OB Chapter 19

A female client has been prescribed oral metronidazole (Flagyl) for the treatment of bacterial vaginosis. What is essential for the nurse to teach the woman? -"Male sexual partners should also be treated." -"Avoid alcohol while taking this medication." -"Take the medication until the symptoms resolve." -"The medication can also treat candidiasis."

-"Avoid alcohol while taking this medication."

The nurse is reviewing discharge instructions with a patient who is postoperative after an abdominal hysterectomy. Which information should be included in the teaching plan? Select all that apply. -"Do not have sexual intercourse until advised by the surgeon." -"Report any amount of vaginal bleeding." -"Remain on bed rest for 2 weeks." -"Notify the provider for drainage or redness at the incision." -"Eat a well-balanced diet including protein, iron, and vitamin C."

-"Do not have sexual intercourse until advised by the surgeon." -"Notify the provider for drainage or redness at the incision." -"Eat a well-balanced diet including protein, iron, and vitamin C."

An elderly female patient has moderate stress incontinence and is prescribed estrogen cream to be applied to the genital area. She asks the nurse how this medication can help the incontinence. What is the best response by the nurse? -"This medication will decrease the stimulation to your bladder." -"Estrogen cream improves the tone and tissue in the urethral and vaginal areas." -"This medication helps to calm an overactive bladder." -"This medication reduces coughing, which triggers your stress incontinence."

-"Estrogen cream improves the tone and tissue in the urethral and vaginal areas."

The nurse is educating a female patient about her diagnosis of trichomoniasis. Which statement by the patient indicates the need for further teaching? -"My partner also needs to be treated." -"I got this from sitting on a toilet seat." -"This is probably causing my abnormal discharge." -"I will finish all of the medication prescribed."

-"I got this from sitting on a toilet seat."

A female patient diagnosed with polycystic ovary syndrome (PCOS) asks why she is having difficulty getting pregnant. What is the best response by the nurse? -"Your tubes may be blocked." -"You are probably not timing intercourse around when you are ovulating." -"It is likely that you are not ovulating." -"The lining of your uterus is too thin to support a pregnancy."

-"It is likely that you are not ovulating."

The nurse is teaching a female patient who has been diagnosed with polycystic ovary syndrome (PCOS). Which comment by the patient shows she understands her condition? -"I will need to have this large cyst on my ovary removed." -"My body is not making enough estrogen." -"My body is making too much testosterone." -"I have pain because I am ovulating every month."

-"My body is making too much testosterone."

The nurse in the post-anesthesia recovery unit is caring for a female patient who just had a laparoscope-assisted vaginal hysterectomy (LAVH). Which assessment finding by the nurse requires prompt reporting to the anesthesia provider? -Ankle edema -Patient reports nausea -Facial edema -Small amount of vaginal bleeding

-Facial edema

A patient with breast cancer is undergoing radiation. Which side effects should the nurse teach the patient about? Select all that apply. -Hair loss -Fatigue -Diarrhea -Skin changes on breast -Urinary tract infections

-Fatigue -Skin changes on breast

The nurse is reviewing preoperative instructions with a patient with stage III breast cancer who is scheduled for a simple mastectomy. Which statement by the patient indicates that she understands the procedure? -"They will remove the lump in my breast." -"They will remove all of the breast tissue, the nipple, and the areola." -"They will remove all of the breast tissue and several axillary lymph nodes." -"They will remove all of the breast tissue, the nodes, and the lining of my chest wall."

-"They will remove all of the breast tissue, the nipple, and the areola."

A female patient with endometriosis has been prescribed nafarelin (Synarel). How should the nurse explain the purpose of the medication? -"This is an anti-inflammatory drug, which will decrease your menstrual cramps." -"This is an oral contraceptive which stops you from ovulating." -"This is a progestin which thins the lining of the uterus." -"This is a gonadotropin-releasing hormone agonist, which suppresses hormones that cause ovulation."

-"This is a gonadotropin-releasing hormone agonist, which suppresses hormones that cause ovulation."

A client was diagnosed with endometriosis and asked the nurse what this is. How should the nurse respond? -"This is inflammation of abnormal endometrial tissue found outside the uterus." -"This is an infection of the lining of the uterus." -"This is excessive growth of cells in the uterus." -"This is a collection of benign growths on the uterus."

-"This is inflammation of abnormal endometrial tissue found outside the uterus."

A female patient was told she has fibrocystic breast changes. She asks the nurse if this means she has breast cancer. What is the best response by the nurse? -"This means you have a pre-cancerous condition, so you need more mammograms." -"This means you have stage I breast cancer, but it was detected early." -"This means you have fibrous tissue and cysts in your breasts. This is not cancer." -"This means you have a solid mass in your breast that needs to be watched."

-"This means you have fibrous tissue and cysts in your breasts. This is not cancer."

A female patient with polycystic ovary syndrome (PCOS) wants to get pregnant. What advice should the nurse give her? -"Weight loss may help with infertility." -"In vitro fertilization is the only option." -"Pregnancy is not possible with PCOS." -"Have intercourse around day 14 of your menstrual cycle."

-"Weight loss may help with infertility."

The nurse is teaching a female client about prevention of sexually transmitted infections (STIs). The client states, "I only have sex with women so I don't need to worry about that, do I?" Which is the best response by the nurse? -"No, only women who have sex with men can get STIs." -"Women who are lesbian and bisexual are also at risk for STIs." -"You are at risk only if you share sex toys with someone who is infected." -"Bacterial vaginosis is the only infection that is transmitted between women."

-"Women who are lesbian and bisexual are also at risk for STIs."

The nurse is caring for several female patients. Which patient is at an increased risk for a urinary tract infection (UTI)? Select all that apply. -A 76-year-old woman with new onset of confusion -A 30-year-old woman admitted for cholelithiasis -An 18-year-old woman using oral contraceptives -A 25-year-old gravid woman at 30 weeks' gestation -A 60-year-old woman postoperative hysterectomy with an indwelling Foley catheter

-A 76-year-old woman with new onset of confusion -A 25-year-old gravid woman at 30 weeks' gestation -A 60-year-old woman postoperative hysterectomy with an indwelling Foley catheter

A female client presents to the outpatient clinic for a possible vaginal infection. She reports vaginal itching and, upon examination, has vulvar erythema and thick curd-like discharge. Which condition should the nurse anticipate treatment for? -Trichomoniasis -Candidiasis -Bacterial vaginosis -Chlamydia

-Candidiasis

A female patient is admitted to the hospital for pelvic inflammatory disease (PID). Which of the following does the nurse know is most likely to cause PID? -Chlamydia trachomatis -Candida albicans -Escherichia coli -Human papillomavirus (HPV)

-Chlamydia trachomatis

A female patient discloses to the nurse that her boyfriend frequently hits her. Which nursing actions are appropriate? Select all that apply. -Initiate a restraining order from law enforcement -Determine urgent safety needs for her -Provide information regarding safe shelters -Assist her in developing a safety plan -Tell her to leave her boyfriend

-Determine urgent safety needs for her -Provide information regarding safe shelters -Assist her in developing a safety plan

The nurse is teaching a female client who desires pregnancy about the female reproductive cycle. Which are the main sites of regulation of the menstrual cycle? Select all that apply. -Hypothalamus -Posterior pituitary -Ovaries -Adrenal glands -Hippocampus

-Hypothalamus -Ovaries

The nurse is providing community education on intimate partner violence (IPV). Which should be included in the presentation? Select all that apply. -IPV mostly affects lower socioeconomic classes. -Stalking or psychological aggression is not considered violence. -Low academic achievement increases the risk. -Around 1 in 10 women in the United States will experience IPV during their lifetime.

-Low academic achievement increases the risk.

A patient with endometrial cancer asks the nurse what could have caused this type of cancer. Which risk factors should the nurse include in her discussion? Select all that apply. -Menopausal hormone therapy (MHT) -Obesity -Estrogen therapy without progesterone -Human papillomavirus (HPV) -Uterine fibroids

-Menopausal hormone therapy (MHT) -Obesity -Estrogen therapy without progesterone

A female client with endometriosis reports painful menstruation. The nurse knows this symptom is associated with which menstrual abnormality? -Primary dysmenorrhea -Secondary dysmenorrhea -Premenstrual syndrome -Oligomenorrhea

-Secondary dysmenorrhea

The nurse is teaching a female patient about her breast cancer reduction medication, tamoxifen (Nolvadex-D). Which should the nurse instruct the patient to report immediately? -Hot flashes and night sweats -Nausea -Sudden shortness of breath -Pain with intercourse

-Sudden shortness of breath

A female patient is concerned about her risk of ovarian cancer since her mother was just diagnosed. Which sign or symptom of ovarian cancer should the nurse teach the patient about? -Heavy menstrual bleeding -Swollen or bloated abdomen -Vaginal dryness -Hot flashes

-Swollen or bloated abdomen

The public health nurse is notifying sexual contacts of patients with sexually transmitted infections (STIs). Which STI would require the treatment of sexual partners? Select all that apply. -chlamydia -HPV -trichomoniasis -bacterial vaginosis -genital herpes

-chlamydia -trichomoniasis

The nurse is reviewing the medical record of a female patient who reports reoccurring vaginal yeast infections. Which items in the patient's history increase her risk for reoccurring vaginal yeast infections? Select all that apply. Frequent antibiotic use Patient reports douching New sexual partner Vaginal pH above 5.0 Diabetes

Frequent antibiotic use Patient reports douching Diabetes

A female client is concerned about breast cancer. Which factors should the nurse explain are risk factors for breast cancer? Select all that apply. Early onset of menarche Early onset of menopause Breast cancer gene (BRCA1 or BRCA2) mutation Oral contraceptive use Excessive alcohol use

Early onset of menarche Breast cancer gene (BRCA1 or BRCA2) mutation Excessive alcohol use

The nurse is reviewing the obstetrical findings of a female patient who had forceps-assisted vaginal births of three large babies. Which gynecological problems is this patient at risk for? Select all that apply. Endometriosis Rectocele Urinary incontinence Vaginal fistula Leiomyoma

Rectocele Urinary incontinence Vaginal fistula

A 22-year-old female patient is reporting urinary frequency and dysuria. Which laboratory test will the nurse anticipate being ordered? Microscopy of vaginal secretions Chlamydia nucleic amplification Urine human chorionic gonadotropin (hCG) Urine culture

Urine culture

A 50-year-old female client has a screening mammogram ordered, and asks the nurse, "Why do I need this if I don't feel any breast lumps?" Which is the best response by the nurse? "The mammogram can detect early stages of breast cancer, even before a lump is felt." "The mammogram can tell if the lump is a fluid-filled cyst or a solid mass." "The mammogram uses magnets and radio waves to find breast tumors." "There will be a small needle inserted in your breast to check for cancer."

"The mammogram can detect early stages of breast cancer, even before a lump is felt."

The nurse is talking to a women's group about cervical cancer and is asked how cervical cancer is diagnosed. Which is the correct response by the nurse? "With a Pap test." "With a test for human papillomavirus (HPV)." "With a colposcopy." "With a computed tomography (CT) scan."

"With a colposcopy."

The community health nurse is teaching a group of female clients about chlamydia. Which statement should be included in the education? -"Most women who are infected with chlamydia will have pelvic pain, fever, and abnormal discharge." -"Chlamydia is treated with a single IM dose of ceftriaxone." -"Chlamydia can lead to infertility and ectopic pregnancy." -"Chlamydia is the most common viral sexually transmitted infection (STI)."

-"Chlamydia can lead to infertility and ectopic pregnancy."

The nurse is caring for a female patient who underwent a total hysterectomy due to cervical cancer. The patient is crying and tells the nurse, "I really wanted to have another baby." Which is the best therapeutic response by the nurse? -"You can always adopt." -"You still have ovaries, so you could have a surrogate carry your baby." -"Now you don't have to worry about cervical cancer." -"You had plans for a family. What have you been told by your doctor?"

-"You had plans for a family. What have you been told by your doctor?"

The nurse is discussing health promotion with a patient with polycystic ovary syndrome (PCOS). Which conditions is the patient at higher risk for? Select all that apply. -Metabolic syndrome -Cardiovascular disease -Depression -Gestational diabetes -Endometriosis

-Metabolic syndrome -Cardiovascular disease -Depression -Gestational diabetes

The nurse is caring for a patient undergoing chemotherapy for ovarian cancer. What should be included in the plan of care for this patient? Select all that apply. -Offer several small meals every day -Provide a soft toothbrush -Encourage a clear liquid diet only -Encourage plenty of fluids -Offer large high-calorie meals

-Offer several small meals every day -Provide a soft toothbrush -Encourage plenty of fluids

The nurse is assessing a female patient with polycystic ovary syndrome (PCOS). Which assessment finding would indicate hyperandrogenism associated with PCOS? Select all that apply. -Patient reports menstrual irregularities -Oily skin with acne -Hirsutism -High-pitched voice -Alopecia

-Oily skin with acne -Hirsutism -Alopecia

A female patient with premenstrual syndrome (PMS) reports bloating, breast tenderness, and mood swings. The nurse would expect the patient to have these symptoms at which times? -Onset of symptoms on the first day of menses, decreased at the end of menses -Onset of symptoms in the second half of the cycle, decreased during menses -Onset of symptoms in the first half of the cycle, decreased at mid-cycle -Onset of symptoms does not correlate to the menstrual cycle and is random

-Onset of symptoms in the second half of the cycle, decreased during menses

A female patient with a history of ovarian cysts asks the nurse about birth control options. Which method of contraception would be best to reduce the risk of recurrence of ovarian cysts? -Oral contraceptives -Condoms -Diaphragm -Copper nonhormonal intrauterine device (IUD)

-Oral contraceptives

A female client has been trying to get pregnant for over 1 year. Which condition does the nurse explain as the most common cause of female infertility? -Endometriosis -Polycystic ovary syndrome -Chronic pelvic pain -Vaginitis

-Polycystic ovary syndrome

A 15-year-old female patient with a history of menarche at age 12 reports that she has not had menses for the last 3 months. Which contributing conditions should the nurse be aware of in order to anticipate medical interventions or orders? Select all that apply. -Congenital absence of the vagina or uterus -Pregnancy -Eating disorder -Competitive gymnast -Turner syndrome

-Pregnancy -Eating disorder -Competitive gymnast

A gravid female has bacterial vaginosis. Which pregnancy complication would the nurse educate the client to watch for? -Preterm labor -Oligohydramnios -Placenta abruption -Polyhydramnios

-Preterm labor

A 48-year-old female is at the clinic for her annual gynecological examination and has a concern over a finding on her vulva. Reviewing her complaints, what prescription does the nurse anticipate the provider ordering? -Metronidazole 2 gm -Tetracycline 500 mg -Ceftriaxone IM -Azithromycin 1 gm

-Tetracycline 500 mg

The nurse caring for a female patient suspects intimate partner violence (IPV). Which assessment finding would alert the nurse to this suspicion? Select all that apply. -A single bruise on her thigh -Untreated injuries -Repeated visits to the emergency department -Several bruises at various stages of healing -Explanation of injury not consistent with injury

-Untreated injuries -Repeated visits to the emergency department -Several bruises at various stages of healing -Explanation of injury not consistent with injury

An older female patient has a mild uterine prolapse and declines surgery. What measures should the nurse suggest to the patient to manage this condition without surgery? Select all that apply. -Avoiding sexual intercourse -Using a vaginal pessary -Eating a high-fat diet to avoid loose stools -Performing Kegel exercises -Avoiding heavy lifting

-Using a vaginal pessary -Performing Kegel exercises -Avoiding heavy lifting

The nurse caring for a female patient suspects she has metabolic syndrome. Which assessment finding would be consistent with metabolic syndrome? -High blood pressure -Body mass index (BMI) of 30 -Waist circumference of 38 inches -Triglyceride level of 130 mg/dL

-Waist circumference of 38 inches

The nurse is caring for a client who is being assessed for abdominal pain, pressure, and dysmenorrhea. The nurse is gathering information for the condition the client is experiencing. Complete the following using the dropdown choices.

-hormonal therapy -suppress menstruation

The nurse in the emergency department is caring for a female patient with multiple bruises on her face and arms. Her husband stays very close to her and states she ran into a door. What is the highest priority nursing action? -Notify law enforcement -Document the bruises -interview the patient in private -Assess for other bruises

-interview the patient in private

The nurse is caring for a 48-year-old client who has had an abnormal test result. The provider is discussing the plan of care with the client. Complete the bowtie by dragging and dropping the condition the client is most likely experiencing, two actions the nurse should take/anticipate related to the condition, and two parameters the nurse should monitor.

-shedule the client for the cryosurgery as ordered by the provider -schedule the client for internal radiation as ordered by the provider -cervical cancer -family repsonse -nutritional status

A patient with gonorrhea has an order for ceftriaxone 250 mg IM one time. The medication is available as a single dose vial with 500 mg of ceftriaxone powder. The nurse reconstitutes the powder with 1 mL of sterile water. How many mL should the nurse administer? Enter the numeral only.

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