OB PrepU Questions Exam #1

Yvonne, a 27-year-old client, is in the first trimester of an unplanned pregnancy. She acknowledges that it would be best if she were to quit smoking now that she is pregnant, but states that it would be too difficult given her 13 pack-year history and circle of friends who also smoke. She asks the nurse, "Why exactly is it so important for me to quit? I know lots of smokers who have happy, healthy babies." What can the nurse tell Yvonne about the potential effects of smoking in pregnancy?

"Babies of women who smoke tend to weigh significantly less than other infants."

Which of the following would the nurse include in the teaching plan for a woman who is to have a screening mammogram?

"Don't use deodorant that day because it may interfere with the x-ray image."

A woman opts to use a diaphragm for contraception. Which instruction would be most important for the nurse to provide?

"Have the diaphragm refitted if you lose 10 lbs or more"

A couple has just learned that their son will be born with Down's syndrome. The nurse shows a lack of understanding when making which of the following statements?

"I will alert your entire family, so that you don't have to"

A woman has just confided in the nurse that her partner slapped and kicked her that morning. What is the best response by the nurse?

"That was very brave of you to tell me that. Help is available if you wish to have it."

Amanda is about 16 weeks pregnant and is concerned because she feels her "abdomen" contracting. She calls the doctors office and speaks to the nurse. What is the most appropriate response to Amanda's concern?

"What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy."

A 38-year-old woman comes to the clinic to discuss discontinuing use of her birth control pills and attempting conception. She says to the nurse, "I know a lot of women who have waited later to have children and don't have any problem." What is the best response by the nurse?

"Women in their late 30s who use oral contraception may face a delay in conception for several months, because the body has to return to normal function before conception is possible."

A married couple, both age 27, is in the reproductive clinic and have been trying for a year to become pregnant. In a year, what percent of couples usually do conceive?

90%

A female patient is having a procedure this morning that involves radiologic examination of the fallopian tubes using a radiopaque medium. What procedure should the nurse document as being performed?

A hysterosalpingography

A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis?

A painless genital ulcer that appeared about 3 weeks after unprotected sex

You care for a woman in a prenatal clinic who thinks she might be pregnant. Which of the following assessments is a probable sign of pregnancy?

A positive pregnancy test

You prepare a couple to have a karyotype performed. Which of the following describes a karyotype?

A visual presentation of the chromosome pattern of an individual

A woman in her third trimester has just learned that her fetus has been diagnosed with cri-du-chat syndrome. The nurse recognizes that this child will likely have which of the following characteristics?

Abnormal cat-like cry

A nurse is teaching a class on preventing pregnancy to high school students. Which of the following would the nurse identify as the best method to prevent both pregnancy and sexually transmitted infections (STIs)?

Abstinence

Primary prevention for HPV includes which of the following?

Administering HPV vaccine

A pregnant client has heard about Down syndrome and wants to know about the risk factors associated with it. Which of the following would the nurse include as a risk factor?

Advanced maternal age.

What advice should the nurse provide to a pregnant patient who admits to continuing to drink alcohol 1 to 2 times a week?

Alcohol should not be consumed during pregnancy

A 24 year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odorless, thick, acid vaginal discharge. She denies sexual activity during the last six months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of antimicrobial medication is most likely to clear her symptoms?

An azole antifungal agent

A young woman is having trouble conceiving and has come in to the office for fertility testing. She states that she has irregular and unpredictable menstrual cycles. On blood testing, it is found that her ovaries are producing excess testosterone, which is lowering her follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels. Which of the following is the most likely cause of her subfertility?

Anovulation

When preparing a teaching plan for a woman with mastitis, which of the following would the nurse include?

Applying a warm compress to the breast

A nurse suspects that a 6-year-old girl is being sexually maltreated by her father, based on some comments made by the girl. Which of the following methods would be most effective in confirming the nurse's suspicion?

Ask the girl to draw a picture of what happened

A pregnant client and her husband are at their first prenatal visit. While performing the admission history, the nurse notes several new and old bruises on the woman's neck and body. She is silent and withdrawn. The husband answers all the questions. Based on these observations, the nurse suspects intimate partner violence. Which of the following is the most appropriate nursing intervention at this time?

Ask the husband to wait in the lobby while the client is being examined.

During a routine antepartal visit, a pregnant woman reports a white thick vaginal discharge. Which of the following would the nurse do next?

Ask the women if she is having any irritation or itching

There are many steps in the process of genetic counseling and testing. Below are some of the key ones. Put them in the correct chronological order.

Assessment of family history Physical examination of parents Nuchal translucency screening Amniocentesis Explain results of genetic testing Support couple in adjusting to diagnosis

Which of the following instructions should the nurse give to a client with genital herpes to help control the infection?

Avoid sexual contact until sores heal

After teaching a client diagnosed with candidiasis about preventative measures, the nurse determines that the teaching was effective when the client states she will do which of the following?

Avoid vaginal trauma

When do condoms need to be applied to be effective?

Before penile and vulvar contact

Your patient wants to discuss birth control options. She is a 36-year-old woman who is in a long-term, monogamous relationship. She runs 2 miles a day but also smokes a pack of cigarettes a day. Which birth control method would you discourage her from using?

Combination oral contraceptives

Which of the following is the gold standard for HSV diagnosis?

Culture

A woman is 40 years old and a heavy smoker. She has a single sexual partner but has very irregular menstrual cycles. She wants a highly reliable contraceptive. Assuming that all of the following methods of birth control are acceptable to her, which of the following would be the best recommendation?

Diaphragm and spermicide

Which of the following would the nurse identify as a normal physiologic change in the renal system due to pregnancy?

Dilation of the renal pelvis

A client in the first trimester complains to the nurse of nausea and vomiting, especially in the morning. Which instruction would be most appropriate to help prevent or reduce the client's compliant?

Eat dry crackers or toast before rising

Patients who have had PID are prone to which of the following complications?

Ectopic pregnancy

On what day during pregnancy does the embryo implant on the uterine surface?

Eight days after ovulation

The nurse is assessing a couple who has come to the health care facility because they have been unable to conceive a child. When assessing the woman, which factor would the nurse identify as increasing the woman's risk for infertility?

Endometriosis

A 30-year-old female is attending a health fair for women. The nurse at the fair is reviewing risk factors for cervical cancer. Which of the following is an important risk factor for the nurse to include at the fair?

Exposure to diethylstilbestrol (DES) in utero

Which of the following best defines the term "subfertility/infertility"?

Failure to achieve pregnancy after one year of unprotected sex

A nursing student studying sexual violence makes the following statement in class, "A man who has sex with his wife even though she did not want it cannot be charged with sexual abuse." Is this statement true or false?

False

Which of the following is a positive sign of pregnancy?

Fetal movement felt by the examiner

You are counseling women on birth control choices. Which woman is the best candidate for an IUD? A woman who:

Has one partner, her husband, and 3 children

Leah is 28 weeks pregnant. In preparing for discomforts that occur during the final trimester of pregnancy, you would teach her about?

Increased shortness of breath and dyspnea before lightening

On a follow-up visit, a woman who was a victim of rape states that she has joined a rape survivor advocacy group. The nurse interprets this as indicating that the woman is in which phase of rape recovery?

Integration and recovery

A nurse is conducting prenatal classes and is reviewing the stages of fetal development. When discussing the pre-embryonic stage, what should the nurse inform the group about when this stage begins and ends?

It begins at fertilization and lasts through the end of the second week of gestation

Which of the following best explains the action of the lactational amenorrhea method (LAM) of fertility control?

LAM causes suppression of the ovulation process

A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last six months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms?

Metronidazole

The nursing instructor is discussing violence and abuse that is seen in women with a student. She realizes that the student needs further instruction when the student states which of the following?

Nurses only come in contact with violence in the ER.

A middle-aged woman is seen in the OB/GYN clinic and complains of abdominal bloating, fatigue, abdominal pain, urinary frequency, and constipation. She also says that she had lost 24 pounds in the last month without trying to lose. For which disease should the physician screen this patient?

Ovarian cancer

A woman has just been prescribed clomiphene citrate to stimulate ovulation. Which of the following is an effect of the drug that the nurse should warn the woman about?

Overstimulation of the ovary resulting in potential multiple births

A pregnant client discloses to the nurse that she has been abused by her husband for the past 4 years. Which of the following is true regarding violence against pregnant women?

Partner abuse may increase during pregnancy.

Which of the following is the medication of choice for early syphilis?

Penicillin G benzathine

A woman calls the clinic to schedule an appointment because "I think I might be pregnant." Upon further assessment gathering of information from the woman, which of the following would be a probable sign of pregnancy?

Positive home pregnancy test

What is the difference between possible, probable, and positive signs of pregnancy?

Possible- Nausea, vomiting, weight gain, etc. Probable- Positive pregnancy test Positive- Ultrasound of baby

The nurse working in an OB clinic realizes that a pregnant patient who has been abused before can expect to be abused during her pregnancy. What is the strongest predictor that a pregnant woman will be abused during her pregnancy?

Prior abuse

The nurse is teaching a class about sexually transmitted diseases to a middle school class. Which of the following is a misconception about condom use that needs to be clarified?

Put the condom on just before the orgasm

A nurse working in the Family Birthing Center is answering the nurse hot line phone. A client calls in to schedule her annual Pap smear procedure. Which of the following strategies would be best to educate the client on before her procedure to make sure results are not affected?

Refrain from sexual intercourse 48 hours before testing to ensure clear results.

A nurse is preparing a client for intrauterine device (IUD) insertion. What should the nurse inform the client when educating her on IUDs?

Regular check of threads must be done

A woman visits your family-planning clinic to request a prescription for birth-control pills. Which of the following factors would indicate that an ovulation suppressant would not be the best contraceptive method for her?

She has a family history of thromboembolism

Mitosis is the process of cell division for which cells?

Somatic

A client with syphilis did not receive treatment and has now progressed into the tertiary stage of the disorder. Which of the following would the nurse expect the client to exhibit?

Tabes dorsalis, ataxia, and Charcot's joints

A woman telephones you after taking an ovulation suppressant for 3 months to tell you that she has forgotten to take her pill two mornings in a row. What would be the best advice to give her regarding this?

Take two pills now and use a second method of contraception for the remainder of the month.

A pregnant woman of Jewish descent comes to the clinic for counseling and tells the nurse that she is worried her baby may be born with a genetic disorder. Which of the following diseases does the nurse identify to be a risk for this patient's baby based on the family's ancestry?

Tay-Sachs

When describing the role of a doula to a group of pregnant women, which of the following would the nurse include?

The doula primarily focuses on providing continuous labor support.

The fetus receives blood flow from the mother via the placenta and umbilical cord. What is the route of fetal circulation through the umbilical cord?

The one umbilical vein carries oxygen rich blood to the fetus from the placenta

A breast tumor is most likely found in what part of the breast?

The upper, outer quadrant

What should the nurse explain to the pregnant patient about the importance of the fetal stage of development?

There is additional growth and development of the organs and body systems.

A nurse urges a pregnant patient at the first prenatal office visit to begin taking iron supplements immediately. What is the rationale for this intervention?

To avoid anemia

A nurse is preparing a patient for rhythm strip testing. She places the woman into a semi-Fowler's position. What is the appropriate rationale for this measure?

To prevent supine hypotension syndrome

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 contraceptives. 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

Copious amounts of frothy, greenish vaginal discharge would be a symptom of which infection?

Trichomoniasis

A number of inherited diseases can be detected in utero by amniocentesis. Which of the following diseases can be detected by this method?

Trisomy 21

Body joints become more relaxed with pregnancy because of relaxin, a hormone produce by the placenta.

True

Couples who engage in coitus daily, hoping to cause early impregnation, may actually have more difficulty conceiving than those who space coitus to every other day.

True

Morning sickness is associated with rising levels of human chorionic gonadotropin (hCG) and progesterone.

True

Smoking may be a cause of ectopic (tubal) pregnancy.

True

There is a strong correlation between poor oral health and preterm birth.

True

A nurse is speaking to a local women's group about the various types of cancer affecting the female reproductive tract. The nurse explains that ovarian cancer is the leading cause of death from gynecologic malignancies based on the understanding that this type of cancer:

Typically manifest with vague symptoms resulting in late diagnosis

Which factor in a client's history indicates she's at risk for candidiasis?

Use of corticosteroids

A nurse is assessing a client diagnosed with bacterial vaginosis. Which of the following is a symptom of bacterial vaginosis?

Vaginal odor smelling of fish

The generation-to-generation continuum of violence refers to the fact that

Violence is a learned behavior, and children who witness abuse are more likely to become abusers themselves

An elderly woman is seen in the clinic complaining of a lesion on her labia majora and states that she has experienced some bleeding and itching as well. She states that this has been going on for approximately three months. She tells the nurse that she has not been to a doctor in over 10 years. What diagnosis would the nurse expect the physician to make?

Vulvar cancer

As part of a presentation on breast cancer being given to a local woman's group, the nurse describes the need for early detection through screening. Which recommendation would the nurse emphasize?

Yearly mammogram in women over the age of 40

Which of the following body system changes would the nurse associate with menopause? Select all that apply.

• Hot flashes • Decreased bone density • Increased abdominal fat • Vaginal dryness

A woman is going to have in vitro fertilization. When preparing her for this, you would tell her which of the following?

"It can be done with frozen donor sperm."

A couple is seeking guidance for their inability to conceive a child after trying for 15 months. They are morbidly obese but state they have friends with the same weight problem who have had no difficulty conceiving. What education can the nurse provide this couple to increase their chances of success?

"Obesity may interfere with effective penetration and deposition of sperm. We will look at several factors to discover what issues you may be encountering."

Which woman is at greatest risk for developing cervical cancer?

A client whose high-risk HPV infection persists in genital skin cells

The nurse should administer Rhogam (Rh immune globulin) to the pregnant woman who is Rho(D)-, after which of the following tests?

Amniocentesis

The nurse understands that the maternal uterus should be at what location at 20 weeks' gestation?

At the level of the umbilicus

An intrauterine device has been inserted into a client as a requested birth control method. Which of the following is an advantage of intrauterine devices (IUDs)?

Continuous protection without client's active participation

The nurse explains to a client diagnosed with trichomoniasis that the disease is caused by the parasitic protozoan Trichomonas vaginalis. What would the nurse say is a factor that triggers growth of trichomoniasis?

Irritation of vaginal walls

A 28-year-old woman had a pap smear 4 weeks ago. The results of the test are classified as ASC-HUS as per the 2001 Bethesda System. Which of the following therapeutic management interventions should the nurse expect the health care provider to order?

Repeat the Pap smear in 4 to 6 months, or refer for a colposcopy.

A woman with ovarian cancer has been told that she is in stage three of the cancer. The nurse is reviewing the information with her. Which of the following statements would help in the woman's understanding of stage three ovarian cancer?

The growth has spread to the lymph nodes and other areas/organs in the abdominal cavity.

An OB/GYN nurse is teaching a new female client how to perform breast self-examination. Which of the following is a recommended step for this examination?

To examine the right breast, put a pillow or folded towel under the right shoulder

During a follow-up visit, a female client who underwent a mastectomy asks the nurse if she can work in her backyard or at least do some household work. Which suggestion would be most appropriate?

Wear gloves and protective clothing to avoid any injuries

A client in her second trimester of pregnancy arrives at the health care facility for a routine follow-up visit. The nurse is required to educate the client so that the client knows what to expect during her second trimester. Which of the following information should the nurse offer?

"You will experience quickening, and you will actually feel the baby."

A woman has just learned that she is pregnant and would like to know how soon she can find out via ultrasound the sex of her fetus. The nurse should respond with which of the following?

At about four months

You care for a child with Down syndrome (trisomy 21). This is an example of which type of inheritance?

Chromosome non disjunction

In which group is it most important for the client to understand the importance of an annual Papanicolaou test?

Clients infected with the human papillomavirus (HPV)

Which of the following would the nurse include in the plan of care for a client diagnosed with breast cancer who has undergone a mastectomy?

Encouraging the client to perform arm exercises

A young woman who has recently been married asks a nurse at the clinic for something to calm her nerves and help her sleep. When assessing the patient the nurse suspects that the husband is abusing the patient. This is confirmed when the patient states, "My husband will not let me look for a job and when I need money he will not give it to me." This patient is suffering from which type of abuse?

Financial abuse

Fetal circulation differs from the circulatory path of the newborn infant. In utero the fetus has a hole connecting the right and left atria of the heart. This allows oxygenated blood to quickly pass to the major organs of the body. What is this hole called?

Foramen ovale

A multigravida client is pregnant for the third time. Her previous two pregnancies ended in an abortion in the first and third month of pregnancy. How will the nurse classify her pregnancy history?

G3 P0020

Genetics-related health care is basic to the holistic practice of nursing. What should nursing practice in genetics include?

Gathering relevant family and medical history information

After teaching a group of students about sexually transmitted infections (STIs), the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment?

Genital Herpes

A physician tells a client to return 2 to 3 months after treatment to have a repeat culture done to verify the cure. This order would be appropriate for a woman with which condition?

Gonorrhea

You are asked to teach a woman to take her basal body temperature daily to assess the time of ovulation. She can detect her day of ovulation, following ovulation, because her temperature will

Increase a degree

A male patient has requested information on vasectomy. Which of the following would you include in your education to him?

It is usually done as an office procedure

A woman is crying because she just recently received the results of her biopsies, and they confirm that she has invasive breast cancer. Which response by the nurse is the most appropriate?

Listen to the woman talk and remain silent for a while

The patient has just been diagnosed with cervical cancer and after discussing her options with her physician and husband she chooses to have cryotherapy. This procedure does which of the following?

destroys abnormal cervical tissue by freezing it with liquid nitrogen

How should the nurse instruct a woman to perform a breast self-examination? Select all that apply.

• "You will need to visually inspect both breasts and palpate them for changes." • "It doesn't matter which pattern you use to palpate the breast as long as you cover the entire breast." • "Look for any changes in shape, size, contour, or symmetry between the breasts, as well as any skin discoloration."

Which of the following body system changes would the nurse associate with menopause? Select all that apply.

• Hot flashes • Increased abdominal fat • Vaginal dryness • Decreased bone density

A couple comes to the clinic and states to the nurse, "I don't think we are ever going to be able to have children. We have been trying but have had no luck." What three assessments does the nurse anticipate will be performed for this couple? (Select all that apply.)

• Ovulation monitoring • Tubal patency • Semen analysis

A 47-year-old woman was just diagnosed with a cancer of her reproductive tract. The public health nurse is aiding in counseling. Which of the following nursing interventions would be supportive in counseling this woman? Select all that apply.

• Validate the client's feelings and provide realistic hope • Give post-operative care and instructions when prescribed • Use sincere basic communication techniques

A female client comes to the clinic and asks the nurse what would be the most cost effective method for her to determine her ovulation patterns. What is the best response by the nurse?

"The least costly method to determine ovulation patterns is to record the basal body temperature for at least 4 months."

In which of the follow patients would the nurse first suspect cancer?

A 30-year-old with a mobile, rubbery, firm, well-circumscribed, nontender lump

Question 4: (see full question) A woman has just learned that she is pregnant and would like to know how soon she can find out via ultrasound the sex of her fetus. The nurse should respond with which of the following?

About 4 months

Which of the following is the most effective treatment for trichominiasis?

Metronidazole (Flagyl)

A woman in the last trimester of pregnancy complains of sleeping poorly. She becomes light-headed and dizzy whenever she sleeps on her back, but she can't sleep at all if she lies on her side. How would you suggest she try sleeping?

Sleep with a pillow under her right hip

A young woman says she is needs a temporary contraceptive but has a latex allergy. She mentions that she has a papillomavirus infection. Also, she says she is terrible about remembering to take pills. Which method should the nurse recommend?

Transdermal contraception

Which of the following would alert the nurse to suspect that a client has a yeast infection?

Vulvar burning and itching