NURS 304 TEST PART 1 CORRECT

A pilot program is being developed to assist new mothers who are at risk for mother-infant relationship problems. Which mother's situation would make her a candidate for the program?

One who had a preference for a child of one sex but gave birth to a baby of the other sex

A nurse is giving discharge instructions to a client who had an aspiration abortion by suction curettage. What postprocedure instructions should the nurse give the client?

Report any bleeding that requires a pad change every 2 hours

A client asks for and receives instruction regarding birth control methods. She elects to use a diaphragm with a spermicide. What disadvantage of using a diaphragm should be explained to the client?

Some women find its insertion and removal inconvenient.

A nurse in the emergency department is assessing a client who has been physically and sexually assaulted. What is the nurse's priority during assessment?

The client's ability to cope with the situation

Oral contraceptives are prescribed for a client. What side effect should the nurse warn the client might occur?

Breakthrough bleeding

A client has just been told that she has cervical erosion. The nurse would expect to help explain that early treatment of the erosion can help prevent:

Cancer of the cervix

A client who menstruates regularly every 30 days asks a nurse on what day she is most likely to ovulate. Because the client's last menses started on January 1, the nurse should tell her that ovulation should occur on which day in January?

16

A nurse is teaching a family planning class about ovulation and conception. The nurse should instruct the class that the ovum is thought to be viable for what period of time after ovulation?

24 to 36 hours

What is the priority nursing intervention before a client undergoes amniocentesis?

Ensuring that informed consent has been obtained from the client

The clinic nurse is providing home care instructions for a client with pelvic inflammatory disease. What resting position should be recommended by the nurse?

Fowler

A 31-year-old client is seeking contraceptive information. Before responding to the client's questions about contraceptives, the nurse obtains a health history. What factor in the client's history indicates to the nurse that oral contraceptives are contraindicated?

History of borderline hypertension

A nurse is teaching a class of expectant parents about nutritional needs during pregnancy. What information should the nurse include?

Protein needs increase to at least 70 g/day during pregnancy.

A nurse is planning care with a client for the recovery period after a laparoscopic hysterectomy and bilateral salpingo-oophorectomy. What should be included among the changes that the client should expect after surgery?

Surgical menopause

A nurse is caring for a client who just had a mastectomy. How should the nurse position the client's arm on the affected side?

On pillows with the hand higher than the arm

After a mastectomy or hysterectomy, the client may feel incomplete as a woman. Which statement causes the nurse to realize that a client may be experiencing this concern?

"I feel washed out; there isn't much left for my family."

A client at 10 weeks' gestation elects to have an induced abortion. After receiving oral mifepristone (Mifeprex), she returns to the clinic 2 days later to have misoprostol (Cytotec) inserted vaginally. How long after the procedure should the nurse have the patient return for a follow-up visit?

2 weeks

A client has a total hysterectomy with bilateral salpingo-oophorectomy for cancer of the ovary. In addition to encouraging ambulation, what exercise should the nurse instruct the client to perform to help prevent postoperative deep vein thrombosis (DVT)?

Ankle pumping is the most effective of the four exercises presented to prevent DVT.

A nurse is writing a teaching plan about osteoporosis. How should the nurse explain what osteoporosis is?

It involves a decrease in bone substance

A nurse explains to a nursing class that the efficiency of the basal body temperature method of contraception depends on fluctuation of the basal body temperature. What factor will the nurse explain can alter the effectiveness of this method?

Stress

The nurse has completed a prenatal class for women who are expecting their first babies. Which statement by a pregnant woman indicates the need for additional teaching?

"During pregnancy it's safe for me to use my regular herbal remedies."

A 63-year-old woman with the diagnosis of estrogen receptor-positive cancer of the breast undergoes lumpectomy and radiation therapy, and tamoxifen (Nolvadex) is prescribed. The client asks the nurse how long she will have to take the medication. The nurse responds:

You'll need to take it for 5 years, after which it will be discontinued.

After a client undergoes a biopsy for suspected cervical cancer, the laboratory report reveals a stage 0 lesion. What does a nurse conclude about this client's stage of cancer?

The lesion is carcinoma in situ

A client with active genital herpes has a cesarean birth. The nurse teaches the mother how to limit transmission of the virus to her newborn. The nurse concludes that the instructions have been understood when the mother states:

"I have to wash my hands with soap and water before handling the baby."

When encouraging a client to cough and deep breathe after a bilateral mastectomy, the client says, "Leave me alone! Don't you know I'm in pain?" What is the nurse's most therapeutic response?

"What's your pain level right now?"

A woman visits the clinic for an annual physical examination, and herpes genitalis is diagnosed. The client asks how the disease can be diagnosed without any tests. How should the nurse reply?

"You have blisters on the skin around your vagina."

A client asks the nurse at the family planning clinic whether contraception is needed while she is breastfeeding. How should the nurse reply?

"You should use contraceptives, because ovulation may occur without a period."

A client is scheduled for a vacuum aspiration abortion to terminate an unwanted pregnancy. What information should the nurse's teaching plan include?

A temperature of 100.4° F (38° C) or higher should be reported immediately

The nurse is teaching a client who is scheduling a vasectomy. What information is essential that the nurse explain to the client?

At least 15 ejaculations to clear the tract of sperm must occur before the semen is checked.

A nurse in the women's health clinic is counseling clients about the signs of gynecological problems. Teaching by the nurse would be deemed effective if the clients stated that which early manifestation of cervical cancer should prompt them to seek professional care?

Bloody spotting after intercourse

While admitting a client who is in labor to the birthing unit, the nurse asks the client about her marital status. The client refuses to answer and becomes very agitated, telling the nurse to leave. How should the nurse respond?

By asking questions that are restricted to the client's present situation

Levofloxacin (Levaquin) is prescribed for a woman who has been experiencing urinary frequency and burning for the past 24 hours. The nurse concludes that the teaching about this medication has been understood when the client says that she should:

Delay taking her mineral supplements within 2 hours of each dose

A nurse at the fertility clinic is counseling a couple about the tests that will be needed to determine the cause of their infertility. Which test should the nurse describe that will be used to evaluate the woman's organs of reproduction?

Hysterosalpingogram

After a mastectomy, a client returns from surgery with a closed suction drainage system in place and a dry sterile dressing covering the incision. What should the nurse do when observing this client for signs of bleeding?

Inspect the bedclothes under the client's axillary area for signs of drainage.

A nurse is assessing a client for the potential for osteoporosis. Which factor in the client's history increases the risk for this disorder?

Prolonged immobility

A thin older adult client is found to have osteoporosis. What should the nurse include in the discharge plan for this client?

Providing instructions relative to diet and exercise

A client asks a nurse about the most common problem associated with the use of an intrauterine device (IUD). What answer should the nurse provide?

Spontaneous device expulsion

A client with osteoporosis has been receiving dietary information from the nurse. Which food selection by the client indicates that the nurse's dietary instruction was effective?

Turnip greens (high in calcium)

After a hysterosalpingo-oophorectomy, a client wants to know whether it would be wise for her to take hormones right away to prevent symptoms of menopause. What is the nurse's most appropriate response?

"Discuss this with your health care provider, because it is important to verbalize your concerns."

A postpartum client is scheduled to have a tubal ligation. She has asked that her husband not be told about the procedure because she has told him that she is having exploratory surgery. The client's husband asks the nurse why his wife needs to have exploratory surgery. How should the nurse respond?

"Have you talked to your wife about your concerns?"

The school nurse is discussing issues related to premarital sex with a group of adolescents taking a health education course. The students are asked to write an essay on what they have learned about preventing pregnancy. Which comment alerts the nurse to have a private discussion with the student?

"I can't get pregnant if I have sex during my period."

A nurse from the pediatric clinic who is strongly opposed to any chemical or mechanical method of birth control is asked to work in the family planning clinic. What is the most professional response that this nurse could give to the requesting supervisor?

"I would prefer another assignment that is not contrary to my beliefs."

A female client who has been sexually active for 5 years is found to have gonorrhea. The client is upset and asks the nurse, "What can I do to keep from getting another infection in the future?" Which statement by the client indicates that the teaching by the nurse was effective?

"My partner has to use a condom all the time."

A client who has had a mastectomy asks what the term ERP-positive means. How should the nurse explain this finding?

The tumor cells generally exhibit a positive response to hormone therapy that reduces estrogen *(Estrogen receptor protein (ERP))

A client has just been informed by the health care provider that she has cervical polyps. The client asks the nurse whether she should worry about them. How should the nurse respond?

They're usually benign, and a biopsy rules out a malignancy.

A woman arrives at the prenatal clinic stating that her pregnancy test is positive. She asks the nurse for information about an abortion. After verifying that the woman is at 8 weeks' gestation, the nurse counsels her that having an abortion is controversial and that many women have long-lasting feelings of guilt after an abortion. What is the nurse's legal responsibility?

To provide the client with correct, unbiased information