Nursing 265 Week 11
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."Anovulation occurs in nursing mothers for varying periods; breastfeeding is not a reliable method of birth control. Periods may not occur for several months; sexual relations need not be delayed this long. Ovulation can occur without menstruation. Lactation may delay menses but does not reliably suppress ovulation.
An 18-year-old adolescent who was diagnosed with new-onset type 1 diabetes mellitus has stress and reports not having a menstrual cycle for a long time. Which condition is the adolescent experiencing?
Hypogonadotropic amenorrhea Rationale Hypogonadotropic amenorrhea may occur in type 1 diabetic adolescents experiencing stress. This condition can also result from sudden and severe weight loss, eating disorders, strenuous exercise, and mental illness.
Which guideline for the assessment of intimate partner violence (IPV) should the emergency nurse follow?
Patients should be routinely screened for family and IPV. Rationale In the emergency department, the nurse needs to screen for family and IPV. Routine screening for this risk factor is required. Such assessment should not be limited to female, high-risk, or young patients, and evidence need not be present to screen for the problem.Test-Taking Tip: Being prepared reduces your stress or tension level and helps you maintain a positive attitude. p. 1644
The nurse is developing a health promotion program regarding osteoporosis. Which population of postmenopausal women should the nurse target that are at risk for osteoporosis?
White American Rationale White and Asian American women are most prone to develop osteoporosis compared to their counterparts from other ethnic groups. Native American, African American, and Mexican American women have higher bone mass when they reach menopausal age. They also have a lower rate of bone loss after menopause compared to White American women. p. 1511
A nurse is educating a patient with a diagnosis of menopause who is not receiving hormone replacement therapy about strategies to prevent or reduce the risk of osteoporosis. Which patient statement is most important for the nurse to determine that the education is understood?
"I should have an intake of at least 1,500 mg of calcium every day." Rationale Menopausal women who are not receiving hormone replacement therapy should have an intake of at least 1,500 mg of calcium every day to counteract the loss in bone density. Either dietary calcium or calcium supplements may be used. Exercise plays a role in decreasing the weight gain and fatigue that are often attributed to menopause. Vitamin D helps to maintain healthy bones but should be used in conjunction with calcium to decrease the loss in bone density. Good nutrition can decrease the risk of osteoporosis, but this statement alone does not include the importance of adequate calcium intake.Test-Taking Tip: After you have eliminated one or more choices, you may discover that two of the options are very similar. This can be helpful, because it may mean that one of these look-alike answers is the best choice and the other is a very good distractor. Test both of these options against the stem. Ask yourself which one completes the incomplete statement grammatically and which one answers the question more fully and completely. The option that best completes or answers the stem is the one you should choose. Here, too, pause for a few seconds, give your brain time to reflect, and recall may occur. p. 1249
A female client who has been sexually active for 5 years is diagnosed with 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."RationaleAlthough not 100% effective, a condom is the best protection against gonorrhea in a sexually active person. Douching has no proven protective effect against sexually transmitted infections; excessive douching can alter the natural environment of the vagina and may even promote an ascending infection. Although abstaining from sex is the best way to prevent a sexually transmitted infection, it is not the most realistic response for a sexually active person. Once people become sexually active, they usually remain sexually active. Spermicidal creams do not have a protective effect against sexually transmitted infections; spermicides kill sperm and limit the risk for pregnancy.
A client confides to the nurse that she enjoys engaging in sex with multiple male adult sex partners simultaneously. What is the most appropriate response by the nurse?
"What are you using for birth control and protection from sexually transmitted infections?" Rationale Adults may have consensual sex as desired, but the nurse should encourage the use of birth control and protection from sexually transmitted infections. The nurse is interjecting personal values by stating that the client should seek counseling for this behavior or that the client's behavior is immoral. If the sex is consensual, it is not abusive.STUDY TIP: Laughter is a great stress reliever. Watching a short program that makes you laugh, reading something funny, or sharing humor with friends helps decrease stress.
A young woman and her spouse present to the emergency room claiming the woman tripped and fell. The woman has periorbital edema and ecchymosis over the right eye. She avoids eye contact and displays a blunted affect. What is the nurse's best action in this situation?
Ask the husband to leave the exam room so the nurse can finish the physical assessment. rationale The priority in this situation is to be able to talk to the woman privately about the events leading to her fall. Asking her if she "really tripped and fell" in front of the spouse is not likely to result in an honest recounting of the situation if there is a domestic violence situation and may anger the spouse. Calling social services to handle the situation without further assessment into the situation is not appropriate. Social services should be contacted after the initial nursing assessment is completed. Calling the nursing supervisor also should not be done until the assessment is completed.Test-Taking Tip: Key words or phrases in the question stem such as first, primary, early, or best are important. Similarly, words such as only, always, never, and all in the alternatives are frequently evidence of a wrong response. No real absolutes exist in life; however, every rule has its exceptions, so answer with care. p. 37
A teenage mother is diagnosed with syphilis. What would be the drug of choice for this client if she wishes to continue breast-feeding?
Benzathine penicillin Rationale Benzathine penicillin is safe to use for syphilis in lactating women. Doxycycline and tetracycline are used in the treatment of syphilis in nonpregnant women. Azithromycin is not the drug of choice for the treatment of syphilis.
A nurse is speaking with a client who was sexually abused as a child. The client does not know what constitutes inappropriate touch by another person. What issue will have to be addressed with this client?
Boundary violations Rationale Clients who have experienced childhood sexual abuse will have difficulty being aware of their personal boundaries and maintaining appropriate boundaries for themselves and others. Clients who have experienced childhood sexual abuse tend to have decreased, not increased, libidos. Phobic behavior, the irrational fear of an object or situation, is not necessarily a concern that the nurse should have for this client more than for other clients. Clients who have experienced childhood sexual abuse can exhibit aggressive behavior, but it does not directly address the identification of inappropriate touching.STUDY TIP: Regular exercise, even if only a 10-minute brisk walk each day, aids in reducing stress. Although you may have been able to enjoy regular sessions at the health club or at an exercise class several times a week, you now may have to cut down on that time without giving up a set schedule for an exercise routine. Using an exercise bicycle that has a book rack on it at home, the YMCA, or a health club can help you accomplish two goals at once. You can exercise while beginning a reading assignment or while studying notes for an exam. Listening to lecture recordings while doing floor exercises is another option. At least a couple of times a week, however, the exercise routine should be done without the mental connection to school; time for the mind to unwind is necessary, too.
The nurse provides information about a healthy diet to a 57-year-old female patient. What should the nurse instruct the patient to increase in the diet?
Calcium Rationale Encouraging the patient to increase her calcium intake would be the best suggestion, because calcium increases bone mass. Menopause occurs at an age of around 50 to 55 years, and postmenopausal complications include reduced bone density due to decreased production of estrogen. Carbohydrates, protein, and fiber do not maintain estrogen levels in the body.Test-Taking Tip: Identifying content and what is being asked about that content is critical to your choosing the correct response. Be alert for words in the stem of the item that are the same or similar in nature to those in one or two of the options . pp. 1193-1194
A known sex worker is brought into the emergency department (ED). She had been working and arrived with facial trauma including a laceration to the lip and eyebrow, and swelling of the right eye. What is the most appropriate nursing action?
Consult sexual assault nurse examiner (SANE) for rape examination. Rationale It is appropriate to consult the SANE for a possible rape examination to help preserve evidence. Nonjudgmental care of the patient is necessary so a possible diagnosis of sexual assault is not overlooked. Cleansing and treatment of the facial injuries would destroy any potential evidence if it is a sexual assault case. The boyfriend may be the perpetrator in this case and should not be called until a further assessment is completed. Obtaining fresh clothing and discarding the clothing she is wearing would potentially destroy evidence needed in a sexual assault case.Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer. p. 1264
The nurse is educating a female patient who is experiencing menopausal symptoms about conditions at which the patient will now be at a greater risk. For which conditions will the nurse monitor this patient?
Depression Osteoporosis Bladder infections Coronary artery disease Rationale Menopause is caused by a decrease in the function of the ovaries, which causes estrogen levels to drop. The loss of estrogen plays a significant role in the cause of age-related alterations, which increase the patient's risk of depression, osteoporosis, bladder infections, and coronary artery disease. Blood clots and endometrial cancer are risks associated with hormone replacement therapy, which is used by some women to manage the symptoms of menopause. However, menopause is not the direct cause of these conditions itself. pp. 1248-1249
The nurse notices bruise marks on the hands and forehead of a patient being treated for hip injury and suspects family violence. What is the appropriate nursing inquiry in this scenario?
Do you feel safe at home? Is anyone hurting you? Rationale There are very few patients who would be wiling discuss the topic of physical abuse unless directly asked. Hence, the nurse should screen the patient for family violence or intimate partner violence and ask a direct questions, such as, "Do you feel safe at home? Is anyone hurting you?" Screening for family and intimate partner violence is required for any patient who is found or suspected to be a victim of abuse. Questions such as, "How did you hurt yourself?", "Did you hurt yourself playing basketball?", and "Are you taking medication for the bruises?" are indirect and the chances of the patient evading the topic of physical abuse are high. p. 1644
A nurse is teaching a class about the male anatomy. What is the function of the structure pointed out in the given figure?
Holds the testes Rationale Label A in the figure indicates the scrotum, which holds the testes by forming a protective sac around it. Sperm is produced by the seminiferous tubules within the testes. Cowper gland, the prostate gland, and the seminal vesicles produce and secrete semen. The epididymis transports sperm during maturation.Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer.
What is the most major cause of acne in adolescent women?
Hormonal imbalance Rationale Hormonal imbalances cause premenstrual flares of acne in nearly 70% of women. A clear association between stress and acne has not been demonstrated. A research study showed that 45% of adolescent men have a family history of acne. Studies show some evidence of an association between the intake of dairy products and high glycemic-index foods and acne.
The nurse is educating a couple concerning the process of fertilization. The nurse explains to the couple that which component stimulates the release of estrogen and progesterone after fertilization?
Human chorionic gonadotropin (hCG) Rationale After fertilization, human chorionic gonadotropin (hCG) stimulates the corpus luteum to produce estrogen and progesterone. Inhibin is a hormone produced by the ovarian follicles; it inhibits the secretion of follicle-stimulating hormone (FSH) and gonadotropin-releasing hormone (GnRH). Testosterone does not affect the release of estrogen and progesterone. Follicle-stimulating hormone (FSH) stimulates the growth and maturity of the ovarian follicle necessary for ovulation.
The nurse is counseling a client infected with human immunodeficiency virus (HIV) regarding prevention of HIV transmission. Which statement by the client indicates the nurse needs to follow up?
I can safely have anal sex without any barriers"The client with HIV should use barrier protection when engaging in insertive sexual activity such as anal, oral, and vaginal. Therefore the nurse should follow up to provide the client with the correct information. All the other statements are correct and need no follow up. Abstaining from all sexual activity is a safe way to eliminate the risk of exposure to HIV in semen and vaginal secretions. The client should undergo HIV counseling and routinely offer access to voluntary HIV-antibody testing when planning for pregnancy. The most commonly used barrier is a condom, which allows for protected intercourse.Test-Taking Tip: Human immunodeficiency virus (HIV) is transmitted through blood and semen. Therefore the person participating in sexual activity should use sexual barriers to reduce the chances of infection or to prevent infection.
What advice should the nurse give to postmenopausal patients about sexuality?
Inform the patient that water-soluble lubricants are effective for atrophic changes in the vagina. Teach the patient that the use of moisturizing soaps and body lotions may help improve dry skin. Rationale Water-soluble lubricants (Replens, Astroglide, K-Y jelly) are often effective in managing atrophic changes in the vaginal epithelium. Dry skin can be improved by the use of moisturizing soaps and body lotions. Femininity and libido do not disappear with menopause. Even though symptoms are normal, they are often temporary. Cessation of menstruation should not be equated with cessation of sexual capability. p. 1249
A 16-year-old client has a steady boyfriend with whom she is having sexual relations. She asks the nurse how she can protect herself from contracting human immunodeficiency virus (HIV). Which guidance is most appropriate for the nurse to provide?
Insist that her partner use a condom when having sex Rationale A condom covers the penis and contains the semen when it is ejaculated; semen contains a high percentage of HIV in infected individuals. Preejaculatory fluid carries HIV in an infected individual, so withdrawing before ejaculation is not effective. Although a monogamous relationship is less risky than having multiple sexual partners, if one partner is HIV positive, the other person is at risk for acquiring HIV. The client is not asking about various contraceptive methods. Most contraceptives do not provide protection from HIV.
A patient is concerned regarding some of the symptoms being experienced after menopause. What information given by the nurse would explain this process?
It is a condition in which atrophic changes in the reproductive tissues are observed. Rationale Postmenopause refers to the time in a woman's life after menopause when changes in reproductive organs and tissues occur, such as atrophy of the vaginal tissue. Libido and femininity do not disappear after postmenopause. Increased menstrual bleeding is a condition associated with menorrhagia.Test-Taking Tip: Be alert for details. Details provided in the stem of the item, such as behavioral changes or clinical changes (or both) within a certain time period, can provide a clue to the most appropriate response or, in some cases, responses. p. 1248
What over-the-counter drugs are used to treat vulvovaginal candidiases? Select all that apply.
Miconazole Clotrimazole Rationale Miconazole and clotrimazole are standard over-the-counter drugs used to treat candidiasis. Tinidazole is used to treat trichomoniasis. Azithromycin is used to treat chlamydia. Metronidazole is used to treat bacterial vaginosis and trichomoniasis.
Which part of the female reproductive system produces testosterone in females?
Ovary Rationale Testosterone is an androgen, and in females, androgens are produced by the ovaries and adrenal glands. The uterus holds the fetus during pregnancy. Fallopian tubes facilitate fertilization of oocyte and sperm. An ovarian follicle is a collection of oocytes in the ovary.
A client is admitted to the hospital after general paresis develops as a complication of syphilis. Which therapy should the nurse anticipate will most likely be prescribed for this client?
Penicillin therapy Rationale Massive doses of penicillin may limit central nervous system damage if treatment is started before neural deterioration from syphilis occurs. Tranquilizers are used to modify behavior, not to treat general paresis. Behavior, not paresis, is treated with behavior modification. Electroconvulsive therapy is used to treat certain psychiatric disorders.STUDY TIP: Try to decrease your workload and maximize your time by handling items only once. Most of us spend a lot of time picking up things we put down rather than putting them away when we have them in hand. Going straight to the closet with your coat when you come in instead of throwing it on a chair saves you the time of hanging it up later. Discarding junk mail immediately and filing the rest of your bills and mail as they come in rather than creating an ever-growing stack saves time when you need to find something quickly. Filing all items requiring further attention in some fashion helps you remember to take care of things on time rather than being so engrossed in your schoolwork that you forget about them. Many nursing students have had their power or telephone service cut off because the bill simply was forgotten or buried in a pile of old mail.
Which structures are included in the external genitalia in males? Select all that apply.
Penis Scrotum Rationale The male reproductive system is divided into primary reproductive organs and secondary reproductive organs. Secondary reproductive organs include ducts, sex glands, and external genitalia. The external genitalia consists of the penis and the scrotum. Testes are the primary reproductive organs. The urethra is the duct, and the seminal vesicles are sex glands.
The nurse is educating new parents about circumcision. Which structure of the penis would this nurse tell the parents is removed during circumcision?
Prepuce Circumcision is a procedure that involves removal of the prepuce, a skin fold over the glans. The glans is the tip of the penis. The epididymis is the internal structure that promotes transportation of the sperm. The vas deferens carries the sperm from the epididymis to the ejaculatory duct.
Which hormone is crucial in maintaining the implanted egg at its site?
Progesterone Rationale Progesterone is necessary to maintain an implanted egg. Inhibin regulates the release of follicle-stimulating hormone (FSH) and gonadotropin-releasing hormone (GnRH). Estrogen plays a vital role in the development and maintenance of secondary sexual characteristics. Testosterone is important for bone strength and development of muscle mass.
Which are nursing interventions provided specifically by sexual assault nurse examiners (SANEs)?
Providing expert emergency care Collecting and documenting evidence Rationale The emergency department nurses are encouraged to become certified sexual assault nurse examiners (SANEs). The SANE provides expert emergency care to the assault victims and collects and documents evidence of the assault. Non-SANE staff may provide emotional support, inform victims about their legal rights, and screen the victim for family violence.Test-Taking Tip: Be alert for details about what you are being asked to do. In this question type, you are asked to select all options that apply to a given situation or patient. All options likely relate to the situation, but only some of the options may relate directly to the situation. p. 1644
A female patient was admitted to the hospital after her mother found her sobbing in the bathroom, washing blood from her clothing and bandaging a laceration from a split eyebrow. Which healthcare team member would the nurse anticipate the health care provider to consult?
Psychiatrist Social worker Sexual assault nurse examiner (SANE) Rationale A psychiatrist would be available to help with any feelings and issues associated with a potential rape and/or assault. A social worker could help to ensure adequate follow up resources and counseling as needed. The SANE is specially trained to examine a possible rape victim while preserving evidence. The SANE needs to help determine if the patient was raped in the course of the assault. Physical and occupational therapists would not be needed, as there doesn't appear to be any lingering injury from the case scenario that would require treatment. Speech and hearing are not mentioned as issues in the case scenario. p. 1264
The nurse is assessing an elderly male. Which finding is seen with aging?
Reduced size of testes Rationale A reduction in the size of the testes is a characteristic of aging. The testes are symmetrical in shape and length; any change in their symmetry denotes an abnormality. Presence of pubic hair is normal. The penis is covered with foreskin; however, circumcised men do not have foreskin. An easily retractable foreskin is an age-related finding.
A mother and her 5-year-old daughter have been referred to a child advocacy center for a forensic pediatric sexual examination. Before the child is examined or interviewed, the mother gives a detailed history, relaying her suspicion that the child's maternal grandfather sexually assaulted her. As the interview progresses, the mother suddenly says, "My father sexually molested me when I was a child, but I try not to think about it." What defense mechanism does the nurse recognize that the mother's statement demonstrates?
Suppression Passive aggressionSuppression is voluntary refusal to admit an unacceptable idea or behavior. Introjection is the unconscious incorporation of wishes, values, and attitudes of others as if they were one's own. Passive-aggressive behavior is the expression of anger and hostility toward others in an indirect and nonassertive way. Reaction formation is the exact opposite of an unconscious feeling.
What sexually transmitted diseases are caused by bacteria? Select all that apply
Syphilis Chlamydia Gonorrhea Rationale Syphilis is caused by Treponema pallidum, a motile spirochete bacterium. Gonorrhea is caused by a bacteria called Neisseria gonorrhoeae. Hepatitis A and herpes simplex are caused by viruses. Trichomoniasis is caused by a protozoan.
A nurse is planning to provide discharge teaching to the family of a client with acquired immunodeficiency syndrome (AIDS). Which statement should the nurse include in the teaching plan?
Wash used dishes in hot, soapy water." Rationale A person cannot contract human immunodeficiency virus (HIV) by eating from dishes previously used by an individual with AIDS; routine care is adequate. Washing used dishes in hot, soapy water is sufficient care for dishes used by the AIDS client. Dishes do not need to soak for 24 hours before being washed. The client's dishes do not need to be boiled for 30 minutes after use. Paper plates are fine to use but are not indicated to prevent the spread of AIDS.
The nurse is providing education to a group of perimenopausal women. Which herbs or supplements would the nurse include in a discussion regarding effective alternative therapies for menopausal symptoms?
soy black cohosh Rationale There is good scientific evidence that soy is useful in decreasing menopausal hot flashes and that black cohosh is safe to use for up to six months to decrease menopausal symptoms. Garlic, ginkgo, and vitamin A do not affect menopausal symptoms. p. 1249
Which structure is removed during circumcision of an infant?
prepuce Rationale Circumcision involves removal of the prepuce, which is a skin folding over the glans. The glans is the tip of the penis. The epididymis is the internal structure that helps in the transportation and maturation of sperm. The vas deferens carries sperm from the epididymis to the ejaculatory duct.
Which client may have concerns related to sexuality when hospitalized with a chronic illness?
Adolescent (teenager; 13-18 years old) Rationale An 18-year-old client is an adolescent, which is the stage of development where concerns about sexuality may occur when hospitalized with a chronic illness. The other clients are not developmentally characterized as adolescents; therefore, the nurse would not anticipate an 8-year-old, 10-year-old, or 12-year-old to have this concern.
A young pregnant adolescent reports bleeding and abdominal pain and is diagnosed with an ectopic pregnancy. Which risk factors should the nurse look for in the client? Select all that apply.
Habit of smoking, Damage to the fallopian tubes,& History of pelvic inflammatory diseaseAdolescents who smoke experience a higher risk for ectopic pregnancy. Inflammation of the fallopian tubes and ovaries and a history of pelvic inflammatory disease are risk factors. The use of contraceptive pills and a history of irregular menses are not associated with ectopic pregnancy.
Which hormonal deficiency causes breast atrophy in female clients?
Luteinizing hormoneA luteinizing hormone deficiency causes atrophy of the breasts. A growth hormone deficiency causes decreased bone density and pathologic fractures. A thyroid-stimulating hormone deficiency results in hirsutism, weight gain, and menstrual abnormalities. An adrenocorticotropic hormone deficiency causes postural hypotension, hypoglycemia, and anorexia.
Which identity may fail to develop if an adolescent lacks physical evidence of maturity?
Sexual identityA lack of physical evidence of maturity can predispose the adolescent to a failure to establish a sexual identity. Adolescents depend on these physical clues because they want assurance of maleness or femaleness and do not wish to be different from their peers. In an adolescent who does not have a feeling of acceptance and belonging, establishment of a group identity may fail to occur. Failure of a family to foster an adolescent's independence yet balance the family structure may hamper the development of family identity. Healthy adolescents evaluate their own health on the basis of feelings of well-being, ability to function normally, and absence of symptoms.
A nursing team holds a conference to develop goals for the care of a withdrawn, shy male client with low self-esteem who is afraid to talk to members of the opposite sex. Which objective should be given priority and documented in the client's plan of care?
"The client will increase his self-esteem." Rationale If the goal to increase the client's self-esteem is met, the client's relationship with others should improve in all aspects, including sexual. Increasing insight may be helpful but should not receive priority. The client may or may not have a sexual disorder. Examining his feelings toward women is not appropriate at this time; examining these feelings is nonproductive until the client's self-esteem improves. Increasing the client's knowledge of sexual function may be done, but improvement of self-esteem should receive priority.
What transformations occur during the mid-puberty stage of a normally developing adolescent female?
Breast enlargement and the growth of pubic hair Rationale During mid-puberty, the breast enlarges from a small bud of breast tissue, while pubic hair develops and covering the mons pubis and labia majora. Scanty and irregular menstrual periods are a characteristic feature of late-puberty. The first appearance of pubic hair, an increase in normal vaginal discharge, changes in the nipple and areola, and the development of a small bud of breast tissue occur during early-puberty.
A client who has been told she needs a hysterectomy for cervical cancer is upset about being unable to have a third child. Which action should the nurse take next?
Ensure that other treatment options for her will be explored. Rationale Although a hysterectomy may be performed, conservative management may include cervical conization[1][2][3] and laser treatment that do not preclude future pregnancies; clients have a right to be informed by their primary healthcare provider of all treatment options. Willingness to pursue adoption currently is not the issue for this client. Encouraging her to focus on her own recovery and emphasizing that she does have two children already negate the client's feelings.
A female adolescent reports excessive hair growth in the pubic region and under the arms. What may be responsible for these changes?
High levels of estrogen Rationale High estrogen levels in the later stages of puberty generally promote the growth of pubic and axillary hair. Progesterone is generally involved in the implantation of the fertilized egg in the uterus and the maintenance of pregnancy. High testosterone levels increase pubic and axillary hair in males. Low follicle stimulating hormone levels reduce estrogen levels.
Which phase of the woman's sexual response is characterized by elevation of the uterus?
Plateau phase Rationale The plateau phase occurs after the excitation phase, and excitation is maintained through the plateau phase, wherein the vagina expands and the uterus is elevated. Therefore elevation of the uterus is a characteristic of the plateau phase of a woman's sexual response. The orgasmic phase is characterized by uterine and vaginal contractions. In the excitation phase, the clitoris is congested and vaginal lubrication increases. The resolution phase is characterized by returning to the preexisting state.
Which test helps to identify fibroids, tumors, and fistulas while performing a reproductive tract examination?
hysterosalpingography Rationale A hysterosalpingogram is an X-ray used to evaluate tubal anatomy and patency and used to identify uterine problems such as fibroids, tumors, and fistulas. A mammography is an X-ray of the soft tissue of the breast. An ultrasonography (US) is a technique used to assess fibroids, cysts, and masses. Computer tomography is used to detect and evaluate masses and identify lymphatic enlargement from metastasis.Test-Taking Tip: Identifying content and what is being asked about that content is critical to your choosing the correct response. Be alert for words in the stem of the item that are the same or similar in nature to those in one or two of the options.
A 16-year-old high school student is referred to a community health center by a local hotline because of the fear of having contracted herpes. The teenager is upset and shares this information with the community health center nurse. What should the nurse's initialresponse be?
"You sound worried. Let me make arrangements to have you examined." Rationale Telling the client that she sounds worried and offering to arrange an examination immediately identifies the client's fear as real and offers a service to meet the need for information about the client's physical status. Obtaining the health history ignores the client's concern and focuses on the nurse's need to complete the task of obtaining a history. Telling the client not to worry minimizes the client's concern about having a sexually transmitted infection. Saying that herpes has received too much attention in the media minimizes the client's concern and implies that the client is being unrealistic.
A patient approaches the nurse expressing concerns about her impending menopause. What information should the nurse give to this patient to alleviate anxiety?
- The age of menopause ranges from 44-55 years. -Cigarette smoking may lead to early menopause Rationale The age of menopause ranges from 44 to 55 years of age. Cigarette smoking is associated with early menopause. Menopause is a gradual event. The age of menopause is not affected by the number of pregnancies. Menopause is a physiologic cessation of ovarian function; however, it may occur due to illness, chemotherapy, or radiotherapy. p. 1248
Which client has the highest risk for human immunodeficiency virus (HIV) infection?
A client who shares equipment to snort or smoke drugs Rationale Clients who use equipment to snort (straws) and smoke (pipes) drugs are at the highest risk for becoming infected with HIV as their judgment may be impaired regarding the high-risk behaviors. Safe activities that prevent the risk of contracting HIV include mutual masturbation, masturbation, and other activities that meet the "no contact" requirements. A client who undergoes perinatal HIV voluntary testing may reduce the chances of getting infected. Insertive sex between partners who are not infected with HIV are not at risk of becoming infected with HIV.Test-Taking Tip: Identifying content and what is being asked about that content is critical to your choosing the correct response. Be alert for words in the stem of the item that are the same or similar in nature to those in one or two of the options.
A client reports an absence of menstruation to the nurse. Which condition does the nurse suspect?
Amenorrhea Rationale An absence of menstruation indicates amenorrhea. Gonorrhea is a sexually transmitted disease. Dysmenorrhea is with painful menstruation associated with abdominal cramps. The formation of a fetus outside the uterus, such as a Fallopian tube, indicates ectopic pregnancy.
Which term should the nurse use in a report to describe the absence of menstrual periods in a 35-year-old non-pregnant client?
Amenorrhea Rationale The absence of menstrual periods in a non-pregnant client less than 55 years old is called amenorrhea. Rhinorrhea is an allergic state that is manifested by a runny nose. Menopause is cessation of menstruation after 55 years of age. Dyspareunia is pain during sexual intercourse.
Which are barrier methods of contraception? Select all that apply.
Condom Lea's shield Diaphragm Rationale A condom is considered a barrier method of contraception because it prevents the entrance of sperm into the vagina. Lea's shield is a reusable vaginal contraceptive made of silicone. A diaphragm is a cervical covering used to prevent sperm from reaching the egg. Spermicidal foams are a chemical methods of contraception. Coitus interruptus is a withdrawal contraceptive method.
Which method of contraception may provide adolescents with the longest duration of protection?
Levonorgestrel intrauterine system Rationale The levonorgestrel intrauterine system is a T-shaped intrauterine system which releases levonorgestrel. It must be placed within seven days of menses and provides protection up to five years. The NuvaRing, a flexible, soft, and transparent ring placed in the vagina, must be replaced every three weeks. The levonorgestrel implant is a small rod that provides protection for up to three years. Spermicidal suppositories are inserted into the vagina to kill sperm and provide protection for only a short duration.
A nurse is counseling a couple in the fertility clinic regarding steps they must take in order to increase their chances of conceiving. Which alteration to their present circumstances will put added stress on the couple?
Planning when to have intercourse Rationale A strategy for increasing the chances of conceiving requires the couple to plan intercourse only while the woman is ovulating; this removes spontaneity and is often stressful. Obtaining and delivering the necessary specimens may be inconvenient but should not be stressful. The number of office visits and examinations that are required may be cumbersome but should not be stressful. Although taking daily temperatures may be annoying, it should not be stressful.
A client asks a nurse for contraceptive information regarding a number of different methods available. What information should the nurse include as part of the teaching plan?
The rim of a condom must be held in place while the penis is withdrawn from the vagina. Rationale Unless the condom is held firmly, it can be displaced, allowing the sperm to enter the vagina. Sperm may be deposited at the beginning of intercourse, without the man's knowledge. Spermicidal cream is needed because the diaphragm may be displaced in some positions. When the woman has an increase rise in her basal temperature, she is most fertile and should avoid intercourse.Test-Taking Tip: Avoid selecting answers that state hospital rules or regulations as a reason or rationale for action.
Which factors that may exist in small rural communities prevent a victim from seeking help with intimate partner violence (IPV)?
Traditional gender roles Fear of lack of confidentiality Patriarchal attitudes Economic factors Rationale Factors that may exist in small rural communities that prevent a victim from seeking help with IPV include traditional gender roles, fear of lack of confidentiality, patriarchal attitudes, and economic factors. Health literacy and age are not factors associated with preventing a victim experiencing intimate partner violence from seeking help in a small rural community.Test-Taking Tip: Be alert for details about what you are being asked to do. In this question type, you are asked to select all options that apply to a given situation or patient. All options likely relate to the situation, but only some of the options may relate directly to the situation. p. 20
