OB Module 10: Women's Health
) In teaching a group of adolescents, the nurse discusses which risk factors for cardiovascular disease (CVD) in women? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Being over 55 and postmenopausal 2. Using cigarettes and tobacco 3. Being overweight 4. Having a low cholesterol level 5. Having an active lifestyle
Answer: 1, 2, 3 Explanation: 1. Being over the age of 55 and postmenopausal increases the risk of CVD. 2. The use of cigarettes and tobacco increases the risk of CVD. 3. Being overweight or obese increases the risk of CVD.
The nurse is teaching a group of clients about risk factors for osteoporosis. The nurse will include which of the following risk factors in the teaching? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Menopause at an early age increases bone loss 2. A family history of osteoporosis 3. A lifetime of high calcium intake 4. Having an active lifestyle 5. A vitamin D deficiency
Answer: 1, 2, 5 Explanation: 1. Abnormal absence of menses and early onset of menopause increase the risk of osteoporosis. 2. Family history of osteoporosis, especially a maternal hip fracture, increases the risk of osteoporosis. 5. Vitamin D deficiency increases the risk of osteoporosis.
A menopausal woman tells her nurse that she experiences discomfort from vaginal dryness during sexual intercourse, and asks, "What should I use as a lubricant?" The nurse should recommend which of the following? 1. Petroleum jelly 2. A water-soluble lubricant 3. Body cream or body lotion 4. Less-frequent intercourse
Answer: 2 Explanation: 2. A water-soluble jelly should be used.
The nurse is seeing clients in the women's clinic. Which client should be treated with ceftriaxone IM and doxycycline orally? 1. A pregnant client with gonorrhea and a yeast infection 2. A nonpregnant client with gonorrhea and chlamydia 3. A pregnant client with syphilis 4. A nonpregnant client with chlamydia and trichomoniasis
Answer: 2 Explanation: 2. The combined treatment of ceftriaxone IM and doxycycline orally provides dual treatment for gonorrhea and chlamydia, which frequently occur together.
The nurse is developing a teaching plan for a client undergoing a tubal ligation. What information should be included in the plan? 1. The surgical procedure is easily reversible. 2. Laparotomy is performed following a vaginal birth. 3. Minilaparotomy is performed in the postpartum period soon after a vaginal birth. 4. Tubal ligation can be done at any time the woman is either pregnant or not pregnant.
Answer: 3 Explanation: 3. A tubal ligation minilaparotomy is performed in the postpartum period soon after a vaginal birth.
The nurse is teaching a group of women about menopause at a community clinic. The nurse tells them that the best indicator of menopause is which of the following symptoms? 1. No menses for 8 consecutive months 2. Hot flashes and night sweats 3. FSH levels rise and ovarian follicles cease to produce estrogen 4. Diagnosed with osteoporosis 4 months ago
Answer: 3 Explanation: 3. Examining FSH and estrogen levels is a very accurate indication of menopause.
The nurse educator is talking with a group of students doing their gynecological rotation. The nurse describes a number of symptoms that include anovulation, reduced fertility, either decreased or increased menstrual flow, and menstrual cycle irregularities. The nurse is describing what condition? 1. Intermenstrual bleeding 2. Hypermenorrhea 3. Menopause 4. Primary amenorrhea
Answer: 3 Explanation: 3. This is the correct answer. Anovulation, reduced fertility, either decreased or increased menstrual flow, and menstrual cycle irregularities are some of the symptoms of menopause.
A client asks the nurse about treatment for human papilloma viral warts. The nurse's response should be based on what knowledge? 1. An antiviral injection cures approximately 50% of all cases. 2. Aggressive treatment is required to cure warts. 3. Warts often spread when an attempt is made to remove them surgically. 4. No single treatment is best for all types of warts or for all clients.
Answer: 4 Explanation: 4. All atypical, pigmented, and persistent warts should be biopsied and treatment instituted promptly.
) Which client would the nurse document as exhibiting signs and symptoms of primary dysmenorrhea? 1. 17-year-old, has never had a menstrual cycle 2. 16-year-old, had regular menses for 4 years, but has had no menses in 4 months 3. 19-year-old, regular menses for 5 years that have suddenly become painful 4. 14-year-old, irregular menses for 1 year, experiences cramping every cycle
Explanation: 4. Dysmenorrhea, or painful menstruation, occurs at, or a day before, the onset of menstruation and disappears by the end of menses. Primary dysmenorrhea is defined as cramps without underlying disease.
A couple asks the nurse what is the safest method of sterilization. What should the nurse reply? 1. "Laparotomy tubal ligation." 2. "Laparoscopy tubal ligation." 3. "Minilaparotomy." 4. "Vasectomy."
Answer: 4 Explanation: 4. Vasectomy (male sterilization) is a relatively minor procedure.
In providing community education about hepatitis, the nurse includes information on the chronic forms of hepatitis. A form of hepatitis that becomes chronic is which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Hepatitis A 2. Hepatitis B 3. Hepatitis C 4. Hepatitis D 5. Hepatitis E
Answer: 2, 3, 4 Explanation: 2. Unlike hepatitis A infection, hepatitis B infection is chronic. 3. Unlike hepatitis A infection, hepatitis C infection is chronic. 4. Unlike hepatitis A infection, hepatitis D infection is chronic.
The nurse educator is teaching a group of teens and 20-year-olds reproductive health care. When several of the women bring up douching, what is the best response the nurse could make? 1. "One should always douche after having intercourse." 2. "When douching, use force putting them in and get the solution up high." 3. "It is a good idea to douche before intercourse so the area is clean for the sperm." 4. "Douching is unnecessary because the lining of the vagina has numerous glands that provide natural cleansing."
Answer: 4 Explanation: 4. This is a true statement. The vagina has a natural cleansing system.
The nurse is taking a history of a new client in the clinic. Histories tend to be lengthy, and the sexual part can be difficult for the client. The nurse should use what technique to make it easier for the client? 1. Let the client fill out a paper copy, so she does not have to talk about intimate matters. 2. Skip the sexual part until the next time the client comes into the clinic. 3. Start with the easier medical and surgical questions, and develop a feeling of trust with the client. 4. Leave the sexual part of the history for the doctor to ask about. Answer: 3
Explanation: 3. Starting with easy-to-answer questions and then going to the sexual ones helps, as client might be at ease by then.
The nurse is teaching nursing students about the different kind of hepatitis. Which statement is the nurse likely to make? 1. Hepatitis A and B have vaccines to prevent them. 2. Hepatitis A, B, and C have vaccines to prevent them. 3. Hepatitis C, D, and E are all bloodborne. 4. Hepatitis A, C, and E are all fecal-oral contamination.
Answer: 1 Explanation: 1. Hepatitis A and B are the only two types of hepatitis that have vaccines.
The nurse is evaluating the outcomes of nursing care for a woman with a urinary tract infection. Which of the following does the nurse include in the evaluation? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. The client implements self-care measures for prevention. 2. The client completed the prescribed antibiotics. 3. The client knows self-care measures for worsening symptoms. 4. The client states that UTIs are controlled, not cured. 5. The client knows that cranberry juice can help prevent UTIs.
Answer: 1, 2 Explanation: 1. In the evaluation, the nurse should determine whether the client implements self-care measures to help prevent recurrent UTI as part of her personal routine. 2. Evaluation includes whether the client completed her prescribed course of antibiotic therapy.
The nurse is admitting a client who is 12 weeks pregnant and an IV drug user. She has had a number of sexual partners, complains of malaise, and has yellow in the eyes, nausea, and vomiting. Having obtained this history, the nurse suspects that the client has which condition? 1. Hepatitis E 2. Hepatitis C 3. Gonorrhea 4. Hepatitis A
Answer: 2 Explanation: 2. Hepatitis C is bloodborne, and found in drug users and those who have multiple sexual partners.
) A nurse is teaching a middle school health class on the different types of viral hepatitis. Which statement made by a student indicates the need for further teaching? 1. "Both hepatitis A and E are not chronic infections." 2. "Hepatitis A is characterized by symptoms of jaundice, anorexia, nausea, vomiting, malaise, and fever." 3. "Hepatitis B, C, and D have symptoms similar to those of hepatitis A, and can also include arthralgias, arthritis and skin eruptions or rash." 4. "Both hepatitis B and C have an incubation period of 45-160 days."
Answer: 4 Explanation: 4. Hepatitis B has an incubation period of 45-160 days, but hepatitis C has an incubation period of 14-180 days.
The client has been diagnosed with hepatitis B. Which statement indicates to the nurse that the client needs more education? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. "This infection could be sexually transmitted." 2. "I might get jaundiced from this illness." 3. "An immunization exists to prevent getting hepatitis B." 4. "I might have gotten this infection from food." 5. "The incubation period is 15-50 days."
Answer: 4, 5 Explanation: 4. Hepatitis B is found in blood and body fluids, and therefore can be sexually transmitted. Hepatitis A and E are foodborne, and transmitted by fecal-oral contamination. 5. The incubation period for hepatitis B is 45-160 days.
The OB-GYN nurse is teaching a client at the clinic that use of a spermicide has an increased effectiveness if used with which other items? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. A non-water-based lubricant 2. A diaphragm 3. A contraceptive sponge 4. Prophylactic antibiotics 5. A condom
2, 3, 5 Explanation: 2. Barrier contraceptives such as a diaphragm act by blocking the transport of sperm and are often used in conjunction with a spermicide. 3. Barrier contraceptives such as the contraceptive sponge act by blocking the transport of sperm and are often used in conjunction with a spermicide. 5. Barrier contraceptives such as the condom act by blocking the transport of sperm and are often used in conjunction with a spermicide.
During a counseling session on natural family planning techniques, the nurse explains that cervical mucus at the time of ovulation should be of what consistency? 1. Egg white appearance and stretchable 2. Opaque and acidic 3. High in leukocytes 4. Lacking in quantity
Answer: 1 Explanation: 1. Cervical mucus at the time of ovulation has an "egg white" appearance and is known as fertile mucus; it is friendly to sperm because it assists passage through the cervix and uterus up into the fallopian tubes.
The nurse educator is talking with the students in the clinical area about amenorrhea. She has discussed both primary and secondary amenorrhea and their possible causes and knows that her teaching has been successful when, upon being questioned, a student explains that amenorrhea can be caused by which of the following? 1. Malfunctioning of the pancreas and insulin usage 2. Lack of testosterone after the time for menses to start 3. Lack of vitamin D and calcium in the system 4. Dysfunction of the hypothalamus
Answer: 4 Explanation: 4. Causes for amenorrhea include dysfunction of the hypothalamus, pituitary, and/or anovulation.
The nurse is educating a group of female adolescents regarding sexually transmitted infections. The nurse knows that learning was achieved when an individual states that the most common symptom is which of the following? 1. Menstrual cramps 2. Heavy menstrual periods 3. Flu-like symptoms 4. Usually there are no signs or symptoms
Answer: 4 Explanation: 4. It is common for women to experience no signs or symptoms when they have contracted a sexually transmitted disease.
A client asks her nurse, "Is it okay for me to take a tub bath during the heavy part of my menstruation?" What is the nurse's correct response? 1. "Tub baths are contraindicated during menstruation." 2. "You should shower and douche daily instead." 3. "Either a bath or a shower is fine at that time." 4. "You should bathe and use a feminine deodorant spray during menstruation."
Explanation: 3. Bathing, whether it is a tub bath or a shower, is as important (if not more so) during menses as at any other time.
The nurse in the clinic instructs a client using the natural method of contraception to begin counting the first day of her cycle as which day? 1. The day her menstrual period ceases 2. The first day after her menstrual period ceases 3. The first day of her menstrual period 4. The day of ovulation
Answer: 3 Explanation: 3. The first day of menstruation is the first day of the cycle.
A client in the emergency department is diagnosed with pelvic inflammatory disease. Before discharge, the nurse will provide the client with some health teaching about which topic? 1. Endometriosis 2. Menopause 3. Ovarian hyperplasia 4. IUD for contraception
Answer: 4 Explanation: 4. The woman who uses an IUD for contraception and has multiple sexual partners needs to understand clearly the risk she faces.
The nurse is instructing a young client on avoiding toxic shock syndrome. Education was successful when the client makes which statements? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. "I will wash my hands before inserting a tampon." 2. "I will change my tampon every 3-6 hours." 3. "I will not touch the part of the tampon I insert." 4. "I will just put the used tampon in the trash." 5. "I will take prophylactic antibiotics if needed."
: 1, 2, 3 Explanation: 1. Washing hands before inserting or removing a tampon is correct. 2. Changing the tampon every 3-6 hours will help prevent toxic shock syndrome from developing. 3. After the tampon is unwrapped, the client should avoid touching the portion of the tampon to be inserted into the vagina.
A pregnant client at 24 weeks' gestation is diagnosed with bacterial vaginosis. Her doctor orders Flagyl to treat the problem. What would be appropriate education for the nurse to provide? 1. The client must be careful to observe for signs of preterm labor. 2. The client should advise her partner to seek therapy as soon as possible. 3. The main side effect of the medication is a large amount of vaginal discharge. 4. A repeat culture should be taken 2 weeks after completing the therapy.
Answer: 1 Explanation: 1. Clients with bacterial vaginosis are at risk for preterm labor.
The nurse obtains a health history from four clients. To which client should she give priority for teaching about cervical cancer prevention? 1. Age 30, treated for PID 2. Age 25, monogamous 3. Age 20, pregnant 4. Age 27, uses a diaphragm
Answer: 1 Explanation: 1. Exposure to sexually transmitted infections increases the risk of abnormal cell changes and cervical cancer.
A client comes to the clinic complaining of difficulty urinating, flu-like symptoms, genital tingling, and blister-like vesicles on the upper thigh and vagina. She denies having ever had these symptoms before. The medication the physician is most likely to order would be: 1. Oral acyclovir 2. Ceftriaxone IM 3. Azithromycin p.o. 4. Penicillin G IM
Answer: 1 Explanation: 1. Malaise, dysuria, and tingling or painful vesicles are indicative of a primary herpes simplex outbreak. Acyclovir treats herpes.
When assessing a client asking about birth control, the nurse knows that the client would not be a good candidate for Depo-Provera (DMPA) if which of the following is true? 1. She wishes to get pregnant within 3 months. 2. She is a nursing mother. 3. She has a vaginal prolapse. 4. She weighs 200 pounds.
Answer: 1 Explanation: 1. Return of fertility after use may be delayed for an average of 10 months.
The nurse is interviewing an adolescent client. The client reports a weight loss of 50 pounds over the last 4 months, and reports running at least 5 miles per day. The client asserts that her menarche was 5 years ago. Her menses are usually every 28 days, but her last menstrual period was 4 months ago. The client denies any sexual activity. Which is the best statement for the nurse to make? 1. "Your lack of menses might be related to your rapid weight loss." 2. "It is common and normal for runners to stop having any menses." 3. "Increase your intake of iron-rich foods to reestablish menses." 4. "Adolescents rarely have regular menses, even if they used to be regular."
Answer: 1 Explanation: 1. Secondary amenorrhea can be caused by rapid weight loss, including the development of the eating disorders anorexia and bulimia. Runners with low body fat might have irregular menses, but amenorrhea is not a normal condition.
The nurse seeing a client just diagnosed with Chlamydia trachomatis knows that which client is at greatest risk for the infection? 1. 16-year-old sexually active girl, using no contraceptive 2. 22-year-old mother of two, developed dyspareunia 3. 35-year-old woman on oral contraceptives 4. 48-year-old woman with hot flashes and night sweats
Answer: 1 Explanation: 1. Teens have the highest incidence of sexually transmitted infections, especially chlamydia. A client not using contraceptives is not using condoms, which decrease the risk of contracting a STI.
A client in the women's clinic asks the nurse, "How is the cervical mucus method of contraception different from the rhythm method?" The appropriate response by the nurse is that the cervical mucus method is which of the following? 1. More effective for women with irregular cycles 2. Not acceptable to women of many different religions 3. Harder to work with than is the rhythm method 4. Requires an artificial substance or device
Answer: 1 Explanation: 1. The cervical mucus method (Billings Ovulation Method) can be used by women with irregular cycles.
A nurse is providing contraceptive counseling to a perimenopausal client in a monogamous relationship. What comment by the client indicates that further teaching is necessary? 1. "The calendar method is the most reliable method for me to use." 2. "If I use the IUC, I will be at minimal risk for pelvic inflammatory disease." 3. "I should still use birth control, even though I had only three periods last year." 4. "The contraceptive skin patch contains both estrogen and progesterone."
Answer: 1 Explanation: 1. The client who believes the calendar method is the most reliable method requires more teaching. The menstrual cycle of perimenopausal women is irregular, and it is difficult to determine safe and unsafe times.
A client using oral contraceptives tells the nurse that her family is complete, and she now desires permanent contraception. Which statement should the nurse include in teaching this client about sterilization options? 1. "Essure becomes effective 3 months after insertion." 2. "Vasectomy is effective immediately after the procedure." 3. "Tubal ligation cannot be performed until the client is age 35." 4. "Oral contraception should be taken until menopause."
Answer: 1 Explanation: 1. The insertion of Essure creates a tissue response that results in tubal occlusion in about 3 months.
The nurse is teaching a group of menopausal women about the signs and symptoms of menopause and how they can get relief. One of the main concerns of the group is vaginal dryness and difficult intercourse. What is the reason the nurse will give for this? 1. The loss of cervical gland function leads to dryness of the mucous membranes of the vagina. 2. The vaginal pH increases, and the number of Doderlein's bacilli decreases. 3. The uterine lining thins and the muscle layer atrophies. 4. The labia shrink and lose their pigmentation.
Answer: 1 Explanation: 1. The loss of cervical gland function leads to dryness of the mucous membranes of the vagina.
The nurse in the OB-GYN office is explaining the benefits and risks associated with Essure to a client and her husband. What statement made by the client indicates that additional education is needed? 1. "A stainless steel microinsert is placed into the distal section of one fallopian tube." 2. "The Essure method of permanent sterilization requires no surgical incision." 3. "The steel microinserts create a benign tissue response that occludes the fallopian tubes." 4. "Women allergic to nickel should consult their physician before placement."
Answer: 1 Explanation: 1. The stainless steel microinsert is placed in the proximal section of both fallopian tubes.
The clinic nurse teaches the pregnant client being treated for trichomoniasis about the risks to her pregnancy due to this infection. Which statement would indicate successful teaching? 1. "I am at risk of having a preterm birth because of this infection." 2. "I might need to have my membranes ruptured because of this infection." 3. "I am at risk of having a baby with a high birth weight." 4. "I may have intercourse with my husband while bring treated for this infection."
Answer: 1 Explanation: 1. There is a risk of preterm birth and rupture of membranes.
A woman is asking the nurse about using the calendar method of contraception. She reports that her last six menstrual cycles were 28, 32, 29, 36, 30, and 27 days long, respectively. Based on this information, when should the nurse tell the client to abstain from intercourse? 1. Days 9-25 2. Days 9-15 3. Days 10-21 4. Days 10-16
Answer: 1 Explanation: 1. To calculate the period of abstinence, the nurse must subtract 18 from the shortest cycle length and 11 from the longest cycle length.
The nurse teaches a group of young women that self-care measures for dysmenorrhea include which of the following actions? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Taking vitamins B and E 2. Decreasing salt intake 3. Using cold packs as needed 4. Using intermittent exercise 5. Taking FSH replacement
Answer: 1, 2 Explanation: 1. Some nutritionists suggest that vitamins B and E help relieve the discomforts associated with menstruation.
What issues should the nurse consider when counseling a client on contraceptive methods? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Cultural perspectives on menstruation and pregnancy 2. Effectiveness of the method 3. Future childbearing plans 4. Whether the client is a vegetarian 5. Age at menarche
Answer: 1, 2, 3 Explanation: 1. Decisions about contraception should be made voluntarily with full knowledge of advantages, disadvantages, effectiveness, side effects, contraindications, and long-term effects. Many outside factors influence this choice, including cultural practices, religious beliefs, personality, cost, effectiveness, availability, misinformation, practicality of method, and self-esteem. 2. Decisions about contraception should be made voluntarily with full knowledge of advantages, disadvantages, effectiveness, side effects, contraindications, and long-term effects. Many outside factors influence this choice, including cultural practices, religious beliefs, personality, cost, effectiveness, availability, misinformation, practicality of method, and self-esteem. 3. Decisions about contraception should be made voluntarily with full knowledge of advantages, disadvantages, effectiveness, side effects, contraindications, and long-term effects. Many outside factors influence this choice, including cultural practices, religious beliefs, personality, cost, effectiveness, availability, misinformation, practicality of method, and self-esteem.
The nurse is providing health education to a group of young people. When teaching about the prevention of sexually transmitted infections (STIs), the nurse will teach which concepts? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Decision-making skills in refusing intercourse 2. How to reduce high-risk behaviors 3. That Pap smears might be needed more often 4. The safety of oral sex 5. Use of petroleum-based lubricants with condoms
Answer: 1, 2, 3 Explanation: 1. Effective prevention and control of STIs is based on planning ahead, review of decision-making skills, and developing strategies to refuse sex. 2. Effective prevention and control of STIs is based on the reduction of high-risk behaviors. Use of recreational drugs and alcohol can increase sexual risk taking. 3. The presence of a genital infection can lead to an abnormal Pap smear. Women with certain infections should have more frequent Pap tests.
The nurse is educating a client on intrauterine contraception (IUC). Which advantages of IUC will the nurse include? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. It is effective, continuous contraception. 2. It is relatively inexpensive over time. 3. It does not need to be inserted immediately prior to coitus. 4. Small amounts of estrogen are released daily. 5. It slightly increases the risk of ectopic pregnancy.
Answer: 1, 2, 3 Explanation: 1. One advantage of IUC is a high rate of effectiveness. 2. One advantage of IUC is that it is inexpensive over time. 3. It is non-coitus-related contraception.
The nurse at a women's clinic is planning a class on premenstrual dysphoric disorder (PMDD). The nurse includes in the education information about what medications that are shown to be effective for PMDD? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Fluoxetine hydrochloride (Prozac) 2. Sertraline hydrochloride (Zoloft) 3. Paroxeline CR (Paxil CR) 4. Hyoscyamine (Anaspaz) 5. Promethazine (Phenergan)
Answer: 1, 2, 3 Explanation: 1. Selective serotonin inhibitors such as fluoxetine hydrocholoride (Prozac) have been found to be effective in controlling PMDD. 2. Setraline hydrochloride (Zoloft) is a selective serotonin inhibitor and has been found to be effective in controlling PMDD. 3. Paroxeline CR (Paxil CR) is a selective serotonin inhibitor and has been found to be effective in controlling PMDD.
The nurse is teaching a group of young women how to prevent urinary tract infections. What will the nurse include in the teaching? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. The importance of good hygiene 2. How to recognize the signs and symptoms 3. How to take prescribed antibiotics 4. Fluids are restricted to 1000 ml 5. To urinate only when the urge is strong
Answer: 1, 2, 3 Explanation: 1. The nurse should make sure that women are aware of good hygiene practices, and should provide information on other ways to avoid UTI. 2. Women need to know the signs and symptoms of UTIs to secure prompt treatment. 3. If an infection is present, the woman needs information on how to take antibiotics, and needs to know to complete all of them.
The nurse is discharging a client after hospitalization for pelvic inflammatory disease (PID). Which statements indicate that teaching was effective? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. "I might have infertility because of this infection." 2. "It is important for me to finish my antibiotics." 3. "Tubal pregnancy could occur after PID." 4. "My PID was caused by a yeast infection." 5. "I am going to have an IUD placed for contraception."
Answer: 1, 2, 3 Explanation: 1. Women sometimes become infertile because of scarring in the fallopian tubes as a result of the inflammation of PID. 2. Antibiotic therapy should always be completed when a client is diagnosed with any infection. 3. The tubal scarring that occurs from tubal inflammation during PID can prevent a fertilized ovum from passing through the tube into the uterus, causing an ectopic or tubal pregnancy.
The nurse teaching a group of new mothers and explains that barrier methods of contraception are appropriate if which of the following conditions exist? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Just started an oral contraceptive 2. Is opposed to systemic medications 3. Is lactating 4. Is unconcerned about using contraception 5. Does not smoke and is perimenopausal
Answer: 1, 2, 3, 5 Explanation: 1. A backup method of contraception is needed for a period of time when beginning oral contraceptives. 2. Opposition to taking systemic medications is a reason to use barriers for contraception. 3. Using a barrier method of contraception is appropriate in the early postpartum period or when lactating. 5. Being perimenopausal and smoking make barrier contraception an appropriate choice.
The culturally sensitive nurse will assess cultural attitudes and beliefs about contraception, which can include which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Gender inequities 2. Religion 3. Deference to authority figures 4. Devaluation of large families 5. Attitudes about bleeding
Answer: 1, 2, 3, 5 Explanation: 1. Gender inequities may prohibit some Arab, Latina, and Eastern Indian women from seeking out or using a contraceptive method unless their husbands do not object. 2. The Roman Catholic Church considers all artificial methods of contraception unacceptable. 3. Deference to authority figures is not uncommon in traditional Chinese, Arab, Latina, and East Indian women, especially if the nurse is male. 5. Attitudes toward bleeding affect a woman's duties to her family and partner. Vaginal bleeding may be seen as "unclean" by Muslim and Orthodox Jewish women. Any contraceptive method that involves irregular bleeding might not be acceptable. Among women who feel a monthly period is necessary, any method that ultimately causes amenorrhea would not be acceptable.
A nurse is teaching contraception to a group of college students during a health class. What reason will the nurse include as to why couples might choose to use contraception? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Couples use contraception to avoid pregnancy. 2. Couples use contraception to space future pregnancies. 3. Couples use contraception to gain control over the number of children conceived. 4. Couples use contraception to avoid decisions about the number of children to have. 5. Couples use contraception to avoid contracting sexually transmitted diseases.
Answer: 1, 2, 3, 5 Explanation: 1. This is the main reason for the use of contraception. 2. Contraception is used to space children. 3. Contraception is used to control the number of children that a couple desires. 5. Some types of birth control will avoid sexually transmitted diseases—for example, some of the barrier methods.
The nurse in the OB-GYN clinic has been seeing a client through her menopausal stage of life. The nurse assesses psychological concerns if the client makes which statement? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. "I feel so lost with all of the kids away from home." 2. "I wish I were younger, and could have a baby." 3. "Although my parents are aging, they travel a lot." 4. "I don't think I am a good wife anymore." 5. "I really enjoy being able to go out when I want."
Answer: 1, 2, 4 Explanation: 1. Adjustment to an "empty nest" is a psychological concern during menopause. 2. Some women express disappointment in approaching this time of their lives, whereas others might see it as a positive transition that offers freedom from menses or concern about contraception. 4. Numerous personal factors influence a woman's ability to transition and cope with these changes, such as self-concept.
The nurse is evaluating the outcomes of nursing care given a female client with a sexually transmitted infection (STI). Which of the following will the nurse verify about the client? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Had an identified infection 2. Could identify the mode of transmission 3. Would never cope with the infection 4. Could recognize the symptoms of an STI 5. Would not disclose the STI to her partner
Answer: 1, 2, 4 Explanation: 1. The infection must be identified and cured, if possible. If not, supportive therapy is provided. 2. The client and her partner should be able to describe the infection, its method of transmission, its implications, and the therapy. 4. The client must be able to recognize the symptoms of an STI.
The nurse is teaching a group of perimenopausal women about treatment choices for their symptoms. The nurse will include which information? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Importance of continuing contraception 2. Benefits of menstrual regulation with hormones 3. Increase in vaginal dryness with hormones 4. Decrease in acne and hirsutism 5. Increase in endometrial cancer risk
Answer: 1, 2, 4 Explanation: 1. Thirty-eight percent of pregnancies for women ages 40 and older are unplanned; some form of contraception is needed. 2. Regulation of menses with effective contraception is a benefit to the perimenopausal woman. 4. Women on hormones might experience less acne and hirsutism.
The nurse assessing a 47-year-old client who is perimenopausal includes which important topics? Note: credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Vasomotor symptoms 2. A decrease in vaginal lubrication 3. Pregnancy not being an option 4. Mood changes that occur 5. An increase in the libido
Answer: 1, 2, 4 Explanation: 1. Women need to know that vasomotor symptoms occur. It might be important to investigate other possible causes of the vasomotor symptoms. 2. Women need to know that a decrease in vaginal lubrication occurs, and that water-soluble lubricants should be used. 4. Mood changes and irritability occur, and the woman might experience more forgetfulness.
The nurse is discussing the use of contraception with a client who has just become sexually active. What factors should the nurse include when educating the client on contraceptive methods? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Contraindications in the client's health history 2. Religious or moral beliefs 3. Partner's belief in the effectiveness of the choice 4. Personal preferences to use method 5. Future childbearing plans
Answer: 1, 2, 4, 5 Explanation: 1. Decisions about contraception should take into consideration any contraindications the client might have. 2. Religious or moral beliefs often impact which choices are acceptable. 4. Personal preferences need to be considered when deciding on a contraceptive method. 5. Plans for future children should be considered before determining whether sterilization should be performed.
The nurse working in a women's clinic is training a recent graduate of nursing school who has been hired. The experienced nurse explains that nurses caring for women of all ages must be which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Aware of their own feelings 2. Judgmental when discussing sexuality 3. Aware of personal values and attitudes 4. Minimally knowledgeable about reproduction 5. Willing to discuss sexuality only one-on-one
Answer: 1, 3 Explanation: 1. Nurses must be aware of their own feelings. 3. Nurses must develop an awareness of their own values and attitudes about sexuality so that they can be more sensitive and objective when they encounter the values and beliefs of others.
The nurse assessing a 50-year-old female client at an orthopedic center asks about the use of complementary and alternative therapies. Which of the following are among those women often try during menopause? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Vitamin and mineral supplements 2. Increasing caffeine intake 3. Soy and red clover 4. Selective estrogen receptor modulators 5. Salmon calcitonin
Answer: 1, 3 Explanation: 1. Vitamin and mineral supplements, especially calcium and vitamins D, E, and B complex, are used to control the symptoms of menopause. 3. Soy and red clover have shown to be effective for some women in controlling their menopausal symptoms.
The nurse working in a women's clinic recognizes that which clients are most at risk for developing vulvovaginal candidiasis? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Clients using antibiotics 2. Immunocompetent clients 3. Pregnant clients 4. Multiparous clients 5. Diabetic clients
Answer: 1, 3, 5 Explanation: 1. A predisposing factor to yeast infections includes the use of antibiotics. 3. Predisposing factors to yeast infections include pregnancy. 5. Predisposing factors to yeast infections include glycosuria and diabetes mellitus.
A nurse is teaching a group of college students at a Catholic university about natural family planning (NFP). Teaching was successful if the students say natural family planning is which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. "It is free, safe, and acceptable according to our religion." 2. "It includes breastfeeding for 1 year." 3. "It is useful in helping us plan pregnancies." 4. "It allows us to safely have intercourse during our fertile days." 5. "It does not involve the use of artificial substances or devices."
Answer: 1, 3, 5 Explanation: 1. NFP is free, safe, and acceptable to many whose religious beliefs prohibit other methods. 3. NFP is useful in helping couples to plan a pregnancy. 5. NFP involves no artificial substances or devices.
A client who was raped is in the emergency department. She asks the nurse what her alternatives are for emergency contraception. The nurse tells her she can receive which of the following treatments? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Take levonorgestrel and ethinyl estradiol. 2. Have Essure implanted. 3. Have a laparoscopic tubal ligation. 4. Take levonorgestrel alone, but in a high dose. 5. Take high doses of male hormones.
Answer: 1, 4 Explanation: 1. Preparations for EC include high doses of levonorgestrel and ethinyl estradiol (Yuzpe regimen). 4. Preparations for EC include high doses of levonorgestrel (Plan B).
The nurse is caring for a client in the clinic whom she suspects has vaginosis. Which test best determines whether this sexually active woman has the disorder? 1. The observation of mycelia upon direct microscopy in a 10% potassium hydroxide preparation 2. The addition of a 10% potassium hydroxide solution to the vaginal secretions 3. A vaginal pH of less than 4.5 4. A Gram stain positive for the fungus
Answer: 2 Explanation: 2. Adding a 10% potassium hydroxide solution to the vaginal secretion of a client with bacterial vaginosis, called a "whiff" test, produces a fishy smell.
The nurse is caring for a client hospitalized for pelvic inflammatory disease. Which nursing intervention would have priority? 1. Encourage oral fluids 2. Administer cefotetan IV 3. Enforce bed rest 4. Remove IUC, if present
Answer: 2 Explanation: 2. Administration of medications to treat the disease is the first priority.
The nurse is answering the perimenopausal client's questions about hormone replacement therapy. Which client statement indicates a need for further teaching? 1. "Estrogen therapy will decrease my chances of developing osteoporosis." 2. "If I am taking estrogen therapy, I will not have to worry about my cholesterol being checked." 3. "Osteoporosis is a decrease in bone strength due to bone density and quality." 4. "Bone mass tends to decrease after menopause."
Answer: 2 Explanation: 2. Cholesterol levels should be checked regularly even when normal, so this statement indicates the need for more teaching.
Extended use combined oral contraceptives (COCs) reduce the side effects of COCs such as which of the following? 1. Cramping 2. Hypertension 3. Breast tenderness 4. Bloating
Answer: 2 Explanation: 2. Complications of COCs include: myocardial infarction, stroke, blood clots, and hypertension.
The nurse is preparing an education session for women on the prevention of urinary tract infections (UTIs). Which statement should be included? 1. Lower urinary tract infections rarely occur in women. 2. The most common causative organism of cystitis is E. coli. 3. Wiping from back to front after a BM will help prevent a UTI. 4. Back pain often develops with a lower urinary tract infection.
Answer: 2 Explanation: 2. E. coli is present in 75% to 90% of women with UTIs.
) A client who is in perimenopause is having a number of severe symptoms. The nurse assesses this client and knows the doctor will likely prescribe what to assist in relieving the distress? 1. Calcium and vitamin D 2. A form of hormonal contraception 3. Prescriptive pain medication 4. Antibiotics
Answer: 2 Explanation: 2. Hormonal contraception is the correct answer, as pregnancy can still be a concern, plus the estrogen will relieve other symptoms, such as hot flashes and vaginal dryness.
The nurse is providing follow-up education to a client just diagnosed with vaginal herpes. What statement by the client verifies correct knowledge about vaginal herpes? 1. "I should douche daily to prevent infection." 2. "I could have another breakout during my period." 3. "I am more likely to develop cancer of the cervix." 4. "I should use sodium bicarbonate on the lesions to relieve discomfort."
Answer: 2 Explanation: 2. Menstruation seems to trigger recurrences of herpes.
A client who is currently 12 weeks pregnant is seeking information on pregnancy termination. The nurse is teaching the client about the risks involved if she were to take the medication mifepristone. Which adverse signs would the client need to know and report immediately to a physician? 1. Fatigue, lack of appetite, and inability to concentrate 2. Nausea, diarrhea, vomiting, and stomach pain 3. Increase in heart rate, inability to sit still, and lack of appetite 4. Headache, fatigue, and hunger
Answer: 2 Explanation: 2. Nausea, diarrhea, vomiting, and stomach pain are the symptoms that must be reported immediately to the physician.
The nurse who is taking a sexual history from a client should do which of the following? 1. Ask questions that the client can answer with "yes" or "no." 2. Ask mostly open-ended questions. 3. Have the client fill out a comprehensive questionnaire and review it after the client leaves. 4. Try not to make much direct eye contact.
Answer: 2 Explanation: 2. Open-ended questions are often useful in eliciting information.
The nurse's response to a client with a history of pelvic inflammatory disease who is trying to get pregnant is based on the knowledge that which condition can contribute to an infertility problem? 1. Hepatitis 2. Postinfection tubal damage 3. Pelvic abscess 4. Tubal infection
Answer: 2 Explanation: 2. Postinfection tubal damage is the most likely cause, as the infection causes tubal damage, which can lead to infertility.
The client demonstrates that the nurse's teaching regarding ways to prevent a recurrence of her urinary tract infection was effective when she makes which statement? 1. "I should wipe from back to front after urination." 2. "I should urinate when I feel the urge." 3. "I should try to restrict my intake of fruits." 4. "I should use a diaphragm."
Answer: 2 Explanation: 2. Retention overdistends the bladder, and can lead to infection.
) A client comes to the clinic complaining of severe menstrual cramps. She has never been pregnant, has been diagnosed with ovarian cysts, and has had an intrauterine device (IUD) for 2 years. What is the most likely cause for the client's complaint? 1. Primary dysmenorrhea 2. Secondary dysmenorrhea 3. Menorrhagia 4. Hypermenorrhea
Answer: 2 Explanation: 2. Secondary dysmenorrhea is associated with pathology of the reproductive tract, and usually appears after menstruation has been established. Conditions that most frequently cause secondary dysmenorrhea include ovarian cysts and the presence of an intrauterine device.
The nurse educator is planning a class about contraception, and includes information about the effects of various contraceptive methods on sexually transmitted diseases. Which statement will the nurse include concerning spermicides? 1. "Spermicides are effective against gonorrhea and chlamydia, but not against HIV." 2. "Spermicides are not effective against sexually transmitted diseases, and can increase a woman's susceptibility to HIV." 3. "Spermicides are effective against HIV, but are not effective against the other sexually transmitted diseases." 4. "Whether or not spermicides are effective against sexually transmitted diseases depends on where the woman is in her cycle."
Answer: 2 Explanation: 2. Spermicides are not effective against any sexually transmitted disease. Spermicides have a negative effect on the integrity of vaginal cells, making them more susceptible.
After a sex education class at a high school, the nurse overhears a student discussing safe sex practices. Which statement indicates that teaching was successful? 1. "I don't have to worry about getting infected if I have oral sex." 2. "Teen women are the group at highest risk for sexually transmitted infections." 3. "The best thing to do if I have sex a lot is to use spermicide each and every time." 4. "Boys get the HIV virus more easily than girls do."
Answer: 2 Explanation: 2. Teens with multiple sex partners are more susceptible to sexually transmitted diseases.
A client is using the contraceptive sponge as a birth control method. What action is important in order to maintain the sponge's effectiveness? 1. Insert the sponge at least 1 hour before intercourse. 2. Thoroughly moisten the sponge with water before inserting. 3. Spermicidal jelly must be inserted at the same time the sponge is inserted. 4. A new sponge must be inserted every time a couple has intercourse.
Answer: 2 Explanation: 2. The sponge is moistened thoroughly with water before use to activate the spermicide.
The nurse is teaching a class on menstruation to young girls. What information would be important for 10-12-year-olds to know? 1. The age they will start having their periods 2. Variations in the age menstruation begins, length of the cycle, and duration of the menses 3. The number of days they will be ill when they have their menses 4. The number of days they will not be able to take part in physical education at school during their menses
Answer: 2 Explanation: 2. These are the issues young girls like to know, as they always question whether they are different from their peers.
The charge nurse is giving an in-service to the orthopedic and gynecology nurses concerning the relationship between estrogen and osteoporosis. Which is a statement the nurse would make concerning this relationship? 1. "Males have a higher incidence of osteoporosis than do females." 2. "Women who experience menopause at a younger age and have less bone mass could have more bone loss." 3. "Estrogen levels affect only bone mass, but they have nothing to with bone strength and bone density." 4. "Osteoporosis puts the client at a decreased
Answer: 2 Explanation: 2. This is a true statement, as women who experience menopause at a younger age and have less bone mass lose the benefit of estrogen for more years.
The nurse is interviewing a 16-year-old client who has been using deodorant tampons during her menses. She comes into the gynecology office complaining of a rash and open sores on her labia and tenderness in the vagina. After obtaining her history, what will the nurse determine is the most likely cause of this client's problem? 1. She had forceful intercourse, which caused the trauma. 2. She is reacting to the deodorant in the tampon. 3. She might be allergic to the underwear she is wearing. 4. She is having a normal reaction to her menses.
Answer: 2 Explanation: 2. This is the correct answer, as women often will react to the deodorant used on pads and tampons.
The clinic nurse is returning phone calls. Which call should the nurse return first? 1. The call from a 22-year-old reporting that she has menstrual cramps and vomiting every month 2. The call from a 17-year-old asking whether there is a problem with using one tampon for a whole day 3. The call from a 46-year-old mother of a teen wondering if her daughter should be on birth control 4. The call from a 34-year-old requesting information on douching after intercourse
Answer: 2 Explanation: 2. Using a single tampon for an entire day can lead to toxic shock syndrome, a potentially life-threatening condition. This client needs education on the danger of using one tampon longer than 3-6 hours.
A client comes to the clinic complaining of a thick, white, tenacious discharge and vulvular soreness. Which medication treatment will the nurse teach the client about? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Silver sulfadiazine 2. Metronidazole 3. Clindamycin cream 4. Ceftriaxone sodium 5. Doxycycline
Answer: 2, 3 Explanation: 2. Metronidazole is the preferred treatment for vulvovaginal candidiasis. 3. Although less effective than metronidazole, clindamycin cream can be used to treat vulvovaginal candidiasis.
When caring for the menopausal woman, nurses need to be empathetic in approaching which of the following areas? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Administering medications 2. Health teaching 3. Providing physical care 4. Counseling 5. Encouraging hormone therapy
Answer: 2, 3, 4 Explanation: 2. The nurse needs to use an empathetic approach in counseling, health teaching, and providing physical care. 3. The nurse needs to use an empathetic approach in counseling, health teaching, and providing physical care. 4. The nurse needs to use an empathetic approach in counseling, health teaching, and providing physical care.
A client in the clinic asks the nurse about available contraceptives. Before responding, the nurse must assess which of the following factors? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. When menarche occurred 2. How frequently the client has intercourse 3. Whether the client has a history of thrombophlebitis 4. What the client's partner prefers 5. Whether the client is in a monogamous relationship
Answer: 2, 3, 5 Explanation: 2. A factor to consider when choosing a method of contraception is how frequently the client has intercourse. 3. A factor to consider when choosing a method of contraception is whether the client has a history of thrombophlebitis or any other condition that would contraindicate its use. 5. A factor to consider when choosing a method of contraception is whether the client is in a monogamous relationship.
The nurse in the community clinic instructs a client starting on a combined oral contraceptive that she must immediately report which of the following symptoms? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Only four withdrawal bleeds per year 2. Speech problems 3. Unscheduled bleeding 4. Blood pressure of 126/84 5. New lumps in her breast
Answer: 2, 5 Explanation: 2. The woman using combined oral contraceptives should contact her healthcare provider if she develops speech problems. 5. The woman using combined oral contraceptives should contact her healthcare provider if she develops a breast lump.
The nurse provides a couple with education about the consequences of not treating chlamydia, and knows they understand when they make which statement? 1. "She could become pregnant." 2. "She could have severe vaginal itching." 3. "He could get an infection in the tube that carries the urine out." 4. "It could cause us to develop a rash."
Answer: 3 Explanation: 3. Chlamydia is a major cause of nongonococcal urethritis (NGU) in men.
The nurse is planning an educational session about contraception. What will the nurse emphasize as being the most significant factor in determining the effectiveness of a specific method of contraception to avoid pregnancy? 1. Reliability 2. Ease of use 3. Consistency of use 4. Cost
Answer: 3 Explanation: 3. Consistency of use is the most important factor for determining the effectiveness of a specific type of contraception.
The nurse is taking a history on a new client in the clinic. She determines from talking with the client that she is recently divorced, is dating, and has had sex with various men. The nurse would be concerned about and would provide some education on what issues? 1. The ethics of dating and having sex with more than one man 2. The client having some kind of permanent birth control done, so she does not become pregnant 3. Education about sexual activity and sexually transmitted infections 4. Referral to a psychologist or counselor for follow-up on the multiple dating
Answer: 3 Explanation: 3. Education about sexual activity and sexually transmitted infections is correct, since it has been determined that the client is having sex with multiple partners.
A 49-year-old client comes to the clinic with complaints of severe perimenopausal symptoms including hot flashes, night sweats, urinary urgency, and vaginal dryness. The physician has prescribed a combination hormone replacement therapy of estrogen and progestin. When the client asks the nurse why she must take both hormones, what is the nurse's best reply? 1. "Hot flashes respond better when replacement includes both hormones." 2. "You are having very severe symptoms, so you need more hormones replaced." 3. "There is an increased risk of tissue abnormality inside the uterus if only one is given." 4. "Your blood pressure can become elevated if only one hormone is used."
Answer: 3 Explanation: 3. Estrogen alone, in a woman with a uterus (unopposed estrogen), increases the risk of endometrial (the lining of the uterus) cancer by eightfold and, therefore, is never given without progesterone in these women.
The nurse is conducting health screening at a community clinic. The client has asked whether there are any risks with body piercing and tattooing, or whether these activities would impact sexual activity. How should the nurse respond? 1. "You should avoid piercing your genitalia and your nipples." 2. "There are no problems that occur with either body piercing or tattooing." 3. "Both piercing and tattooing carry risks of infection, including hepatitis." 4. "The benefit of body art outweighs
Answer: 3 Explanation: 3. For tattooing and body piercing, risks include infections such as HIV and hepatitis B and C because of the use of inadequately sterilized equipment, as well as allergic reactions, local swelling and burns, granulomas, and keloid formation.
A 19-year-old woman comes to the gynecologist's office. When the nurse asks the reason for this visit, the client explains that she has never had a menstrual period, and that she is concerned there might be something wrong. What is the diagnosis that the physician is most likely to make based on this information? 1. Primary dysmenorrhea 2. Secondary infertility 3. Primary amenorrhea 4. Secondary amenorrhea
Answer: 3 Explanation: 3. Primary amenorrhea is the term for the condition when menses have never occurred.
The nurse is preparing educational materials at a family planning clinic. The client who is an appropriate candidate for using emergency contraception would be one who reports which of the following? 1. Forgetting to start her pill pack yesterday 2. Unprotected intercourse during her menses 3. That a condom broke yesterday in the middle of her cycle 4. Increased dysmenorrhea since IUC insertion
Answer: 3 Explanation: 3. Research indicates that oral hormonal EC taken as soon as possible within 72 hours, but up to 5 days, can reduce the risk of pregnancy after a single act of unprotected intercourse by at least 74%.
The nurse in the clinic is seeing four clients. Which one is the best candidate for receiving an IUC? 1. An unmarried, 22-year-old college graduate 2. A married 24-year-old who has never been pregnant 3. An unmarried 25-year-old with a history of chlamydia 4. A married 26-year-old who has two children
Answer: 4 Explanation: 4. This client is the best candidate, as she is in a stable relationship, and has children.
The client who was raped is extremely upset when a pregnancy test confirms that she is pregnant, and requests information regarding pregnancy termination. Which statement is best for the nurse to include? 1. "Abortion is morally wrong, and should not be undertaken." 2. "Hypertension is a risk with any abortion." 3. "Surgical abortion in the first trimester is technically easier and safer than abortion in the second trimester." 4. "The most accurate method to determine gestational age are the results of a pregnancy test."
Answer: 3 Explanation: 3. Second-trimester abortion (greater than 13 weeks' gestation up to 24 weeks or as per state law) may be done medically or surgically.
Which of the following diagnostic tests would the nurse question when ordered for a client diagnosed with pelvic inflammatory disease (PID)? 1. CBC (complete blood count) with differential 2. Venereal Disease Research Laboratory (VDRL) 3. Throat culture for Streptococcus A 4. RPR (Rapid Plasma Reagin)
Answer: 3 Explanation: 3. Streptococcus of the throat is not associated with PID.
A client asks the nurse, "Can you explain to us how to use the basal body temperature method to detect ovulation and prevent pregnancy?" What response by the nurse is best? 1. "Take your temperature every evening at the same time and keep a record for a period of several weeks. A noticeable drop in temperature indicates that ovulation has occurred." 2. "Take your temperature every day at the same time and keep a record of the findings. A noticeable rise in temperature indicates ovulation." 3. "Take your temperature each day, immediately upon awakening, and keep a record of each finding. A noticeable rise in temperature indicates that ovulation is about to occur." 4. "This is an unscientific and unproven method of determining ovulation, and is not recognized as a means of birth control."
Answer: 3 Explanation: 3. The basal body temperature method is used to detect ovulation by an increase in the basal temperature during the menstrual cycle. It requires that the woman take her temperature every morning upon awakening (before any activity) and record the findings on a temperature graph, and is based on the fact that the temperature almost always rises and remains elevated after ovulation because of the production of progesterone, a thermogenic (heat-producing) hormone.
A client has been diagnosed with bacterial vaginosis. The nurse obtains a sexual history from the client, including contraceptive measures, number of sexual partners, and frequency of intercourse. What is the rationale for the questions? 1. Clients can infect their sexual partners. 2. The nurse is required by law to ask the questions. 3. Clients with bacterial vaginosis can become infected with HIV and other sexually transmitted diseases more easily. 4. The laboratory needs a full client history in order to know for which organisms and antibiotic sensitivities it should test.
Answer: 3 Explanation: 3. The change in normal flora increases the woman's susceptibility to other organisms, making the client more vulnerable to sexually transmitted diseases, including HIV.
The nurse is providing instructions for a woman who has just had intrauterine contraception inserted. What is essential for the nurse to teach the client? 1. To palpate her lower abdomen each month to check the patency of the device 2. To remain on bed rest for 24 hours after insertion of the device 3. To report any pain during intercourse to the physician 4. To insert spermicidal jelly within 4 hours of every sexual encounter
Answer: 3 Explanation: 3. The client should report any pain during intercourse to the physician. This can be due to an infection.
When the nurse is teaching a woman about the use of a diaphragm, it is important to instruct her that the diaphragm should be rechecked for correct size how often? 1. Every five years routinely 2. When weight gain or loss beyond five pounds has occurred 3. After each birth 4. Only after significant weight loss
Answer: 3 Explanation: 3. The diaphragm should be rechecked for correct size after each childbirth and whenever a woman has gained or lost 10 pounds or more.
A woman comes into the emergency department stating she was raped the day before, and requests emergency contraception. She states that she is in the middle of her cycle. The nurse knows which of the following about the client? 1. This client has waited too long before coming to the emergency department. 2. The client will have to wait 10 days before she can have emergency contraception. 3. The client can receive emergency contraception up to 72 hours to 5 days after the intercourse. 4. The client will have to wait and see whether she misses a period.
Answer: 3 Explanation: 3. This client is within the 72-hour to 5-day timeframe, and is able to receive the medicine.
The nurse is instructing a client in the use of combined oral contraceptives. The nurse knows that additional teaching is required when the client makes which statement about the risks of taking combined oral contraceptives? 1. "They will lower my risk for breast cancer." 2. "They will increase my risk for cervical cancer." 3. "They will lower my risk for ovarian cancer." 4. "They will increase my risk for uterine cancer."
Answer: 3 Explanation: 3. This is true. There is a reduction in the incidence of ovarian cancer.
A client who wants to use the vaginal sponge method of contraception shows that she understands the appropriate usage when she makes which statement? 1. "I need to use a lubricant prior to insertion." 2. "I need to add spermicidal cream prior to intercourse." 3. "I need to moisten it with water prior to use." 4. "I need to leave it in no longer than 6 hours."
Answer: 3 Explanation: 3. To activate the spermicide in the vaginal sponge, it must be moistened thoroughly with water.
Women with pyelonephritis during pregnancy are at significantly increased risk for which condition? 1. Foul-smelling discharge 2. Ectopic pregnancy 3. Preterm labor 4. A colicky large intestine
Answer: 3 Explanation: 3. Women with pyelonephritis during pregnancy are at significantly increased risk of preterm labor, preterm birth, development of adult respiratory distress syndrome, and septicemia.
The nurse is providing discharge instructions to a client with a diagnosis of vulvovaginal candidiasis (VVC), and knows the client understands when she makes which of the following statements? 1. "I need to apply the miconazole for 10 days." 2. "I need to douche daily." 3. "I need to add yogurt to my diet." 4. "I need to wear nylon panties."
Answer: 3 Explanation: 3. Yogurt helps reestablish normal vaginal flora.
A nonpregnant client is diagnosed with bacterial vaginosis (BV). What does the nurse expect to administer? 1. Penicillin G 2 million units IM one time 2. Zithromax 1 mg p.o. b.i.d. for 2 weeks 3. Doxycycline 100 mg p.o. b.i.d. for a week 4. Metronidazole 500 mg p.o. b.i.d. for a week
Answer: 4 Explanation: 4. The nonpregnant woman who is diagnosed with bacterial vaginosis (BV) is treated with metronidazole 500 mg orally twice a day for 7 days.
The nurse is interviewing a new client in the clinic. The client is premenopausal, but is concerned about the bone changes and osteoporosis that can occur, since she is getting close to menopause. The nurse tells the client that prevention is the primary goal. Which of the following would be a primary goal for prevention? 1. Eliminating all alcohol intake 2. Taking 500 mg of calcium each day 3. Use of sunscreen to assist with absorption of vitamin D 4. Regular weight-bearing and muscle-strengthening exercises
Answer: 4 Explanation: 4. This is correct. Regular weight bearing of the long bones is a primary goal for the prevention of osteoporosis.
A client is asking the nurse what she can do about the "falling down of her reproductive organs and urinary tract wall." The nurse will tell the client to try what exercise? 1. Lifting weights to strengthen those muscles 2. Running two miles a day 3. Running up and down stairs a few times every day 4. Performing Kegel exercises and having regular sexual activity
Answer: 4 Explanation: 4. This is the correct answer. Kegel exercises are done by tightening and relaxing the perineal muscles, and this activity as well as sexual activity will help the client's problem.
A 12-year-old girl and her mother are at the doctor's office for a routine check-up for the daughter. The mother tells the nurse that she would like the daughter to have the Gardasil vaccine that is effective against the human papilloma virus. The nurse does some teaching, and knows it has been successful when the mother makes which statement? 1. "The human papilloma virus is spread through casual contact in schools." 2. "Gardasil will protect against all types of the human papilloma virus." 3. "The human papilloma virus affects a million people in the United States." 4. "Gardasil will be given to my daughter in three doses."
Answer: 4 Explanation: 4. This is true. The vaccine is given in three doses.
A female client who is 36 years old, weighs 200 pounds, is monogamous, and does not smoke desires birth control. The nurse understands that which contraceptive method is inappropriate for this client? 1. Intrauterine device 2. Vaginal sponge 3. Combined oral contraceptives 4. Transdermal hormonal contraception
Answer: 4 Explanation: 4. Transdermal hormonal contraception is contraindicated because of the client's obesity.
