OB Quiz #1 Review
It is essential to assist the woman by assessing her safety and the safety of her children. To do this, speak to the woman alone and ask her:
Does she feel safe going home after her meeting with you? Does she need an immediate place of safety for herself or her children? Does she have a plan of escape if she becomes at risk for her safety? Does she need to consider an alternative exit from this building? Who are the people she could contact for help or support?
Transgender
Someone whose gender identity is different from the one they were assigned at birth might identify as transgender. Sometimes trans or transgender gets used as an umbrella term for gender diverse people. However, not everyone uses it to describe themselves. When in doubt ask, and always honors someone's personal terms when it comes to gender identities. What do we mean assigned at birth? Think about one of the first things the doctor (or midwife) says when someone is born, "It's a girl" or "It's a boy." This is gender assignment and it is based on an assumption that someone's genitals match their gender. However, we know this isn't always the case and that each of us gets to decide what gender we know our selves to be. It may not align with the genitals we are born with or be part of the gender binary (male-female). For example, someone may be born with a vagina but know themselves to be male
Non-Binary
is someone who does not identify as a man or a woman, or solely as one of those two genders. It's often used as an umbrella term for identities that fall outside the male/female gender binary. Being non-binary means different things to different people, so this definition is purposely broad.
Pansexual
is someone who is attracted to people of any or all genders. Some people use the word pansexual as an umbrella term to describe individuals that are attracted to more than one gender.
Pangender
is someone whose identity is comprised of all or many gender identities and expressions.
Gender fluid
may refer to a gender which varies over time. Someone who identifies as gender fluid may fluctuate between genders or express multiple genders at the same time. Their gender may also vary at random or vary in response to different circumstances.
The ABCDE of caring for an abused person
A is reassuring the woman that she is not alone. The isolation by her abuser keeps her from knowing that others are in the same situation and that health care providers can help her. B is expressing the belief that violence against women is not acceptable in any situation and that it is not her fault. Demonstrate by your actions and words that you believe her disclosure. C is confidentiality, since the woman might believe that if the abuse is reported, the abuser will retaliate. Interview her in private, without her partner or family members being present. Assure her that you will not release her information without her permission. D is documentation, which includes the following: 1. A clear quoted statement about the abuse in the woman's own words. 2. Accurate descriptions of injuries and the history of them. 3. Information on the first, the worst, and the most recent abusive incident. 4. Photos of the injuries (with the woman's consent). E is education about the cycle of violence and that it will escalate: 1. Educate about abuse and its health effects. 2. Help her to understand that she is not alone. 3. Offer appropriate community support and referrals. 4. Display posters and brochures to foster awareness of this public health problem. S is safety, the most important aspect of the intervention, to ensure that the woman has resources and a plan of action to carry out when she decides to leave.
Which statement would be most appropriate when explaining endometriosis as a cause of a woman's infertility?
A. "Ovulation does take place; however, the misplaced endometrial tissue interferes with transport of the ovum." B. "Your uterine cervix fails to close because it is engorged with tissue." C. "Menstrual sloughing does not occur, so there is never a new base for embryo growth." D. "You do not ovulate because of endometrial implants on the ovaries." Answer: A."Ovulation does take place; however, the misplaced endometrial tissue interferes with transport of the ovum."
A nurse is required to assess a client reporting unusual vaginal discharge for bacterial vaginosis. For which classic manifestation of this condition should the nurse assess?
A. Characteristic "stale fish" odor B. Heavy yellow discharge C. Dysfunctional uterine bleeding D. Erythema in the vulvovaginal area Answer: A. Characteristic "stale fish" odor
A nurse is conducting a presentation for a local women's group about pelvic floor disorders. Which instruction would the nurse include about preventing pelvic support disorders?
A. Consuming low-fiber diet B. Performing Kegel isometric exercises C. Using hormone replacement D. Voiding every 2 hours Answer: B. Performing Kegel isometric exercises
Which finding would the nurse expect to find in a client with endometriosis?
A. HOT FLASHES B. DYSPAREUNIA C. FLUID RETENTION D. FEVER Answer: B. Dyspareunia (painful intercourse)
After assessing a woman who has come to the clinic, the nurse suspects that the woman is experiencing abnormal uterine bleeding. Which statement by the client would support the nurse's suspicions?
A. I've been having bleeding off and on that's irregular and sometimes heavy. B. I get sharp pains in my lower abdomen usually starting soon after my period comes. C. I get irritable and moody about a week before my period starts. D. My periods have been unusually long and heavy lately. Answer: A. I've been having bleeding off and on that's irregular and sometimes heavy.
A young woman is newly married and is seeking advice on contraception. She is in a monogamous relationship and would like a temporary contraceptive, as she plans to have children in the future. Her husband dislikes the feel of condoms. Also, she mentions that she typically experiences dysmenorrhea. Which method should the nurse recommend?
A. IUD B. Diaphragm C. Oral contraceptive pills (OCPs) D. Vasectomy Answer: C. Oral contraceptive pills (OCPs)
The nurse encourages a female client with human papillomavirus (HPV) to receive continued follow-up care because she is at risk for:
A. Infertility B. Dyspareunia (Painful intercourse) C. Cervical cancer D. Dysmenorrhea (Menstrual cramps) Answer: C. Cervical cancer
The nurse is caring for a client with polycystic ovary syndrome (PCOS) who is receiving oral contraceptives as part of her treatment plan. The nurse teaches the client about the drug therapy and how it will help her. The nurse determines that the teaching was successful when the client states which reason for the drug?
A. It will help regulate my menstrual cycle. B. It will help me to ovulate. C. My body will be able to use insulin better. D. It will help decrease my hair growth. Answer: A. It will help regulate my menstrual cycle.
A woman has opted to use the basal body temperature method for contraception. The nurse instructs the client that a rise in basal body temperature indicates which event?
A. Onset of menses B. Ovulation C. Pregnancy D. Safe period for intercourse Answer: B. Ovulation
The nurse is assessing a 52-year-old perimenopausal female who is concerned about the changes occurring in her body. When questioned about the most serious changes, which effect should the nurse point out?
A. Pelvic support muscles lose tone. B. Dense breast tissue is replaced with adipose tissue C. The uterus and ovaries decrease in size. D. Bone mineral density decreases. Answer: D. Bone mineral density decreases.
A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection?
A. Syphilis B. Candida albicans C. Human papilloma virus (HPV) D. Gonorrhea Answer: D. Gonorrhea
When developing a teaching plan for a couple who are considering contraception options, the nurse would include which statement?
A. You should select one that is considered to be 100% effective. B. The best one is the one that is least expensive and most convenient. C. A good contraceptive doesn't require a primary care provider's prescription. D. The best contraceptive is the one you will use correctly and consistently. Answer: D. The best contraceptive is the one you will use correctly and consistently.
Assessment of a client reveals evidence of a cystocele. The nurse interprets this as:
A.Bulging of the bladder into the vagina B.Herniation of the rectum into the vagina C.Protrusion of intestinal wall into the vagina D.Downward displacement of the cervix Answer: A.Bulging of the bladder into the vagina
A nurse is conducting a discussion group at a local women's health center about violence and women. The nurse would include that women are at a higher risk for violence at which time?
A.During the winter B.On paydays C.If they leave the abuser D.During pregnancy Answer: During pregnancy
When assessing a client, a nurse determines that the client has a rectocele based on which finding?
A.Protrusion of the bladder wall through the anterior vaginal wall B.Bulging of the small intestine through the posterior vaginal wall. C.Sagging of the rectum which pushes against or into the posterior vaginal wall D.Downward movement of the uterus through the pelvic floor and into the vagina Answer: C.Sagging of the rectum which pushes against or into the posterior vaginal wall
Nurses sometimes have difficulty assessing clients for intimate partner violence. Which screening protocol is most thorough when assessing for violence?
A.The SAVE model B.The SBAR model C.The FACE module D.The RACE module Answer: A.The SAVE Model
Which STI's necessitate a delivery by Cesarean Section?
HIV Current Herpes Simplex Virus outbreak
The Danger Assessment Tool
Increased frequency or severity of abuse Presence of firearms Sexual abuse Substance abuse Precipitated by arguments and conflicts Generally violent behavior outside of the home Control issues (e.g., daily chores, friends, job, money) Physical abuse during pregnancy Suicide threats or attempts (victim or abuser) Child abuse
The SAVE Model
SCREEN all of your clients for violence by asking: Within the last year, have you been physically hurt by someone? Do you feel you are in control of your life? Within the last year, has anyone forced you to engage in sexual activities? Can you talk about your abuse with me now? In general, how would you describe your present relationship? ASK direct questions in a nonjudgmental way: Begin by normalizing the topic to the woman. Make continuous eye contact with the woman. Stay calm; avoid emotional reactions to what she tells you. Never blame the woman, even if she blames herself. Do not dismiss or minimize what she tells you, even if she does. Wait for each answer patiently. Do not rush to the next question. Do not use formal, technical, or medical language. Avoid using leading questions; be direct and to the point. Use a nonthreatening, accepting approach. VALIDATE the client by telling her: You believe her story. You do not blame her for what happened. It is brave of her to tell you this. Help is available for her. Talking with you is a hopeful sign and a first big step. EVALUATE, educate, and refer this client by asking her: What type of violence was it? Is she now in any danger? How is she feeling now? Does she know that there are consequences to violence? Is she aware of community resources available to help her?
Genderqueer
Someone may identify as genderqueer if their gender identity is neither male nor female, is between or beyond genders, or is some combination of genders. This identity is often related to or in reaction to the social construction of gender, gender stereotypes and the gender binary system.
Safety Plan
When leaving an abusive relationship, take the following items: Driver's license or photo ID Social Security number or green card/work permit Birth certificates for you and your children Phone numbers for social services or women's shelter The deed or lease to your home or apartment Any court papers or orders A change of clothing for you and your children Pay stubs, checkbook, credit cards, and cash Health insurance cards If you need to leave a domestic violence situation immediately, turn to authorities for assistance in gathering this material Develop a "game plan" for leaving and rehearse it Don't use phone cards—they leave a trail to follow
Gender dysphoria and gender incongruence
are terms used to describe the distress or discomfort an individual experiences as a result of that individual's gender identity and assigned sex not aligning.
Cisgender
is a term to describe someone whose gender matches what they were assigned at birth. For example, they were assigned female at birth based on being born with a vagina and know themselves to be female.
A gender pronoun
is the word someone uses to described their gender. The most common ones used in our society are she/her and him/he. However there are more pronouns, such as zi/hir or them/they. It is important to never assume which gender pronoun someone uses. If you aren't sure what pronoun someone uses just ask them!
Asexual, or ace
someone who experiences little or no sexual attraction, or who experiences attraction but doesn't feel the need to act out that attraction sexually. Many people who are asexual still identify with a specific sexual orientation.
Ally
someone who supports equal civil rights, gender equality, and LGBTQ+ social movements; advocates on behalf of others; and challenges fear and discrimination in all its forms.