Exam 3 Study Questions 345 Sexuality Quiz

What are the manifestations of hypoestrogenism? Select all that apply.

Hot flashes, Amenorrhea, Reduced bone density- Low levels of estrogen may cause hot flashes, amenorrhea, and reduced bone density. Gynecomastia and hypermenorrhea are manifestations of excess estrogen production.

Chlamydial infections are the most commonly reported sexually transmitted infection. Syphilis and gonorrhea are not the most commonly reported STI. Herpes simplex is not a reportable infection.

Swab the drainage directly from the urethra to obtain a specimen- Swabbing the drainage directly from the urethra obtains a specimen uncontaminated by environmental organisms. Instructing the client to provide a semen specimen is not as accurate as obtaining the purulent discharge from the site of origin. Swabbing the discharge when it appears on the prepuce will contaminate the specimen with organisms external to the body. Teaching the client how to obtain a clean catch specimen of urine will dilute and possibly contaminate the specimen.

A client is visiting the prenatal clinic for the first time. While giving the nursing history the client states that her last menstrual period started on June 10. What is her expected date of birth (EDB), according to Nägele's rule?

The date is March 17 of the following year. Using Nägele's rule, subtract 3 months from the first day of the last menstrual period and add 7 days. March 3 and March 10 are too early. March 24 is too late.

Despite medication, a client's preterm labor continues, her cervix dilates, and birth appears inevitable. Which medication does the nurse anticipate will be prescribed to increase the chance of the newborn's survival?

Betamethasone- Betamethasone enhances fetal lung maturity when administered before a preterm birth. Carboprost tromethamine is a prostaglandin and nalbuphine HCl is a narcotic antagonist, neither of which is appropriate for administration in this case. Misoprostol is used for labor induction.

Which drug may be used both for cervical ripening during labor and as a stomach protectant?

Chlamydia. Chlamydial infections are the most commonly reported sexually transmitted infection. Syphilis and gonorrhea are not the most commonly reported STI. Herpes simplex is not a reportable infection.

Exercise helps to relieve menstrual discomfort through increased vasodilation followed by a subsequent decrease in ischemia. Exercise reduces congestion in the pelvis and minimizes the discomfort in the pelvis. Exercise promotes the release of endogenous opiates and suppresses prostaglandin production.

Intrusion on movement- Because the client is attached to a machine and movement may alter the tracings, movement is discouraged. Placement of the external monitor leads does not interfere with the administration of sedatives. An external monitor does not interfere with breathing techniques. An external monitor does not necessitate more frequent vaginal examinations.

A client reports an absence of menstruation to the nurse. Which condition does the nurse suspect?

Amenorrhea- An absence of menstruation indicates amenorrhea. Gonorrhea is a sexually transmitted disease. Dysmenorrhea is with painful menstruation associated with abdominal cramps. The formation of a fetus outside the uterus, such as a Fallopian tube, indicates ectopic pregnancy.

A nurse is caring for a primigravida during labor. At 7 cm of dilation a prescribed pain medication is administered. Which medication requires monitoring of the newborn for the side effect of respiratory depression?

Butorphanol- Respiratory depression may occur in the newborn because the duration of action of butorphanol is 3 to 4 hours and the circulating blood level will be high if birth occurs during that time. Hydroxyzine, promethazine, and diphenhydramine are all antihistamines that have a sedative effect and are administered early in labor to promote sleep and decrease anxiety.

The nurse discusses fetal weight gain with a pregnant client. When does the fetus generally show a marked increase in size?

During the third trimester- During the third trimester the fetus is laying down fat deposits and gaining the most weight. Fetal weight gain occurs throughout pregnancy, including the second trimester, but it is most marked in the third trimester. There is little fetal weight gain during the first trimester, when organ development is occurring.

What is gynecomastia? Select all that apply.

Gynecomastia is a bilateral or unilateral enlargement of breast seen in adolescent boys. It is an unusual change during growth and development and subsides on its own. Gynecomastia is caused by a hormone imbalance of testosterone and estrogen. Epididymitis is inflammation of epididymis of testis. Intravaginal torsion of the testicle is a condition in which the tunica vaginalis, which normally encases the testicle, fails to do so and the testis hangs free from its vascular structures. A varicocele is characterized by elongation, dilation, and tortuosity of the veins of the spermatic cord superior to the testicle.

Which tocolytic agent inhibits prostaglandin activity and is given along with sucralfate to help manage preterm labor?

Indomethacin- Indomethacin is a nonsteroidal antiinflammatory agent that may cause gastric irritation so sucralfate is administered along with this drug. Nifidipine is a calcium channel blocker used to manage preterm labor. Calcium gluconate is used to reverse magnesium sulfate toxicity. Magnesium sulfate is used to manage preterm labor and pregnancy-induced hypertension.

Which birth control agent requires administration once every three months?

Intramuscular progestin requires the administration of a single injection every three months. Progestin-only oral contraceptive pills should be taken on a daily basis due to a higher incidence of ovulatory cycles. Combination biphasic and monophasic forms are administered as either a 21 or 28-day course.

Which gonadotropin-releasing hormone agonists are used to treat endometriosis? Select all that apply.

Leuprolide and nafarelin acetate are gonadotropin-releasing hormone (GnRH) agonists used to treat endometriosis. Trazodone is used in cases of erectile dysfunction. Diclofenac is a nonsteroidal antiinflammatory drug used to relieve pain in endometriosis. Isotretinoin is an oral agent that is effective against severe cystic acne.

A nurse explains to a nursing class that the efficiency of the basal body temperature method of contraception depends on fluctuation of the basal body temperature. Which factor can alter the effectiveness of this method?

Stress- Stress or infection can alter the body's metabolism, causing an elevation in temperature; a rise in temperature from these causes may be misinterpreted as ovulation. Length of abstinence may increase sperm volume, but does not affect the female's basal temperature. Age is not a factor in the efficiency of the basal body temperature method of contraception in premenopausal woman. Frequency of intercourse may affect the volume of sperm, but does not alter the female's basal temperature.

When a client at 39 weeks' gestation arrives at the birthing suite she says, "I've been having contractions for 3 hours, and I think my water broke." What will the nurse's action be to confirm that the membranes have ruptured?

Test the leaking fluid with Nitrazine paper- Nitrazine paper will turn dark blue if amniotic fluid is present; it remains the same color in the presence of urine. Temperature assessment is not specific to ruptured membranes at this time; vital signs are part of the initial assessment. Although this may be done as part of the initial assessment, a urine test is unrelated to leakage of amniotic fluid. Inspecting the vagina for leaking fluid will not confirm rupture of the membranes

How does exercise help relieve menstrual discomfort in adolescents? Select all that apply.

Exercise helps to relieve menstrual discomfort through increased vasodilation followed by a subsequent decrease in ischemia. Exercise reduces congestion in the pelvis and minimizes the discomfort in the pelvis. Exercise promotes the release of endogenous opiates and suppresses prostaglandin production.

Which drug may be used both for cervical ripening during labor and as a stomach protectant?

Misoprostol. Misoprostal can be used for cervical ripening and as a stomach protectant. Raloxifene is used to prevent postmenopausal osteoporosis. Clomiphene is used for ovulation. Dinoprostone can be used for cervical ripening, but this drug does not act as a stomach protectant.

A client who is pregnant for the first time attends the prenatal clinic. She tells the nurse, "I'm worried about gaining too much weight, because I've heard that it's unhealthy." How should the nurse respond?

"A 25-lb (11.3-kg) weight gain is recommended; however, the pattern of weight gain is more important than the total amount."- A sudden sharp increase in weight may indicate fluid retention related to preeclampsia. Weight gain is necessary to ensure adequate nutrition for the fetus. The term "too much" is vague; complications are rare when weight gain is more than 25 to 30 lb (11.3 kg to 13.6 kg) in an uncomplicated pregnancy. There is no specific number of pounds that the client should gain, but a low-calorie diet is contraindicated. Telling the client that the staff is more concerned that she won't gain enough weight to ensure adequate growth of her baby closes off communication and does not allow the client to ask more questions about weight gain.

A 28-year-old woman who has phenylketonuria (PKU) visits the fertility clinic for genetic counseling. After deciding that she wants to become pregnant, she tells the nurse that she ate a low-phenylalanine diet until she was 18 years old. What is the nurse's best response?

"Return to the low-phenylalanine diet before becoming pregnant."- It is essential that a woman with PKU return to a low-phenylalanine diet before becoming pregnant; phenylalanine crosses the placenta, and a high blood level can damage the fetus, especially during organogenesis. Eating a regular pregnancy diet can endanger the fetus. Starting the low-phenylalanine diet in the third trimester is too late to protect the fetus. Advising a client to eat a low-protein diet is too vague, and starting the diet in the second trimester is too late to protect the fetus.

A married couple has been using oral contraceptives to delay pregnancy. When the wife misses her regular menstrual period, she decides to find out whether she is pregnant. She tells the nurse that pregnancy may have occurred because she missed her contraceptive pills for 1 week when she had the flu. How should the nurse respond?

"You may be correct. The effect of contraceptive pills depends on their being taken on a regular schedule."- An oral contraceptive program requires the client to take one tablet daily from the fifth day of the cycle and continue taking tablets for 20 or 21 days. Interrupting the monthly dosage program may permit release of luteinizing hormone, resulting in ovulation and possibly pregnancy. Stating that people often forget to take oral contraceptive pills is judgmental; contraceptive practice is the client's choice. It is premature to discuss abortion. Oral contraceptives that are taken on an exact schedule have a very high rate of success.