OB Chapter 6

A nurse is receiving a client from the postanesthesia unit to the recovery unit at the ambulatory surgery center. The client just had a laparoscopic tubal ligation. Which is the nurse's priority assessment? Pain Abdominal bloating Depression Bleeding

Bleeding

The nurse is assessing the laboratory test results of a client with abnormal uterine bleeding (AUB). Which finding should the nurse prioritize? serum cholesterol of 140 mg/dl (3.63 mmol/L) hemoglobin level of 10.1 g/dl (101 g/L) negative pregnancy test prothrombin time of 40 seconds

hemoglobin level of 10.1 g/dl (101 g/L)

A client is requesting information on the various available contraceptives. When explaining a vaginal spermicide, which information should the nurse prioritize? Wash with clean water and soap after intercourse. Apply the spermicide directly to the glans penis to kill the sperm when they exit the penis. Leave the product in place for 24 hours after intercourse. Insert the product by applicator in the vagina prior to intercourse.

Insert the product by applicator in the vagina prior to intercourse.

The school nurse is preparing a health education session on the topic of birth control for a college group. Which method should the nurse emphasize for this group? hormonal rhythm barrier transdermal

barrier

The nurse is teaching a young couple who desire to start their family the various methods for determining fertility. After discovering the woman regularly travels internationally for work, deals with a lot of job anxiety, and frequently uses an electric blanket at home, the nurse will discourage the use of which method? calendar method basal body temperature method symptothermal method cervical mucus method

basal body temperature method

A nurse is talking to an adolescent who informs the nurse about being sexually active and wanting some type of birth control. Which option should the nurse recommend to this client? female condom Intrauterine device (IUD) male condom birth control pills

birth control pills

The nurse is developing a presentation for a group of young adult women about premenstrual syndrome. Which treatment options should the nurse point out as most appropriate? Select all that apply. reduction of caffeine intake antipsychotic medications decrease in water intake vitamin and mineral supplements NSAIDs

reduction of caffeine intake vitamin and mineral supplements NSAIDs

After teaching a woman who has chosen the vaginal ring as her method of contraception, the nurse determines that the client needs additional teaching when she makes which statement? "I will insert a new ring at the same time and day of every week." "Once I remove the ring, I will discard it." "I will compress the ring, inserting it as far back as possible." "If I do not get the ring centered on my cervix, it will still be effective."

"I will insert a new ring at the same time and day of every week."

A woman in the 15th week of gestation is planning on terminating the pregnancy. The procedure done for second-trimester terminations is which of the following? hysterotomy dilatation and curettage menstrual extraction dilatation and extraction

dilatation and extraction

A newly married couple is meeting with the nurse to discuss a temporary method of birth control that is both a natural form and does not employ birth control pills/devices, in keeping with their religious beliefs. Which method should the nurse point out will best meet their request to delay conception until they are ready? coitus interruptus lactation amenorrhea method vasectomy CycleBeads

CycleBeads

The nurse is providing education about barrier contraceptives. Which statement by the client indicates a need for further education? "I can insert my female condoms up to 8 hours before intercourse." "Male latex condoms when used correctly are an effective means of contraception." "I have to wash my cervical caps after each use." "I can leave my diaphragm in for up to 48 hours."

"I can leave my diaphragm in for up to 48 hours."

The nurse is educating a class of high school students on safe sexual practices. The nurse knows the group understood the content when a group member makes which statement? "Spermicide should be applied immediately following intercourse." "A diaphragm can be used by males and females." "A condom is the best way to prevent pregnancy." "Abstinence is the only way to prevent the spread of sexually transmitted infections."

"Abstinence is the only way to prevent the spread of sexually transmitted infections."

An 18-year-old female client who is sexually active asks the nurse for information on barrier contraceptives. Which statement is appropriate for the nurse to include in the response? "The use of a diaphragm is a good choice if you have frequent urinary tract infections." "A diaphragm must be inserted 1 hour prior to sexual intercourse." "A cervical cap is a barrier contraceptive that you can purchase over the counter." "Cervical caps are most effective when used along with a spermicidal agent."

"Cervical caps are most effective when used along with a spermicidal agent."

A nurse is preparing a client for intrauterine device (IUD) insertion. Which education will the nurse provide to the client? "The insertion procedure for an IUD is painless." "An IUD will prevent sexually transmitted infections (STIs)." "Expect to have continuous uterine cramps after insertion." "Checking the strings is recommended following insertion."

"Checking the strings is recommended following insertion."

A nurse is completing an informed consent on a client preparing for a tubal ligation. Which statement by the client would require the nurse to notify the health care provider? "I will continue to have my menstrual cycle every month." "I may need to use a second form of contraception for a while." "I will not be able to have children after this procedure." "I will be able to have my third child in about a year from now."`

"I will be able to have my third child in about a year from now."

After assessing a woman who has come to the clinic, the nurse suspects that the woman is experiencing abnormal uterine bleeding. Which statement by the client would support the nurse's suspicions? "I get really irritable and moody about a week before my period." "I've been having bleeding off and on that's irregular and sometimes heavy." "My periods have been unusually long and heavy lately." "I get sharp pain in my lower abdomen usually starting soon after my period comes."

"I've been having bleeding off and on that's irregular and sometimes heavy."

The nurse working in a free health clinic assesses a 17-year-old client interested in contraceptives. Which statement by the client would indicate that female or male condoms would be the appropriate recommendation? "Last year I was diagnosed with HPV." "I am leaving for college in just a few months." "I do not want to follow in my sister's footsteps." "I have no problems swallowing medications."

"Last year I was diagnosed with HPV."

A couple is deciding about contraceptive measures. The male partner has decided to undergo a vasectomy. After teaching the client about this procedure, which client statement indicates the need for additional teaching? "I will have this done in my urologist's office." "I will be able to go back to work in a day or two." "I will be awake and will get local anesthesia." "Right after surgery, my semen will be sperm-free."

"Right after surgery, my semen will be sperm-free."

The nurse educates a 15-year-old female client on ways to prevent pregnancy. Which statement will the nurse include in the teaching? "Oral contraceptive pills are effective at preventing pregnancy as long as you take one each week." "The use of a condom is a method often recommended to prevent pregnancy for people your age." "If you do not want to become pregnant within the next 10 years, an intrauterine device would be best." "The withdrawal method is effective as long as you have a monogamous partner."

"The use of a condom is a method often recommended to prevent pregnancy for people your age."

The nurse is providing education to a male client on vasectomy. What teaching should the nurse include? Select all that apply. "You will be placed under general anesthesia for the procedure." "You can resume sexual intercourse in about one week." "The procedure will stop the production of sperm." "There will be a significant amount of pain following the procedure." "The vas deferens is cut or cauterized to stop the passage of sperm."

"The vas deferens is cut or cauterized to stop the passage of sperm." "You can resume sexual intercourse in about one week."

A client is seen in the clinic requesting an emergency postcoital contraception pill levonorgestrel (Plan B). The client states that she had unprotected sex 3 ½ days ago. What is the most appropriate response by the nurse? "You will need to also be treated with antibiotics for an STI." "Unfortunately you are past the time frame to take that prescription." "You should contact the local abortion clinic to set up an appointment." "The pill will cause you to begin menstruating within a day."

"Unfortunately you are past the time frame to take that prescription."

A nurse working at a family planning clinic is educating a client on the use of an intrauterine device (IUD) for pregnancy prevention. Which instruction will the nurse provide? "You will place the IUD within the uterus to prevent implantation of a fertilized ovum." "Your IUD will not prevent fertilization of the egg." "Your IUD is small devices made of flexible plastic that provides irreversible birth control." "Your IUD likely affects the way the sperm or egg moves."

"Your IUD likely affects the way the sperm or egg moves."

A woman has opted to use medroxyprogesterone injections for birth control. The client receives the first injection today. The nurse instructs the woman to return to the clinic in how many months for the next injection? 1 4 3 2

3

The nurse is caring for four female clients, all prescribed oral contraceptive pills. The nurse will question giving an oral contraceptive pill to which client? 25-year-old client who has had three miscarriages and leads a sedentary lifestyle 30-year-old client who drinks a glass of wine daily and whose aunt had breast cancer 40-year-old client who has a history of asthma and a total cholesterol level of 170 mg/dl (4.40 mmol/l) 37-year-old client who has migraines with aura several times a week and smokes

37-year-old client who has migraines with aura several times a week and smokes

A client who delivered her baby 3 months ago is seen in the clinic and tells the nurse that she and her husband have yet to resume a sexual relationship. The nurse notes that no contraception is currently being used. What is the most appropriate nursing diagnosis for this client? Powerlessness related to failure of chosen contraceptive Decisional conflict related to unintended pregnancy Spiritual distress related to partner's preference for contraception Altered sexual pattern related to fear of pregnancy

Altered sexual pattern related to fear of pregnancy

A client expresses interest in having an intrauterine device (IUD) placed for contraception. Which finding noted in the health history would indicate to the nurse that this would not be an appropriate contraceptive option? Bicornuate uterus G1P0 Sexually active since 16 Dysmenorrhea

Bicornuate uterus

The nurse is discussing permanent birth control with a female client and her husband. Which of the following is considered a permanent nonsurgical sterilization method? Essure vasectomy tubal occlusion tubal ligation

Essure

The nurse is working in a family planning clinic assisting people with with a variety of reproductive issues. Which nursing consideration(s) is appropriate when providing care? Select all that apply. Establish realistic outcomes. Honor all wishes of the client. Be sensitive to religious, cultural, and moral beliefs. Explore his or her own beliefs and values. Teach the client what the nurse is comfortable with.

Establish realistic outcomes. Be sensitive to religious, cultural, and moral beliefs. Explore his or her own beliefs and values.

The school nurse is counseling a sexually active 16-year-old adolescent about the various forms of contraception. She is afraid of getting pregnant or contracting a sexually transmitted infection because her boyfriend refuses to use a condom. In answering the client's questions as to which option will be best suit her needs, which form should the nurse recommend? Oral contraceptive Female condom Tubal ligation Coitus interruptus

Female condom

Which statement best explains the action of the lactational amenorrhea method (LAM) of fertility control? LAM causes suppression of the ovulation process. LAM prevents fertilization between the egg and sperm. LAM prevents introduction of sperm into the vagina. LAM thickens the cervical mucus and blocks sperm.

LAM causes suppression of the ovulation process.

A nurse is planning care for a client and her husband recently diagnosed with multiple sclerosis and wanting to prevent pregnancy for now. What is the most appropriate nursing diagnosis for this couple? Readiness for enhanced knowledge regarding contraception options Decisional conflict regarding choice of birth control because of health concerns Risk for ineffective health maintenance related to lack of knowledge Altered sexuality pattern related to fear of pregnancy

Readiness for enhanced knowledge regarding contraception options

The nurse is preparing to teach a client how to conduct the basal body temperature method to determine her fertile window. Which instruction should the nurse prioritize? It depends on the average temperature taken each morning. Temperature should be taken prior to any activity every morning. Avoid intercourse only on the days the temperature drops. It is the best method for predicting ovulation.

Temperature should be taken prior to any activity every morning.

The nurse is teaching a client about a vasectomy. The nurse determines the session is successful when the client correctly chooses which fact concerning the vasectomy? Usually done as an office procedure May notice permanent increased scrotal swelling Testes will no longer produce sperm. Will no longer ejaculate

Usually done as an office procedure

A client with liver disease is seen in the clinic wanting to begin contraception. The nurse recognizes that which type of contraception is best for this client? Intramuscular injections Vaginal estrogen/progestin (contraceptive) ring Subdermal hormone implant Oral contraceptive pills (OCPs)

Vaginal estrogen/progestin (contraceptive) ring

A client prescribed a combined oral contraceptive (COC) has presented for a routine visit. Which finding if reported by the client upon assessment should the nurse prioritize? abdominal pain light menstrual flow cramping during menses small amount of breakthrough bleeding

abdominal pain

A woman is to receive methotrexate and misoprostol to terminate a first-trimester pregnancy. When preparing the teaching plan for this client, the nurse understands that misoprostol works by: causing uterine contractions to expel the uterine contents. blocking the action of progesterone on the endometrium. acting as a toxin to the trophoblastic tissue. dilating the cervix.

causing uterine contractions to expel the uterine contents.

The nurse is providing care to a woman who has come to the clinic for suggestions about contraception. When determining the recommendation for a client, which factor would be most important for the nurse to integrate into the plan of care? desire for protection against sexually transmitted infections (STIs) client's ability to tolerate side effects sexual orientation of the client client's partner's desire for pregnancy

client's ability to tolerate side effects

An adolescent client asks the nurse if there is any 100% effective method of birth control and protection against sexually transmitted infections. Instruction should be provided on which method? intrauterine devices with copper use of spermicides condoms continual abstinence

continual abstinence

Which of the following would not be considered a disadvantage of the calendar/rhythm method of family planning? cost effectiveness need for cooperation need for motivation

cost

The nurse discusses various contraceptive methods with a client and her partner. Which method would the nurse explain as being available only by prescription? basal body temperature spermicide diaphragm condom

diaphragm

A nurse is conducting education classes at the local high school on reproductive life planning. Which would be appropriate for the nurse to implement during the teaching? Select all that apply. various religious viewpoints encouragement of abstinence sexually transmitted infection statistics nurse's personal opinion on abortion (elective termination of pregnancy) proper condom application

encouragement of abstinence proper condom application sexually transmitted infection statistics

A nurse practitioner (NP) is presenting information about birth control pills to a group of young women. One of the women in the group asks the NP, "When would birth control pills not be a good idea?" Which situation would the nurse include as a possible contraindication for the use of birth control pills? Select all that apply. history of thromboembolic disease smoking 40 years or older family history of cerebrovascular or cardiovascular disease diabetes

history of thromboembolic disease family history of cerebrovascular or cardiovascular disease 40 years or older smoking

A client comes to the clinic for a medical termination of pregnancy. Which potential complications should the nurse point out are possible with this type of procedure? Select all that apply. hypoglycemia prolonged bleeding incomplete abortion infection pneumonia

incomplete abortion prolonged bleeding infection

The nurse is providing contraception counseling to a perimenopausal woman who has had negative reactions to oral contraceptives (OCs) in the past and would like a long-term, nonhormone-based method that has a high rate of success. Neither she nor her husband wants to undergo surgery, however. Which method should the nurse recommend? transdermal patch tubal ligation intrauterine device subdermal progestin implant

intrauterine device

When discussing contraceptive options, the nurse would recommend which option as being the most reliable? coitus interruptus intrauterine system natural family planning lactational amenorrheal method (LAM)

intrauterine system

A woman is using depot medroxyprogesterone acetate (Depo-Provera) as a method of birth control. Which side effect would the nurse most likely include as common? irregular menstruation nausea pregnancy constipation

irregular menstruation

The nurse is meeting with a 36-year-old client who wishes to begin using contraceptives. The client reports being in a long-term, monogamous relationship, runs 2 miles per day, and smokes a pack of cigarettes each day. Which method will the nurse be least likely to suggest to the client? coitus interruptus oral contraceptive pills (OCPs) spermicides condoms

oral contraceptive pills (OCPs)

A woman has opted to use the basal body temperature method for contraception. The nurse instructs the client that a rise in basal body temperature indicates which event? safe period for intercourse onset of menses ovulation pregnancy

ovulation

A woman is diagnosed with premenstrual dysphoric disorder. To address the woman's behavioral symptoms, which class of agents would the nurse anticipate needing to be addressed in the woman's teaching plan? vitamin supplements nonsteroidal anti-inflammatory drugs (NSAIDs) selective serotonin reuptake inhibitors (SSRIs) diuretics

selective serotonin reuptake inhibitors (SSRIs)

A woman who is using an intrauterine system for contraception comes to the clinic. When assessing the woman, which finding(s) would alert the nurse to a possible complication? Select all that apply. menstrual flow lighter and shorter string length shorter than on initial visit absence of pain with intercourse reports of abdominal pain oral temperature of 101°F (38.3°C)

string length shorter than on initial visit reports of abdominal pain oral temperature of 101°F (38.3°C)

A nurse is helping a couple choose a contraception method that is right for them. Which is the least likely factor the nurse should consider? the popularity of the method among the couple's friends ability to use a method correctly whether the method will affect sexual enjoyment financial factors

the popularity of the method among the couple's friends

A couple has chosen fertility awareness as their method of contraception. The nurse explains that the unsafe period for them during the menstrual cycle would be at which time? five days after the first day of the menstrual cycle six days before the onset of menstruation midway between the normal menstrual cycle three days before and three days after ovulation

three days before and three days after ovulation

A client desires protection from unwanted pregnancies. However, the client does not enjoy sex when her partner wears a male condom. Also, the client experiences breast tenderness, headache, and nausea after taking oral contraceptive pills (OCPs). Which method would be the most likely choice for the couple to help them enhance their sexual experience as well as prevent any side effects? transdermal contraceptive natural membrane condom polyurethane condom ethinyl estradiol

transdermal contraceptive

A nurse is instructing a client on birth control methods. The client asks about the cervical mucus method. When should the nurse tell the client she is fertile in relation to her mucus? when it is thick Cervical mucus is not a reliable indicator. when it is thin, watery, and copious when it does not stretch

when it is thin, watery, and copious