Nurs 304 test Mater
One of the responsibilities of a nurse in a fertility specialist's office is to provide health teaching to the client in relation to timing of intercourse. Which time should the nurse stress as the best time to achieve a pregnancy?
14 days before the next period is expected
A client seeking advice about contraception asks a nurse about how an intrauterine device (IUD) prevents pregnancy. How should the nurse respond?
"It produces a spermicidal intrauterine environment."
While being admitted for a lumpectomy the client begins to cry and says, "I found the lump a few months ago, but I didn't go to the doctor because of what it could be." How should the nurse reply?
"This has been frightening for you."
Genetic testing is being discussed with a couple at the fertility clinic. What is the nurse's best response when they express concerns?
"Environmental factors can have an impact on genetic factors."
A nurse is counseling an obese postmenopausal client how to prevent bone loss. Which statements indicate understanding of the strategies to prevent bone loss? Select all that apply.
"I should take 1200 mg of calcium every day." "Going to an aerobics class three times a week will help my bones."
Which statements by a client with hyperemesis gravidarum would confirm that the client needs further teaching? Select all that apply.
"I'll start limiting my carbohydrates." "I'll lie down for at least 2 hours after I eat."
A 45-year-old client is to undergo a hysterectomy and expresses concern because she has heard from friends that she will experience severe symptoms of menopause after surgery. What is the nurse's most appropriate response?
"Women may experience symptoms of menopause if their ovaries are removed with their uterus."
A client is scheduled for a laparoscopic bilateral tubal ligation. What should the nurse include in preoperative teaching?
"You will be admitted as an outpatient for same-day surgery."
Contraceptives that contain estrogen-like and/or progesterone-like compounds are prepared in a variety of forms. Which contraceptives should the nurse tell clients have a hormonal component? Select all that apply.
Oral drugs Transdermal agents
A health care provider prescribes teriparatide (Forteo), a parathyroid hormone (PTH) agonist, for a client with osteoporosis. What should the nurse consider before administering this medication?
Osteoblastic activity is stimulated more than osteoclastic activity
After treatment for a bladder infection, a client asks whether there is anything she can do to prevent cystitis in the future. What is the best response by the nurse?
Increase daily fluid consumption.
A couple interested in delaying the start of a family discuss the various methods of family planning. Together they decide to use the basal body temperature method. The nurse explains that the fertile period surrounding ovulation lasts from:
72 hours before to 24 hours after ovulation
At 12 weeks' gestation a client who is Rh negative expels the total products of conception. What is the nursing action after it has been determined that she has not been previously sensitized?
Administering RhoGAM within 72 hours
The clinic nurse is planning care for a client found to have Chlamydia. Which treatment should the nurse plan to implement?
Administration of azithromycin (Zithromax) 1 g orally in a single dose
After an abdominal hysterectomy the client returns to the unit with an indwelling catheter. The nurse notes that the urine in the client's collection bag has become increasingly sanguineous. What complication does the nurse suspect?
An incisional nick in the bladder
A client with a third-degree uterine prolapse is scheduled for a vaginoplasty. What should the nurse anticipate the surgeon will prescribe?
Apply moist compresses to the uterine prolapse
The clinic nurse is reviewing the dietary intake of a 16-year-old client who is 12 weeks pregnant. What is the nurse's next action?
Asking the client, "How many servings of dairy do you generally consume each day?
A client who has breast cancer had postlumpectomy chemotherapy and is now scheduled for radiation on an outpatient basis. What is an important nursing intervention while the client is receiving radiation?
Assessing the irradiated site daily for redness or irritation
A 25-year-old woman comes to the clinic complaining of increased vaginal discharge, milky gray in color with a "fishy" odor that both she and her husband have noticed. A wet smear is performed and the presence of "clue cells" confirmed. Which type of infection does the nurse suspect?
Bacterial vaginosis
An estrogen-progestin oral contraceptive is prescribed for a client. Which adverse effects should the nurse teach the client to report to the health care provider? Select all that apply.
Chest pain Breast soreness Calf tenderness
A couple interested in family planning ask the nurse about the cervical mucus method of family planning. The nurse explains that with this method the couple must avoid intercourse when and a few days after the cervical mucus is:
Clear and stretchable
A client is admitted to the postanesthesia care unit after abdominal hysterectomy. Which assessment should the nurse report to the health care provider immediately?
Decreased urine output
A nurse is teaching a group of women about the side effects of different types of contraceptives. What frequent side effect associated with the use of an intrauterine device (IUD) should the nurse discuss during the teaching session?
Excessive menstrual flow (After IUD insertion there may be excessive menstrual flow for several cycles)
A client with cancer of the cervix has an intracavity radioactive sealed implant in place. What precaution should the nurse take to protect against excessive exposure to radiation?
Exiting the room walking backward while wearing a lead apron
The nurse is providing nutrition teaching to a 22-year-old primipara who is 6 weeks pregnant. To decrease the occurrence of neural tube defects in newborns, the nurse would encourage the adequate intake of:
Folic acid
The nurse is caring for a couple who just received amniocentesis results indicating that their fetus has trisomy 18. Why is it important for a nurse to support the parents' decision to abort a fetus with a birth defect even if the nurse is morally opposed to abortion?
It is important for maintenance of the family equilibrium (Although support may help minimize guilt and feelings of pressure, it will not eliminate it; however, support will sustain family cohesion and unity)
A 23-year-old woman comes to the clinic for a Pap smear. After the examination, the client confides that her mother died of endometrial cancer 1 year ago and says that she is afraid that she will die of the same cancer. Which risk factor stated by the client after an education session on risk factors indicates that further teaching is needed?
Late-onset menarche
A client in preterm labor is to receive a tocolytic medication, and bedrest is prescribed. Which position should the nurse suggest that the client maintain while on bedrest?
Lateral
A 32-year-old woman is admitted to the unit with a history of fibroids and menorrhagia. Which findings does the nurse expect to encounter during assessment of the client? Select all that apply
Pale mucous membranes Difficulty emptying the bladder
A histogram (hysterosalpingography [HSG]) is performed to determine whether a client has a tubal obstruction. The nurse explains to the client that infertility caused by a defect in the tube is most often related to:
Past infection
What is the most important factor for a nurse to consider when selecting nursing measures to help parent-child relationships during the immediate postpartum period?
Physical status of the infant
A nurse is planning to administer RhoGAM (Rh immune globulin). Which situation requires the administration of this medication?
Rh-negative woman who has had an amniocentesis
A client appears at the clinic after getting a positive result on a home pregnancy test. She states that her last menstrual period began 10 weeks ago. The client expresses fear because she has been recently found to have syphilis. What prescriptions will the nurse expect to receive from the health care provider because of this information? Select all that apply.
Screening and testing of sexual partners Intramuscular benzathine penicillin G, 2.4 million units, one dose
1-The nurse is interviewing a 41-year-old woman who is being seen in the infertility clinic for her first visit. She and her husband have been married for 3 years and have not used any form of contraception during this time. Neither the woman nor her husband has children from previous relationships. She asks the nurse what test or treatment will be done first. The nurse informs her that she and her husband should first expect:
Semen analysis
A 36-year-old client undergoes a modified radical mastectomy. The nurse determines that the client understands the schedule for self-examination of her remaining breast when she states that she will examine her breast:
Seven days after each menstrual period
A nurse is obtaining a health history from a client with newly diagnosed cervical cancer. What aspect of the client's life is most important for the nurse to explore at this time?
Support system
A nurse is evaluating a client's understanding regarding postoperative concerns after mastectomy. Which development near and around the incision noted by the client should be reported to her practitioner?
Swelling with erythema
A client has undergone suction curettage for the removal of a hydatidiform mole. What should the nurse emphasize when planning for the client's discharge?
The reasons for postponing another pregnancy for an entire year
On the first day after a mastectomy, a nurse encourages the client to perform exercises such as flexion and extension of the fingers and pronation and supination of the hand. The client asks why she has to do these exercises. The best response by the nurse is:
They will help stimulate peripheral circulation.
A 37-year-old woman is admitted to the unit with severe menorrhagia. During assessment the nurse learns that she has a history of fibroids, menorrhagia, pelvic pain, and depression. The client has been undergoing hormone therapy in hopes of easing the symptoms and reducing the size of the fibroids, without success. The lab reports hemoglobin and hematocrit readings of 6.8 and 20.2, respectively. The client begins to sob and cries, "I don't know what to do—the doctor is recommending a hysterectomy, but I haven't had children yet!" What is the best response by the nurse?
This must be so difficult for you. Children are really important to you?
A woman questions the nurse about the effectiveness of oral contraceptives. What most important factor about the effectiveness of oral contraceptives should be included in the reply to this question?
User motivation
A nurse is assessing a 55-year-old client who is experiencing postmenopausal bleeding. The tentative diagnosis is endometrial cancer. Which findings in the client's history are risk factors associated with endometrial cancer? Select all that apply.
Obesity Family history of endometrial cancer Previous hormone replacement therapy
A 20-year-old woman visiting the clinic says that she wishes to begin using depot medroxyprogesterone acetate (Depo-Provera) as a form of birth control. What important information should the nurse include when teaching the client about Depo-Provera?
Calcium intake and exercise should be increased because of possible loss of bone mineral density with increasing duration of use.
A nurse is caring for a client who has contracted a trichomonal infection. Which oral drug should the nurse anticipate that the health care provider will most likely prescribe?
Metronidazole (Flagyl)
The plan of care for a client with osteoporosis includes active and passive exercises, calcium supplements, and daily vitamins. How does a nurse determine that the desired effect of therapy has been achieved?
Mobility increases
A nurse is teaching clients how to determine the time of ovulation by taking the basal body temperature. What change in the basal temperature during ovulation should the nurse teach the clients to expect?
A slight drop followed by an increase
While preparing a client for her first routine Papanicolaou (Pap) smear, a nurse determines that she appears anxious. What should the nurse include as part of the teaching plan?
Current statistics on the incidence of cervical cancer
A 28-year-old woman comes into the clinic and tells the nurse that she fears that she is infertile because she has been trying to become pregnant for 2 years. While collecting the health history the nurse learns that the client experiences irregular and infrequent menstrual periods. The client is overweight and has severe acne and alopecia. The health care provider diagnoses polycystic ovarian syndrome (PCOS). Which of the following interventions is the most important?
Discussing weight loss, exercise, and a balanced low-fat diet
A 24-year-old woman wants to use her basal body temperature (BBT) in natural family planning but is unsure when to take her temperature. The nurse informs her that an accurate BBT is best taken:
Each morning prior to getting out of bed or increasing her activity
A nurse in the fertility clinic is instructing a client who will be using progesterone gel vaginally in the treatment of luteal phase infertility. When discussing the side effects of progesterone, what should the nurse tell the client to expect?
Enlarged, tender breasts
A pregnant client with severe preeclampsia is receiving an infusion of magnesium sulfate. What does the nurse identify as the main reason that this medication is administered?
It acts as an anticonvulsant.
A nurse in the family planning clinic reviews the health history of a sexually active 16-year-old girl whose chief concern is a thick, burning discharge accompanied by a burning sensation and lower abdominal pain. After an examination the girl is informed that she may have a sexually transmitted infection (STI) that requires treatment. The adolescent is concerned that her parents will discover that she has been sexually active and asks the nurse whether her parents will be contacted. The nurse explains that her parents will:
Not be contacted, because treatment at the clinic is confidential
A nurse is counseling a couple in the fertility clinic. Which aspect of the protocol requires anticipatory guidance by the nurse because of the stress it puts on the couple?
Planning when to have intercourse
All women of childbearing age are advised to include at least 400 micrograms of folic acid in the daily diet to lessen the risk of neural tube defects in pregnancy. What should the nurse recommend to meet the recommendation? Select all that apply.
Vitamin B9 Legumes, dark-green leafy vegetables, and citrus fruits
A client is trying to become pregnant. The nurse should teach the client that a postcoital test to evaluate fertility should be performed:
Within 1 to 2 days of presumed ovulation
