Delegating household chores and tasks after the baby is born 2.Purchasing diapers, wipes, bottles, and other baby care items 3.Reorienting of relationships with relatives 4.Expanding communication to meet emotional needs 5.Preparing a birth plan that includes all members of the family

1.Delegating household chores and tasks after the baby is born 2.Purchasing diapers, wipes, bottles, and other baby care items 3.Reorienting of relationships with relatives 4.Expanding communication to meet emotional needs rationale: Realignment of tasks and responsibilities is a developmental task of the childbearing family. Preparing to provide the physical care for the newborn is a developmental task of the childbearing family. Reorienting relationships with relatives is a developmental task for the childbearing family. Expanding communication to meet emotional needs is a developmental task of pregnancy. 5. Preparation of a birth plan is not a developmental task of family adaptation.

Which response would the prenatal nurse expect for a client who recently learned the fetus has a potentially fatal cardiac defect? 1.Feelings of powerlessness 2.Sense of loss 3.Distancing herself emotionally from the fetus 4.Increased anxiety and fear 5.Requesting termination of the pregnancy

1.Feelings of powerlessness 2.Sense of loss 3.Distancing herself emotionally from the fetus 4.Increased anxiety and fear rationale: Disequilibrium, feelings of powerlessness, increased anxiety and fear, and a sense of loss are all responses to the news of a pregnancy complication.The woman may distance herself emotionally from the fetus as she faces uncertainty about the pregnant. 5. Requesting termination of the pregnancy is not an expected response.

A pregnant client in her second trimester is in the provider's office for an ultrasound. Her provider finds that the fetus has a congenital heart defect. Which condition is the client at risk for during pregnancy? Select all that apply. 1.Oligohydramnios 2.Polyhydramnios 3.One-vessel umbilical cord 4.Two-vessel umbilical cord 5.Three-vessel umbilical cord

2. polyhydraminos 4. two vessel umbilical cord Rationale: An excess amount of amniotic fluid is associated with chromosomal disorders and gastrointestinal, cardiac, and neural tube defects.An umbilical cord should have three vessels; two arteries and a vein. When a two-vessel cord is found, it is indicative of cardiac defects. 1. A decrease in amniotic fluid is associated with decreased placental function. 3. A one-vessel umbilical cord would be incompatible with life. 5. A three-vessel umbilical cord is a normal finding.

A prenatal nurse is caring for a client that is G4P1. Which statement by the client indicates an appropriate response of her 3-year-old to their mother's progressing pregnancy? 1."My daughter seems unaware of the pregnancy." 2."My daughter is constantly asking the same questions month to month about my enlarging abdomen." 3."My daughter wants to know how I got pregnant and what will happen at the birth." 4."My daughter has been throwing temper tantrums because I can no longer lift or carry her."

2."My daughter is constantly asking the same questions month to month about my enlarging abdomen." rationale: Children ages 2 to 4 years old may respond to the obvious changes in their mother's body, but may not remember from month to month why these changes are occurring. 1. Children younger than 2 years old are usually unaware of the pregnancy and do not understand anything about the arrival of the baby. 3. School-age children are usually enthusiastic and interested in the details of the pregnancy and birth 4. Children ages 4 to 5 years old may resent the pregnancy's interference with their mother's ability to hold or lift them.

The primary care nurse is reviewing records for female clients coming in today. Which clients are at higher risk of developing osteoporosis? Select all that apply. 1.48-year-old woman with a BMI of 32 2.Caucasian woman who smokes 3.60-year-old woman with auto-immune disease who frequently takes corticosteroids 4.African-American woman with normal vitamin D level 5.Asian small-boned woman who drinks 3 alcoholic beverages a day

2.Caucasian woman who smokes 3.60-year-old woman with auto-immune disease who frequently takes corticosteroids 5.Asian small-boned woman who drinks 3 alcoholic beverages a day rationale: Caucasian background and smoking are both risk factors for osteoporosis. Corticosteroids increase risk of osteoporosis. Asian background and alcohol consumption both increase the risk of osteoporosis.

The nurse is conducting an investigation on the effects of teratogenic agents on the newborn. The nurse found that exposure to some viruses during pregnancy may result in blindness in the newborn. What are the possible viral infections the nurse would have identified that can cause blindness in newborns? 1.Syphilis, rubella, and Zika 2.Chicken pox, rubella, and Zika 3.Syphilis, cytomegalovirus, and Zika 4.Cytomegalovirus, rubella, and chicken pox

2.Chicken pox, rubella, and Zika rationale: Chicken pox, rubella, and Zika are viruses that may lead to blindness.

During preconception counseling, the nurse is teaching a client about diagnosing pregnancy. Which signs are considered probable signs of pregnancy? Select all that apply. 1.Fetal heart tones 2.Quickening 3.Uterine growth 4.Frequent urination 5.Positive home pregnancy test

3. uterine growth 5. positive home pregnancy test rationale: Uterine growth is an objective measure that could be caused by something other than pregnancy, such as uterine fibroids or tumors, which makes it a probable sign of pregnancy. This is an objective measure that could produce false-positive or false-negative results, therefore making it a probable sign of pregnancy. 1. This is an objective sign of pregnancy that is only caused by the presence of a fetus, which makes it a positive sign of pregnancy. 2.Quickening is fetal movement felt by the mother. This is subjective and could be caused by something other than pregnancy, such as intestinal gas. 4. Frequent urination can be caused by multiple factors other than pregnancy, such as bladder infection, increased water intake, diabetes, etc. It is a presumptive sign of pregnancy.

During a written exam, a nursing student was asked to list the structures derived from the primary germ layers. The student states that the mucosa of the oral and nasal cavities is derived from the ectoderm. Which other statement about the primary germ made by the student is correct? 1.The mucosa of the esophagus, stomach, and intestines are developed from the mesoderm. 2.The bone marrow, blood, and lymphatic tissues are developed from the ectoderm. 3.The epidermis, hair, and nail follicles are developed from the ectoderm. 4.The lens, cornea, and internal ear are developed from the mesoderm.

3.The epidermis, hair, and nail follicles are developed from the ectoderm. rationale: The epidermis, hair, and nail follicles are developed from the ectoderm. 1. The mucosa of the esophagus, stomach, and intestines are developed from the endoderm. 2. The bone marrow, blood, and lymphatic tissues are developed from the mesoderm. 4. The lens, cornea, and internal ear are developed from the ectoderm.

A client reported that her menstrual period started 14 days ago and she is unsure of when ovulation will be taking place. Based on the client's history, the nurse notes that the client is ovulating. Which activity does the nurse expect to be happening with this client at this time? Select all that apply. 1.She is unable to get pregnant. 2.The endometrial tissue is about to be sloughed off. 3.The empty Graafian follicles morph to form the corpus luteum. 4.The client's estrogen levels will peak and decrease with the release of the oocyte. 5.Before the surge of luteinizing hormone estrogen levels decrease and progesterone levels increase.

4. The client's estrogen levels will peak and decrease with the release of the oocyte 5. Before the surge of lutenizing hormone estrogen levels decrease and progesterone levels increase Rationale: The client's estrogen levels will peak and decrease with the release of the oocyte during the ovulatory phase.Before the surge of luteinizing hormone, estrogen levels decrease and progesterone levels increase during the ovulatory phase. 3. The empty Graafian follicles morph to form the corpus luteum during the luteal phase.

A 50-year-old female client is prescribed menopausal hormone therapy (MHT) for severe hot flashes. The client asks why she needs to take progesterone if her symptoms are due to low estrogen. Which is the best explanation by the nurse? 1."Estrogen alone is not enough to control hot flashes." 2."Severe menopausal symptoms require both hormones." 3."Estrogen given alone increases the risk of blood-clotting disorders." 4."The use of progesterone with estrogen therapy reduces the risk of endometrial cancer."

4."The use of progesterone with estrogen therapy reduces the risk of endometrial cancer." rationale: Unopposed estrogen can cause endometrial hyperplasia, which increases the risk of uterine cancer. 1. Estrogen is the hormone which will improve hot flashes, but progesterone is added to prevent endometrial hyperplasia. 2. Progesterone is given to decrease the risk of endometrial cancer, not to treat hot flashes. 3. Estrogen with or without progesterone increases the risk of thromboembolism, and is contraindicated with a history of blood-clotting disorders

A female patient with endometriosis has been prescribed nafarelin (Synarel). How should the nurse explain the purpose of the medication? 1.This is an anti-inflammatory drug, which will decrease your menstrual cramps." 2.This is an oral contraceptive which stops you from ovulating." 3."This is a progestin which thins the lining of the uterus." 4."This is a gonadotropin-releasing hormone agonist, which suppresses hormones that cause ovulation."

4."This is a gonadotropin-releasing hormone agonist, which suppresses hormones that cause ovulation."

The nurse is reviewing a client's chart, noting the client has tried assessing for ovulatory dysfunction. Which tool is used for assessing ovulatory dysfunction? 1.Basal body temperature charting (BBT) 2.Endometrial biopsy 3.Hysterosalpingogram 4.Laparoscopy

1. basal body temperature charting (BBT) rationale:The BBT technique is used by the female partner to take her temperature each morning before rising, using a basal thermometer. The woman's temperature should be recorded daily. Ovulation has occurred if there is a rise in the temperature by 0.4°F for 3 consecutive days. 2. Endometrial biopsy is performed to assess the response of the uterus to hormonal signals that occur during the cycle. The biopsy is performed at the end of the menstrual cycle in the clinical or medical office. 3. Hysterosalpingogram is a radiological examination that provides information about the endocervical canal, uterine cavity, and fallopian tubes. Under fluoroscopic observation, dye is slowly injected through the cervical canal into the uterus. This examination can detect tubal problems such as adhesions or occlusions and uterine abnormalities, such as fibroids, bicornate uterus, and uterine fistulas. 4. Laparoscopy uses an instrument called a laparoscope to visualize and inspect the ovaries, fallopian tubes, and uterus for abnormalities, such as endometriosis and scarring.

The nurse is presenting on breast cancer screening during a health fair. Understanding of cancer detection that provides the best opportunity for successful treatment is reflected by which statement? 1."Early detection of breast cancer when the small tumor has not spread." 2."MRI screening is recommended for all women to detect breast cancer." 3."Average risk for breast cancer includes BRACA1 gene mutation." 4."Monthly self-breast exams are recommended for all women."

1."Early detection of breast cancer when the small tumor has not spread." rationale: According to the American Cancer Society, the best opportunity for successful treatment of breast cancer is when small tumors, which have not yet spread, are detected early.

A client that is G2P1 at 30 weeks gestation is being educated at a routine prenatal appointment. which information would be the most important for the nurse to include in a discussion about sibling adaptation in regards to her 3-year-old daughter? 1."If your other child is still sleeping in a crib you may want to consider changing their sleeping arrangements within the next two weeks." 2."It may take a few weeks for your daughter to show interest in the new baby." 3."Your daughter will probably feel jealous of the new baby. You need to make sure to give her special attention." 4."Your daughter is young enough that she will probably not be phased by the new baby."

1."If your other child is still sleeping in a crib you may want to consider changing their sleeping arrangements within the next two weeks." rationale: Children 2 to 4 years old are particularly sensitive to disruptions of the physical environment. If parents plan to change their sleeping arrangements, they should implement them well in advance of the birth. 2. This may or may not be true. It is difficult to know how a child will react to the arrival of their new sibling. 3. The older child will often feel jealously towards the new sibling. 4. Children younger than 2 years old are usually unaware of the pregnancy and do not understand explanations about the future arrival of the newborn.

During a prenatal visit, the client's husband states he has been experiencing nausea, weight gain, and abdominal pains. which is the best response by the nurse? 1."Men may experience pregnancy-like symptoms similar to those of their partner." 2."It is common for men to experience physical symptoms at the same time as their partner." 3."Because you are a middle-aged man, you should be screened for colon and prostate cancer." 4."The increased estrogen levels in your wife can transfer to you; mimicking pregnancy symptom

1."Men may experience pregnancy-like symptoms similar to those of their partner." rationale: Couvade syndrome, or a sympathetic pregnancy, is when men experience pregnancy-like symptoms and discomforts similar to those of his pregnant partner. 2. Men may experience pregnancy-like symptoms similar to those of their partner. However, although it is possible, it is not common. 3. This response has nothing to do with the question. The stem did not state the man was middle-aged. 4. Couvade syndrome is not caused by the woman's increased estrogen levels.

the nurse is reviewing the medical record of a female patient who reports reoccurring vaginal yeast infections. Which items in the patient's history increases her risk for reoccurring vaginal yeast infections? Select all that apply. 1.Frequent antibiotic use 2.patient reports douching 3.New sexual partner 4.Vaginal pH above 5.0 5.Diabetes

1.Frequent antibiotic use 2.patient reports douching 5.Diabetes rationale: some antibiotics destroy lactobacillus, which is necessary for a healthy vaginal flora. Douching can alter the vaginal flora by removing lactobacillus and causing a change in the pH, which increases the likelihood of candidiasis. Elevated serum glucose can alter the vaginal pH, increasing the risk of candidiasis. 3. Since candidiasis is not sexually transmitted, this is not a contributing factor. 4. Candidiasis is associated with a normal pH (3.5-4.5). A high vaginal pH is associated with bacterial vaginosis.

The nurse in a primary care clinic is working on a project to improve care for lesbian, gay, bisexual, and transgender (LGBT) individuals. Which processes should be included? Select all that apply. 1.Have smoking cessation educational material available. 2.Screen all individuals for domestic violence. 3.Discuss family planning only with heterosexual clients. 4.Ensure confidentiality of records. 5.Educate staff and providers on LGBT health issues.

1.Have smoking cessation educational material available. 2.Screen all individuals for domestic violence. 4.Ensure confidentiality of records. 5.Educate staff and providers on LGBT health issues.

A spouse calls the birthing center stating that his wife who is 36 weeks gestation is going into premature labor. Which data from the spouse would assist the nurse in determining that premature labor is imminent? Select all that apply. 1."Her headache is not responding to the medication." 2."She is having abdominal cramps every 6 minutes." 3."She is having low back pain with pelvic pressure." 4."Her bag of membranes has just ruptured." 5."She has generalized edema."

2."She is having abdominal cramps every 6 minutes." 3."She is having low back pain with pelvic pressure." 4."Her bag of membranes has just ruptured." rationale: 2 means labor is imminent, 3 and 4 are signs of preterm labor

A female client with osteoporosis is being prescribed alendronate (Fosamax). What should the nurse include when teaching the client about bisphosphonates? Select all that apply. 1."Take the medication with food." 2."Take the medication in a sitting or standing position." 3."Remain upright for at least 30 minutes after taking the pill." 4."This medication works by increasing the resorption of bone." 5."Side effects include musculoskeletal aches and pains, gastrointestinal irritation, and esophageal ulcerations."

2."Take the medication in a sitting or standing position." 3."Remain upright for at least 30 minutes after taking the pill." 5."Side effects include musculoskeletal aches and pains, gastrointestinal irritation, and esophageal ulcerations."

A female client with osteoporosis is being prescribed alendronate (Fosamax). What should the nurse include when teaching the client about bisphosphonates? Select all that apply. 1."Take the medication with food." 2."Take the medication in a sitting or standing position." 3."Remain upright for at least 30 minutes after taking the pill." 4."This medication works by increasing the resorption of bone." 5.Side effects include musculoskeletal aches and pains, gastrointestinal irritation, and esophageal ulcerations."

2."Take the medication in a sitting or standing position." 3.Remain upright for at least 30 minutes after taking the pill." 5.Side effects include musculoskeletal aches and pains, gastrointestinal irritation, and esophageal ulcerations." This reduces the risk of the pill becoming lodged in the esophagus where it can cause ulcerations and scarring. This will decrease the risk of reflux of the pill into the esophagus.Most common side effects of alendronate are gastrointestinal irritation, and less commonly esophageal ulcerations.

A pregnant client has experienced a 10 lb weight gain in the first 6 months of her pregnancy. During a routine prenatal appointment, the woman begins crying and states that she feels fat and undesirable. which would be the most therapeutic response by the nurse? 1."You are beautiful. Please don't be too hard on yourself." 2."Your weight gain so far is appropriate for your pre- pregnancy weight." 3."I can see you are upset. Have you discussed your concerns with your partner?" 4."I know how you are feeling. I felt like that when I was pregnant as well."

3."I can see you are upset. Have you discussed your concerns with your partner?" rationale: Open communication regarding sexual activity is important during pregnancy and can help alleviate a woman's fears and concerns. 2.The stem of the question does not state the woman's pre-pregnancy weight. This response also does not facilitate communication between the nurse and client.

The nurse is teaching the new pregnant mother about the placenta and its many roles in fetal development. Which statements show an understanding of the hormones the placenta produces? Select all that apply. 1."Progesterone is the hormone that makes you feel bloated." 2."Testosterone is produced only if you are having a boy." 3."Human chorionic gonadotropin doubles or triples the longer you are pregnant." 4."Human placental lactogen helps in the production of breast milk." 5."Estrogen is the reason for my pregnancy glow."

1."Progesterone is the hormone that makes you feel bloated." 3."Human chorionic gonadotropin doubles or triples the longer you are pregnant." 4."Human placental lactogen helps in the production of breast milk." 5."Estrogen is the reason for my pregnancy glow." Rationale: these hormones are produced by the placenta

the nurse is reviewing a client's chart, noting the client has tried assessing for ovulatory dysfunction. Which tool is used for assessing ovulatory dysfunction? 1.Basal body temperature charting (BBT) 2.Endometrial biopsy 3.Hysterosalpingogram 4.Laparoscopy

1.Basal body temperature charting (BBT) Rationale: The BBT technique is used by the female partner to take her temperature each morning before rising, using a basal thermometer. The woman's temperature should be recorded daily. Ovulation has occurred if there is a rise in the temperature by 0.4°F for 3 consecutive days. 2. Endometrial biopsy is performed to assess the response of the uterus to hormonal signals that occur during the cycle. The biopsy is performed at the end of the menstrual cycle in the clinical or medical office. 3. Hysterosalpingogram is a radiological examination that provides information about the endocervical canal, uterine cavity, and fallopian tubes. Under fluoroscopic observation, dye is slowly injected through the cervical canal into the uterus. This examination can detect tubal problems such as adhesions or occlusions and uterine abnormalities, such as fibroids, bicornate uterus, and uterine fistulas 4. Laparoscopy uses an instrument called a laparoscope to visualize and inspect the ovaries, fallopian tubes, and uterus for abnormalities, such as endometriosis and scarring.

The nurse has received bedside report on clients with postoperative conditions. Which findings require communication with the prescribing provider for medication clarification due to potential error? Select all that apply. 1.Bilateral salpingo-oophorectomy, discharge prescriptions include 17β-estradiol (Estraderm®) 2.Total vaginal hysterectomy, discharge prescriptions include17β-estradiol (Estraderm®) 3.Abdominal hysterectomy with salpingectomy, postoperative day 2, discharge prescriptions include 17β-estradiol topical emulsion/topical gel (EstroGel®) 4.Laparoscopic bilateral tubal ligation, postoperative day 1, discharge prescriptions include 17β-estradiol and norgestimate (Ortho-Prefest®) 5.Total abdominal hysterectomy, discharge prescriptions include 17β-estradiol and norgestimate (Ortho-Prefest®)

1.Bilateral salpingo-oophorectomy, discharge prescriptions include 17β-estradiol (Estraderm®) 5.Total abdominal hysterectomy, discharge prescriptions include 17β-estradiol and norgestimate (Ortho-Prefest®) rationale: Estradiol is an estrogen medication. The uterus has not been removed during this procedure, therefore a progestogen product along with the estrogen is recommended to prevent uterine cancer.Estradiol is an estrogen medication. This uterus has been removed during this procedure, therefore a progestogen product along with the estrogen is not indicated. 2. Estradiol is an estrogen medication. The uterus has been removed during this procedure and no progestogen product is indicated. 3. Estradiol is an estrogen medication. The uterus has been removed during this procedure and no progestogen product is indicated. 4. The uterus has not been removed during this procedure, therefore a progestogen product along with the estrogen is recommended to prevent uterine cancer.

The public health nurse is notifying sexual contacts of patients with sexually transmitted infections (STIs). Which STI would require treatment of sexual partners? Select all that apply. 1.Chlamydia 2.Human papillomavirus (HPV) 3.Trichomoniasis 4.Bacterial vaginosis 5.Genital herpes

1.Chlamydia 3.Trichomoniasis rationale: these require treatment of sex partners The HPV virus does not have a treatment, other than for the destruction of condyloma. Partners are not treated unless condyloma is present and they desire destruction. herpes is not a treatable sexually transmitted infection. Antiviral medications are used to shorten duration and relieve symptoms.

The nurse is preparing the necessary equipment for a client to have hysterosalpingogram done. Which equipment is the nurse expected to have prepared for this procedure? 1.Fluoroscope 2.Laparoscope 3.Biopsy needle 4.Basal thermometer

1.Fluoroscope Rationale: A fluoroscope is used to observe the dye injected through the cervical canal into the uterus during a hysterosalpingogram. 2. A laparoscope is an instrument used to visualize the ovaries, fallopian tubes, and uterus for abnormalities. 3. biopsy needle is used to remove endometrial tissue to assess the response of the uterus to hormonal signals that occur during the cycle.

A nurse is caring for a pregnant client who recently learned her fetus has a life-threatening complication. The nurse recognizes that the client's response to this finding will depend on which factors? Select all that apply. 1.The condition of the pregnancy 2.The perceived threat to the mother or fetus 3.Whether or not this is her first pregnancy 4.The woman's coping skills 5.The woman's available support

1.The condition of the pregnancy 2.The perceived threat to the mother or fetus 4.The woman's coping skills 5.The woman's available support rationale: Response to pregnancy complications depends on the pregnancy condition, perceived threat to the mother or fetus, coping skills, and available support. 3. A woman's response to pregnancy complications does not necessarily change depending on the number of pregnancies she has had.

A 17-year-old female client received her first dose of the human papillomavirus (HPV) vaccine. When should the nurse advise the client to return for her next dose? 1.In 1 year 2.In 6 to 12 months 3.In 1 to 2 months 4.In 1 to 2 weeks

3.In 1 to 2 months rationale: This is the correct dosing interval for HPV vaccine.

A 55-year-old female client is concerned because her twin sister has osteoporosis. She asks the nurse what she can do to prevent osteoporosis. Which methods of risk reduction should the nurse advise? Select all that apply. 1."Ensure a daily calcium intake of 500 mg through diet or supplements." 2."Avoid smoking." 3."Ensure adequate intake of vitamin D from diet, sunlight, and/or supplements." 4."Try to swim three to four times per week." 5."Try to walk or jog three to four times per week."

2."Avoid smoking." 3."Ensure adequate intake of vitamin D from diet, sunlight, and/or supplements." 5."Try to walk or jog three to four times per week." rationale: Smoking increases the risk of osteoporosis. Vitamin D helps with absorption of calcium which helps prevent osteoporosis.Walking and jogging are weight-bearing exercises which will reduce the risk of osteoporosis. 1. An intake of 500 mg of calcium per day is too low. The recommended daily intake of calcium for women 51 years and older is 1,200 mg. 4. Swimming is not a weight-bearing exercise and would not be effective in preventing osteoporosis.

A neonate was admitted shortly after birth with a history of the mother who consumed at least six alcoholic beverages per day during pregnancy. For which feature of fetal alcohol syndrome should the nurse expect to assess? Select all that apply. 1.Microcephaly 2.Cardiac defects 3.Cerebral infarction 4.Neural tubal defects 5. unusual facial features

2.Cardiac defects 1.Microcephaly 5. unusual facial features rationale: these are characteristics of fetal alcohol syndrome 3. Cocaine increases the neonate risk of having a cerebral infarction. 4. Carbamazepine increases the neonate in having neural tubal defects.

A nurse is providing prenatal education to a group of primigravida clients with gestational diabetes. Which is the nurse's best explanation for increased maternal insulin needed during the second trimester? 1."Placental hormone human chorionic gonadotropin (hCG) causes maternal insulin resistant." 2."Placental hormone progesterone causes maternal insulin resistant." 3."Placental hormone human chorionic somatomammotropin (hCS) causes maternal insulin resistant." 4. "Placental hormone oxytocin causes maternal insulin resistant."

3. "Placental hormone human chorionic somatomammotropin (hCS) causes maternal insulin resistant." Rationale: Placental hormone hCS produced in the second trimester facilitates fetal growth by acting as an insulin antagonist thereby altering maternal glucose metabolism. 1. Placental hormone hCG does not cause maternal insulin resistant. It is detected by a pregnancy test, maintains corpus luteum until placenta becomes fully functional. 2. Placental hormone progesterone does not cause maternal insulin resistant. It maintains pregnancy by relaxation of smooth muscles leading to decreased uterine activity. 4. Oxytocin is a posterior pituitary hormone. It stimulates uterine contraction.

A nurse is providing emotional support for a woman experiencing infertility. Which statement would require further assessment from the nurse? 1."Due to my infertility, I have felt isolated and alone. Thus, my provider suggested therapy for depression." 2."I feel like I am less of a woman because I am unable to become pregnant." 3."I am afraid of what my partner will do if I am unable to become pregnant in the next few months." 4."We are hesitant to spend the money on assisted reproductive technology due to the ethical dilemmas that can occur."

3."I am afraid of what my partner will do if I am unable to become pregnant in the next few months." Rationale: This comment raises a red flag of intimate partner violence. Although infertility can be stressful on a couple, violence should be further assessed and reported.

The nurse is interviewing a 50-year-old female client about menopause related symptoms. Which description by the client indicates she is experiencing vasomotor symptoms? 1."I feel dry in my vaginal area." 2.I'm putting on weight, especially around my waist." 3."My neck and face turn red and I then I begin to sweat." 4."My skin is dry."

3."My neck and face turn red and I then I begin to sweat."

The nurse has decided to implement the Centering Pregnancy model for prenatal care instead of the conventional antenatal care. which is the focus of this model of care? Select all that apply. 1.The nurse spends more time dealing with the complications of pregnancy. 2.The nurse will be better able to take responsibility for the clients' health. 3.The clients will be spending more time with the nurse in antenatal care. 4.More social support will be available for clients. 5.The clients will get one-on-one prenatal care

3.The clients will be spending more time with the nurse in antenatal care. 4.More social support will be available for clients. rationale: the focus is to increase the time the clients spend in antenatal care and provide more support. The focus will be on normalcy of pregnancy.The focus is to promote individual responsibility for health in pregnancy. Small groups meet w/ the nurse.

woman diagnosed with Gestational Diabetes Mellitus (GDM) was referred to have a Group B Streptococcus (GBS) screening done. At which stage of the pregnancy would the nurse recommend the client to have this screening done? 1.10 to 12 weeks of gestation 2.15 to 23 weeks of gestation 3.24 to 28 weeks of gestation 4.35 to 37 weeks of gestation

4. 35 to 37 weeks of gestation rationale: Screening for Group B Streptococcus is recommended between 35 to 37 weeks of gestation. 1. Doppler ultrasound is recommended between 10 to 12 weeks of gestation to assess the fetal heart tones. 2. Screening for neural tube defect and Trisomy 21 screening are recommended between 15 to 23 weeks of gestation. 3. Screening for Gestational Diabetes Mellitus is recommended between 24 to 28 weeks of gestation.

The nurse is providing education regarding exercise and pregnancy. Which response by the client indicates an understanding of the teaching? 1."I should start a new exercise routine to keep in shape." 2."I will perform non-weight-bearing exercises." 3."Exercise will help me lose weight during the pregnancy." 4."Walking and stretching exercises will help with overall body conditioning."

4."Walking and stretching exercises will help with overall body conditioning." rationales: Aerobic exercise and stretching helps condition the entire body, helps with weight management, and can enhance psychological well-being. 1. Women should confer with their health care provider before starting any new exercise routine. It is best to start such a program several months in advance, so exercise is already comfortable and routine. 2. Weight-bearing exercises are recommended to enhance muscle tone and bone health. 3. Weight loss should not be a goal during pregnancy. Preconception weight loss is advisable if BMI is over normal.

The nurse is caring for a primiparous client in her first trimester. which information regarding sexual intercourse is most important for the nurse to include in teaching this client? 1."All women's sexual desire changes when they get pregnant, due to the rising levels of estrogen." 2."You may need to modify intercourse positions for your comfort." 3."Your genitals may change after the birthing process." 4."You should abstain from sexual intercourse if you are having vaginal bleeding."

4."You should abstain from sexual intercourse if you are having vaginal bleeding." rationale: There are no contraindications to intercourse in pregnancy, as long as there is no vaginal bleeding present. 1. Many women's sexual desires fluctuate during pregnancy, but you cannot say for certain that all women will experience this change. 2. It may be necessary for pregnant women to modify intercourse positions for comfort, especially in the late stages of the pregnancy. However, it is not the most important information to include in the teaching. 3. not most important

The nurse is caring for a pregnant client experiencing a possible miscarriage. which is the priority nursing action? 1.Intervene to promote psychosocial adaptation to the news of the complication. 2.Allow the woman time to discuss her feelings about the pregnancy complication. 3.Ensure other family members have a correct understanding of the diagnosis. 4.Reestablish and maintain physiologic stability.

4.Reestablish and maintain physiologic stability. rationale: Reestablishment of physiologic stability is the priority of the nurse when caring for a pregnant woman with complications. 1. Once physiologic stability is re-established, the nurse can then intervene to promote psychosocial adaptation. 2.The woman should be allowed time to discuss her feelings after physiologic stability is established. 3.This is not the top priority of the nurse at this time.