Exam 3 Nurs 351

A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know if it is safe for her to have a drink with dinner now. The nurse would tell her: "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy." "One drink every night is too much. One drink three times a week should be fine." "Since you're in your second trimester, there's no problem with having one drink with dinner." "Since you're in your second trimester, you can drink as much as you like."

"Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy."

The nurse is planning to teach a class of expectant couples about the typical progression of feelings when establishing a relationship with the fetus. Which would the nurse most likely expect to hear from the pregnant woman? "I am pregnant," "I am going to have a baby," and then "I am going to be a mother." "I fantasize about the child's gender and personality," "I view the child as part of myself," and then "I have become introspective." "I see the child as part of myself," "I have feelings of well-being," and then "I accept the biologic fact of pregnancy." "I accept the fetus as distinct from myself,"I accept the biologic fact of pregnancy," and then "I have a feeling of caring and responsibility."

"I am pregnant," "I am going to have a baby," and then "I am going to be a mother."

After the nurse teaches the patient who has primary genital herpes about management of the disease, which statement by the patient indicates that the teaching has been effective? "I will need to take all of the medication to be sure the infection is cured." Correct "I will take the acyclovir (Zovirax) every 8 hours for the next week." "I will use condoms for intercourse until the medication is all gone." "I will use the acyclovir ointment on the area to relieve the pain.

"I will take the acyclovir (Zovirax) every 8 hours for the next week."

What is the HP 2020 goal of family planning/contraception?

"Improve pregnancy planning and spacing, and prevent unintended pregnancy"

A patient hospitalized for depression will be discharged tomorrow. The patient asks a nurse, "Could the two of us meet for coffee away from the hospital sometime?" The most therapeutic response by the nurse would be: "The hospital has a policy that does not allow professional staff to date patients." Correct "We've developed a positive working relationship, and meeting socially would have a negative impact on that relationship." "I guess there would be no harm in meeting for coffee, if we know in advance that we're meeting just as friends." "That sounds nice, but I'm already in a romantic relationship with someone."

"We've developed a positive working relationship, and meeting socially would have a negative impact on that relationship."

What are risk factors of sexual dysfunction?

-Adolescents, esp. LGBTQ teens -Intellectual/developmental disabilities -Newly unpartnered -unsafe sexual practices

What are health people 2020 goals of primary prevention for sexuality?

-Adolescents: increase education, abstinence, or protection use; reduce pregnancies -Reduce all STIs -Vaccinations to reduce HPV

What are risk factors of reproduction?

-Biophysical: age, genetic, nutrition, disorders -Sociodemographic: income, location, ethnic -Environmental: exposures, infections, stress -Psychosocial: lifestyles and mental health

What is the PLISSIT model?

-Counseling of sexual dysfunction -P(ermission): encourage discussion of concerns -LI (limited information) teaching -SS (specific suggestions) may provide simple ideas -IT (intensive therapy) requires further training and time

What history topics do you want to assess about with sexuality?

-Current nutrition and medical conditions -current medications, including vaccinations -Menstrual history -Mental health status -Type/frequency of sexual activity/partners -Safe sex practices and infection exposures -Exposure to sexual abuse violence

What are examples of nursing diagnoses?

-Deficient knowledge/anxiety/coping -Imbalanced nutrition/nausea -Effective/ineffective childbearing processes -Acute pain/impaired urinary elimination -Ineffective breastfeeding/infant feeding

How often are prenatal visits?

-Every 4 weeks for the first two trimesters -every 2 weeks ffom 28-36 weeks -Ever week until birth

What are fertility awareness methods?

-How effective is it? -How do we use it? -What are the advantages? -What are the disadvantages? -What else do we need to know?

What does physical assessment of sexuality consist of?

-Inspect genitalia and rectal areas -Providers: pelvic exam and digital rectal exam

What are types of sexual dysfunction?

-Reduced sexual desire -impaired sexual arousal -erectile dysfunction in men -lack of lubrication or dryness and coital discomfort in women -lack of subjective pleasure -delayed anorgasmia in men -difficulty reaching orgasm or anorgasmia in women -painful intercourse, including vaginismus -sexual aversion

What is secondary prevention of sexuality dysfunction?

-Routine (annual) screening of all sexually active individuals for STIs, including chlamydia, HIV and cervical cancer -Treatment of common conditions

What are the nursing interventions for preconception care?

-Screen for teratogenic risks, recommend interventions to reduce risks (which substances should be avoided, which activities should be avoided?)

What is tertiary prevention of sexuality dysfunction?

-Treatment: pharmacological, surgical for erectile dysfunction, menopausal symptoms, management of chronic conditions affecting sexuality

What is included in the baseline pelvic exam?

-Vaginal cultures: gonorrhea and chlamydia -Pap smear: cervical cancer -Chadwick's sign: bluish color of the vagina -Goodell's sign: softening of the cervic -Hagar's sign: softening of the uterus -Ballottement: rebounding of a fetus

What are biological risk factors of STIs?

-asymptomatic nature of STIs -gender disparities -age disparities -lag time b/w infection and complications

What are options of nursing diagnoses for impaired sexuality?

-ineffective health maintenance' -Risk of infection -Anxiety -Ineffective individual or family coping

What are the cons of the implant (nexplanon)?

-irregular bleeding, after 1 year, no period, does not protect against HIV or STIs

`What are risk factors of sexual dysfunction?

-older age -chronic conditions -certain medications -depression or anxiety -acute conditions -obesity or lack of conditioning -alcohol, drug, or tobacco use -Pregnancy and breastfeeding

What are diagnostic tests for pregnancy?

-pregnancy test: HcG hormone in blood or uring -Blood type and RH (IG if Rh is negative) -Complete blood count (CBC) -Infections: rubella, syphilis, heb B, HIV, TB -Urinalysis: NO RBCs, WBCs, protein, ketones

A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravidity and parity using the GTPAL system? _____.

0. 3-1-0-1-0 Using the GPTAL system, this woman's gravidity and parity information is calculated as follows: G: Total number of times the woman has been pregnant (she is pregnant for the third time) T: Number of pregnancies carried to term (she has one stillborn) P: Number of pregnancies that resulted in a preterm birth (she has none) A: Abortions or miscarriages before the period of viability (she has had one) L: Number of children born who are currently living (she has no living children)

What is the normal weight gain in pregnancy for 1st trimester?

1 lb/month

What is the normal weight gain in pregnancy for 2nd trimester?

1 lb/week

What is the normal weight gain in pregnancy for 3rd trimester?

1 lb/week

A pregnant woman is the mother of two children. Her first pregnancy ended in a still birth at 32 weeks of gestation, her second pregnancy with the birth of her daughter at 36 weeks, and her third pregnancy with the birth of her son at 41 weeks. Using the 5-digit system to describe this woman's current obstetric history, the nurse would record ____________________________.

1. 4-1-2-0-2 Gravida (the first number) is 4 since this woman is now pregnant and was pregnant 3 times before. Para (the next 4 numbers) represents the outcomes of the pregnancies and would be described as: 4T: 1 = Term birth at 41 weeks of gestation (son) 4P: 2 = Preterm birth at 32 weeks of gestation (stillbirth) and 36 weeks of gestation (daughter) 4A: 0 = Abortion: none occurred 4L: 2 = Living children: her son and her daughter

A pregnant woman's last menstrual period began on April 8, 2009, and ended on April 13. Using Nägele's rule, her estimated date of birth would be________.

1. January 15, 2010. Nägele's rule requires subtracting 3 months and adding 7 days and 1 year if appropriate to the first day of a pregnant woman's last menstrual period. When this rule is used with April 8, 2009, the estimated date of birth is January 15, 2010.

What is the normal fetal heart rate?

110-160 bpm

What are the normal HGB levels for women?

12-16 g/dL

What is pelvic inflammatory disease?

15-40% of women with chlamydia develop PID, 10-15% will become infertile, and 18% will develop chronic pelvic pain

What is the normal weight gain?

25-35 pounds for normal BMI

How many calories do you add during 2nd trimester?

340 kcal/day

What are the normal HCT levels for women?

36-46%

When is the embryo an embryo?

3rd-8th week: all major organs and systems are formed

How many calories do you add during 3rd trimester?

452 kcal/day

When is the fetus a fetus?

9 weeks until birth

What are the pros of the implant Nexplanon?

>99% effective, long lasting (3 years), decreases cramps, use while breastfeeding, can become pregnant right after it is removed

What are the pros of Progestin IUD (Liletta, Mirena, Skyla)?

>99% effective, up to 7/3 years, no pill, may improve period cramps, can be used while breastfeeding, can become pregnant right after.

After a pregnant woman has learned that her fetus has a mild neural tube defect, she asks the nurse what happened. Which is the best response by the nurse? A. "We are not totally sure what causes it." B. "You must not have eaten enough protein." C. "Why don't you ask the doctor about it." D. "The baby did not form midway through."

A

Which suggestions should the nurse include when teaching about appropriate weight gain in pregnancy? (Select all that apply.) A. Underweight women should gain 12.5 to 18 kg. B. Obese women should gain at least 7 to 11.5 kg. C. Adolescents are encouraged to strive for weight gains at the upper end of the recommended scale. D. In twin gestations, the weight gain recommended for a single fetus pregnancy should simply be doubled. E. Normal weight women should gain 11.5 to 16 kg.

A, B, C, E

The nurse is developing a dietary teaching plan for a patient on a vegetarian diet. The nurse should provide the patient with which examples of protein containing foods? (Select all that apply.) A. Dried beans B. Seeds C. Peanut butter D. Bagel E. Eggs

A, B, C, E. All of the foods listed except a bagel provide protein. A bagel is an example of a whole grain food, not protein.

What should teaching for patients with a sexually transmitted infection (STI) include (select all that apply.)? A. Treatment of sexual partners B. Douching may help to provide relief of itching. C. Importance of retesting after treatment to confirm cure D. Cotton undergarments are preferred over synthetic materials. E. Sexual abstinence is indicated during the communicable phase of the disease. F. Condoms should be used during as well as after treatment during sexual activity.

A, C, D, E, F. Teaching for patients with an STI should include the treatment of all sexual partners, retesting after treatment to confirm cure, cotton undergarments are more comfortable, sexual abstinence is needed during the communicable phase of the infection to prevent spread, and condoms should be used for sexual activity during and after treatment to prevent spread and reinfection. Douching may spread the infection or alter the local immune responses and is therefore contraindicated in patients with STIs

A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a: A. primipara. B. primigravida. C. multipara. D. nulligravida.

A. A primipara is a woman who has completed one pregnancy with a viable fetus. To remember terms, keep in mind that gravida is a pregnant woman; para comes from parity, meaning a viable fetus; primi means first; multi means many; and null means none. A primigravida is a woman pregnant for the first time. A multipara is a woman who has completed two or more pregnancies with a viable fetus. A nulligravida is a woman who has never been pregnant.

During a client's physical examination, the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as the: A. Hegar sign. B. McDonald sign. C. Chadwick sign. D. Goodell sign.

A. At approximately 6 weeks of gestation, softening and compressibility of the lower uterine segment occur; this is called the Hegar sign. The McDonald sign indicates a fast-food restaurant. The Chadwick sign is a blue-violet cervix caused by increased vascularity; this occurs around the fourth week of gestation. Softening of the cervical tip is called the Goodell sign, which may be observed around the sixth week of pregnancy.

A patient comes to the clinic after being informed by a sexual partner of possible recent exposure to syphilis. The nurse will examine the patient for what characteristic finding of syphilis in the primary clinical stage? A. Chancre B. Alopecia C. Condylomata lata D. Regional adenopathy

A. Chancres appear in the primary stage of the bacterial invasion of Treponema pallidum, the causative organism of syphilis. The other findings do not appear until the secondary stage of syphilis, occurring a few weeks after the chancres appear.

The CDC-recommended medication for the treatment of chlamydia would be: A. doxycycline. B. podofilox. C. acyclovir. D. penicillin.

A. Doxycycline is effective for treating chlamydia, but it should be avoided if the woman is pregnant. Podofilox is a recommended treatment for nonpregnant women diagnosed with human papilloma virus infection. Acyclovir is recommended for genital herpes simplex virus infection. Penicillin is not a CDC-recommended medication for chlamydia; it is the preferred medication for syphilis.

With regard to protein in the diet of pregnant women, nurses should be aware that: A. many protein-rich foods are also good sources of calcium, iron, and b vitamins. B. many women need to increase their protein intake during pregnancy. C. as with carbohydrates and fat, no specific recommendations exist for the amount of protein in the diet. D. high-protein supplements can be used without risk by women on macrobiotic diets.

A. Good protein sources such as meat, milk, eggs, and cheese have a lot of calcium and iron. Most women already eat a high-protein diet and do not need to increase their intake. Protein is sufficiently important that specific servings of meat and dairy are recommended. High-protein supplements are not recommended because they have been associated with an increased incidence of preterm births.

A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. The nurse would be most concerned regarding what this woman consumes during and after tennis matches. Which is the MOST important? A. Several glasses of fluid B. Extra protein sources, such as peanut butter C. Salty foods to replace lost sodium D. Easily digested sources of carbohydrate

A. If no medical or obstetric problems contraindicate physical activity, pregnant women should get 30 minutes of moderate physical exercise daily. Liberal amounts of fluid should be consumed before, during, and after exercise, because dehydration can trigger premature labor. Also the woman's calorie intake should be sufficient to meet the increased needs of pregnancy and the demands of exercise. All pregnant women should consume the necessary amount of protein in their diet, regardless of level of activity. Many pregnant women of this gestation tend to retain fluid. This may contribute to hypertension and swelling. An adequate fluid intake prior to and after exercise should be sufficient. The woman's calorie and carbohydrate intake should be sufficient to meet the increased needs of pregnancy and the demands of exercise.

The nurse must evaluate a male patient's knowledge regarding the use of a condom. The nurse would recognize the need for further instruction if the patient states that he: A lubricates the condom with a spermicide containing nonoxynol-9. B. leaves an empty space at the tip of the condom. C. leaves a small amount of air in the tip. D. removes his still-erect penis from the vagina while holding onto the base of the condom.

A. Nonoxynol-9 is no longer recommended. Recent data suggest that frequent use of nonoxynol-9 may increase human immunodeficiency virus transmission and can cause genital lesions. An empty space at the tip of the condom is the correct instruction. Leaving a small amount of air at the tip of the condom is the correct instruction. Removing the condom while holding the base is the correct instruction.

1. When planning a diet with a pregnant woman, the nurse's FIRST action would be to: A. review the woman's current dietary intake. B. teach the woman about the food pyramid. C. caution the woman to avoid large doses of vitamins, especially those that are fat-soluble. D. instruct the woman to limit the intake of fatty foods.

A. Reviewing the woman's dietary intake as the first step will help to establish if she has a balanced diet or if changes in the diet are required. These are correct actions on the part of the nurse, but the first action should be to assess the patient's current dietary pattern and practices since instruction should be geared to what she already knows and does.

With regard to medications, herbs, shots, and other substances normally encountered, the maternity nurse should be aware that: A. prescription and over-the-counter (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus. B. the greatest danger of drug-caused developmental deficits in the fetus is seen in the final trimester. C. killed-virus vaccines (e.g., tetanus) should not be given during pregnancy, but live-virus vaccines (e.g., measles) are permissible. D. no convincing evidence exists that secondhand smoke is potentially dangerous to the fetus.

A. This is especially true for new medications and combinations of drugs. The greatest danger of drug-caused developmental defects exists in the interval from fertilization through the first trimester, when a woman may not realize that she is pregnant. Live-virus vaccines should be part of postpartum care; killed-virus vaccines may be administered during pregnancy. Secondhand smoke is associated with fetal growth restriction and increases in infant mortality.

A young male patient is seeking treatment for recurrence of genital tingling, burning, and itching. The nurse will expect a prescription for which class of medications? A. Antivirals B. Antibiotics C. Vaccination D. Contraceptives

A. This patient is experiencing a reoccurrence of genital herpes (HSV2). Although not a cure, he will be treated with antiviral medications to decrease the duration of viral shedding and the healing time of genital lesions and reduce outbreaks. Antibiotics and contraceptives are not used to treat acute HSV2. There are no vaccinations for HSV.

What do you assess in newborn?

ABCs, temperature, and feeding

What is readiness for advanced family processes?

Accepting the pregnancy and feeling supported

The nurse caring for the newly pregnant woman would advise her that ideally prenatal care should begin: Before the first missed menstrual period. After the first missed menstrual period. After the second missed menstrual period. At 20 weeks when the pregnancy is viable.

After the first missed menstrual period.

Which medications or types of medications are known to have sexual side effects? SSRIs, digoxin, cimetidine Amphetamines, anticonvulsants, diuretics Lipid-lowering agents, beta blockers, oral contraceptives All of the above

All of the above

Which of these patients will the nurse plan on teaching about the Gardasil vaccine? An 18-year-old female who has never been sexually active A 23-year-old woman who is pregnant for the first time A 28-year-old woman who is in a monogamous relationship A 50-year-old woman who has multiple sexual partners

An 18-year-old female who has never been sexually active

A woman's obstetric history indicates that she is pregnant for the fourth time and all of her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system?

Answer: G 4, T 1, P 3, A 0, L 4 She has conceived 4 pregnancies. She had 1 infant at term. She had the twins at 34 weeks and a single pregnancy at 35 weeks, so 3 preterm outcomes. She had 0 pregnancies that lasted less than 20 weeks. She has 4 living children (1 set of twins and 2 single pregnancies).

KH is currently pregnant. She had a therapeutic abortion at 6 weeks' gestation, and a miscarriage at 10 weeks gestation. She gave birth to an infant at 36 weeks gestation, who was stillborn, and had a baby at 22 weeks gestation that lived for 20 minutes. She has a 3 year-old girl at home who was born at term and 7 year-old twin boys who were born "6 weeks early." Using TPAL, how would you record this obstetric history now? G___ T___ P___ A___ L___

Answer: G 7, T 1, P 4, A 2, L 3 She has conceived 7 pregnancies (the twins count as one conception). She had 1 baby born at term. She had 4 preterm outcomes (36 weeks, 22 weeks, and 2 babies at 34 weeks). She had 2 abortions (one therapeutic abortion and one spontaneous abortion). She has 3 living children.

A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravidity and parity using both the GP and the GTPAL system?

Answer: Gravida 3 Para 1 or G 3, T 1, P 0, A 1, L 0 (also written as 1-0-1-0) She has conceived 3 pregnancies, so she is gravida 3. She had 1 pregnancy grow past 20 weeks, so she is para 1. For the TPAL system, she had 1 pregnancy end at term, 0 pregnancies end at preterm (20 up to 37 weeks), 1 pregnancy end before viability (less than 20 weeks), and 0 living children.

A few hours ago, a woman delivered a live girl at 42 weeks gestation. She had a boy at 28 weeks last year, who is still living. She had one therapeutic abortion at 10 weeks a few years ago. Also, she adopted her nephew when he was a baby. Using the G-TPAL acronym to document her pregnancies, she would be:

Answer: Gravida 3, TPAL 1-1-1-2 She has conceived 3 times (not currently pregnant). She had 1 baby at term (although post-term, it counts as making it past the 37 weeks.) She had 1 preterm outcomes. She had 1 abortion (in this case, therapeutic). She has 2 living biologic children (the adopted child would need to be noted separately).

What are the two questions you ask when assessing sexuality?

Are you currently involved in a sexual relationship? Are your partners men, women, or both?

A patient who has labs drawn for an insurance screening has a positive Venereal Disease Research Laboratory (VDRL) test. Which action should the nurse take next? Ask the patient about past treatment for syphilis. Discuss the need for blood and spinal fluid cultures. Obtain a specimen for fluorescent treponemal antibody absorption (FAT-ABS) testing. Assess for the presence of chancres, flulike symptoms, or a bilateral rash on the trunk.

Ask the patient about past treatment for syphilis.

A healthy pregnant patient has completed her prenatal visit at 28 weeks gestation. When should the nurse instruct her to return to the clinic for the next regular visit? A. In one week B. In two weeks C. In four weeks D. In six weeks

B

10. The nurse should include which information when teaching a 15-year-old about genital tract infection prevention? (Select all that apply.) A. Wear nylon undergarments. B. Avoid tight-fitting jeans. C. Use floral scented bath salts. D. Decrease sugar intake. E. Do not douche. F. Limit time spent wearing a wet bathing suit.

B, D, E, F Correct Feedback: Patient teaching for the prevention of genital tract infections in women includes the following guidelines: • Practice genital hygiene. • Choose underwear or hosiery with a cotton crotch. • Avoid tight-fitting clothing (especially tight jeans). • Select cloth car seat covers instead of vinyl. • Limit the time spent in damp exercise clothes (especially swimsuits, leotards, and tights). • Limit exposure to bath salts or bubble bath. • Avoid colored or scented toilet tissue. • If sensitive, discontinue use of feminine hygiene deodorant sprays. • Use condoms. • Void before and after intercourse. • Decrease dietary sugar. • Drink yeast-active milk and eat yogurt (with lactobacilli). • Do not douche. Incorrect Feedback: Patient teaching for the prevention of genital tract infections in women includes the following guidelines: • Practice genital hygiene. • Choose underwear or hosiery with a cotton crotch. • Avoid tight-fitting clothing (especially tight jeans). • Select cloth car seat covers instead of vinyl. • Limit the time spent in damp exercise clothes (especially swimsuits, leotards, and tights). • Limit exposure to bath salts or bubble bath. • Avoid colored or scented toilet tissue. • If sensitive, discontinue use of feminine hygiene deodorant sprays. • Use condoms. • Void before and after intercourse. • Decrease dietary sugar. • Drink yeast-active milk and eat yogurt (with lactobacilli). • Do not douche.

A nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates an understanding of the nurse's instructions if she states that a positive sign of pregnancy is: A. a positive pregnancy test. B. fetal movement palpated by the nurse-midwife. C. Braxton Hicks contractions. D. quickening.

B. A positive pregnancy test is a probable sign of pregnancy. Positive signs of pregnancy are those that are attributed to the presence of a fetus, such as hearing the fetal heartbeat or palpating fetal movement. Braxton Hicks contractions are a probable sign of pregnancy. Quickening is a presumptive sign of pregnancy.

A pregnant woman with a body mass index (BMI) of 22 asks the nurse how she should be gaining weight during pregnancy. The nurse's BEST response would be to tell the woman that her pattern of weight gain should be approximately: A. a pound a week throughout pregnancy. B. 2 to 5 lbs during the first trimester, then a pound each week until the end of pregnancy. C. a pound a week during the first two trimesters, then 2 lbs per week during the third trimester. D. a total of 25 to 35 lbs.

B. A pound a week is not the correct guideline during pregnancy. A BMI of 22 represents a normal weight. Therefore, a total weight gain for pregnancy would be about 25 to 35 lbs or about 2 to 5 lbs in the first trimester and about 1 lb/wk during the second and third trimesters. These are not accurate guidelines for weight gain during pregnancy. The total is correct, but the pattern needs to be explained.

A pregnant woman experiencing nausea and vomiting should: A. drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning. B. eat small, frequent meals (every 2 to 3 hours). C. increase her intake of high-fat foods to keep the stomach full and coated. D. limit fluid intake throughout the day.

B. A pregnant woman experiencing nausea and vomiting should avoid consuming fluids early in the day or when nauseated. This is a correct suggestion for a woman experiencing nausea and vomiting. A pregnant woman experiencing nausea and vomiting should reduce her intake of fried foods and other fatty foods. A pregnant woman experiencing nausea and vomiting should avoid consuming fluids early in the morning or when nauseated but should compensate by drinking fluids at other times.

When providing care to a young single woman just diagnosed with acute pelvic inflammatory disease, the nurse should: A. point out that inappropriate sexual behavior caused the infection. B. position the woman in a semi-Fowler position. C. explain to the woman that infertility is a likely outcome of this type of infection. D. tell her that antibiotics need to be taken until pelvic pain is relieved.

B. Although sexual behavior may have contributed to the infection, the nurse must discuss these practices in a nonjudgmental manner and provide information about prevention measures. The position of comfort is the semi-Fowler position. In addition, the foot of the bed could be elevated to keep the uterus in a dependent position and reduce discomfort. Until treatment is complete and healing has occurred, the outcome is unknown and should not be suggested. The nurse should emphasize that medication must be continued until follow-up assessment indicates that the infection has been treated successfully.

A woman who is 32 weeks pregnant is informed by the nurse that a danger sign of pregnancy could be: A. constipation. B. alteration in the pattern of fetal movement. C. heart palpitations. D. edema in the ankles and feet at the end of the day.

B. Constipation is a normal discomfort of pregnancy that occurs in the second and third trimesters. An alteration in the pattern or amount of fetal movement may indicate fetal jeopardy. Heart palpitations are a normal change related to pregnancy. This is most likely to occur during the second and third trimesters. As the pregnancy progresses, edema in the ankles and feet at the end of the day is not uncommon.

A pregnant woman at 7 weeks of gestation complains to her nurse midwife about frequent episodes of nausea during the day with occasional vomiting. She asks what she can do to feel better. The nurse midwife could suggest that the woman: A. drink warm fluids with each of her meals. B. eat a high-protein snack before going to bed. C. keep crackers and peanut butter at her bedside to eat in the morning before getting out of bed. D. schedule three meals and one midafternoon snack a day.

B. Fluids should be taken between (not with) meals to provide for maximum nutrient uptake in the small intestine. A bedtime snack of slowly digested protein is especially important to prevent the occurrence of hypoglycemia during the night that would contribute to nausea. Dry carbohydrates such as plain toast or crackers are recommended before getting out of bed. Eating small, frequent meals (about five or six each day) with snacks helps to avoid a distended or empty stomach, both of which contribute to the development of nausea and vomiting.

A male client asks the nurse why it is better to purchase condoms that are not lubricated with nonoxynol-9 (a common spermicide). The nurse's most appropriate response is: A. "The lubricant prevents vaginal irritation." B. "Nonoxynol-9 does not provide protection against sexually transmitted infections, as originally thought; also it has been linked to an increase in the transmission of human immunodeficiency virus (HIV) and can cause genital lesions." C. "The additional lubrication improves sex." D. "Nonoxynol-9 improves penile sensitivity."

B. Nonoxynol-9 may cause vaginal irritation. This is a true statement. Nonoxynol-9 has no effect on the quality of sexual activity. Nonoxynol-9 has no effect on penile sensitivity

The patient is being treated for a recurrent episode of Chlamydia. What should the nurse include in patient teaching? A. If you are treated, your sexual partner will not need to be treated. B. Abstain from sexual intercourse for 7 days after finishing the treatment. C. You will probably get gonorrhea if you have another recurrence of Chlamydia. D. Because you have been treated before, you do not need to take a full course of medication this time.

B. Patients treated for Chlamydia infections should abstain from sexual intercourse for 7 days after treatment until all sexual partners have completed a full course of treatment to prevent recurrence, and a follow-up culture is done. A single-dose treatment is also available. Because Chlamydia and gonococcal infections are closely associated, they are frequently both treated, but having Chlamydia does not give the patient gonorrhea. Each time a patient is treated for Chlamydia, a full course of treatment is required.

A 52-yr-old man with a primary infection of genital herpes was prescribed acyclovir (Zovirax) orally for 10 days. The patient returns to the clinic for a follow-up visit. Which finding indicates that treatment is effective? A. Negative bacterial culture B. Absence of genital lesions C. Reduction of genital warts D. No drainage from chancre sore

B. Primary genital herpes is a viral disorder caused by the herpes simplex virus. Genital herpes results in painful, vesicular lesions. The lesions rupture, form crusts, and heal in 17 to 21 days. Genital warts are caused by the human papillomavirus. Genital herpes is caused by a viral infection (not bacterial). Syphilis is caused by a bacterial organism and results in a chancre, which is a painless, indurated lesion.

Women with an inadequate weight gain during pregnancy are at higher risk of giving birth to an infant with: A. spina bifida. B. intrauterine growth restriction. C. diabetes mellitus. D. Down syndrome.

B. Spina bifida is not associated with inadequate maternal weight gain. An adequate amount of folic acid has been shown to reduce the incidence of this condition. Both normal-weight and underweight women with inadequate weight gain have an increased risk of giving birth to an infant with intrauterine growth restriction. Diabetes mellitus is not related to inadequate weight gain. A gestational diabetic mother is more likely to give birth to a large-for-gestational age infant. Down syndrome is the result of a trisomy 21, not inadequate maternal weight gain.

Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester? A. Less audible heart sounds (S1, S2) B. Increased pulse rate C. Increased blood pressure D. Decreased red blood cell (RBC) production

B. Splitting of S1 and S2 is more audible. Between 14 and 20 weeks of gestation, the pulse increases about 10 to 15 beats/min, which persists to term. In the first trimester blood pressure usually remains the same as the prepregnancy level, but it gradually decreases up to about 20 weeks of gestation. During the second trimester both the systolic and diastolic pressures decrease by about 5 to 10 mm Hg. Production of RBCs accelerates during pregnancy.

When assessing the fetal heart rate (FHR) of a woman at 30 weeks of gestation, the nurse counts a rate of 82 beats/min. Initially the nurse should: A. recognize that the rate is within normal limits and record it. B. assess the woman's radial pulse. C. notify the physician. D. allow the woman to hear the heartbeat.

B. The expected FHR is 120 to 160 beats/min. The nurse may have inadvertently counted the uterine souffle, the beatlike sound of blood flowing through the uterine blood vessels, which corresponds to the mother's heartbeat. The physician should be notified if the FHR is confirmed to be 82 beats/min. Allow the woman to hear the heart beat as soon as a full assessment is made.

If exhibited by an expectant father, what would be a warning sign of ineffective adaptation to his partner's first pregnancy? A. Views pregnancy with pride as a confirmation of his virility B. Consistently changes the subject when the topic of the fetus/newborn is raised C. Expresses concern that he might faint at the birth of his baby D. Experiences nausea and fatigue, along with his partner, during the first trimester

B. This is an expected view for an expectant father. Persistent refusal to talk about the fetus-newborn may be a sign of a problem and should be assessed further. This is an expected feeling for an expectant father. This is an expected finding with expectant fathers.

The nurse administers a Gardasil vaccine to an 18-yr-old female patient. After the injection, which patient instruction is priority? A. Avoid sexual activity for 24 to 48 hours. B. Remain lying down for at least 15 minutes. C. Return to the clinic in 6 months for a second dose. D. Use two methods of birth control to avoid pregnancy.

B. To prevent syncope (fainting) during and after the administration of Gardasil, the patient should remain sitting or lying down for 15 minutes. The vaccine is not recommended during pregnancy. Gardasil vaccine is given in three IM doses over a 6-month period. There are no sexual activity restrictions after administration of Gardasil.

A 22-yr-old man is being treated at a college health care clinic for gonorrhea. What should the nurse include in patient teaching? A. "While being treated for the infection, you will not be able to pass this infection on to your sexual partner." B. "While you're taking the antibiotics, you will need to abstain from participating in sexual activity and drinking alcohol." C. "It's important to complete your full course of antibiotics in order to ensure that you become resistant to reinfection." D. "The symptoms of gonorrhea will resolve on their own, but it is important for you to abstain from sexual activity while this is occurring."

B. Treatment for gonorrhea necessitates abstinence from sexual activity (to prevent infection of partners) and alcohol (to avoid urethral irritation). The disease is not self-limiting, nor does successful treatment confer future resistance.

With regard to nutritional needs during lactation, a maternity nurse should be aware that: A. the mother's intake of vitamin C, zinc, and protein now can be lower than during pregnancy. B. caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful. C. critical iron and folic acid levels must be maintained. D. lactating women can go back to their prepregnant calorie intake.

B. Vitamin C, zinc, and protein levels need to be moderately higher during lactation than during pregnancy. A lactating woman needs to avoid consuming too much caffeine. The recommendations for iron and folic acid are somewhat lower during lactation. Lactating women should consume about 500 kcal more than their prepregnancy intake, at least 1800 kcal daily overall

What is the antepartum period?

Before childbirth

What are the goals of preconception care?

Birth defects, fetal loss, preterm birth, and low birth weight

In adults between 18 and 59 years of age, what percentage report sexual dysfunction? >30% of men >40% of women Both of the above None of the above

Both of the above Expect that many cases are unreported or attributed to "normal" changes with aging. Incidence does increase with age. Highest risk for sexual dysfunction is seen in persons with chronic medical conditions and in menopausal women.

In working with teenagers, what should the nurse include when teaching about prevention of STIs? A. Spermicidal jellies reduce the risk of getting STIs. B. STIs are easily cured so prevention is not important. C. Abstinence and then condoms are the best prevention. D. Douches for women and cleaning the penis will prevent STIs.

C. Abstinence and then condom use are the best prevention of STIs. Spermicidal jellies or creams do not reduce the risk of contracting STIs. Most STIs are curable, but complications are serious and costly if they are not cured. Douches may spread the infection, undermine local immune responses, and do not prevent STIs. Cleansing of the penis will provide comfort after an STI has been diagnosed but will not prevent STIs.

The history and physical of a 29-yr-old female patient are indicative of human papillomavirus (HPV) infection. What treatment option should be discussed with the patient? A. Gardasil B. Antibiotic therapy C. Wart removal options D. Treatment with antiviral drugs

C. Although discussion should focus on the various options for physically removing the symptomatic warts, the removal may or may not decrease infectivity. The HPV vaccine (Gardasil) is ineffective in cases of existing HPV, and neither antiviral nor antibiotic drugs are effective treatments.

An expectant father confides in the nurse that his pregnant wife, 10 weeks of gestation, is driving him crazy. "One minute she seems happy, and the next minute she is crying over nothing at all. Is there something wrong with her?" The nurse's BEST response would be: A. "This is normal behavior and should begin to subside by the second trimester." B. "She may be having difficulty adjusting to pregnancy; I will refer her to a counselor that I know." C. "This is called emotional liability and is related to hormone changes and anxiety during pregnancy. The mood swings will eventually subside as she adjusts to being pregnant." D. "You seem impatient with her. Perhaps this is precipitating her behavior."

C. Although this statement is appropriate, it does not answer the father's question. Mood swings are a normal finding in the first trimester; the woman does not need counseling. This is the most appropriate response since it gives an explanation and a time frame for when the mood swings may stop. This statement is judgmental and not appropriate.

Which presumptive signs (felt by the woman) or probable sign (observed by the examiner) of pregnancy is not matched with another possible cause? A. Amenorrhea: stress, endocrine problems B. Quickening: gas, peristalsis C. Goodell sign: cervical polyps D. Chadwick sign: pelvic congestion

C. Amenorrhea sometimes can be caused by stress, vigorous exercise, early menopause, or endocrine problems. Quickening can be gas or peristalsis. Goodell sign might be the result of pelvic congestion, not polyps. Chadwick sign might be the result of pelvic congestion.

A 24-yr-old patient is at the clinic with symptoms of purulent vaginal discharge, dysuria, and dyspareunia. She is sexually active and has multiple partners. What should the nurse explain as the rationale for Chlamydia screening? A. Chlamydia is frequently comorbid with HIV. B. Chlamydial infections may progress to sepsis. C. Untreated chlamydial infections can lead to infertility. D. Chlamydial infections are treatable only in the early stages of infection.

C. Because of the potential for infertility, routine screening for Chlamydia is recommended for women sexually active younger than age 25 years and annually for those older than 25 years with one or more risk factors for the infection. Chlamydia is not a primary risk for sepsis and is not noted to be strongly correlated with HIV infection. The disease is treatable at all stages of infection.

1. A 26-year-old woman is considering Depo-Provera as the form of contraception that is best for her since she does not like to worry about taking a pill every day. To assist this woman with decision making concerning this method of contraception, the nurse would tell her that Depo-Provera: A. is a combination of progesterone and estrogen. B. is a small adhesive hormonal birth control patch that is applied weekly. C. thickens and decreases cervical mucus, thereby inhibiting sperm penetration and ovulation. D. has an effectiveness rate in preventing pregnancy of 99% when used correctly.

C. Depo-Provera is a progestin-only form of hormonal contraception. Depo-Provera is administered as an intramuscular injection. In addition to the changes in the cervical mucus, some but not all ovulatory cycles are suppressed, and formation of an endometrium capable of supporting implantation is inhibited. The effectiveness rate is 99% or greater over 5 years.

Which minerals and vitamins usually are recommended to supplement a pregnant woman's diet? A. Fat-soluble vitamins A and D B. Water-soluble vitamins C and B6 C. Iron and folate D. Calcium and zinc

C. Fat-soluble vitamins should be supplemented as a medical prescription, as vitamin D might be for lactose-intolerant women. Water-soluble vitamin C sometimes is consumed in excess naturally; vitamin B6 is prescribed only if the woman has a very poor diet. Iron generally should be supplemented, and folic acid supplements often are needed because folate is so important. Zinc sometimes is supplemented. Most women get enough calcium.

1. During the first trimester the pregnant woman would be most motivated to learn about: A. fetal development. B. impact of a new baby on family members. C. measures to reduce nausea and fatigue so she can feel better. D. location of childbirth preparation and breastfeeding classes.

C. Fetal development concerns are more apparent in the second trimester when the woman is feeling fetal movement. Impact of a new baby on the family would be appropriate topics for the second trimester when the fetus becomes "real" as its movements are felt and its heartbeat heard. During this trimester a woman works on the task of, "I am going to have a baby." During the first trimester a woman is egocentric and concerned about how she feels. She is working on the task of accepting her pregnancy. Motivation to learn about childbirth techniques and breastfeeding is greatest for most women during the third trimester as the reality of impending birth and becoming a parent is accepted. A goal is to achieve a safe passage for herself and her baby.

Several noted health risks are associated with menopause. These risks include all except: A. osteoporosis. B. coronary heart disease. C. breast cancer. D. obesity.

C. Osteoporosis is a major health problem in the United States. It is associated with an increase in hip and vertebral fractures in postmenopausal women. A woman's risk of developing and dying of cardiovascular disease increases significantly after menopause. Breast cancer may be associated with the use of hormone replacement therapy for women who have a family history of breast cancer. Women tend to become more sedentary in midlife. The metabolic rate decreases after menopause, which may require an adjustment in lifestyle and eating patterns.

1. A 19-yr-old man comes to the outpatient clinic for treatment of uncomplicated gonorrhea. Which patient statement requires immediate clarification by the nurse? A. "I should avoid alcohol intake for at least 2 weeks." B. "I will have my sexual partner come in for treatment." C. "After I start the antibiotic, it is safe to have sex again." D. "After the treatment, I do not need to return to the clinic for retesting."

C. Patients should avoid sexual intercourse for 7 days after completing treatment with antibiotics. All sexual contact of patients with gonorrhea must be evaluated and treated to prevent reinfection. Patients should abstain from sexual intercourse and alcohol during treatment. Sexual intercourse allows the infection to spread and can delay healing. Alcohol is irritating to the healing urethral walls. Patients with uncomplicated gonorrhea who are treated do not need to return to the clinic to confirm the disease has been cured.

A pregnant woman demonstrates understanding of the nurse's instructions regarding relief of leg cramps if she: A. Wiggles and points her toes during the cramp. B. Applies cold compresses to the affected leg. C. Extends her leg and dorsiflexes her foot during the cramp. D. Avoids weight bearing on the affected leg during the cramp.

C. Pointing toes can aggravate rather than relieve the cramp. Application of heat is recommended. Extending the leg and dorsiflexing the foot is the appropriate relief for a leg cramp. Bearing weight on the affected leg can help to relieve the leg cramp, so it should not be avoided.

When a client makes an attempt to hug a nurse, the nurse responds immediately by stating the behavior is sexually inappropriate and will not be tolerated. The unit's nurse manager reacts to the nurse's response by: A. reinforcing to the client that such behavior will not be tolerated. B. encouraging the nurse to ignore such innocent behaviors in the future. C. confirming that the nurse responded in an appropriate, therapeutic manner. D. explaining to the client that such behavior is often misinterpreted and should be avoided.

C. Rationale: If a patient makes a sexual advance, the nurse should let the patient know that the behavior is unacceptable. The nurse needs to respond in a firm, matter-of-fact manner that clearly states what limits are being set. The nurse has handled the situation appropriately; there is no need for the nurse manager to intervene. Such behavior should not be ignored.

A client has begun to view the nurse in a sexual context. The primary client-focused reason for informing the client that this is an inappropriate expression of sexual feelings is that the: A. nurse is at risk for being sued for professional misconduct. B. client will never redirect these feelings without extensive professional help. C. nurse can then assist the client in identifying the causes of the inappropriate feelings. D. client can then begin to transfer the sexual attention to a more appropriate individual.

C. Rationale: If the nurse is able to help the patient see that the patient's sexual interactions and behaviors are being expressed to an inappropriate partner (the nurse), the sexual acting out will usually decrease; this allows the nurse to help the patient begin to identify the reasons for the behavior. The risk of being sued is not a client-focused reason but rather a possible nursing outcome if the nurse were to act on the client's advances. While professional help will assist in the process, it is not the primary reason for the nursing intervention described. The transference of attention is not likely to occur without the described nursing intervention

The nurse is conducting a therapy session for clients diagnosed with various forms of sexual dysfunction. When asked why a nurse should never engage in a sexual relationship with a client, the nurse replies most informatively when stating: A. "Violating sexual boundaries would be considered professional misconduct." B. "A nurse would surely be sued and certainly lose his or her license to practice nursing." C. "Such contact is never therapeutic and would ultimately harm the client emotionally." D. "Professional responsibilities would certainly prevent a nurse from engaging in such behavior."

C. Rationale: Sexual contact of any kind is never therapeutic and never acceptable within the nurse-patient relationship. This option provides a clear, concise client-focused answer to the client's question. The statement about violating sexual boundaries and about a nurse being sued, while both true statements, do not provide the most informative answer to the client's question. The option about the contact never being therapeutic is not necessarily true since such inappropriate behavior does occasionally occur.

The nurse is preparing to provide a client diagnosed with erectile dysfunction as a result of a spinal cord injury with an educational plan that will help address his limitations. In order to best assure a positive outcome for both the client and his sexual partner, the nurse will: A. educate the client and his partner on how the injury brought about the development of his limitations. B. assess the client's readiness to accept the limitations regarding sexual performance his injury has caused. C. encourage the client's partner to play an active role in contributing to the topics discussed in the educational plan. D. evaluate the commitment between the client and his partner and their ability to sustain such a challenge to their relationship.

C. Rationale: The limitations caused by the injury will affect both the client and his partner. Success is best assured when both individuals have the opportunity to express their needs and concerns so that the educational plan can be tailored to include those areas. While education will assist in acceptance and understanding of the limitations, there is another option that will have greater impact on the couples' positive outcomes. While assessing the client's readiness to accept limitations, the focus of the item is the couples' positive outcomes not just the client's. While evaluating the commitment between the client and partner is important, the couple's potential for a positive outcome will be better if consideration is given to the needs and concerns of both parties.

Which hematocrit (Hct) and hemoglobin (Hgb) results represent(s) the lowest acceptable values for a woman in the third trimester of pregnancy? A. 38% Hct; 14 g/dL Hgb B. 35% Hct; 13 g/dL Hgb C. 33% Hct; 11 g/dL Hgb D. 32% Hct; 10.5 g/dL Hgb

C. This is within normal limits in the nonpregnant woman. This is within normal limits for a nonpregnant woman. Represents the lowest acceptable value during the first and the third trimesters. This represents the lowest acceptable value for the second trimester when the hemodilution effect of blood volume expansion is at its peak.

What are the pros of the male/external condom?

Can buy anywhere, can put on as part of foreplay, can help prevent early ejaculation, can be used for oral/vaginal/anal sex, protects agains STIs

What are the pros of female/internal condom

Can buy at many stores, can put in as part of foreplay, can be used for anal and vaginal sexy, may increase pleasure, good for people with latex allergy, protects against STIs

What are the cons of male/external condom?

Can decrease sensation, cause loss of erection, or break/slip off

What are the cons of The Ring?

Can increase vaginal discharge, may cause spotting, no protection agains other STIs

What are the cons of The Patch?

Can irritate skin under, may cause spotting, noes not protect against STIs

What are the pros of The Patch?

Can make periods more regular and less painful, no pill to take, can become pregnant right after

What are the pros of the pill?

Can make periods more regular/improve PMS/improve acne/ovarian cancer/ can become pregnant after pills

What is the most common bacterial STD?

Chlamydia

Retesting after treatment for a chlamydia infection is completed is recommended in 3 months because: a test of cure upon completion of treatment has a low sensitivity the greatest chance of re-infection is within the first 3 months after diagnosis treatment regimens for chlamydia have low efficacy Correct Answer Reply:

Correct the greatest chance of re-infection is within the first 3 months after diagnosis

Which of the following sexually transmitted infections could attack the brain? A. Syphilis B. Pubic Lice C. Gonorrhea D. HPV

Correct Answer: A - Syphilis. If not treated, syphilis could infect the brain and the central nervous system (tertiary syphilis) causing paralysis and dementia.

What is the difference between a sexually transmitted infection (STI) and a sexually transmitted disease (STD)? All STIs are STDs All STDs are STIs There is no difference; the terms are interchangeable

Correct Answer: B What is the difference between a sexually transmitted infection (STI) and sexually transmitted disease (STD)? These terms are often confused, but they are not interchangeable. Sexually transmitted infection is the broadest term. All STDs are STIs, but not all STIs are STDs. To keep with the trends in modern health care, we will be using the label "STI" where previously you would have expected to see "STD" in discussing this topic. A sexually transmitted infection is an invasion of and multiplication in bodily tissue by a microorganism (for example, bacterium, virus, protozoan) that is usually (more than half the time) passed from one person to another during intimate bodily contact meant to give or derive sexual gratification. A sexually transmitted disease, on the other hand, involves manifest damage to the body with or without symptoms secondary to an infection that is usually (more than half the time) passed from one person to another during intimate bodily contact meant to give or derive sexual gratification.

Trichomoniasis is the MOST common STI. True False

Correct Answer: B - False However, A - True - is also true. Depends on the source. See graph on next slide.

Which of the following sexually transmitted infections could damage the fallopian tubes, leading to an increased risk of ectopic pregnancies? A. Chlamydia B. Gonorrhea C. Both A & B

Correct Answer: C - Both Chlamydia and Gonorrhea. In women, gonorrhea is a common cause of pelvic inflammatory disease (PID). This happens in up to 40 percent of women with untreated chlamydia. About one million women each year in the United States develop PID. The symptoms may be quite mild or can be very severe and can include abdominal pain and fever. PID can lead to internal abscesses (pus-filled "pockets" that are hard to cure) and long-lasting, chronic pelvic pain. PID can damage the fallopian tubes enough to cause infertility or increase the risk of ectopic pregnancy. Ectopic pregnancy is a life-threatening condition in which a fertilized egg grows outside the uterus, usually in a fallopian tube.

Which of the following sexually transmitted infections can contribute to the development of cancer? A. HIV B. HPV C. Both A & B

Correct Answer: C - Both HIV and HPV. After HIV weakens the immune system, the body loses its ability to fight infections and abnormal growths which may result in cancer. Cancer is a significant cause of mortality and morbidity in people infected with HIV; in fact 30% to 40% will develop a malignancy during their lifetime. The majority of cancers affecting HIV-positive people are those established as AIDS-defining: Kaposi's sarcoma, non-Hodgkin's lymphoma, and invasive cervical cancer. Persistent HPV infections are now recognized as the major cause of cervical cancer. In 2007, it was estimated that 11,000 women in the United States would be diagnosed with this type of cancer and nearly 4,000 would die from it. Cervical cancer strikes nearly half a million women each year worldwide, claiming a quarter of a million lives. Studies also suggest that HPVs may play a role in some cancers of the anus, vulva, vagina, and penile cancer (cancer of the penis). Studies have also found that oral HPV infection is a strong risk factor for oropharyngeal cancer (cancer that forms in tissues of the oropharynx, which is the middle part of the throat and includes the soft palate, the base of the tongue, and the tonsils. Researchers found that an oral HPV infection and past HPV exposure increase the risk of oropharyngeal squamous cell cancer, regardless of tobacco and alcohol use, two other important risk factors for this disease. However, combining HPV exposure and heavy tobacco and alcohol use did not have an additive effect.

Which of the following are examples of questions that are at the permission level in the PLISSIT model?A. "If you are having any difficulties with your sexual functioning, please know that you can ask your primary healthcare provider." B. "Here is a handout that describes all the side effects of the blood pressure medication that you are using, including possible effects on sexual functioning. If you have any further questions, just let me know." C. "If you are experiencing erectile dysfunction as a result of your blood pressure medication, you can ask to be switched to another anti-hypertensive that might have fewer effects on sexual functioning." D. "Many men who are taking medications to treat hypertension report problems with sexual functioning such as difficulty gaining and keeping an erection. Have you noticed any changes?"

Correct Answer: D This is the only answer choice that gives permission to discuss a sexual health topic right then - clue is the open-ended question. Note: Answer C is good anticipatory guidance - health promotion but what key piece of information is missing (in addition to the open-ended question?) That the patient should call if experiencing unwanted side effects and that should not stop taking medication due to detrimental effects on blood pressure control (links sexuality and perfusion concepts).

In the United States, one in ______ persons will be affected by an STI sometime during his or her life. 20 15 10 4

Correct Answer: D - one in 4. In addition, 20 million new STI cases occur in the US per year. Almost half occur in someone between the ages of 15 and 24.

Chlamydia infections are a concern because A) 15 to 40% of women with a chlamydia infection develop pelvic inflammatory disease (PID). B) a single episode of PID increases the risk of ectopic pregnancy 6 to 10 fold. C) an infant born to a mother with chlamydia has a 25 - 50% chance of developing an eye infection. D) a person infected with chlamydia who is exposed to HIV is 3 to 5 times more likely to acquire HIV. E) all of the above.

Correct Answer: E - all of the above Even with only mild symptoms - serious damage is being done to a woman's reproductive organs. Chlamydia can cause fallopian tube infection with out any symptoms. 15- 40% of women with PID = ~ 750,000 women/year Of women with PID, 10 - 15% will become infertile due to tubal scarring and 18% will develop chronic pelvic pain.

Sexually transmitted infections can be transferred from a pregnant mother to her baby? A. True B. False

Correct Answer: True. A pregnant woman can infect her baby. Syphilis and HIV can be transmitted to the fetus during pregnancy (before birth). Gonorrhea, chlamydia, Hepatitis B, and genital herpes can be transmitted to the baby during the birth. In addition, STIs in pregnancy can cause spontaneous abortion, low birth weight, preterm birth, and permanent neurological damage to the newborn.

What are the pros of withdrawal?

Costs nothing

A 22-year-old woman pregnant with a single fetus has a preconception body mass index (BMI) of 24. When she was seen in the clinic at 14 weeks of gestation, she had gained 1.8 kg (4 lbs) since conception. How would the nurse interpret this? A. This weight gain indicates possible gestational hypertension. B. This weight gain indicates that the woman's infant is at risk for intrauterine growth restriction (IUGR). C. This weight gain cannot be evaluated until the woman has been observed for several more weeks. D. The woman's weight gain is appropriate for this stage of pregnancy.

D

The nurse advises the woman who wants to have a nurse-midwife provide obstetric care that: A. she will have to give birth at home. B. she must see an obstetrician as well as the midwife during pregnancy. C. she will not be able to have epidural analgesia for labor pain. D. she must be having a low-risk pregnancy.

D. Most nurse-midwife births are managed in hospitals or birth centers; a few may be managed in the home. Nurse-midwives may practice with physicians or independently with an arrangement for physician backup. They must refer clients to physicians for complications. Care in a midwifery model is noninterventional, and the woman and family usually are encouraged to be active participants in the care. This does not imply that medications for pain control are prohibited. Midwives usually see low-risk obstetric clients. Care is often noninterventional with active involvement from the woman and her family. Nurse-midwives must refer clients to physicians for complications.

A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know if it is safe for her to have a drink with dinner now. The nurse tells her: A. "Because you're in your second trimester, there's no problem with having one drink with dinner." B. "One drink every night is too much. One drink three times a week should be fine." C. "Because you're in your second trimester, you can drink as much as you like." D. "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy."

D. Regardless of which trimester the woman has reached, no amount of alcohol during pregnancy has been deemed safe for the fetus. Neither one drink per night nor three drinks per week is a safe recommendation. Although the first trimester is a crucial period of fetal development, pregnant women of all gestations are counseled to eliminate all alcohol from their diet. A safe level of alcohol consumption during pregnancy has not yet been established. Although the consumption of occasional alcoholic beverages may not be harmful to the mother or her developing fetus, complete abstinence is strongly advised.

Which event discovered during pregnancy would alert the nurse that a cesarean section delivery is indicated? A. Contact with an individual with syphilis 2 weeks ago B. Treatment for gonococcal pharyngitis before conception C. Treatment for Chlamydia trachomatis at her 20th week of gestation D. Active herpes simplex virus type 2 vesicles on her cervix at the time of delivery

D. The woman with active herpes simplex virus type 2 at the time of delivery has the greatest risk for the fetus, and the baby will be delivered by cesarean section to prevent infection. Syphilis has an average incubation period of 21 days, so even if the contact was sexual, the syphilis should not infect the baby at birth. The woman treated for gonococcal pharyngitis should have been cured with treatment, but the baby's eyes will be treated at birth to prevent gonorrheal eye infection regardless. Treatment of the pregnant woman with Chlamydia trachomatis prevents transfer of the infection to the fetus.

When counseling a client about getting enough iron in her diet, the maternity nurse should tell her that: A. milk, coffee, and tea aid iron absorption if consumed at the same time as iron. B. iron absorption is inhibited by a diet rich in vitamin C. C. iron supplements are permissible for children in small doses. D. constipation is common with iron supplements.

D. These beverages inhibit iron absorption when consumed at the same time as iron. Vitamin C promotes iron absorption. Children who ingest iron can get very sick and even die. Constipation can be a problem.

A pregnant woman at 32 weeks of gestation complains of feeling dizzy and light-headed while her fundal height is being measured. Her skin is pale and moist. The nurse's initial response would be to: A. assess the woman's blood pressure and pulse. B. have the woman breathe into a paper bag. C. raise the woman's legs. D. turn the woman on her side.

D. Vital signs can be assessed next. Breathing into a paper bag is the solution for dizziness related to respiratory alkalosis associated with hyperventilation. Raising her legs will not solve the problem since pressure will still remain on the major abdominal blood vessels, thereby continuing to impede cardiac output. During a fundal height measurement the woman is placed in a supine position. This woman is experiencing supine hypotension as a result of uterine compression of the vena cava and abdominal aorta. Turning her on her side will remove the compression and restore cardiac output and blood pressure.

A 30-yr-old woman reports the recent appearance of itchy lesions on her vulva, some of which have recently burst. Which STI should the nurse suspect first? A. HIV B. Gonorrhea C. Chlamydia D. Genital herpes

D. A primary episode of genital herpes is often marked by multiple small, vesicular lesions on the genitals. This symptomatology is not commonly associated with HIV, gonorrhea, or Chlamydia.

Which statements about multifetal pregnancy are most appropriate? (Select all that apply.) A. The expectant mother often develops anemia because the fetuses have a greater demand for iron. Correct B. Twin pregnancies come to term with the same frequency as single pregnancies. C. The mother should be counseled to increase her nutritional intake and gain more weight. Correct D. Backache and varicose veins are often more pronounced. E. Spontaneous rupture of membranes before term is uncommon.

D. A woman with a multifetal pregnancy often develops anemia due to the increased demands of two fetuses. This should be monitored closely throughout her pregnancy. Twin pregnancies often end in prematurity. Serious efforts should be made to bring the pregnancy to term. The client may need nutrition counseling to ensure that she gains more weight than what is needed for a singleton birth. The considerable uterine distention is likely to cause backache and leg varicosities. Maternal support hose should be recommended. Spontaneous rupture of membranes before term is common

The nurse obtains a history from a 34-yr-old woman diagnosed with a chlamydial infection. Which patient statement indicates additional teaching is required? A. "This infection can be cured by taking antibiotics." B. "It is important to use condoms for all sexual activity." C. "I will avoid sexual contact for 1 week after taking the antibiotics." D. "My sexual partner does not have symptoms and will not need treatment."

D. All sexual partners require treatment. Most men and women with chlamydial infections are either asymptomatic or have minor symptoms. Chlamydial infections are caused by Chlamydia trachomatis, a gram-negative bacterium. Antibiotics will cure this disease. Patients should avoid sexual intercourse for 7 days after completing treatment with antibiotics. Condoms should be used for all sexual contacts.

While summarizing teaching regarding genital herpes, which patient statement indicates a need for further instruction? A. "No cure is available for my genital herpes." B. "I will utilize my medication when I begin to have symptoms." C. "Genital herpes may be caused by herpes simplex virus type 1 or 2" D. "I am not able to infect a sexual partner unless I have active lesions."

D. Correct The majority of herpes simplex virus (HSV) transmission occurs during asymptomatic periods. When active lesions are present, the patient is most likely to infect others. There is no cure for HSV, but antiviral medication is prescribed for current infections or suppression of recurrent infections. Early treatment reduces the duration of ulcers and risk of transmission. HSV-1 has been commonly associated with cold sores or fever blisters. HSV-2 has been more associated with genital disease. However, HSV-1 and HSV-2 can cause oral or genital lesions.

A maternal serum alpha-fetoprotein (MSAFP) test is performed at 16 to 18 weeks of gestation. An elevated level has been associated with: A. Down syndrome. B. sickle cell anemia. C. cardiac defects. D. open neural tube defects such as spina bifida.

D. Low levels of MSAFP are associated with Down syndrome. Sickle cell anemia is not detected by the MSAFP. Cardiac defects would not be detected with the MSAFP. A triple marker test determines the levels of MSAFP along with serum levels of estriol and human chorionic gonadotropin; an elevated level is associated with open neural tube defects.

1. If exhibited by a pregnant woman, what represents a positive sign of pregnancy? A. Morning sickness B. Quickening C. Positive pregnancy test D. Fetal heartbeat auscultated with Doppler/fetoscope

D. Morning sickness and quickening, along with amenorrhea and breast tenderness, are presumptive signs of pregnancy; subjective findings are suggestive but not diagnostic of pregnancy. Other probable signs include changes in integument, enlargement of the uterus, and Chadwick sign. A positive pregnancy test is still considered to be a probable sign of pregnancy (objective findings are more suggestive but not yet diagnostic of pregnancy) since error can occur in performing the test or in rare cases human chorionic gonadotropin (hCG) may be detected in the urine of nonpregnant women. Chances of error are less likely to occur today since pregnancy tests used are easy to perform and are very sensitive to the presence of the hCG associated with pregnancy. Detection of a fetal heartbeat, palpation of fetal movements and parts by an examiner, and detection of an embryo/fetus with sonographic examination would be positive signs diagnostic of pregnancy.

When a nurse shares that discussing sex-related topics in group sessions is uncomfortable for the clients and should be avoided, the nurse's nursing mentor replies: A. "Such conversations are appropriate only when the client initiates the discussion." B. "I agree; such conversations should be conducted by specially trained professionals." C. "If the client is uncomfortable with the topic, they know they can always leave the group." D. "Clients are often reluctant to ask sex-related questions until the nurse opens up the topic."

D. Rationale: Patients prefer that nurses initiate discussions of sexuality with them so that they know it's an appropriate, safe conversation to engage in. If nurses believe that the client must initiate the discussion, they deny the patients the opportunity to ask questions and clarify concerns relating to issues of sexuality. This type of discussion is within the scope of the mental health nurse. Having the client leave the group is they are uncomfortable with a topic is not an appropriate manner in which to run a therapeutic group.

An expectant couple asks the nurse about intercourse during pregnancy and if it is safe for the baby. The nurse should tell the couple that: A. intercourse should be avoided if any spotting from the vagina occurs afterward. B. intercourse is safe until the third trimester. C. safer-sex practices should be used once the membranes rupture. D. intercourse and orgasm are often contraindicated if a history or signs of preterm labor are present.

D. Some spotting can normally occur as a result of the increased fragility and vascularity of the cervix and vagina during pregnancy. Intercourse can continue as long as the pregnancy is progressing normally. Safer-sex practices are always recommended; rupture of the membranes may require abstaining from intercourse. Uterine contractions that accompany orgasm can stimulate labor and would be problematic if the woman were at risk for or had a history of preterm labor.

Over-the-counter (OTC) pregnancy tests usually rely on which technology to test for human chorionic gonadotropin (hCG)? A. Radioimmunoassay B. Radioreceptor assay C. Latex agglutination test D. Enzyme-linked immunosorbent assay (ELISA)

D. The radioimmunoassay tests for the summit of hCG in serum or urine samples. This test must be performed in the laboratory. The radioreceptor assay is a serum test that measures the ability of a blood sample to inhibit the binding of hCG to receptors. The latex agglutination test in no way determines pregnancy. Rather, it is done to detect specific antigens and antibodies. OTC pregnancy tests use ELISA for its one-step, accurate results.

In order to reassure and educate pregnant clients about changes in their blood pressure, maternity nurses should be aware that: A. a blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high. B. shifting the client's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit. C. the systolic blood pressure increases slightly as pregnancy advances; the diastolic pressure remains constant. D. compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the latter stage of term pregnancy.

D. The tightness of a cuff that is too small produces a reading that is too high; similarly, the looseness of a cuff that is too large results in a reading that is too low. Because maternal positioning affects readings, blood pressure measurements should be obtained in the same arm and with the woman in the same position. The systolic blood pressure generally remains constant but may decline slightly as pregnancy advances. The diastolic blood pressure first drops and then gradually increases. This compression also leads to varicose veins in the legs and vulva.

What laboratory results would be a cause for concern if exhibited by a woman at her first prenatal visit during the second month of her pregnancy? A. Hematocrit 38%, hemoglobin 13 g/dL B. White blood cell count 6000/mm3 C. Platelets 300,000/mm3 D. Rubella titer 1:6

D. This is a normal laboratory value in the pregnant woman. This is a normal laboratory value in the pregnant woman. This is a normal laboratory value in the pregnant woman. A rubella titer of less than 1:10 indicates a lack of immunity to rubella, a viral infection that has the potential to cause teratogenic effects on fetal development. Arrangements should be made to administer the rubella vaccine after birth during the postpartum period since administration of rubella, a live vaccine, would be contraindicated during pregnancy. Women receiving the vaccine during the postpartum period should be cautioned to avoid pregnancy for 3 months.

A patient has genital warts around her external genitalia and perianal area. She tells the nurse that she has not had treatment until now because "the warts are so disgusting." Which nursing diagnosis is most appropriate? Risk for infection related to lack of knowledge about transmission Disturbed body image related to feelings about the genital warts Ineffective coping related to denial of increased risk for infection Anxiety related to impact of condition on interpersonal relationships

Disturbed body image related to feelings about the genital warts

A pregnant woman at 18 weeks of gestation calls the clinic to report that she has been experiencing occasional backaches of mild-to-moderate intensity. Which of the following should the nurse recommend? Stay in bed for 24 hours. Do Kegel exercises. Use a softer mattress. Do pelvic rock exercises

Do pelvic rock exercises

What is dyspareunia?

Dyspareunia is defined as genital pain associated with sexual intercourse and it is listed under the Pain Disorders Classification.

What are the pros of Depo Provera (the shot)?

Each shot works for 12 weeks, private, decreases periods, helps prevent cancer, no pill, can be used while breastfeeding

A couple comes to the clinic for treatment of sexual dysfunction. A therapist obtains a detailed sexual history and decides to employ the Masters and Johnson model of therapy. The nurse expects that treatment planning will include: Examination of performance failures. Exploring the couple's early sexual experiences. Delving into the early growth and development of each person. Enhancing mutual feelings of warmth.

Enhancing mutual feelings of warmth.

What are the phases of sexual activity?

Excitement, plateau, organsmic, and resolution.

A married woman has made the decision to use a diaphragm as her primary method of birth control. The clinic nurse should provide which instructions regarding care of, insertion, and removal of the diaphragm? (Select all that apply.) E. Remove the diaphragm by catching the rim from below the dome. F. Avoid using mineral oil body products. G. On insertion, direct the diaphragm down toward the space below cervix. H. Wash diaphragm monthly with mild soap and water. I. A dusting of cornstarch is appropriate after drying the diaphragm.

F, G, H, I The diaphragm should not be removed by trying to catch the rim from below the dome. Oil-based products can cause the breakdown of the rubber. The diaphragm should be inserted into the vagina, directing it inward and downward as far as it will go to the space behind and below the cervix. The diaphragm should be washed after each use with mild soap and water. Cornstarch may be used. Avoid use of scented talc, body powder, and baby powder because they can weaken the rubber.

What does sexuality mean?

Factors or concerns affecting sexual health and function. It is a state of physical, emotional, mental, and social well being which requires a positive and respectful approach to sexuality and sexual relationships

What are the passengers of labor complex?

Fetus and placenta. fetus has head molding and there is fetal presentation

What are nutrition requirements for pregnancy?

Fluids - increase, esp. when breastfeeding Protein - add approx. 50% more Folate - add approx. 50% more Iron - approx. double the amount

What are the important nutrients to add in pregnancy?

Fluids - increase, esp. when breastfeeding Protein - add approx. 50% more Folate - add approx. 50% more Iron - approx. double the amount!

What do you assess in postpartum?

Fundus, perineum, and breasts

AR is currently pregnant. Her birth children at home are: Dominic - age 12, Izaac - age 9, Mario - age 7, and Mia - age 4. In addition, she has had 1 miscarriage. How would you record her basic obstetric history? Gravida ____ Para ____

G 6 P 4 She has conceived 6 times (4 children + 1 miscarriage + 1 current pregnancy = 6), so she is Gravida 6. She has carried and completed 4 pregnancies past viability so far, so she is Para 4. The miscarriage is a pregnancy loss before 20 weeks, so it is not counted in her para. Once she completes the current pregnancy and it ends past 20 weeks, then it would be counted in her parity.

What are inter-related concepts?

Glucose regulation, gas exchange, perfusion, sexuality, nutrition

The nurse obtains a reproductive history from a woman, who is currently 2 months pregnant. In the past, the woman had 2 miscarriages and had 4 live births at term. Which gravida and para will the nurse record? Gravida 7 Para 4 Gravida 7 Para 5 Gravida 6 Para 4 Gravida 6 Para 5

Gravida 7 Para 4

What is the most common viral STD?

HPV

What are examples of viral STDs?

HPV (most common), herpes simplex, hepatitis B, HIV

A woman, who is 3 months pregnant, has just immigrated to the United States. During her assessment interview, the nurse discovers that she has not had any immunizations. Which immunizations should she receive at this point in her pregnancy? Choose all that apply. Rubella Hepatitis B Chickenpox Pertussis Influenza

Hepatitis B Pertussis Influenza

What is sexual behavior?

How one responds to sexual desires

What is definition of family planning/contraception?/

Intentional prevention of pregnany

Discharge instructions after tubal ligation should include: (Select all that apply.) J. being prepared for significant mood swings due to hormonal influences. K. expecting heavier menstrual periods. L. using two forms of birth control to prevent pregnancy. M. not expecting change in sexual functioning; may enjoy more. N. using condoms to prevent sexually transmitted infections.

M, N Patient teaching regarding what to expect after tubal ligation includes: • You should expect no change in hormones and their influence. • Your menstrual period will be about the same as before the sterilization. • You may feel pain at ovulation. • The ovum disintegrates within the abdominal cavity. • It is highly unlikely that you will become pregnant. • You should not have a change in sexual functioning; you may enjoy sexual relations more because you will not be concerned about becoming pregnant. • Sterilization offers no protection against sexually transmitted infections. Therefore you may need to use condoms.

What are the cons of Progestin IUD?

May cause lighter periods, spotting, rarely uterine injury, no protection against HIV/STIs

What are cons of the pill?

May cause nausea, weight gain, headaches, change in sex-drive, spotting over first 1-2 months, does not protect against HIV or STIs

What are the cons of The Shot?

May cause spotting, weight gain, depression, etc. May cause delay in getting pregnant, side effects may last up to 6 months post shot, does not protect agains HIV/other STIs

What are the cons of emergency contraception-pills?

May cause upset stomach upset/nausea, next period may come early or late, may cause spotting, does not protect against HIV/STIs, women under age 17 need a prescription for some brands, may cost a lot

What is the assessment for preconception care?

May no know if pregnant of what to do to improve health

What are the cons of spermicide?

May raise the risk of getting HIV, may irritate vagina/penis, cream/gel/foam can be messy

What is the fundal height?

Measured from the symphysis to the fundus. Centimeters=weeks of gestation. increases 1 centimeter per week

What are the cons of rhythm?

Must use another method during fertile days, does not work well if your periods are irregular, many things to remember with this method, does not protect against HIV or other STIs

When counseling a woman who is having difficulty conceiving, the nurse will be most concerned about a history of infection with: N. gonorrhoeae. Treponema pallidum. condyloma acuminatum. herpes simplex virus type 2

N. gonorrhoeae.

The nurse is interviewing a woman, who is at the clinic for a pregnancy test. The first day of her last menstrual period (LMP) was February 14. Which estimated date of birth (EDB) would the nurse record? September 17 November 7 November 21 December 17

November 21

What are cons of progestin-only pills?

Often causes spotting, may cause depression, hair or skin changes, does not protect against HIV or other STIs

What are the pros of The Ring?

One size fits all, private, does not require spermicide, can make periods more regular/less painful, no pill, can become pregnant right after

What is PID associated with?

PID is associated with uterine tube scarring, tubal infertility, ectopic pregnancy, pelvic abscess and chronic pelvic pain

What is the passage of the labor complex?

Pelvis and soft tissues. passes through the fetal station

What are the 5 Ps of labor complex?

Powers, passengers, passage, position of the mother, and psyche

When does reproduction start/end for men?

Puberty (ave. 14 yo) and continues through out life.

When does reproduction start/end for women?

Puberty (average 12 yo)- menopause (average 50 yo)

What is supind hypotensive syndrome?

REmain side-lying

A man who has a profuse, purulent urethral discharge with painful urination is seen at the sexually transmitted disease (STD) clinic. Which information will be most important for the nurse to obtain? Contraceptive use Recent sexual contacts Immunization history Sexual orientation

Recent sexual contacts

What are interrelated concepts to sexuality?

Reproduction, development, and communication

What diagnostic tests are used for sexuality assessment?

STIs/STDs: cultures, urine/blood samples Female: pap test Male: prostate specific antigen

A nurse caring for an attractive patient of similar age and background begins fantasizing about having a social and sexual relationship with the patient. The most effective means of dealing with these feelings is to: Ask to change patient assignments immediately. Limit contact with the patient to include only care. Seek advice from an experienced peer. Make a personal promise to not act on the feelings.

Seek advice from an experienced peer.

What is the rationale for seeking information about the effects of prescribed medications on a patient's sexual function? Sexual dysfunction may result from use of prescription medications.: The question provides an opening to question about nonprescription drug use. The question eases the transition to questioning about sexual practices. Patients are more comfortable talking about medications than about sex.

Sexual dysfunction may result from use of prescription medications.:

The nurse measures a fundal height of 20 centimeters on a pregnant patient who says she is 24 weeks gestation. Which is the best analysis by the nurse? She may have experienced lightening. She may have a twin pregnancy. She may have incorrectly remembered her last menstrual period. This is within the normal range of pregnancy growth.

She may have incorrectly remembered her last menstrual period.

What are positive symptoms of pregnancy?

Signs directly attributable to the fetus. FHT, fetal movement. fetal sonography

What is the TPAL system?

T: term (37 up to 42 weeks) and post-term (42) P: Preterm (20 up to 37 weeks) A: Abortions (less than 20 weeks) L: living children (total number living now)

A pregnant patient with an average body mass index and one fetus weighed 120 pounds at her first prenatal visit in the first trimester of pregnancy. Now at term, she weighs 148 pounds. Which is the correct analysis of her weight gain by the nurse? This is too much weight gained, so the baby will be very large. There is not enough information since there is no prepregnancy weight in her chart. This is not enough weight gain, so the baby will be malnourished. This is an appropriate weight gain, so her baby is likely to be average weight.

This is an appropriate weight gain, so her baby is likely to be average weight.

T/F: Each conception and pregnancy is counted, regardless of the number of fetuses

True

T/F: sterilization is considered contraception

True

The following steps in placing a male condom on a penis are correct. Before you put a condom on: Store condoms in a cool, dry place away from direct sunlight. Check the expiration date on the condom. Do a pillow test — does the air stay in the package? Tear the condom package carefully — without using your teeth — to open. If the condom looks damaged, discolored, or brittle, do not use. To put a condom on: With one hand, pinch the tip of the condom to leave room for the ejaculate. With the other hand, roll the condom to the base of the penis or object. Continue using this hand to guide any air bubbles out of the condom. True False

True

Dyspareunia is one type of female sexual disorder. True False

True DSM Classifications of Female Sexual Disorders include Sexual Desire Disorders Sexual Arousal Disorders Orgasmic Disorders Pain Disorders

What are the cons of the diaphragm?

Using spermicide may raise risk of getting HIV, should not be used with vaginal bleeding or infection, raises risk of bladder infection

A nurse assesses a patient who reports that she is unable to have intercourse because of involuntary contractions at the vaginal opening. The nurse can correctly assess this as: Vaginismus. Dyspareunia. Orgasmic dysfunction. Arousal disorder.

Vaginismus

What do you assess in antepartum?

Weight, fundal height, & FHR

What is the excitement phase of sexual activity?

What leads to sexual arousal

Can pregnant women pass infection to their infants?

Yes, during delivery, potentiall resulting in neonatal ophthalmia and pneumonia

What are estrogen BC symptoms?

abdominal pain, chest pain, headaches, eye problems, swelling and/or aching in the legs and thighs (mnemonic for side effects of BC pill)

When does conception occur?

about 2 weeks after menses. genetic process of joining gametes

The nurse is reviewing the indications for tests in pregnancy. Prenatal testing for the human immunodeficiency virus (HIV) is recommended for: a woman who has had more than one sexual partner. a woman who is monogamous with her partner. a woman who has had a sexually transmitted infection. all women, regardless of risk factors.

all women, regardless of risk factors.

What is sexual identity?

biological genetic sexual differences

What is Para?

birth after 20 weeks' gestation regardess of the neonatal outcome. para is counted after pregnancy ends

A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of exercise on the fetus. The nurse should inform her: A. "You don't need to modify your exercising any time during your pregnancy." B. "Stop exercising, because it will harm the fetus." C. "You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month." D. "Jogging is too hard on your joints; switch to walking now."

c. The nurse should inform the woman that she may need to reduce her exercise level as the pregnancy progresses. Physical activity promotes a feeling of well-being in pregnant women. It improves circulation, promotes relaxation and rest, and counteracts boredom. Typically, running should be replaced with walking around the seventh month of pregnancy. Simple measures should be initiated to prevent injuries, such as warm-up and stretching exercises to prepare the joints for more strenuous exercise.

What are the pros of emergency contraception-pills?

can be used while breastfeeding, available at pharmacies, women and men of any use can get some brands without a prescription

What are the pros of progestin-only pills?

can be used while breastfeeding, you can become pregnant right after pills

What are the pros of spermicide?

can buy at many stores, can be put in during foreplay, comes in many forms: cream, gel, sponge, foam, inserts, film

What are the cons of female/internal condoms?

can decrease sensation, may be noisy, may be hard to insert, may slip out of place during sex

What are the pros of the diaphragm?

can last several years, cheap, may protect against some infections but not HIV,

What are presumptive symptoms of pregnancy?

changes a woman notes in her body that are commonly associated with pregnancy: no periods, N&V, increase urination, breast changes, quickening, increase pigmentation

What typically causes PID?

chlamydia and gonorrhea

What is the nursing diagnosis for preconception?

deficient knowledge

What is the preconception care?

efforts to improve health before conception (also for early pregnancy before prenatal care begins)

What is the prenatal care?

efforts to improve health during pregnancy (usually starts around 11 to 12 weeks gestation)

What is gravida?

every conception, regardless of duration, including the present pregnancy

What are examples of bacterial STDs?

gonhorrea, syphilis, and chlamydia

What is gender identity?

how one views themselves (socially)

What is the plateau phase?

increased rr, excitement. right before orgasm

A woman who is 6 weeks' pregnant is diagnosed with primary syphilis. The nurse will plan to teach the patient about the likelihood of a stillbirth. use of antibiotic eye drops for the newborn. the need for cesarean section. intramuscular injection of penicillin.

intramuscular injection of penicillin.

What are the characteristics of false labor?

irregular contractions, interval sa,e, intensity same or lessens, felt in abdomen, walking decreases pain, sedation relieves pain, no show, 0 dilation

What are the cons of withdrawal?

less preasure for some, does not protect against STIs, must interrupt sex

A male patient who has been diagnosed with gonococcal urethritis tells the nurse about recent sexual contact with a woman but says she did not appear to have any disease. In responding to the patient, the nurse explains that when gonorrhea infections occur in women, the disease affects only the ovaries and not the genital organs. women do not develop gonorrhea infections but can serve as carriers to spread the disease to males. Correct many women are not aware they have gonorrhea because they often do not have symptoms of infection. women develop subclinical cases of gonorrhea that do not cause tissue damage or clinical manifestations.

many women are not aware they have gonorrhea because they often do not have symptoms of infection

What is prenatal care history?

often obtained by RN, includes a thorough history of her health, any genetic conditions of both parents, estimated date of birth, gravida and para, pregnancy symptoms

What is sexual orientation?

one's view of attraction to others

What is the resolution phase?

post-orgasm

What do you assess in intrapartum?

powers (UC), passageway, passenger (fetus), and psyche

What is the orgasmic phase?

quick contraction of lower pelvic muscles, increased RR, HR

What is the true labor?

regular contractions, decrease in intervals, increase intensity, back to abdomen, walking increases pain, no effect from mild sed., bloody show, dilation of the cervix

What is the nursing diagnosis for preconception care?

risk for injury

What are probable symptoms of pregnancy?

signs which are usually due to pregnancy. PG test, enlarged abdomen, Hegar's sign, chadwick's sign, ballottement, palpable fetal outline, braxton hick's contractions

What is Nagele's rule?

subtract 3 months, add 7 days, and add a year to first day of LNMP

What is intrapartum?

the time from the onset of true labor until the birth of the infant and the placenta

What is modified CPR/heimlich maneuver?

tipped board/ pound sternum just below manubrium

A patient with gonorrhea is treated with a single IM dose of ceftriaxone (Rocephin) and is given a prescription for doxycycline (Vibramycin) 100 mg bid for 7 days. The nurse explains to the patient that this combination of antibiotics is prescribed to: treat any coexisting chlamydial infection. prevent reinfection during treatment. eradicate resistant strains of N. gonorrhoeae. prevent the development of resistant organisms.

treat any coexisting chlamydial infection.

What are topics of education for patients with STI's?

treatment, partner notification and treatment, follow-up, transmission risk, long term complications, prevention of future infections

What is the most common protozoal STD?

trichmoniasis

What are examples of protozoal STDs?

trichomoniasis

How do you minimize infertility in men?

wear loose underwear, no sauna/hot tubs, avoid drugs and alcohol