Maternity Ch 1-6
"Lower cylindric portion of the uterus composed of fibrous connective tissue and elastic tissue."
"Cervix"
Transitional phase during which ovarian function and hormone produc- tion decline.
"Climacteric"
Upper triangular portion of the uterus.
"Corpus"
Cycle that involves secretion of hormones required to stimulate ovulation.
"Hypothalamic-pituitary cycle"
" Also known as the lower uterine segment, it is the short constricted portion that separates the corpus of the uterus from the cervix."
"Isthmus"
Phase of the menstrual cycle during which the uterine lining becomes luxuriant with blood and glandular secretions suitable to protect and nurture a fertilized ovum.
"Secretory phase"
Stretchable quality of the cervical mucus at the time of ovulation.
"Spinnbarkeit"
Bladder opening found between the clitoris and the vagina.
"Urethra (urinary meatus)"
"Almond-shaped area enclosed by the labia minora that contains openings to the urethra, Skene glands, vagina, and Bartholin glands."
"Vestibule"
Efforts to decrease disparities
-HRSA Health Disparities Collaboratives -The National Institutes of Health -National Institute of Nursing Research -Centers for Disease Control and Prevention (CDC) -U.S. Department of Health and Human Services
Healthy People 2020 goals related to maternal health:
-Reduce the rate of fetal and infant deaths -Reduce the rate of maternal mortality -Reduce preterm births -Reduce cesarean births among low risk women
Euploid
A cell with the correct number of chromosomes within the cell.
46. Examples of sexual risk behaviors associated with exposure to a sexually transmitted infection (STI) include (Select all that apply): a. Fellatio. b. Unprotected anal intercourse. c. Multiple sex partners. d. Dry kissing. e. Abstinence.
A, B, C
1. The uterus is a muscular pear-shaped organ that is responsible for: Cyclic menstruation. Sex hormone production. Fertilization. Sexual arousal.
A. Cyclic menstruation.
Aneuploidy
Abnormal number of chromosomes.
_______________________________ Any form of uterine bleeding that is irregular in amount, duration, or timing and not related to regular menstrual bleeding.
Abnormal uterine bleeding(AUB)
Breast structures that are lined with epithelial cells that secrete colostrum and milk.
Acini
X Linked Dominant Inheritance
Autosomal Dominant inheritance of a sex chromosome. Most commonly exhibited in males.
BRCA1 and BRCA2
Autosomal inheritance of these increases risk for breast cancer.
Hereditary breast and ovarian cancer
BRCA1 and BRCA2
Dysfunctional uterine bleeding (DUB) is most likely to occur when women: A. Experience ovulatory cycles B. Weigh less than their expected body weight C. Experience signs of the onset of perimenopause D. Secrete high levels of prostaglandin
C
3. Which statement about female sexual response is not accurate? Women and men are more alike than different in their physiologic responses to sexual arousal and orgasm. Vasocongestion is the congestion of blood vessels. The orgasmic phase is the final state of the sexual response cycle. Facial grimaces and spasms of hands and feet are often part of arousal.
C. The orgasmic phase is the final state of the sexual response cycle. (There are 4 phases: excitement, plateau, orgasmic, & resolution)
Homozygous
Carrying two copies of the same allele
Heterozygous
Carrying two different copies of an allele
first
Children with Trisomoy 18 and 13 will likely die before their _________ birthday. Some live into 20-30's.
Mentally Retarded
Children with Trisomy 18 and 13 are profoundly ____________ ___________.
Homologous Chromosomes
Chromosomes that have the same sequence of genes, that have the same structure, and that pair during meiosis.
_______________________________ Collective term used to describe pain and discomfort associated with the menstrual cycle. The three main conditions included are _______________________, _______________________, and _______________________.
Cylic perimenstrual pain and discomfort(CPPD); dysmenorrhea; premenstrual syndrome(PMS); premenstrual dysphoric disorder(PMDD)
4. The nurse who provides preconception care understands that it: Is designed for women who have never been pregnant. Includes risk factor assessments for potential medical and psychologic problems but by law cannot consider finances or workplace conditions. Avoids teaching about safe sex to avoid political controversy. Could include interventions to reduce substance use and abuse.
D. Could include interventions to reduce substance use and abuse.
2. The hormone responsible for maturation of mammary gland tissue is: Estrogen. Testosterone. Prolactin. Progesterone.
D. Progesterone
3 to 4
Death in children with Tay Sach's disease occurs commonly around this age.
Alleles
Different forms of a gene
Excessive uterine bleeding with no demonstrable organic cause, genital or extragenital; it is most frequently associated with anovulation.
Dysfunctional uterine bleeding(DUB)
A family theory that views the family as a whole greater than the sum of its individual members and thus focuses on observing the interaction among family members rather than studying family members individually.
Family systems theory
Multiple roles for nurses in genetic counseling
Identify families in need of genetic counseling Make referrals to specialists Provide information about genetics Provide emotional support
Terminal Deletion
Loss of chomrosomal material at the end of a chromosome.
Deletions
Loss of chromosomal material.
Interstitial deletion
Loss of chromosome any where except the end of the chromosome.
which family category? Gloria and Andy are married couple living with their new biological baby girl, Danny, and their adopted son Thomas
Married-parent family
Mammary papilla.
Nipple
_______________________________ Generalized metabolic disease characterized by decreased bone mass and increased incidence of bone fractures.
Osteoporosis
"Skin-covered muscular area between the fourchette and the anus that covers the pelvic structures."
Perineum
Genotype
Refers to the genetic material a person has.
Segment of mammary tissue that extends into the axilla.
Tail of Spence
1%
What is the liklihood that a mother with a history of down's sydrome in her children will have another child with down's syndrome?
1. When providing care for a pregnant woman, the nurse should be aware that one of the most frequently reported maternal medical risk factors is: a. Diabetes mellitus. b. Mitral valve prolapse (MVP). c. Chronic hypertension. d. Anemia.
a. Diabetes mellitus.
multifactorial inheritance
an interaction between genes and the environment that contributes to a phenotype or trait
primary prevention
immunizations, encouraging exercise and healthy nutrition
Menstrual cycle day 1-5
menses
monosomy
union between a normal gamete and on ethat is missing a chromosome
interstitial deletion
when an internal segment is lost from a linear chromosome
Vulnerable populations
women racial and ethnic minorities adolescent girls older women incarcerated women immigrant, refugee and migrant women
AWHONN
•Standards and Guidelines for Professional Nursing Practice in the Care of Women and Newborns (United States) •Standards for Professional Perinatal Nursing Practice and Certification in Canada
Phase of the menstrual cycle during which the uterine lining grows rapidly and thickens from about the fifth day to the time of ovulation.
"Proliferative phase"
menstrual cycle
-hypothalmic-pituitary cycle - ovarian cycle - endometrial cycle
Congenital Heart Disease
40 to 50% of people with down syndrome commonly have this as well.
A 55-year-old woman tells the nurse that she has started to experience pain when she and her husband have intercourse. The nurse would record that this woman is experiencing: A. Dyspareunia B. Dysmenorrhea C. Dysuria D. Dyspnea
A
25. Which interventions would help alleviate the problems associated with access to health care for maternity patients (Select all that apply)? a. Provide transportation to prenatal visits. b. Provide childcare so that a pregnant woman may keep prenatal visits. c. Mandate that physicians make house calls. d. Provide low-cost or no-cost health care insurance. e. Provide job training.
A, B, D
colon cancer, two examples of predisposing genes
APC tumor suppressor gene Mutations in two MMR genes (i.e., MSH2 and MLH1) result in hereditary nonpolyposis colon cancer (HNPCC)
Health Belief Model
Addresses the relationship between a person's beliefs and behaviors
The nurse counseling a 30-year-old woman regarding effective measures to use to relieve symptoms associated with PMS could suggest that she: (Circle all that apply.) A. Decrease intake of fruits, especially peaches and watermelon B. Take a bugleweed or evening primrose oil supplement C. Limit alcohol intake to less than 1 oz per day D. Reduce exercise during the luteal phase of the menstrual cycle when symptoms are at their peak E. Eat small, more frequent meals and snacks
B,C,E
8. The nurse-midwife is teaching a group of women who are pregnant about Kegel exercises. Which statement by a participant would indicate a correct understanding of the instruction? "I will see results only if I perform 100 Kegel exercises each day." "I should hold the Kegel exercise contraction for 10 seconds and rest for 10 seconds between exercises." "I should perform Kegel exercises only in the sitting position." "I will perform daily Kegel exercises during the last trimester of my pregnancy to achieve the best results."
B. "I should hold the Kegel exercise contraction for 10 seconds and rest for 10 seconds between exercises."
"Structure that protects the bladder, uterus, and rectum; accommodates the growing fetus during pregnancy; and anchors support structures."
Bony pelvis
The paired mammary glands.
Breasts
Cri du chat Syndrome
Deletion of the short arm of chromosome 5. Leads to microcephaly, Mental Retardation, Cry sounds like a cat.
_______________________________ Menstrual disorder characterized by the presence and growth of endometrial glands and stroma outside the uterus.
Endometriosis
_______________________________ or _______________________________ Excessive menstrual bleeding, either in duration or amount
Menorrhagia; hypermenorrhea
decrease in estrogen
Menstruation
Loci
Point on the chromosome where the gene is found
Occurrence Risk
Probability the first child with be affected
Phenotype
The observable expression of a genotype.
Multifactorial Injeritance
Where a combination of genetic and environmental factors leads to a phenotype.
23. On vaginal examination of a 30-year-old woman, the nurse documents the following findings: profuse, thin, grayish white vaginal discharge with a "fishy" odor; complaint of pruritus. On the basis of these findings, the nurse suspects that this woman has: a. Bacterial vaginosis (BV). b. Candidiasis. c. Trichomoniasis. d. Gonorrhea.
a. Bacterial vaginosis (BV)
3. The role of the professional nurse caring for childbearing families has evolved to emphasize: a. Providing care to patients directly at the bedside. b. Primarily hospital care of maternity patients. c. Practice using an evidence-based approach. d. Planning patient care to cover longer hospital stays.
c. Practice using an evidence-based approach.
Cultural factors related to family health
culture, subculture, acculturation, assimilation
4. A 23-year-old African-American woman is pregnant with her first child. Based on the statistics for infant mortality, which plan is most important for the nurse to implement? a. Perform a nutrition assessment. b. Refer the woman to a social worker. c. Advise the woman to see an obstetrician, not a midwife. d. Explain to the woman the importance of keeping her prenatal care appointments.
d. Explain to the woman the importance of keeping her prenatal care appointments.
13. One of the alterations in cyclic bleeding that occurs between periods is called: a. Oligomenorrhea. b. Menorrhagia. c. Leiomyoma. d. Metrorrhagia.
d. Metrorrhagia.
Family theory with a focus on reducing cultural and environmental barriers that interfere with access to health care. Key elements include perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and confidence.
health belief model
"Small structure underneath the prepuce composed of erectile tissue with numerous sensory nerve endings; it increases in size during sexual arousal."
"Clitoris"
"Passage that connects the uterine cavity to the vagina. The opening between the uterus and this passage is the _______. The opening between this passage and the vagina is the _______."
"Endocervical canal; internal os; external os"
The cycle that involves cyclic changes in the lining of the uterus.
"Endometrial cycle"
Highly vascular lining of the uterus.
"Endometrium"
Ovarian hormone that stimulates the thickening of the endometrium that occurs after menstruation and prior to ovulation; it is also responsible for changes in the cervix and cervical mucus.
"Estrogen"
Pituitary hormone that stimulates the development of follicles in the ovary.
"Follicle-stimulating hormone "
Anterior, posterior, and lateral pockets that surround the cervix.
"Fornices"
"Thin, flat tissue formed by the joining of the labia minora; it is underneath the vaginal opening at the midline."
"Fourchette"
Fold of tissue under the clitoris.
"Frenulum"
Dome-shaped top of the uterus.
"Fundus"
Hormone secreted by the hypothalamus when ovarian hormones are re- duced to a low level. It stimulates the pituitary gland to secrete two critical hormones.
"Gonadotropin-releasing hormone (GnRH)"
Structure that encloses the developing ovum; it ruptures at the time of ovulation, releasing the ovum.
"Graafian follicle"
Phase during which the blood supply to the functional uterine lining is blocked and necrosis develops; the functional layer separates from the basal layer and menstrual bleeding begins.
"Ischemic phase"
Pituitary hormone that stimulates the expulsion of the ovum from the graafian follicle and formation of the corpus luteum.
"Luteinizing hormone"
The last menstrual period dated with certainty once 1 year has passed after menstruation ceases.
"Menopause"
Periodic uterine bleeding that begins approximately 14 days after ovula- tion and lasts an average of 5 days.
"Menstruation"
"Layer of the uterus composed of smooth muscles that extend in three different directions."
"Myometrium"
Cycle that involves the changes in the ovary, leading to ovulation. It con- sists of two phases, namely, follicular and luteal.
"Ovarian cycle"
Period preceding the last menstrual period that lasts about 4 years; during this time ovarian function declines, ova diminish, more menstrual cycles become anovulatory, and irregular bleeding occurs.
"Perimenopause"
Hoodlike covering of the clitoris.
"Prepuce"
Ovarian hormone that is responsible for the changes in the endometrium that occur after ovulation to facilitate implantation should fertilization occur; it is also responsible for the rise in temperature that occurs after ovulation.
"Progesterone"
"Muscular pelvic organ located between the bladder and the rectum and just above the vagina. The _______________________________ is a deep pouch, or recess, posterior to the cervix formed by the posterior ligament."
"Uterus; cul-de-sac of Douglas"
health risks to women: AGE
- adolescence: teenage pregnancy - young and middle adulthood: parenthood after 35 - late reproductive age
three main ways that people acquire gene mutations that can lead to cancer
- environmental factors - acquire by chance - inherited
breast self exam motion and technique?
- lie down and put pillow under shoulder with arm behind your head - use pads of three middle fingers on opposite hand in circular motion
Ethical, legal, and social implications (ELSIs)
- privacy and fairness - clinical integration - issues of possible discrimination - education for professionals and general public
Calgary Family Assessment Model (CFAM)
-caution: the assessment is not "the truth" about the family but is just one perspective at one point in time - structural, developmental, functional -the model is used to ask the family questions about themselves in order to gain understanding of the structure, development, and function at a point in time
57. A women's health nurse practitioner is going to perform a pelvic examination on a female client. Which nursing action would be least effective in enhancing the client's comfort and relaxation during the examination? A. Encourage the client to ask questions and express feelings and concerns before and after the examination. B. Ask the client questions as the examination is performed. C. Allow the client to keep her shoes and socks on when placing her feet in the stirrups. D. Instruct the client to place her hands over her diaphragm and take deep, slow breaths.
57. Choice B is correct; do not ask questions during the examination because it may distract the client, inter- fering with relaxation measures she may be using; offer explanations only as needed during the exami- nation. B. Ask the client questions as the examination is performed.
58. When assessing women it is important for a nurse to keep in mind the possibility that they are victims of violence. The nurse should: A. Use an abuse assessment screen during the assessment of every woman B. Recognize that abuse rarely occurs during pregnancy C. Assess a woman's legs and back as the most commonly injured areas D. Notify the woman's partner immediately if abuse is suspected
58. Choice A is correct; all women should be screened because abuse can happen to any woman; abuse can begin or escalate during pregnancy; the most com- monly injured sites are head, neck, chest, abdomen, breasts, and upper extremities. If abuse is suspected, the nurse needs to assess further to encourage disclo- sure and then assist the woman to take action and formulate a safety plan. Nurses should follow the laws of their state with regard to reporting instances of abuse. A. Use an abuse assessment screen during the assessment of every woman
A female client, age 26 years, describes scant bleeding between her menstrual periods. The nurse records this finding as: A. Metrorrhagia B. Oligomenorrhea C. Menorrhagia D. Hypomenorrhea
A
Women experiencing primary dysmenorrhea should be advised to avoid: A. Pretzels and potato chips B. Valerian C. Cranberry juice D. Whole-grain cereals
A
deletion
A change to a chromosome in which a fragment of the chromosome is removed.
Polyploidy
A deviation in the exact multiple of chromosomes. (Aneuploidy, Triploid / Tetraploid)
Karyotype
A display of the chromosome pairs of a cell arranged by size and shape. - a pictorial analysis
Inborn Errors of Metabolism (IEM)
A group of congenital conditions that cause either accumulation of toxins or disorders of energy metabolism in the neonate. These conditions are characterized by an infant's failure to thrive and by vague signs such as poor feeding.
unifactorial inheritance
A single gene controls a particular trait or disorder
45. There is little consensus on the management of premenstrual dysphoric disorder (PMDD). However, nurses can advise women on several self-help modalities that often improve symptoms. The nurse knows that health teaching has been effective when the client reports that she has adopted a number of lifestyle changes, including (Select all that apply): a. Regular exercise. b. Improved nutrition. c. A daily glass of wine. d. Smoking cessation. e. Oil of evening primrose.
A, B, D, E
47. The exact cause of breast cancer remains undetermined. Researchers have found that there are many common risk factors that increase a woman's chance of developing a malignancy. It is essential for the nurse who provides care to women of any age to be aware of which of the following risk factors (Select all that apply)? a. Family history b. Late menarche c. Early menopause d. Race e. Nulliparity or first pregnancy after age 30
A, D, E
7. Which is correct concerning the performance of a Papanicolaou (Pap) test? The woman should not douche, use vaginal medications, or have intercourse for at least 24 hours before the test. It should be performed once a year beginning with the onset of puberty. A lubricant such as Vaseline should be used to ease speculum insertion. The specimen for the Pap test should be obtained after specimens are collected for cervical infection.
A. The woman should not douche, use vaginal medications, or have intercourse for at least 24 hours before the test.
X-linked dominant inheritance
All females of the affected father are diseased. Affected mother can pass on the disease to both male and female offspring.
_______________________________ Absence of menstrual flow. It is a clinical symptom of a variety of disorders but most commonly a result of pregnancy and is a classic sign of anorexia nervosa.
Amenorrhea
Human Genome Project (HGP)
An international collaborative effort to map and sequence the DNA of the entire human genome.
Pigmented section of wrinkled skin that surrounds the nipple.
Areola
Neurofibromatosis
Autosomal Dominant inheritance; pigmented neurofibromas; cafe au lait spots
Tay Sachs Disease
Autosomal Recessive; Lipid storage disease that occurs commonky in Jewish people. Leads to apathy and regression in motor and social development
Phenylketonuria
Autosomal recessive disorder that leads to the inability to metabolize phenylalanine. Mostly found in caucasians.
Herbal preparations can be used as part of the treatment for a variety of menstrual disorders. Which herb is beneficial for a woman experiencing menorrhagia? A. Ginger B. Shepherd's purse C. Black cohosh root D. Black haw
B
Which woman is at greatest risk for developing hypogonadotropic amenorrhea? A. A 48-year-old woman in Weight Watchers who lost 20 pounds over 6 months B. A 14-year-old figure skater C. An 18-year-old softball player D. A 30-year-old (G3 P3003) breastfeeding woman
B
26. Which of the following statements indicate that the nurse is practicing appropriate family-centered care techniques (Select all that apply)? a. The nurse commands the mother to do as she is told. b. The nurse allows time for the partner to ask questions. c. The nurse allows the mother and father to make choices when possible. d. The nurse informs the family about what is going to happen. e. The nurse tells the patient's sister, who is a nurse, that she cannot be in the room during the delivery.
B, C
6. During a health history interview, a woman states that she thinks that she has "bumps" on her labia. She also states that she is not sure how to check herself. The correct response would be to: Reassure the woman that the examination will not reveal any problems. Explain the process of vulvar self-examination to the woman and reassure her that she will become familiar with normal and abnormal findings during the examination. Reassure the woman that "bumps" can be treated. Reassure her that most women have "bumps" on their labia.
B. Explain the process of vulvar self-examination to the woman and reassure her that she will become familiar with normal and abnormal findings during the examination.
5. A 62-year-old woman has not been to the clinic for an annual examination for 5 years. The recent death of her husband reminded her that she should come for a visit. Her family doctor has retired, and she is coming to see the women's health nurse practitioner for her visit. To facilitate a positive health care experience, the nurse should: Remind the woman that she is long overdue for her examination and that she should come in annually. Listen carefully and allow extra time for this woman's health history interview. Reassure the woman that a nurse practitioner is just as good as her old doctor. Encourage the woman to talk about the death of her husband and her fears about her own death.
B. Listen carefully and allow extra time for this woman's health history interview.
9. Which statements are true regarding the occurrence of obesity in the United States? (Select all that apply.) 25% of women in the United States are currently considered to be obese. Women in the age group 40 to 59 years have the highest prevalence. Obesity is associated with hypercholesterolemia. Obesity is associated with a decreased incidence of diabetes. Women who are obese may be more likely to have irregularities of the menstrual cycle.
B. Women in the age group 40 to 59 years have the highest prevalence. C. Obesity is associated with hypercholesterolemia. E. Women who are obese may be more likely to have irregularities of the menstrual cycle.
Genes
Basic physical unit of inheritance that are passed from parent to offspring containing information needy to specify traits
_______________________________ Bleeding that occurs when the contraceptive pill does not maintain a sufficiently hypoplastic endometrium, resulting in shedding of the endometrium in small amounts at a time.
Breakthrough bleeding
Pharmacologic preparations can be used to treat primary dysmenorrhea. Choose the preparation that is least effective in relieving the symptoms of primary dysmenorrhea. A. Combined oral contraceptive pill (OCP) B. Naproxen sodium (Anaprox) C. Acetaminophen (Tylenol) D. Ibuprofen (Motrin)
C
A 28-year-old woman has been diagnosed with endometriosis. She has been placed on a course of treatment with danazol (Danocrine). The woman exhibits understanding of this treatment when she states: (Circle all that apply.) A. "Because this medication stops ovulation, I do not need to use birth control." B. "I will experience more frequent and heavier menstrual periods when I take this medication." C. "I should follow a low-fat diet because this medication can increase the level of cholesterol in my blood." D. "I can experience a decrease in my breast size, oily skin, and hair growth on my face as a result of taking this medication." E. "I will need to spray this medication into my nose twice a day." F. "I may need to use a lubricant during intercourse to reduce discomfort."
C,D,F
Which statement is most accurate regarding persons who should participate in preconception counseling? A. All women and their partners as they make decisions about their reproductive future, including becoming parents B. Women older than 40 years of age who wish to become pregnant C. Sexually active women who do not use birth control D. Women with chronic illnesses such as diabetes who are planning to get pregnant
Choice A is correct; all women—not just specific groups—should participate in preconception care approximately 1 year before planning to become pregnant. A. All women and their partners as they make decisions about their reproductive future, including becoming parents
A 52-year-old woman asks the nurse practitioner about how often she should be assessed for the common health problems that women of her age could experience. The nurse recommends: A. An endometrial biopsy every 3 to 4 years B. A fecal occult blood test annually C. A mammogram every other year D. Bone mineral density testing annually
Choice B is correct; bone mineral density testing should be initiated at 65 years of age or older unless risk factors are present; endometrial biopsies are not recommended on a routine basis for most women but women at risk for endometrial cancer should have one done at menopause; mammograms should be done annually for women 50 years of age and older. B. A fecal occult blood test annually
56. A nurse instructed a female client regarding vulvar self-examination (VSE). Which statement made by the client indicates that further instruction is needed? A. I will perform this examination at least once a month, especially if I change sexual partners or am sexually active. B. I will become familiar with how my genitalia look and feel so that I will be able to detect changes. C. I will use the examination to determine when I should get medications at the pharmacy for infections. D. I will wash my hands thoroughly before and after I examine myself.
Choice C is correct; self-examination should not be used for self-diagnosis but rather to detect early changes, which would call for the guidance of a health care provider. C. I will use the examination to determine when I should get medications at the pharmacy for infections.
To enhance the accuracy of the Pap test, the nurse should instruct the woman to: A. Schedule the test just prior to the onset of menses B. Stop taking birth control pills for 2 days before the test C. Avoid intercourse for 24 to 48 hours before the test D. Douche with a specially prepared antiseptic solution on the night before the test
Choice C is correct; women should not use vaginal medications or douche for 24 to 48 hours before the test; oral contraceptives can continue; the best time for the test is midcycle. C. Avoid intercourse for 24 to 48 hours before the test
55. When palpating the small breasts of a young, slender woman the nurse should: A. Wear clean gloves B. Lift the hands when moving from one segment of the breast to another C. Use both hands D. Follow a systematic, overlapping pattern
Choice D is correct; clean gloves are required only if open lesions are present and when compressing the nipple if discharge is anticipated; fingers should not be lifted; two hands are used for women with large, pendulous breasts. D. Follow a systematic, overlapping pattern
54. A 20-year-old woman tells the nurse that she performs breast self-examination (BSE) on a regular basis. The nurse evaluates the woman's understanding of BSE and ability to perform the technique correctly. Which actions by the woman indicate that she needs further instruction regarding BSE? (Circle all that apply.) A. Performs BSE every month on the first day of her menstrual cycle. B. Observes the size of her breasts, direction of her nipples, and appearance of her skin, including the presence of dimpling, when looking at her breasts in the mirror. C. Lies down on a bed and puts a pillow under the shoulder of the breast she is going to palpate. Then she places the arm on that side under her head. D. Uses the tips of two fingers to palpate her breast E. Palpates her breast, using an overlapping circular pattern around her entire breast. F. Palpates her breasts again, including up into her axillae, while taking a shower.
Choices A and D are correct; a woman should perform BSE every month at the end of menstruation when the breasts are the least tender; she should use the finger- pads of her three middle fingers for palpation. A. Performs BSE every month on the first day of her menstrual cycle. D. Uses the tips of two fingers to palpate her breast
which family category? George and Denise, if we're not married, lives together with her daughter Rose
Cohabitating parent family
A 65-year-old woman is beginning treatment with alendronate sodium (Fosamax). Which statement by this woman indicates the need for further instructions? A. "I will take this medication first thing in the morning." B. "I will sit in a chair and read a book for about 30 minutes after I take this medication." C. "I will take this medication with a full glass of water." D. "I will eat my breakfast just before I take the medication."
D
_______________________________ Pain that occurs during or shortly before menstruation; it is one of the most common gynecologic problems in women of all ages.
Dysmenorrhea
_______________________________ Painful intercourse.
Dyspareunia
Healthy People 2020 Goals
Eliminate preventable disease, disability, injury, and premature death Achieve health equity, eliminate disparities, and improve the health of all groups Create social and physical environments that promote good health for all Promote healthy development and healthy behaviors across every stage of life
Reciprocal Translocation
Exchange among two chromosomes is equal.
Dominant Trait
Expression occurs when only one allele is present.
Recessive Trait
Expression occurs when only two alleles are present.
which family category? Ham and Dan are married and lives with her daughter, Susan, and Dan mother Ruth
Extended family
Hormone stimulating growth follicle
FSH and LH
_______________________________ Interrelatedness of disordered eating, amenorrhea, and altered bone mineral density.
Female athlete triad
23
Gametes have this many chromosomes and are considered haploid.
which family category? Carl and Allen are a gay couple living with Carl's daughter, Sally, and son, Thomas, born for surrogacy whom they are reasons together
Homosexual family
_______________________________ Sudden warm sensation in the neck, head, and chest.
Hot flash
_______________________________ Visible red flush of the skin with perspiration.
Hot flush
_______________________________ Absence of menstrual flow related to a problem of the central hypothalamicpituitary axis.
Hypogonadotropic amenorrhea
_______________________________ Scanty bleeding at normal intervals.
Hypomenorrhea
Hormone housing ovulation
LH
Two rounded folds of fatty tissue covered with skin that extend downward and backward from the mons pubis; their purpose is to protect the inner vulvar structures.
Labia majora
"Two flat reddish folds composed of connective tissue and smooth muscle, which are supplied with extremely sensitive nerve endings."
Labia minora
Family theory that involves a strength-based approach in clinical practice with families as opposed to a deficit approach.
McGill model of nursing
50%
Men who have BRCA mutations are this likely to pass the gene on.
The first menstruation.
Menarche
_______________________________ First menstrual period.
Menarche
_______________________________ Complete cessation of menses, said to have occurred when menstrual flow or spotting has ceased for 1 year.
Menopause
_______________________________ or _______________________________ Any episode of bleeding (e.g., spotting, menses, hemorrhage) that occurs at a time other than the normal menses.
Metrorrhagia; intermenstrual bleeding
_______________________________ Small amount of bleeding or spotting that occurs at the time of ovulation (14 days before onset of the next menses); it is considered to be normal.
Mittlestaining
Turner's Syndrome
Monosomy X that makes women exhibit juvenile external genitalia with underdeveloped ovaries. Women are short, exhibit webbing of the neck low hairline, low-set ears, and edema in the hands and feet.
"Fatty pad that lies over the anterior surface of the symphysis pubis."
Mons pubis
Sebaceous glands that cause the areola to appear rough.
Montgomery glands (tubercles)
Factor V Leiden
Most common hypercoagulable state, mutated factor V that is resistant to , Protein C and Protein S cleavage.
Down Syndrome
Most commonly caused by an extra 21 chromosome. Occurs in 1/773 births. Almost all have some form of mental retardation. Most commonly present with a flat face, alteration in ears, a single crease across the palm, and hyperflexibility and hypotonia.
Family History
Most important tool for diagnosis and risk assessment in health care genetics. Should contain 3 generations.
nondisjunction
Most trisomies occur due to this event where chromosomes do not separate during the first meiotic division.
FVL mutation
Mutation that increases risk for venous blood clots. Autosomal Dominant.
"Layer of breast tissue below the epithelium that contracts to expel milk from the acini forward toward the nipple."
Myoepithelium
Menstrual cycle day 23
Negative feedback from corpus luteum to pituitary decrease in LH and FSH from pituitary
Menstrual cycle day 10
Negative feedback from ovary to pituitary Decrease in FSH from two to enter
_______________________________ Profuse perspiration and heat radiating from the body that disrupts sleep.
Night sweats
X-linked recessive inheritance
No male to male transmission (mutation is only on the X chromosome). Son of heterozygous mothers have a 1/2 chance of being affected.
which family category? Tina and her brother Mark lives with her grandmother, Eileen, who is freezing
No-parent family
Family structure in which male and female partners and their children live as an independent unit, sharing roles, responsibilities, and economic resources.
Nuclear family
Robertsonian Translocation
Occurs when the long arms of 2 acrocentric chromosomes (chrom with centromeres near their ends) fuse at the centromere and the 2 short arms are lost
_______________________________ Infrequent menstrual periods characterized by intervals of 40 to 45 days or longer.
Oligomenorrhea
"Almond-shaped organs located on each side of the uterus. Their two functions are ____ and the production of the hormones _______, _______, and ______."
Ovaries ovulation estrogen progesterone androgen
_______________________________ or _______________________________ Period that encompasses the transition from normal ovulatory cycles to cessation of menses; it is marked by irregular menstrual cycles.
Perimenopause; climacteric
_______________________________ or _______________________________ Substances found in certain plant foods (e.g., red clover, wild yams, dandelion greens, cherries, alfalfa sprouts, black beans, soybeans) that are capable of interacting with estrogen receptors in the body.
Phytoestrogens; isoflavones
_______________________________ The period of time after menopause occurs.
Postmenopause
A more severe variant of premenstrual syndrome (PMS) with an emphasis on symptoms associated with mood disturbances, such as marked irritability, dysphoria, mood lability, anxiety, fatigue, appetite changes, and a sense of feeling overwhelmed.
Premenstrual dysphoric disorder(PMDD)
_______________________________ A cluster of physical and psychologic symptoms beginning in the luteal phase of the menstrual cycle and followed by a symptom-free period.
Premenstrual syndrome(PMS)
high progesterone levels
Present in the luteal phase, Suitable environment for implantation a fertilized egg
_______________________________ Painful menstruation that occurs as a result of increased uterine activity due to myometrial contractions induced by excessive release of prostaglandins in the second half of the menstrual cycle; it is associated with ovulatory cycles.
Primary dysmenorrhea
Oxygenated fatty acids classified as hormones. They are thought to play an essential role in ovulation, transport of sperm, regression of the corpus luteum, and menstruation. By increasing the myometrial response to oxytocin, they also play a role in labor and dysmenorrhea."
Prostaglandins
Bony pelvis: primary purposes
Protect the pelvic structures - accommodates the growing fetus during pregnancy - anchors the pelvic support structures
Transitional stage between childhood and sexual maturity.
Puberty
Autosomal abnormalities
Results from abnormal distribution of the genetic material during GAMETE (egg and sperm) production
Trisomy 18 (Edwards Syndrome)
Rocker-bottom feet Micrognathia Die within the first year
_______________________________ Acquired menstrual pain that typically develops after age 25 years and is associated with pelvic pathology.
Secondary dysmenorrhea
which family category? Miss M. lives with her 4 year old adopted daughter, kim.
Single-parent family
46
Somatic cells are diploid and have this many chromosomes.
"Location in the cervix where the squamous and columnar epithelia meet (the transformation zone); it is the most common site for neoplastic changes; cells from this site are scraped for the ________ test."
Squamocolumnar junction; Papanicolaou (Pap)
McGill model of nursing
Strength-based approach identification feedback on strengths assistance to develop strengths and use resources
_______________________________ Cessation of the menstrual cycle that occurs as a result of hysterectomy and bilateral oophorectomy.
Surgical menopause
Genome
The entire set of genetic instructions found in each cell.
gene therapy
The insertion of working copies of a gene into the cells of a person with a genetic disorder in an attempt to correct the disorder
80%
The lifetime risk of colon cancer for individuals with Hereditary nonpolyposis colon cancer.
Recurrence Risk
The probability that a subsequent child will be affected
Trisomy
The union of a normal gamete with a gamete containing an extra chromosome (47).
Huntington's Disease, Neurofibromatosis
These diseases have an autosomal dominant pattern of transmission.
Leukemia
This blood disorder is 20 times more common in people with down's syndrome.
Presymptomatic Testing
To determine the presence of a gene that will likely cause symptoms in the future. (Huntington's Disease)
climacteric
Transitional phase when ovarian function and hormone production decline
Patau Syndrome
Trisomy 13, Occurs in 1/10000 births
Edward's Syndrome
Trisomy 18; occurs in 1/3000 births
Klinefelter Syndrome
Trisomy XXY that leads to poorly developed sexual characteristics , small testes, infertility.
Monosomy
Uniting of two gametes where one lacks a chromosome. (45 total)
Predictive Testing
Used to clarify the genetic status of an asymptomatic person.
Passageways between the ovaries and the uterus; they are attached at each side of the dome-shaped uterine fundus.
Uterine (fallopian) tubes
"Fibromuscular collapsible tubular structure that extends from the vulva to the uterus and lies between the bladder and rectum. Its mucosal lining is arranged in transverse folds called ________. ________ and ______ glands secrete mucus that lubricates the vagina."
Vagina rugae; Skene; Bartholin
Age
What is the main factor that increases risk for having a child with down's syndrome?
85%
What percentage of kids born with down syndrome are born with parents under 35 years of age.
Unifactorial Inheritance
When a certain trait or disorder is controlled by a single gene
Autosomal Dominant
When only one gene is necessary for the development of siease.
Mosaicism
Where an individual has a mixture of cells, som with normal number of chromosomes, and others either missing a chromosome or having an extra.
Autosomal Recessive
Where two genes bust be inherited in order to express the pathologic phenotype.
Hemophilia
X linked Dominant Disorder that leads to blood clotting issues.
Predispositional Testing
a predictive test that, when positive, means the person being tested has a higher likelihood of getting the disease in the future than the general population (BRCA1/2)
Family Systems Theory
a theory that views the family as a system of interacting parts whose interactions exhibit consistent patterns and unstated rules
3. Which symptom described by a patient is characteristic of premenstrual syndrome (PMS)? a. "I feel irritable and moody a week before my period is supposed to start." b. "I have lower abdominal pain beginning the third day of my menstrual period." c. "I have nausea and headaches after my period starts, and they last 2 to 3 days." d. "I have abdominal bloating and breast pain after a couple days of my period."
a. "I feel irritable and moody a week before my period is supposed to start."
12. A newly graduated nurse is attempting to understand the reason for increasing health care spending in the United States. Her research finds that these costs are much higher compared with other developed countries as a result of: a. A higher rate of obesity among pregnant women. b. Limited access to technology. c. Increased usage of health care services along with lower prices. d. Homogeneity of the population.
a. A higher rate of obesity among pregnant women.
18. The nurse caring for a pregnant client should be aware that the U.S. birth rate shows which trend? a. Births to unmarried women are more likely to have less favorable outcomes. b. Birth rates for women 40 to 44 years old are beginning to decline. c. Cigarette smoking among pregnant women continues to increase. d. The rates of maternal death owing to racial disparity are elevated in the United States.
a. Births to unmarried women are more likely to have less favorable outcomes.
39. Fibrocystic changes in the breast most often appear in women in their 20s and 30s. The etiology is unknown, but it may be an imbalance of estrogen and progesterone. The nurse who cares for this client should be aware that treatment modalities are conservative. One proven modality that may provide relief is: a. Diuretic administration. b. Including caffeine daily in the diet. c. Increased vitamin C supplementation. d. Application of cold packs to the breast as necessary.
a. Diuretic administration.
41. A benign breast condition that includes dilation and inflammation of the collecting ducts is called: a. Ductal ectasia. b. Intraductal papilloma. c. Chronic cystic disease. d. Fibroadenoma.
a. Ductal ectasia.
4. A woman complains of severe abdominal and pelvic pain around the time of menstruation that has gotten worse over the last 5 years. She also complains of pain during intercourse and has tried unsuccessfully to get pregnant for the past 18 months. These symptoms are most likely related to: a. Endometriosis. b. PMS. c. Primary dysmenorrhea. d. Secondary dysmenorrhea.
a. Endometriosis.
20. A woman has a thick, white, lumpy, cottage cheese-like discharge, with patches on her labia and in her vagina. She complains of intense pruritus. The nurse practitioner would order which preparation for treatment? a. Fluconazole b. Tetracycline c. Clindamycin d. Acyclovir
a. Fluconazole
25. Which viral sexually transmitted infection is characterized by a primary infection followed by recurrent episodes? a. Herpes simplex virus (HSV)-2 b. Human papillomavirus (HPV) c. Human immunodeficiency virus (HIV) d. Cytomegalovirus (CMV)
a. Herpes simplex virus (HSV)-2
9. From the nurse's perspective, what measure should be the focus of the health care system to reduce the rate of infant mortality further? a. Implementing programs to ensure women's early participation in ongoing prenatal care b. Increasing the length of stay in a hospital after vaginal birth from 2 to 3 days c. Expanding the number of neonatal intensive care units (NICUs) d. Mandating that all pregnant women receive care from an obstetrician
a. Implementing programs to ensure women's early participation in ongoing prenatal care
14. As relates to dysfunctional uterine bleeding (DUB), the nurse should be aware that: a. It is most commonly caused by anovulation. b. It most often occurs in middle age. c. The diagnosis of DUB should be the first considered for abnormal menstrual bleeding. d. The most effective medical treatment is steroids.
a. It is most commonly caused by anovulation.
34. A patient has been prescribed adjuvant tamoxifen therapy. What common side effect might she experience? a. Nausea, hot flashes, and vaginal bleeding b. Vomiting, weight loss, and hair loss c. Nausea, vomiting, and diarrhea d. Hot flashes, weight gain, and headaches
a. Nausea, hot flashes, and vaginal bleeding
29. An essential component of counseling women regarding safe sex practices includes discussion regarding avoiding the exchange of body fluids. The physical barrier promoted for the prevention of sexually transmitted infections and human immunodeficiency virus is the condom. Nurses can help motivate clients to use condoms by initiating a discussion related to a number of aspects of condom use. The most important of these is: a. Strategies to enhance condom use. b. Choice of colors and special features. c. Leaving the decision up to the male partner. d. Places to carry condoms safely.
a. Strategies to enhance condom use.
37. What important, immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy? a. The blood pressure (BP) cuff should not be applied to the affected arm. b. Venipuncture for blood work should be performed on the affected arm. c. The affected arm should be used for intravenous (IV) therapy. d. The affected arm should be held down close to the woman's side.
a. The blood pressure (BP) cuff should not be applied to the affected arm.
24. Healthy People 2020 has established national health priorities that focus on a number of maternal-child health indicators. Nurses are assuming greater roles in assessing family health and providing care across the perinatal continuum. Therefore it is important for the nurse to be aware that significant progress has been made in: a. The reduction of fetal deaths and use of prenatal care. b. Low birth weight and preterm birth. c. Elimination of health disparities based on race. d. Infant mortality and the prevention of birth defects.
a. The reduction of fetal deaths and use of prenatal care.
20. The level of practice a reasonably prudent nurse provides is called: a. The standard of care. b. Risk management. c. A sentinel event. d. Failure to rescue.
a. The standard of care.
14. Through the use of social media technology, nurses can link with other nurses who may share similar interests, insights about practice, and advocate for patients. The most concerning pitfall for nurses using this technology is: a. Violation of patient privacy and confidentiality. b. Institutions and colleagues may be cast in an unfavorable light. c. Unintended negative consequences for using social media. d. Lack of institutional policy governing online contact.
a. Violation of patient privacy and confidentiality.
27. A 25-year-old single woman comes to the gynecologist's office for a follow-up visit related to her abnormal Papanicolaou (Pap) smear. The test revealed that the patient has human papillomavirus (HPV). The client asks, "What is that? Can you get rid of it?" Your best response is: a. "It's just a little lump on your cervix. We can freeze it off." b. "HPV stands for 'human papillomavirus.' It is a sexually transmitted infection (STI) that may lead to cervical cancer." c. "HPV is a type of early human immunodeficiency virus (HIV). You will die from this." d. "You probably caught this from your current boyfriend. He should get tested for this."
b. "HPV stands for 'human papillomavirus.' It is a sexually transmitted infection (STI) that may lead to cervical cancer."
22. Care management of a woman diagnosed with acute pelvic inflammatory disease (PID) most likely would include: a. Oral antiviral therapy. b. Bed rest in a semi-Fowler position. c. Antibiotic regimen continued until symptoms subside. d. Frequent pelvic examination to monitor the progress of healing.
b. Bed rest in a semi-Fowler position.
15. An important development that affects maternity nursing is integrative health care, which: a. Seeks to provide the same health care for all racial and ethnic groups. b. Blends complementary and alternative therapies with conventional Western treatment. c. Focuses on the disease or condition rather than the background of the client. d. Has been mandated by Congress.
b. Blends complementary and alternative therapies with conventional Western treatment.
9. During her gynecologic checkup, a 17-year-old girl states that recently she has been experiencing cramping and pain during her menstrual periods. The nurse would document this complaint as: a. Amenorrhea. b. Dysmenorrhea. c. Dyspareunia. d. Premenstrual syndrome (PMS).
b. Dysmenorrhea.
21. To detect human immunodeficiency virus (HIV), most laboratory tests focus on the: a. virus. b. HIV antibodies. c. CD4 counts. d. CD8 counts.
b. HIV antibodies.
28. Which of the following statements about the various forms of hepatitis is accurate? a. A vaccine exists for hepatitis C but not for hepatitis B. b. Hepatitis A is acquired by eating contaminated food or drinking polluted water. c. Hepatitis B is less contagious than human immunodeficiency virus (HIV). d. The incidence of hepatitis C is decreasing.
b. Hepatitis A is acquired by eating contaminated food or drinking polluted water.
18. The viral sexually transmitted infection (STI) that affects most people in the United States today is: a. Herpes simplex virus type 2 (HSV-2). b. Human papillomavirus (HPV). c. Human immunodeficiency virus (HIV). d. Cytomegalovirus (CMV).
b. Human papillomavirus (HPV).
19. Maternity nursing care that is based on knowledge gained through research and clinical trials is: a. Derived from the Nursing Intervention Classification. b. Known as evidence-based practice. c. At odds with the Cochrane School of traditional nursing. d. An outgrowth of telemedicine.
b. Known as evidence-based practice.
6. While interviewing a 31-year-old woman before her routine gynecologic examination, the nurse collects data about the client's recent menstrual cycles. The nurse should collect additional information with which statement? a. The woman says her menstrual flow lasts 5 to 6 days. b. She describes her flow as very heavy. c. She reports that she has had a small amount of spotting midway between her periods for the past 2 months. d. She says the length of her menstrual cycle varies from 26 to 29 days.
b. She describes her flow as very heavy.
2. To ensure optimal outcomes for the patient, the contemporary maternity nurse must incorporate both teamwork and communication with clinicians into her care delivery, The SBAR technique of communication is an easy-to-remember mechanism for communication. Which of the following correctly defines this acronym? a. Situation, baseline assessment, response b. Situation, background, assessment, recommendation c. Subjective background, assessment, recommendation d. Situation, background, anticipated recommendation
b. Situation, background, assessment, recommendation
21. During a prenatal intake interview, the client informs the nurse that she would prefer a midwife to provide her care during pregnancy and deliver her infant. What information would be most appropriate for the nurse to share with this patient? a. Midwifery care is available only to clients who are uninsured because their services are less expensive than an obstetrician. Costs are often lower than an obstetric provider. b. The client will receive fewer interventions during the birth process. c. The client should be aware that midwives are not certified. d. Delivery can take place only at the client's home or in a birth center.
b. The client will receive fewer interventions during the birth process.
19. The U.S. Centers for Disease Control and Prevention (CDC) recommends that HPV be treated with client-applied: a. Miconazole ointment. b. Topical podofilox 0.5% solution or gel. c. Penicillin given intramuscularly for two doses. d. Metronidazole by mouth.
b. Topical podofilox 0.5% solution or gel.
26. The nurse should know that once human immunodeficiency virus (HIV) enters the body, seroconversion to HIV positivity usually occurs within: a. 6 to 10 days. b. 2 to 4 weeks. c. 6 to 8 weeks. d. 6 months.
c. 6 to 8 weeks.
42. Which patient is most at risk for fibroadenoma of the breast? a. A 38-year-old woman b. A 50-year-old woman c. A 16-year-old girl d. A 27-year-old woman
c. A 16-year-old girl
16. Recent trends in childbirth practices in the United States indicate that: a. More than 15% of mothers had late or no prenatal care. b. The percentage of Hispanics, non-Hispanic African Americans, and Caucasians who received prenatal care was essentially the same. c. Births occurring in the hospital accounted for 99% of births. d. Cesarean births have been declining as a percentage of live births.
c. Births occurring in the hospital accounted for 99% of births.
43. The drug of choice for treatment of gonorrhea is: a. Penicillin G. b. Tetracycline. c. Ceftriaxone. d. Acyclovir.
c. Ceftriaxone.
17. When evaluating a patient for sexually transmitted infections (STIs), the nurse should be aware that the most common bacterial STI is: a. Gonorrhea. b. Syphilis. c. Chlamydia. d. Candidiasis.
c. Chlamydia.
31. Which diagnostic test is used to confirm a suspected diagnosis of breast cancer? a. Mammogram b. Ultrasound c. Fine-needle aspiration (FNA) d. CA 15.3
c. Fine-needle aspiration (FNA)
7. What is the primary role of practicing nurses in the research process? a. Designing research studies b. Collecting data for other researchers c. Identifying researchable problems d. Seeking funding to support research studies
c. Identifying researchable problems
23. To ensure patient safety, the practicing nurse must have knowledge of the current Joint Commission's "Do Not Use" list of abbreviations. Which of the following is acceptable for use? a. q.o.d. or Q.O.D. b. MSO4 or MgSO4 c. International Unit d. Lack of a leading zero
c. International Unit
38. A woman has a breast mass that is not well delineated and is nonpalpable, immobile, and nontender. This is most likely: a. Fibroadenoma. b. Lipoma. c. Intraductal papilloma. d. Mammary duct ectasia.
c. Intraductal papilloma.
12. With regard to endometriosis, nurses should be aware that: a. It is characterized by the presence and growth of endometrial tissue inside the uterus. b. It is found more often in African-American women than in white or Asian women. c. It may worsen with repeated cycles or remain asymptomatic and disappear after menopause. d. It is unlikely to affect sexual intercourse or fertility.
c. It may worsen with repeated cycles or remain asymptomatic and disappear after menopause.
1. When assessing a patient for amenorrhea, the nurse should be aware that this is unlikely to be caused by: a. Anatomic abnormalities. b. Type 1 diabetes mellitus. c. Lack of exercise. d. Hysterectomy.
c. Lack of exercise.
44. The nurse providing education regarding breast care should explain to the woman that fibrocystic changes in breasts are: a. A disease of the milk ducts and glands in the breasts. b. A premalignant disorder characterized by lumps found in the breast tissue. c. Lumpiness with pain and tenderness found in varying degrees in the breast tissue of healthy women during menstrual cycles. d. Lumpiness accompanied by tenderness after menses.
c. Lumpiness with pain and tenderness found in varying degrees in the breast tissue of healthy women during menstrual cycles
8. A 36-year-old woman has been given a diagnosis of uterine fibroids. When planning care for this patient, the nurse should know that: a. Fibroids are malignant tumors of the uterus that require radiation or chemotherapy. b. Fibroids increase in size during the perimenopausal period. c. Menorrhagia is a common finding. d. The woman is unlikely to become pregnant as long as the fibroids are in her uterus.
c. Menorrhagia is a common finding.
15. Management of primary dysmenorrhea often requires a multifaceted approach. The nurse who provides care for a client with this condition should be aware that the optimal pharmacologic therapy for pain relief is: a. Acetaminophen. b. Oral contraceptives (OCPs). c. Nonsteroidal antiinflammatory drugs (NSAIDs). d. Aspirin.
c. Nonsteroidal antiinflammatory drugs (NSAIDs).
7. When evaluating a patient whose primary complaint is amenorrhea, the nurse must be aware that lack of menstruation is most often the result of: a. Stress. b. Excessive exercise. c. Pregnancy. d. Eating disorders.
c. Pregnancy.
11. Which statement concerning cyclic perimenstrual pain and discomfort (CPPD) is accurate? a. Premenstrual dysphoric disorder (PMDD) is a milder form of premenstrual syndrome (PMS) and more common in younger women. b. Secondary dysmenorrhea is more intense and medically significant than primary dysmenorrhea. c. Premenstrual syndrome is a complex, poorly understood condition that may include any of a hundred symptoms. d. The causes of PMS have been well established.
c. Premenstrual syndrome is a complex, poorly understood condition that may include any of a hundred symptoms.
10. Alternative and complementary therapies: a. Replace conventional Western modalities of treatment. b. Are used by only a small number of American adults. c. Recognize the value of clients' input into their health care. d. Focus primarily on the disease an individual is experiencing.
c. Recognize the value of clients' input into their health care.
11. A 38-year-old Hispanic woman delivered a 9-pound, 6-ounce girl vaginally after being in labor for 43 hours. The baby died 3 days later from sepsis. On what grounds would the woman potentially have a legitimate legal case for negligence? a. She is Hispanic. b. She delivered a girl. c. The standards of care were not met. d. She refused fetal monitoring.
c. The standards of care were not met.
35. After a mastectomy a woman should be instructed to perform all of the following except: a. Emptying surgical drains twice a day and as needed. b. Avoiding lifting more than 4.5 kg (10 lb) or reaching above her head until given permission by her surgeon. c. Wearing clothing with snug sleeves to support the tissue of the arm on the operative side. d. Reporting immediately if inflammation develops at the incision site or in the affected arm.
c. Wearing clothing with snug sleeves to support the tissue of the arm on the operative side.
Family structure in with children live with two unmarried biologic or adoptive parents.
cohabitating parent
carrier screening for single gene disorders
cystic fibrosis sickle cell disease tay-sachs disease
22. While obtaining a detailed history from a woman who has recently emigrated from Somalia, the nurse realizes that the client has undergone female genital mutilation (FGM). The nurse's best response to this patient is: a. "This is a very abnormal practice and rarely seen in the United States." b. "Do you know who performed this so that it can be reported to the authorities?" c. "We will be able to restore your circumcision fully after delivery." d. "The extent of your circumcision will affect the potential for complications."
d. "The extent of your circumcision will affect the potential for complications."
32. A healthy 60-year-old African-American woman regularly receives her health care at the clinic in her neighborhood. She is due for a mammogram. At her previous clinic visit, her physician, concerned about the 3-week wait at the neighborhood clinic, made an appointment for her to have a mammogram at a teaching hospital across town. She did not keep her appointment and returned to the clinic today to have the nurse check her blood pressure. What would be the most appropriate statement for the nurse to make to this patient? a. "Do you have transportation to the teaching hospital so that you can get your mammogram?" b. "I'm concerned that you missed your appointment; let me make another one for you." c. "It's very dangerous to skip your mammograms; your breasts need to be checked." d. "Would you like me to make an appointment for you to have your mammogram here?"
d. "Would you like me to make an appointment for you to have your mammogram here?"
36. A nurse practitioner performs a clinical breast examination on a woman diagnosed with fibroadenoma. The nurse knows that fibroadenoma is characterized by: a. Inflammation of the milk ducts and glands behind the nipples. b. Thick, sticky discharge from the nipple of the affected breast. c. Lumpiness in both breasts that develops 1 week before menstruation. d. A single lump in one breast that can be expected to shrink as the woman ages.
d. A single lump in one breast that can be expected to shrink as the woman ages.
13. The term used to describe legal and professional responsibility for practice for maternity nurses is: a. Collegiality. b. Ethics. c. Evaluation. d. Accountability.
d. Accountability.
5. During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of a 21-year-old Hispanic patient with limited English proficiency. It is important for the nurse to: a. Use maternity jargon in order for the patient to become familiar with these terms. b. Speak quickly and efficiently to expedite the visit. c. Provide the patient with handouts. d. Assess whether the patient understands the discussion.
d. Assess whether the patient understands the discussion.
5. Nafarelin is currently used as a treatment for mild-to-severe endometriosis. The nurse should tell a woman taking this medication that the drug: a. Stimulates the secretion of gonadotropin-releasing hormone (GnRH), thereby stimulating ovarian activity. b. Should be sprayed into one nostril every other day. c. Should be injected into subcutaneous tissue BID. d. Can cause her to experience some hot flashes and vaginal dryness.
d. Can cause her to experience some hot flashes and vaginal dryness.
40. The nurse providing care in a women's health care setting must be aware regarding which sexually transmitted infection that can be successfully treated and cured? a. Herpes b. Acquired immunodeficiency syndrome (AIDS) c. Venereal warts d. Chlamydia
d. Chlamydia
8. When the nurse is unsure about how to perform a patient care procedure, the best action would be to: a. Ask another nurse. b. Discuss the procedure with the patient's physician. c. Look up the procedure in a nursing textbook. d. Consult the agency procedure manual and follow the guidelines for the procedure.
d. Consult the agency procedure manual and follow the guidelines for the procedure.
33. The nurse must watch for what common complications in a patient who has undergone a transverse rectus abdominis myocutaneous (TRAM) flap? a. Axillary edema and tissue necrosis b. Delayed wound healing and muscle contractions c. Delayed wound healing and axillary edema d. Delayed wound healing and hematoma
d. Delayed wound healing and hematoma
6. When managing health care for pregnant women at a prenatal clinic, the nurse should recognize that the most significant barrier to access to care is the pregnant woman's: a. Age. b. Minority status. c. Educational level. d. Inability to pay.
d. Inability to pay.
17. Recent trends in childbirth practice indicate that: a. Delayed pushing is now discouraged in the second stage of labor. b. Episiotomy rates are increasing. c. Midwives perform more episiotomies than physicians. d. Newborn infants remain with the mother and are encouraged to breastfeed.
d. Newborn infants remain with the mother and are encouraged to breastfeed.
10. With regard to dysmenorrhea, nurses should be aware that: a. It is more common in older women. b. It is more common in leaner women who exercise strenuously. c. Symptoms can begin at any point in the ovulatory cycle. d. Pain usually occurs in the suprapubic area or lower abdomen.
d. Pain usually occurs in the suprapubic area or lower abdomen.
16. The two primary areas of risk for sexually transmitted infections (STIs) are: a. Sexual orientation and socioeconomic status. b. Age and educational level. c. Large number of sexual partners and race. d. Risky sexual behaviors and inadequate preventive health behaviors.
d. Risky sexual behaviors and inadequate preventive health behaviors.
30. The nurse who is teaching a group of women about breast cancer would tell the women that: a. Risk factors identify more than 50% of women who will develop breast cancer. b. Nearly 90% of lumps found by women are malignant. c. One in 10 women in the United States will develop breast cancer in her lifetime. d. The exact cause of breast cancer is unknown.
d. The exact cause of breast cancer is unknown.
2. When a nurse is counseling a woman for primary dysmenorrhea, which nonpharmacologic intervention might be recommended? a. Increasing the intake of red meat and simple carbohydrates b. Reducing the intake of diuretic foods such as peaches and asparagus c. Temporarily substituting physical activity for a sedentary lifestyle d. Using a heating pad on the abdomen to relieve cramping
d. Using a heating pad on the abdomen to relieve cramping
24. The recommended treatment for the prevention of human immunodeficiency virus (HIV) transmission to the fetus during pregnancy is: a. Acyclovir. b. Ofloxacin. c. Podophyllin. d. Zidovudine.
d. Zidovudine.
terminal deletion
deletion at end of chromosome
microdeletion
deletion of a small part of a chromosome
Menstrual cycle day 28-30
end of cycle
What hormone stimulates growth of breasts and increase vascularity
estrogen
Family structure that includes the nuclear family and other people related by blood (kin) such as grandparents, aunts, uncles and cousins
extended
two parts of bony pelvis
false pelvis and true pelvis
A family theory that focuses on the family as it moves through stages and relationships among family members as the progress through transitions
family life cycle theory
A family theory concerned with the ways families react to stressful events; stress is studied within the internal and external contexts in which the family is living.
family stress theory
Family theory based on the belief that behavior is a function of the interaction of traits and abilities with the environment. Major concepts include ecosystem, niches, adaptive range, and ontogenetic development.
human developmental ecology
ANA ethical guidelines
in conduct, dissemination, and implementation of nursing research
Translocation
moves a segment from one chromosome to another
two main types of genes that have been recognized as playing a critical role in the development of cancer
oncogenes tumor suppressor genes
Menstrual cycle day 14
ovulation occurs and the mature egg is released into one of the fallopian tubes
causes mammary gland maturation
progesterone
menoapuse
refers to the last menstrual period
Trisomy 13 (Patau Syndrome)
severe cleft lip and/or palate, microphthlamia, severe mental retardation, microcephaly, holoprosencephaly, NTDs, polydactyly, rocker-bottom feet,
secondary prevention
targets populations at risk for certain diseases
mearche
the first menstrual period
puberty
the period of sexual maturation, during which a person becomes capable of reproducing
Pharmacogenomics
the study of how genetic inheritance affects the body's response to drugs
tertiary prevention
treatment and rehabilitation to prevent complications and further deterioration
Autosomal Recessive Inheritance
two recessive alleles must be present for trait to be displayed