Wellness and Health Promotion

A nurse is conducting a health promotion program, encouraging lifestyle changes to help clients prevent various benign and treatable conditions. Which suggestions would the nurse most likely include? Select all that apply. 1 low-fat diet 2 regular exercise 3 high-impact aerobics 4 high vegetable-fruit diet 5 adequate fluid intake

1.2.4.5. Many of the conditions can be improved and/or prevented by following a low-fat, high vegetable-fruit diet, and getting regular exercise. NOT 3 High-impact aerobics should be avoided because of the excessive downward pressure placed on organs. Educating clients will help improve their lives and possibly prevent many disorders.

A woman is to have a Papanicolaou test. When teaching the woman about this test, the nurse would emphasize which instruction to the client? 1 "Refrain from sexual intercourse for 1 week before the test." 2 "Wear cotton underwear on the day of the test." 3 "Avoid taking any medications for 24 hours." 4 "Do not douche for 48 hours before the test."

4 The nurse should instruct the woman not to douche for 48 hours before the test to prevent washing away cervical cells, which might be abnormal. NOT 1 Sexual intercourse should be avoided for 48 hours before the test. 2 Wearing cotton underwear is unrelated to preparation for a Papanicolaou test. 3 Medications do not need to be withheld before the test.

diethylstilbestrol (DES)

A synthetic form of the female hormone estrogen. It was prescribed to pregnant women between 1940 and 1971 to prevent miscarriage, premature labor, and related complications of pregnancy

Cryosurgery

destruction of tissue (HPV warts) by using extreme cold, often by using liquid nitrogen

internal cervical os

opening of cervical canal into uterine cavity

external cervical os

opening of cervical canal into vaginal cavity

Which food below is not a good source of iron? 1 milk 2 legumes 3 grains 4 beef

1 Although milk is sometimes advertised as a near-perfect food, it is not high in iron.

The nurse is caring for a client diagnosed with trichomoniasis. The health care provider has prescribed a single dose of metronidazole. Which information will the nurse provide this client? 1 "You may crush or chew this tablet if you have difficulty swallowing medications." 2 "Once you are healed, you need to come back to get the human papillomavirus (HPV) vaccination." 3 "We need to complete a pregnancy test first, to be sure you can take this medication." 4 "Avoid alcohol consumption for at least 24 hours after you take this medication."

4 Metronidazole is an antibiotic used to treat bacterial infections of the vagina. Clients should not consume alcohol or foods or medicines that contain propylene glycol while taking metronidazole and for at least 1 day after to avoid unpleasant side effects (tachycardia, flushed, nausea, vomiting). NOT 2 The HPV vaccine is not required for clients diagnosed with trichomoniasis. The nurse would educate the client that having one sexually transmitted infection (STI) places the client at higher risk for future STIs; however, the client does not have to receive the vaccine. 3 A pregnancy test is not necessary, because metronidazole is safe to take during pregnancy. 1 The nurse would instruct the client to not crush, chew, or break the extended-release tablet.

Vitamin B12 deficiency is most likely to be found in which client? 1 a vegetarian 2 an adolescent 3 a woman with a short pregnancy interval 4 a vegan

4 Vitamin B12 is almost exclusively found in foods that come from animals. Although most vegetarians eat animal products, such as dairy and eggs, vegans do not eat any animal foods. Vegans are at highest risk for vitamin B12 deficiency.

A nurse is conducting a teaching session with a group of adolescent females at a local women's health clinic. When describing appropriate screening guidelines for cervical cancer, at which age would the nurse would instruct the group to have their first Papanicolaou test? A 18 B 21 C 25 D 30

B. Although professional medical organizations disagree as to the recommended frequency of screening for cervical cancer, ACOG (2015) recommends that cervical cancer screening should begin at age 21 years (regardless of sexual history) since women younger than age 21 are at very low risk for cancer

squamous columnar junction

Point at which the squamous & columnar epithelium meet. HPV lesions appear in this area 1st. Position influenced by anatomy and hormones

A 17-year-old G2 P0010 patient develops hypertension at 32 weeks' gestation and is required to limit her intake of sodium and increase her protein intake. The client is out of work and does not attend school. Her time is spent primarily at the local shopping mall with friends. The best dietary suggestion that the home visiting nurse can make to this client is: 1 Bring water and a lunch from home rather than eating at the food court. 2 Eat salad with chicken from the food court. 3 Ice cream has protein and is available at the food court. 4 Make fewer trips to the shopping mall.

1 A teenager has a developmental need for socialization. It is an appropriate statement that most foods purchased outside the home have more sodium than foods made in the home. Salads with dressing are high in sodium, and ice cream is not an appropriate source of protein. Dietary intake is the issue of concern

The nurse is taking a diet history from a client. The client has identified the foods eaten in the last 24 hours. What should the nurse assess next? 1 portion sizes 2 amount of calories 3 which foods were fried 4 number of sodas

1 An assessment of the client's diet can identify the components that may contribute to or lessen health risks. An evaluation should include questions about portion size, food-related behaviors, and foods consumed. Many people have difficulty estimating portion size and tend to underestimate the quantity of the food they consume. A complete food assessment evaluates the client for weight loss or gain, food allergies and intolerances, alterations in the ability to digest food, eating disorders, changes in appetite, the ability to chew and swallow, and the skills and readiness of the client to implement change. If the client is having weight gain, then the nurse would want to how much daily food intake is fried and with what type of fat, along with how much sugar intake is derived from soda.

A young adult woman is admitted to the hospital with symptoms of anorexia nervosa. What information should the nurse obtain in determining the client's psychological status? 1 body perception 2 desire to gain weight 3 previous psychological trauma 4 family history

1 Anorexia nervosa is defined as an intense fear of weight gain, abnormally low weight, calorie restriction, and a distorted perception of one's body. The acute problems of low weight and calorie restriction are physiologic problems that need to be addressed first because they are a threat to the life of the client. The distorted perception of the body is a psychological problem that will need to be identified. In planning care, this need will be identified as a long-term goal. The goal is to have the client understand positive body image.

A nurse is providing education to a client who is 8 weeks' pregnant. The client stated she does not like milk. What is a source of calcium that the nurse can recommend to the client? 1 dark, leafy green vegetables 2 deep red or orange vegetables 3 white bread and rice 4 meat, poultry, and fish

1 Dark leafy green vegetables are a source of calcium. NOT 2 Red and orange vegetables contain a variety of vitamins 3 bread and rice contain carbohydrates 4 meat and fish contain protein, but none of these foods are a good source of calcium.

After a discussion on the human papillomavirus (HPV) vaccine with a parent and 15-year-old adolescent at a well-child visit, the nurse recognizes the discussion was successful when the parent makes which statement? 1 "My adolescent will need three injections over a 6-month period." 2 "My adolescent will need one injection every 5 years." 3 "One injection will give my adolescent a lifetime of protection." 4 "My adolescent will need to get a total of two injections in the next 3 months."

1 For a client 15 through 45 years of age, the HPV vaccine is given using a 3-dose schedule; the second shot should be given 2 months after the first shot and the third shot should be given 6 months after the first shot. If the client was 9 through 14 years of age, the HPV vaccine can be given using a 2-dose or 3-dose schedule. For the 2-dose schedule, the second shot should be given 6 to 12 months after the first shot. If the second shot is given less than 5 months after the first shot, a third shot should be given at least 4 months after the second shot. For the 3-dose schedule, the second shot should be given 2 months after the first shot and the third shot should be given 6 months after the first shot.

Working at the college health care clinic, the nurse recognizes the importance of educating students that the human papillomavirus has been confirmed to be the cause of essentially all cases of which type of cancer? 1 cervical 2 uterine 3 ovarian 4 vaginal

1 Prophylactic HPV vaccines are designed primarily for cervical cancer prevention. NOT 2.3.4. It plays no role in the prevention of ovarian, uterine, or vaginal cancers.

A nurse is educating a 25-year-old client with a family history of cervical cancer. Which test should the nurse inform the client about to detect cervical cancer at an early stage? 1 Papanicolaou test 2 blood tests for mutations in the BRCA genes 3 CA-125 blood test 4 transvaginal ultrasound

1 The client should have Papanicolaou tests regularly to detect cervical cancer during the early stages. NOT 2 Blood tests for mutations in the BRCA genes indicate the lifetime risk of the client of developing breast or ovarian cancer. 3 CA-125 is a biologic tumor marker associated with ovarian cancer, but it is not currently sensitive enough to serve as a screening tool. 4 The transvaginal ultrasound can be used to detect endometrial abnormalities.

The nurse is teaching a client ways to improve the diet. The nurse teaches the client that it is important to limit simple carbohydrates in the diet because these types of foods produce: 1 increased blood glucose. 2 decreased glycemic index. 3 increased insulin resistance. 4 decreased hemoglobin A1C.

1 The ingestion of simple carbohydrates such as sugar and white flour can lead to short-term spikes in the blood glucose level. NOT 2 Simple carbohydrates also produce a higher glycemic index. 4 The HgbA1C is a laboratory test that measures the levels of glucose over a 3-month time frame. 3 Simple carbohydrates will not affect insulin resistance, which is caused by the pancreas.

A 25-year-old woman is at the health care provider's office for her annual checkup. The nurse educated the woman on risks for cervical cancer. Which question would be important to ask as part of a risk screening? 1 "Were you sexually active at an early age?" 2 "Do you have a history of high blood pressure?" 3 "Have you had problems trying to get pregnant?" 4 "How long have you been severely overweight?"

1 Women that have a history of sexual activity within the first year of getting their menstrual cycle are at increased risk for cervical cancer later in life. NOT 2.3.4. Infertility, obesity, and high blood pressure put women more at risk for endometrial cancer.

A pregnant client tells the nurse that saturated fats are avoided by using vegetable oil. What additional information about vegetable oil can the nurse use to reinforce this client's decision? 1 aids in fluid balance 2 contains linoleic acid 3 stimulates kidney function 4 has a high-potassium content

2 Linoleic acid is a fat that is essential for new cell growth but cannot be manufactured by the body. Vegetable oils such as safflower, corn, olive, peanut, and cottonseed; fatty fish; omega-3-infused eggs; and omega-3-infused spreads are all good sources of linoleic acid. NOT 1.3.4. Vegetable oil does not aid in fluid balance, stimulate kidney function, or have high potassium content.

A nurse working in the Family Birthing Center is answering the nurse hotline phone. A client calls in to schedule her annual Papanicolaou test. How could the nurse best educate the client before her procedure to make sure the results are not affected? 1 Make sure the appointment is 5 days after the last menses. 2 Refrain from sexual intercourse 48 hours before testing to ensure clear results. 3 It is safe to use tampons 72 hours before testing. 4 The client may douche at least 48 hours before testing.

2 Nurses should use teaching guidelines with clients to optimize the Papanicolaou test results. Strategies to educate would include no douche, no tampons, no jellies, no spermicides, no intercourse. The optimal time for testing is 2 weeks after the first day of your last menses.

A client has been referred for a colposcopy by the primary care provider. The client wants to know more about the examination. Which information regarding a colposcopy should the nurse give to the client? 1 Client may feel pain in the vaginal area during the examination. 2 The test is conducted because of abnormal results in a Papanicolaou test. 3 Intercourse should be avoided for at least 1 week afterward. 4 Client may experience pain during urination for a week following the test.

2 The nurse should explain to the client that the colposcopy is done because the care provider has observed abnormalities in the Papanicolaou test results. The nurse should also explain to the client that the procedure is painless and there are no adverse effects, such as pain during urination. There is no need to avoid intercourse for a week after the colposcopy.

The nurse is educating a female client diagnosed with human papillomavirus (HPV). Which information will the nurse include in the client's education plan? 1 "You will be prescribed an antiviral medication to take that will clear your infection." 2 "Your best option is to surgically remove genital warts to prevent you from spreading the disease." 3 "You should be sure to receive consistent testing for cervical cancer." 4 "During colder weather, you will note more outbreaks than during warmer weather."

3 An infection with HPV is a risk factor for developing cervical cancer. Women with a history of HPV should receive consistent testing/screening for cervical cancer. NOT 1 HPV is a virus; however, no antiviral to date resolves the virus in the body. 2 Surgical removal is an option for genital warts; however, it is not the best option as the virus can still be spread without the presence of warts. Wart removal is done for comfort and appearance. 4 Outbreaks are most noted during times of stress or illness and trauma; outbreaks are not temperature related.

A 30-year-old female is attending a health fair for women. The nurse at the fair is reviewing risk factors for cervical cancer. Which important risk factor should the nurse include at the fair? 1 one life partner 2 first intercourse after age 25 3 exposure to diethylstilbestrol (DES) in utero 4 protected sexual intercourse

3 Cervical cancer has several risk factors: early age of first intercourse (in first year of menarche), lower socioeconomic status, unprotected sex, family history of cervical cancer, exposure to DES in utero, HIV, use of oral contraceptives, HPV, and multiple male partners.

A nurse is conducting an in-service program for a group of nurses about cervical cancer. The nurse determines that the teaching was successful when the group identifies which area as most commonly involved? 1 internal cervical os 2 junction of the cervix and fundus 3 squamous-columnar junction 4 external cervical os

3 Cervical cancer starts with abnormal changes in the cellular lining or surface of the cervix. Typically these changes occur in the squamous-columnar junction of the cervix. Here, cylindrical secretory epithelial cells (columnar) meet the protective flat epithelial cells (squamous) from the outer cervix and vagina in what is termed the transformation zone.

A nurse will be speaking at a local high school about women's health. The nurse is planning to talk about sexually transmitted infections (STIs) as well as routine checks, along with guidelines for Papanicolaou testing. What should the nurse include in the Papanicolaou test guidelines about when to have a first test? 1 at the age of 16 2 2 years after first sexual intercourse 3 at the age of 21 or within 3 years of first sexual intercourse 4 at the age of 18 or within 2 years of first sexual intercourse

3 Pap testing recommend that the first Pap test is done at age 21 or within 3 years of first sexual intercourse. Other guidelines state that the tests should be done yearly until age 30 using the glass slide method and every 2 years using liquid-based method. At age 30 to 70, the tests should be done every 2 to 3 years if the previous three Papanicolaou tests were normal. They may be discontinued after age 70 if the previous three Papanicolaou tests were normal and no Papanicolaou tests in the previous 10 years were abnormal.

The nurse instructs a pregnant client on the need to increase foods containing folic acid. Which client statement indicates that teaching has been effective? 1 "Eating an extra orange a day is important." 2 "I need to drink two glasses of milk each day." 3 "I will add spinach to my salad every evening." 4 "Cabbage and cauliflower are important for me to eat."

3 The client should be instructed to eat foods that are high in folic acid such as spinach, asparagus, and legumes. Adding spinach every day to the evening salad indicates that teaching about folic acid nutrition has been effective. NOT 1.2.4. Oranges, milk, cabbage, and cauliflower are not food items that will specifically influence the folic acid level.

A client with a family history of cervical cancer is to undergo a Papanicolaou test. During the client education, what group should the nurse include as at risk for cervical cancer? 1 clients with irregular menstrual cycles 2 clients who have not had babies 3 clients who have genital warts 4 clients with fibrocystic breast disease

3 The presence of genital warts (condyloma) increases the risk of developing cervical cancer. NOT 1 Women with metrorrhagia or irregular menstrual cycles are at an increased risk of developing breast cancer, not cervical cancer. 2.4. Clients who have never had a baby or those with a history of fibrocystic breast disease have an increased risk of developing breast cancer, but not cervical cancer.