OB - Infertility and Contraception

C. Primary amenorrhea

A 19-year old woman comes to the gynecologist's office. When the nurse asks the reason for the visit, the woman explains that she has never had a menstrual period. Her nurse correctly documents this subjective information in the chart as: A. Secondary amenorrhea B. Primary dysmenorrhea C. Primary amenorrhea D. Secondary infertility

C. The complete series of three intramuscular injections

A 19-year-old client with multiple sex partners is being counseled about the hepatitis B vaccination. During the counseling sessions, which of the following should the nurse advise the client to receive? A. The vaccine as soon as she turns 21 B. A vaccine booster every 10 years C. The complete series of three intramuscular injections D. The hepatitis B immune globulin before receiving the vaccine

C. "There is an increased risk of tissue abnormality inside your uterus if only estrogen is given"

A 49-year old client comes to the clinic with complaints of severe perimenopausal symptoms such as hot flashes, night sweats, urinary urgency, and vaginal dryness. The MD has prescribed a combination hormone replacement therapy of estrogen and progestin. When the client asks the nurse why she must take 2 hormones, the best reply is: A. "Your blood pressure may become elevated if only one hormone is used" B. "You are having very severe symptoms, so you need more hormones replaced" C. "There is an increased risk of tissue abnormality inside your uterus if only estrogen is given" D. "The MD thinks that this is best"

B. Menorrhagia

A client is complaining of having heavier than normal bleeding during her menstrual period. Her nurse correctly documents this subjective information in the chart as: A. Metrorrhagia B. Menorrhagia C. Hypermenorrhea D. Polymenorrhea

B. Sister with premenopausal breast cancer

A client is concerned about her risk for breast cancer. Following the initial history, the RN identifies which of the following as a high risk factor for breast cancer? A. Mother with fibrocystic breast B. Sister with premenopausal breast cancer C. Multiparity D. History of late menarche and early menopause

C. Vitamin D

A client is put on calcium supplements to maintain bone health. To maximize absorption, the client is also advised to take which of the following supplements? A. Iron B. Vitamin E C. Vitamin D D. Folic acid

C. Diaphragm

A woman has a history of toxic shock syndrome. She should be taught to avoid which of the following forms of birth control? A. Depo provera injection B. Intrauterine Device C. Diaphragm D. Birth control pills

A. avoid vitamin C intake for 72 hours before testing.

As part of the client teaching concerning fecal occult blood testing, the nurse should tell clients to: A. avoid vitamin C intake for 72 hours before testing. B. include plenty of raw fruits and vegetables in her diet 3 days before and throughout the testing time. C. take 81 mg of aspirin each day for 7 days before the test D. collect a specimen from three sections of one stool and return the slides immediately

D. Chlamydia

The most common sexually transmitted bacterial infection (STI) in the United States is: A. Gonorrhea B. HIV C. Trichomoniasis D. Chlamydia

B. Chlamydia

The nurse providing care in a womens health care setting must be aware that which sexually transmitted disease (STD) can be cured? A. Acquired immunodeficiency syndrome (AIDS) B. Chlamydia C. Herpes D. Venereal warts

A. do Kegel exercises.

To assist the woman in regaining control of the urinary sphincter, the nurse should teach her to: A. do Kegel exercises. B. allow the bladder to become distended before voiding. C. void every hour while awake D. drink 8 to 10 glasses of water each day.

D. Limit the use of superabsorbant tampons to the times when the flow is heavy

To reduce the risk of toxic shock syndrome, women should be taught to: A. Use a diaphragm with spermicidal jelly during the menstrual period B. Avoid changing tampons until they are thoroughly saturated C. Wash hands throroughly before inserting a tampon or diaphragm into the vagina D. Limit the use of superabsorbant tampons to the times when the flow is heavy

B. "Water-soluble vaginal lubricants may provide relief."

A 49-year-old client confides to the nurse that she has started experiencing pain with intercourse and asks, "Is there anything I can do about this?" The nurse's best response is: A. "No, it is part of the aging process." B. "Water-soluble vaginal lubricants may provide relief." C. "You need to be evaluated for a sexually transmitted disease." D. "You may have vaginal scar tissue that is producing the discomfort."

A. "You do not have cancer, but it is especially important for you to have regular mammograms in order to monitor for any changes"

A client states that she has been diagnosed with fibrocystic breast disease. She asks the nurse, "Does this mean that I have breast cancer?" Which of the following statements by the nurse is appropriate at this time? A. "You do not have cancer, but it is especially important for you to have regular mammograms in order to monitor for any changes" B. "If your lumps are round and mobile they are not cancerous, but if they are hard to the touch you probably do have cancer" C. "I am so sorry. I am sure that the doctor will do everything possible to cure you of the cancer" D. "I am not the best person to ask about your diagnosis. I suggest that you ask the doctor"

C. Make a general statement then proceed to a more direct question

A complete history includes information about any history of sexually-transmitted diseases. The best way for a nurse to handle this subject is to: A. Begin the interview with questions that may be embarrassing B. Ask a direct question to obtain the information she needs C. Make a general statement then proceed to a more direct question D. Apologize for having to ask such personal questions

D. Heavy alcohol intake

A nurse is educating a group of women in her parish about osteoporosis. The nurse should include in her discussion that which of the following is a risk factor for the disease process? A. Increased body weight B. Late onset of menopause C. Multiparity D. Heavy alcohol intake

A. Human papillomavirus (HPV)

A pregnant client is being treated with trichloroacetic acid for lesions on the perineum and vagina which sometimes itch and bleed. The most likely causative agent of the lesions is: A. Human papillomavirus (HPV) B. Pubic lice C. Herpes Type II D. Gonorrhea

D. Coffee, colas, and chocolate cake

A teaching plan for a client with premenstrual syndrome (PMS) should include a recommendation to restrict her intake of: A. Chicken, eggs, and fish B. Breads, cereals, and beans C. High-starch foods such as potatoes and spagetti D. Coffee, colas, and chocolate cake

B. Diaphragm

A woman has a history of toxic shock syndrome. She should be taught to avoid which of the following forms of birth control? A. Depo provera injection B. Diaphragm C. Intrauterine Device D. Birth control pills

A. Neisseria gonorrhoeae

A woman has been diagnosed with pelvic inflammatory disease. Which of the following organisms is the most likely causative agent? A. Neisseria gonorrhoeae B. Treponema pallidum C. Candida albicans D. Herpesviridae

D. Human papillomavirus (HPV)

A woman is noted to have multiple soft warts on her perineum and rectal areas. The nurse suspects this client is infected with which of the following sexually transmitted diseases? A. Human immunodeficiency virus (HIV) B. Trichomoniasis C. Syphilis D. Human papillomavirus (HPV)

A. ultrasound

A woman noted a lump in her breast. The physician ordered a mammogram, which showed a suspicious area. The next step that may be taken to differentiate if the lump is a cyst or a malignant mass may be: A. ultrasound B. open biopsy C. fine needle aspiration biopsy. D. core needle biopsy

C. Do not take non-steroidal antiinflammatory drugs (NSAIDS) for 1 week before collecting the samples

A woman will have screening for fecal occult blood. Choose the correct instructions: A. Collect a small sample of stool from the first stool expelled each morning for 3 days B. Refrigerate the samples until they can be returned to the laboratory for testing C. Do not take non-steroidal antiinflammatory drugs (NSAIDS) for 1 week before collecting the samples D. Eat 2 servings of red meat each day for 3 days before collecting the samples

C. Diffuse rash with fever

Four women who use superabsorbant tampons during their menses are being seen in the medical clinic. The woman with which of the following findings would lead the nurse to suspect that the woman's complaints are related to her use of tampons rather than to an unrelated medical problem? A. Thrombocytopenia with pallor B. Hypertension C. Diffuse rash with fever D. Angina

D. 40 years

The American Cancer Society recommends yearly mammography to screen for breast cancer in women starting at which age? A. 20 years B. 30 years C. 50 years D. 40 years

B. The client must be taught to use sunscreen whenever in sunlight

The RN is administering Depo Provera (medroxyprogesterone acetate) to a postpartum client. Which of the following data must the nurse consider before administering the medication? A. The client must use an alternative form of birth control for the first 2 months B. The client must be taught to use sunscreen whenever in sunlight C. The medication is contraindicated if the woman has lung or esophageal cancer D. The medicine must be administered subcutaneously in the upper arm

C. "You will probably have a monthly period of withdrawal bleeding"

The client is given a prescription for hormone replacement therapy. She asks the RN, "What type of side effects or consequences should I expect from taking this medication?" The RN's best response is: A. "You will notice migraine headaches initially that will subside" B. "You may notice some intermittent cramping" C. "You will probably have a monthly period of withdrawal bleeding" D. "You may notice a change in your skin tone"

B. Look for dimpling while bending forward from the waist

The nurse is educating a group of women on how to perform a breast self-exam (BSE). Which of the following actions should the nurse advise the women to take? A. Feel for lumps while encircling the breast from the nipple outward B. Look for dimpling while bending forward from the waist C. Use the fingertips of their index, middle, and ring fingers D. Use pressure in two intensities, light and deep

C. Apply a heating pad to the abdomen and drink warm liquids

To relieve dysmenorrhea (menstrual cramps), you should advise your client to: A. Take acetaminophen every 4 - 6 hours and apply ice to her abdomen B. Decrease fat and carbohydrate intake until it subsides C. Apply a heating pad to the abdomen and drink warm liquids D. Participate in rigorous exercise

D. Around the clock for 2 to 3 days at the onset of menstruation

To relieve her menstrual cramps, a woman should be taught to take ibuprofen A. During the week before the expected onset of her period B. On an empty stomach before the pain becomes severe C. Within 8 hours of the onset of menstruation D. Around the clock for 2 to 3 days at the onset of menstruation

C. Cervical cancer

Veneral warts should be treated because of their possible link to: A. Vaginal cancer B. Pyelonephritis C. Cervical cancer D. Infertility

D. new moles

When doing a vulvar self-examination, the woman should inspect for: A. differences in the sizes of the labia majora and labia minora B. changes in the location of the meatus C. muscle tone D. new moles

D. 20 years

When doing client teaching, it is important for the nurse to include breast self-examination information for all women older than: A. 40 years B. 50 years C. 30 years D. 20 years

C. A 19-year-old who never had a period

Which client would be classified as primary amenorrhea? A. A 32-year-old with two children B. A 45-year-old who had regular menses until 1 year ago, when they became irregular C. A 19-year-old who never had a period D. A 25-year-old who had regular menses until 1 year ago, when they stopped

A. Femur

Which of the following is not a common fracture site for women with osteoporosis? A. Femur B. Forearm C. Vertebrae D. Hip

D. Is taking oral antibiotics

Which of the following women is predisposed to vulvovaginal candidiasis - the one who: A. Uses a diaphragm for conctraception B. Is hypoglycemic C. Uses vaginal lubricants D. Is taking oral antibiotics

A. African American

Which one of the following is NOT a risk factor for osteoporosis? A. African American B. Cigarette smoker C. Small boned and thin D. Nulliparity

B. "Have you ever had any type of surgery?"

Which one of the following is an example of effective interviewing/communication skills when beginning to take a client's sexual and gynecologic history? A. "Have you had any elective abortions?" B. "Have you ever had any type of surgery?" C. "Have you had a sexually transmitted infection?" D. "When was the last time you had intercourse?

C. Decrease alcohol, nicotine and red meat

Which one of the following recommendations would be helpful to a client in reducing her symptoms of PMS? The woman should: A. Reduce whole grains and proteins B. Take estrogen supplements C. Decrease alcohol, nicotine and red meat D. Avoid strenuous physical activity

D. "I may have another breakout during my period"

Which one of the following statements by the client verifies correct knowledge about vaginal herpes? A. "I am more likely to develop cancer of the cervix" B. "I should douche daily to prevent infection" C. "I should use sodium bicarbonate on the lesions to relieve discomfort" D. "I may have another breakout during my period"

A. "I may have another breakout during my period"

Which one of the following statements by the client verifies correct knowledge about vaginal herpes? A. "I may have another breakout during my period" B. "I am more likely to develop cancer of the cervix" C. "I should use sodium bicarbonate on the lesions to relieve discomfort" D. "I should douche daily to prevent infection"

C. "I'll eat only three meals per day."

Which statement by a woman diagnosed with premenstrual syndrome indicates that further health teaching is needed? A. "I will not eat chips or pickles." B. "Drinking alcohol makes me more depressed." C. "I'll eat only three meals per day." D. "Coffee and chocolate can make me more irritable and nervous."

A. "The IUD can remain in place for a year or more"

Which statement by the client indicates that she understands the teaching provided about the intrauterine device (IUD)? A. "The IUD can remain in place for a year or more" B. "Pain during intercourse is a common side effect" C. "The device will reduce my chances of getting infected" D. "I will not menstruate while the IUD is in"

C. It may be due to excessive endometrial prostaglandin

Which statement is true about primary dysmenorrhea? A. It is unaffected by oral contraceptives B. It occurs in young multiparous women. C. It may be due to excessive endometrial prostaglandin D. It is experienced by all women

C. A 55-year-old woman with a sedentary lifestyle

Which woman is most likely to have osteoporosis? A. A 60-year-old woman who takes supplemental calcium and vitamin D B. A 65-year-old woman who walks 2 miles each day C. A 55-year-old woman with a sedentary lifestyle D. A 50-year-old woman on raloxifene (Evista)

A. Endometrial cancer

Women who are on hormone replacement therapy (HRT) for an extended period of time have been shown to be at high risk for which of the following complications? A. Endometrial cancer B. Gynecomastia C. Renal dysfunction D. Mammary hypertrophy

C. With meals

Your perimenopausal client has been advised to begin taking calcium supplements daily. The nurse should instruct the client to take the medicine: A. With several glasses of water B. Before bed C. With meals D. Between meals