OB Test 1 NCLEX QUESTIONS
The nurse is caring for a client who is using complementary therapies to manage menopausal symptoms. Which client statement should indicate to the nurse the need for further discussion? (Select all that apply.) A. "Herbs have not been proven to be effective, but they can't hurt." B. "I understand that there is little high-level research on alternative treatments for menopausal symptoms." C. "A friend used black cohosh for relief of her hot flashes, so I think I will try it." D. "As long as I take soy supplements, I can go back to eating spicy foods." E. "Ginseng may not help with my hot flashes, but it may help me sleep better."
A. "Herbs have not been proven to be effective, but they can't hurt." C. "A friend used black cohosh for relief of her hot flashes, so I think I will try it." D. "As long as I take soy supplements, I can go back to eating spicy foods." E. "Ginseng may not help with my hot flashes, but it may help me sleep better." Rationale: Little high-level research has been done on alternative treatment options for menopause symptoms. While research has shown some herbs to be beneficial, they can interact with other medications and need to be discussed with the healthcare provider. Research suggests that soy is beneficial in reducing hot flashes, but diet adjustments should also be made to help reduce hot flashes. Although black cohosh has been a popular alternative to HRT for years, a Cochrane Database review (Leach & Moore, 2012) examined 16 studies and found that, compared to placebo, black cohosh did not decrease hot flashes and other symptoms. The authors concluded that evidence for use of black cohosh is lacking and further research is needed. Ginseng may not help with symptoms of hot flashes, but it can be used for some other symptoms of menopause.
The nurse reviews with a client recovering from an oophorectomy the reason why symptoms of menopause are occurring. Which client statement should indicate to the nurse that teaching was effective? A. "Removal of my ovaries has caused an abrupt onset of menopause, and the symptoms can be severe." B. "Since my uterus has been removed, the symptoms of menopause have started." C. "Surgical menopause is usually less abrupt and should subside quickly once the body adjusts." D. "Removal of my fallopian tubes has started surgical menopause, and the symptoms start quickly."
A. "Removal of my ovaries has caused an abrupt onset of menopause, and the symptoms can be severe." Rationale: Surgical menopause is caused by removal of the ovaries, known as oophorectomy. Unlike medical menopause, onset of surgical menopause is abrupt and the symptoms may be severe. Removal of the uterus and fallopian tubes does not cause surgical menopause.
A male client is prescribed an androgen drug. The client asks, "What can I expect from this?" Which response by the nurse is accurate? (Select all that apply.) A. "You may notice a persistent and painful erection." B. "It will increase your sperm count." C. "You will probably notice that you will lose weight." D. "It will decrease your blood sugar." E. "It will boost your testosterone level to normal."
A. "You may notice a persistent and painful erection." B. "It will increase your sperm count." E. "It will boost your testosterone level to normal." Rationale: Androgen drugs are used to treat hypogonadism resulting in insufficient testosterone. They are also used to increase sperm count when low testosterone is the cause. Side effects include acne, weight gain, priapism (persistent and painful erection of the penis), and increased blood sugar.
The nurse instructs the woman taking oral contraceptives to report which possible side effect(s)? Select all that apply. a. Abdominal pain b. Weight gain c. Headache d. Eye or visual problems e. Speech disturbances
A. Abdominal pain C. Headache D. Eye or visual problems E. Speech disturbances The memory aid ACHES is helpful: Abdominal pain, Chest pain, Headaches, Eye problems, Speech disturbances. Weight gain is an expected side effect of oral contraceptives.
The nurse reminds a group of high school students that the most effective choice of birth control for preventing pregnancy and sexually transmitted diseases is to: a. abstain from sex. b. use the male condom. c. use the female condom. d. use the barrier method.
A. Abstain from sex Abstinence is 100% effective in preventing pregnancy and sexually transmitted diseases
A client is experiencing severe symptoms of menopause. About which treatment should the nurse prepare teaching for this client? (Select all that apply.) A. Acupuncture B. Hormone replacement therapy C. Soy and ginseng D. Bioidentical hormones E. Muscle relaxers
A. Acupuncture B. Hormone replacement therapy C. Soy and ginseng D. Bioidentical hormones Rationale: Menopausal symptoms can be treated with medications or the use of alternative and complementary therapies. Medications include hormone replacement therapy and selective serotonin reuptake inhibitors (SSRIs) and other antidepressants, and selective estrogen receptor modulators (SERMs). Alternative and complementary therapies include bioidentical hormones, acupuncture, biofeedback, massage, meditation, yoga, soy, and ginseng. Muscle relaxers are not used to treat manifestations of menopause.
A client reports burning on urination and a vaginal discharge. Which information should the nurse include in the client's documentation? (Select all that apply.) A. Allergies to any medications B. History of unprotected sex C. History of fever or chills D. Length of time since symptoms presented E. Names and phone numbers of all sexual contacts
A. Allergies to any medications B. History of unprotected sex C. History of fever or chills D. Length of time since symptoms presented Rationale: The client's sexual history, assessment, and examination must be documented, including symptoms like fever, chills, burning on urination, vaginal drainage, and their onset and duration. It is critical to document allergies for every client, especially because antibiotics may be ordered. An STI has not yet been confirmed, so a list of sexual contacts is not needed.
An older adult client seeks medical attention for vaginal bacterial infections. Which change in the client should the nurse consider as an explanation for the infections? A. As vaginal pH rises, bacterial infections can become more common. B. Increased vaginal lubrication can result in more bacteria being harbored in the vagina. C. Night sweats can lead to more bacteria. D. Thickened vaginal tissues tear more easily.
A. As vaginal pH rises, bacterial infections can become more common. Rationale: Vaginal pH rises after menopause, predisposing women to bacterial infections. Night sweats do not increase vaginal infections. Vaginal tissue atrophies, not thickens. Vaginal lubrication decreases.
Which nursing diagnosis should the nurse consider when planning care for a client experiencing menopause? (Select all that apply.) A. Body Image, Disturbed B. Constipation C. Knowledge, Deficient D. Self-Esteem, Situational Low E. Sexuality Pattern, Ineffective
A. Body Image, Disturbed C. Knowledge, Deficient D. Self-Esteem, Situational Low E. Sexuality Pattern, Ineffective Rationale: A client with menopause may have diagnoses of Knowledge, Deficient about menopause; Body Image, Disturbed; Self-Esteem, Situational Low; and Sexuality Pattern, Ineffective. Constipation is not a diagnosis associated with menopause. (NANDA-I ©2014)
The nurse is teaching a client who is trying to conceive about proper nutrition. Which essential nutrient should the client include in her daily diet? (Select all that apply.) A. Calcium B. Iron C. Vitamin E D. Protein E. Vitamin A
A. Calcium B. Iron D. Protein Rationale: A client who is trying to conceive should include ample quantities of essential nutrients, with particular emphasis on calcium, iron, and protein. Vitamins E and A are not essential for a client who is trying to conceive.
Your patient is scheduled for a DEXA scan this morning. The patient is having heartburn and requests a PRN medication to help with relief. Which medications can the patient NOT have at this time?* A. Calcium Carbonate B. Bismuth Salicylate C. Milk of Magnesia D. Famotidine
A. Calcium Carbonate Before a DEXA scan, which is a bone density test, the patient should not take any type of calcium supplements (calcium carbonate (TUMs) or vitamins containing calcium.
An 18 y.o. female is to have a pelvic exam. Which response by the nurse would be BEST when the client says that she is nervous about the upcoming pelvic exam? A. Can you tell me more about how you are feeling? B. You are not alone. Most women feel uncomfortable about this exam C. Do not worry about Dr. Smith. He is a specialist in female problems D. We will do everything we can to avoid embarrassing you
A. Can you tell me more about how you are feeling? Rationale: Asking the client to describe her nervousness gives her the opportunity to express her concerns. Responses that make assumptions about the source of the concern or offer reinforcement are not supportive and block successful communication.
The nurse is caring for a client who has been diagnosed with reactive arthritis. The nurse notes symptoms of a sexually transmitted infection (STI). Which STI should the nurse suspect? A. Chlamydia B. Herpes simplex virus C. Syphilis D. Gonorrhea
A. Chlamydia Rationale: Reactive arthritis (formally Reiter syndrome) is a complication of chlamydia, which is most likely to occur in men. It does not occur secondary to gonorrhea, herpes simplex virus, or syphilis.
The nurse is providing teaching to a community group. Which disorders should the nurse include that are considered multifactorial inheritance disorders? (Select all that apply.) A. Cleft lip B. Clubfoot C. Huntington disease D. Neural tube defect E. Cystic fibrosis
A. Cleft lip B. Clubfoot D. Neural tube defect Rationale: Multifactorial inheritance disorders are caused by a combination of environmental and genetic factors. Examples of multifactorial inheritance disorders include neural tube defects such as spina bifida, clubfoot, and cleft lip. Huntington disease is an autosomal dominant disorder. Cystic fibrosis is an autosomal recessive disorder.
What is the safest form of contraception apart from abstinence to protect from both pregnancy and STI's? A. Condoms B. The contraceptive pill C. Diaphragm D. Injectable Contraception
A. Condoms
The nurse is caring for a client who has been diagnosed with gonorrhea. Following the diagnosis, which intervention should the nurse perform next? A. Contact any potentially exposed sexual partners. B. Instruct the client to take antibiotics until symptoms resolve. C. Encourage the client to drink extra fluids to flush system. D. Perform a physical exam.
A. Contact any potentially exposed sexual partners. Rationale: Contacting sexual partners who may have been exposed to sexually transmitted infections (STIs) is a part of the care plan for a client who has been diagnosed with a sexually transmitted infection like gonorrhea. Drinking fluids is important, but would not be the next intervention. The antibiotics would need to be taken for the prescribed amount of time, not just until symptoms resolve. A physical examination is done initially as a part of diagnosis.
The nurse is obtaining a history on a middle-age female client. Which factor affecting sexual function should the nurse anticipate finding? (Select all that apply.) A. Decreased hormone production B. Climacteric C. Decreased sexual activity D. Sexual orientation experimentation E. Menopause
A. Decreased hormone production B. Climacteric E. Menopause Rationale: Based on the client's age, sexual functioning may be affected by the climacteric, menopause, and decreased hormone production. Decreased sexual activity may occur in the older adult, and experimentation with sexual orientation occurs more frequently during adolescence.
The nurse is reviewing the chart of a pediatric client at risk for osteoporosis. Which factor in the client's history should the nurse identify as placing the client at risk for osteoporosis? A. Diabetes B. Cystic fibrosis C. Congenital cardiac disease D. Systemic lupus erythematosus
A. Diabetes Rationale: Diabetes is associated with a lower bone mass, placing the client at risk for osteoporosis. Cystic fibrosis, congenital cardiac disease, and systemic lupus erythematosus do not place the client at risk for osteoporosis. If the client has periods of immobility, the nurse can collaborate with physical therapy to provide the client with preventative exercises.
Which factor should the nurse identify as a health risk that may affect pregnancy outcomes? (Select all that apply.) A. Diabetes mellitus B. Alcohol use C. Migraines D. Caffeine intake E. Secondhand smoke
A. Diabetes mellitus B. Alcohol use D. Caffeine intake E. Secondhand smoke Rationale: Risk factors that may affect the client's pregnancy outcome include exposure to secondhand smoke, caffeine intake, alcohol use, and diabetes mellitus. Migraines are not commonly identified as a health risk that may adversely affect pregnancy outcomes.
The nurse suspects that a male client with a sexual disorder is experiencing a problem with elimination. Which assessment finding correlates with the nurse's concern? A. Difficulty voiding B. Inability to maintain an erection C. Clear discharge from the penis D. Arthritis in both hips and knees
A. Difficulty voiding Rationale: The proximity and interrelatedness of the sexual organs and organs of elimination may lead to difficulties such as urinary retention. The inability to maintain an erection is a problem related to perfusion. Clear discharge from the penis, arthritis in the hips and knees, and an inability to maintain an erection are not associated with difficulty voiding.
The nurse is caring for an older adult client experiencing discomfort during sexual activity as a result of osteoarthritis. Which nursing intervention is most appropriate for the client? A. Discussing the timing of sexual activity. B. Encouraging an increase in routine exercise. C. Incorporating the use of cold compresses on sore joints. D. Encouraging the client to have sex in a semi-reclined position.
A. Discussing the timing of sexual activity. Rationale: The nursing intervention that is most appropriate for the client is to discuss the timing of sexual activity. Sexual activity can take place at a time during the day in which the client is not experiencing much discomfort. An increase in routine exercise may exacerbate the joint pain. Warm compresses on painful joints can be utilized to provide comfort. A semi-reclined position is recommended for clients with heart failure that develop fatigue or shortness of breath.
A client asks about the symptoms of menopause during a wellness visit. Which vasomotor manifestation of menopause should the nurse describe? (Select all that apply.) A. Dizziness B. Palpitations C. Decreased body hair D. Night sweats E. Hot flashes
A. Dizziness B. Palpitations D. Night sweats E. Hot flashes Rationale: The manifestations of menopause affect many body systems, including the vasomotor system. Vasomotor manifestations include hot flashes, palpitations, dizziness, headaches, insomnia, and night sweats. Decreased body hair is an integumentary, not vasomotor, manifestation of menopause. Menopausal clients have integumentary manifestations that include decreased body hair, decreased skin elasticity, and decreased subcutaneous tissue.
During an outpatient visit you are assessing the patient's understanding about the signs and symptoms associated with osteoporosis. Select all of the signs and symptoms stated by the patient that are correct:* (Select all that apply) A. Dowager's Hump B. Loss of 0.5 inches in height compared to young adult height C. Swelling and warmth at the bone site D. Some patients are asymptomatic E. Fractures most commonly in the hips, wrist, and spine
A. Dowager's Hump D. Some patients are asymptomatic E. Fractures most commonly in the hips, wrist, and spine Option B is wrong because there is normally a loss of 2-3 inches in height compared to the patient's height in young adulthood. Option C is wrong because the bone site will not present as warm or swollen (most patients are asymptomatic).
A client experiencing perimenopausal symptoms asks what can be done to help control the symptoms. Which intervention should the nurse recommend? (Select all that apply.) A. Drinking cool liquids B. Increasing caffeine intake C. Engaging in regular exercise D. Dressing in layers E. Avoiding sexual intercourse
A. Drinking cool liquids C. Engaging in regular exercise D. Dressing in layers Rationale: Exercise can help manage the anxiety and mood swings associated with perimenopause. Dressing in loose layers of clothing that can be added or removed will increase comfort during hot flashes. Drinking cool liquids can help with hot flashes. Caffeine is not identified as having an impact on menopausal symptoms. Sexual intercourse does not have to be avoided during perimenopause, but lubricants may be used to decrease discomfort from vaginal dryness.
When planning care for a client with family planning needs, which intervention should the nurse include? (Select all that apply.) A. Encouraging the client to verbalize feelings about sexual health B. Teaching the client about fertility and contraception C. Consulting a social worker for genetic counseling D. Providing an environment that promotes discussion E. Emphasizing the importance of using condoms for disease prevention
A. Encouraging the client to verbalize feelings about sexual health B. Teaching the client about fertility and contraception D. Providing an environment that promotes discussion E. Emphasizing the importance of using condoms for disease prevention Rationale: When planning care for a client with family planning needs, the nurse needs to provide a nonjudgmental, accepting atmosphere to promote discussion. Other interventions should include encouraging the client to verbalize feelings of sexual health, teaching about fertility and contraception, and emphasizing the importance of condom use for disease prevention. The social worker is not the appropriate person to provide genetic counseling.
A sexually active male client has burning urination and milky discharge from the urethral meatus. What documentation should be included on the client's medical record? (Select all that apply) A. History of unprotected sex (sex without a condom) B. Length of time since symptoms presented C. History of fever or chills D. Presence of any enlarged lymph nodes upon examination E. Names and phone numbers of all sexual partners F. Allergies to any medications
A. History of unprotected sex (sex without a condom) B. Length of time since symptoms presented C. History of fever or chills D. Presence of any enlarged lymph nodes upon examination F. Allergies to any medications Rationale: The client is suspected of having an STI. Therefore, the client's sexual history, assessment, and examination must be documented including: symptoms (such as fever, chills, and enlarged glands) and their onset and duration. Allergies are critical to document for every client but are especially noteworthy in this case because antibiotics will be prescribed. To protect privacy, the names and phone numbers of partners should NEVER be placed in the medical record.
Which methods must be applied/placed/done by a doctor? (select all that apply) A. IUD B. The shot C. Female condom D. Family planning
A. IUD B. The shot
The nurse receives notification from the lab that a client tests positive for syphilis. Which nursing action should the nurse implement? (Select all that apply.) A. Initiate client teaching regarding sexually transmitted infections and their consequences. B. Inform the client that syphilis is not contagious if there are no symptoms of infection. C. Verify the client's drug allergies. D. Ensure that this case is reported to the public health system. E. Recommend that a pregnancy test be obtained.
A. Initiate client teaching regarding sexually transmitted infections and their consequences. C. Verify the client's drug allergies. D. Ensure that this case is reported to the public health system. E. Recommend that a pregnancy test be obtained. Rationale: In the event of a positive syphilis test, the nurse would report the case to the public health system, initiate client teaching regarding STIs, verify the client's drug allergies in preparation for the prescribed treatment regime, and, if the client is female, arrange for a pregnancy test. Syphilis is contagious, and it is critical to treat the infection to avoid complications, even when there are no symptoms present.
The PRIMARY reason that a herpes simplex virus infection is a serious concern to a client with HIV is that it: A. Is an aquired immunodeficiency virus-defining illness B. Is curable only after 1 year of antiviral therapy C. Leads to cervical cancer D. Causes severe electrolyte imbalances
A. Is an AIDS-defining illness Rationale: HSV is one of a group of disorders that, when diagnosed in the presence of HIV, are considered to be diagnostic for AIDS. Other AIDS defining illnesses include Kaposi's sarcoma, CMV of the liver spleen or lymph, and Pneumocytis carinii pneumonia.
Check all that are true about emergency contraception: (Select all that apply) A. It is also referred to as "the morning after pill." B. It is also referred to as "the plan B pill." C. It may be taken only within 24 hours. D. It is considered safe to take as often as possible. E. It may be taken within 72 hours. F. It contains a large dose of hormones.
A. It is also referred to as "the morning after pill." B. It is also referred to as "the plan B pill." E. It may be taken within 72 hours. F. It contains a large dose of hormones.
The nurse is teaching at a community health clinic about the risk factors for syphilis. Which statement should the nurse include? (Select all that apply.) A. It is contracted by unprotected sex. B. Only women are at risk for syphilis. C. It is only contracted through anal sex. D. It has an incubation period of 10 to 90 days. E. It spreads through the body by way of blood and lymph nodes.
A. It is contracted by unprotected sex. D. It has an incubation period of 10 to 90 days. E. It spreads through the body by way of blood and lymph nodes. Rationale: Syphilis is a sexually transmitted infection, wherein the microorganisms invade the body and spread through blood and lymph nodes. The incubation period is 10 to 90 days. Both men and women can be infected with syphilis; however, it is not only anal sex through which this infection can be contracted.
The nurse interviews a middle-aged client experiencing menopause. Which option should the nurse discuss to help with the symptoms? (Select all that apply.) A. Lifestyle changes B. Hormone replacement therapy C. Nonpharmacologic methods of relief D. Calcium intake of 500 mg a day E. Sexual abstinence
A. Lifestyle changes B. Hormone replacement therapy C. Nonpharmacologic methods of relief Rationale: Many physiologic effects of menopause are amenable to either hormone replacement therapy (HRT) or nonpharmacologic methods of relief, such as lifestyle changes, so these options should be discussed. The recommended daily calcium intake for women over age 50 is 1200 mg to help prevent osteoporosis. Menopause does not require abstaining from sexual contact.
The nurse is preparing teaching for home care to a client with family planning needs. Which topic should the nurse address? (Select all that apply.) A. Making a dental appointment B. Avoiding all vaccines C. Maintaining a balanced, nutritional diet D. Participating in a weekly exercise class E. Smoking cessation
A. Making a dental appointment C. Maintaining a balanced, nutritional diet E. Smoking cessation Rationale: When teaching on home care to a client with family planning needs, the nurse should include the importance of maintaining a balanced, nutritional diet and making a dental appointment. The nurse should also include smoking cessation or the importance of reducing the number of cigarettes, if possible. The client should maintain a regular exercise routine and not just participate in a weekly exercise class. The client should also receive the flu vaccine.
Which finding should the nurse identify as inappropriate sexual behavior? (Select all that apply.) A. Making sexual statements B. Whistling at the nurse C. Pulling at the condom catheter D. Touching the nurse improperly E. Exposing genitalia
A. Making sexual statements B. Whistling at the nurse D. Touching the nurse improperly E. Exposing genitalia Rationale: Clients who experience alterations in sexuality may act out and demonstrate inappropriate behavior. Findings the nurse can anticipate in a client exhibiting inappropriate sexual behavior include whistling, exposing genitalia, making sexual statements, and touching the nurse improperly. Pulling at a condom catheter may be a result of discomfort.
Which procedure of clinical interruption of a pregnancy is most likely to be performed for a woman in the first 7 to 9 weeks of a pregnancy? A. Medical abortion by administration of mifepristone and misoprostol B. Medical abortion by dilation and curettage (D&C) and minisuction C. Surgical abortion by dilation and curettage (D&C) and minisuction D. Surgical abortion by dilation and extraction (D&E) and hypertonic saline
A. Medical abortion by administration of mifepristone and misoprostol Rationale: Clinical interruption of a pregnancy is performed in the early weeks by medical abortion, meaning that there is no surgical procedure involved. Medical abortion does not involve dilation and curettage. Mifepristone is administered to alter the uterine lining, followed 1 to 3 days later by administration of misoprostol to induce contractions to expel the embryo. Surgical abortions have higher risk than medical abortions, and are not as likely to be performed for an elective clinical interruption. The D&C can be performed during the first trimester, and a D&E can be done in the second trimester.
The nurse cautions that women with a history of which disorders are not candidates for HRT? Select all that apply. a. Melanoma b. Estrogen-dependent breast cancer c. Hepatitis C d. Thromboembolic disease e. Hyperthyroidism
A. Melanoma B. Estrogen-dependent breast cancer C. Hepatitis C D. Thromboembolic disease Persons who are absolutely restricted from HRT are those with melanoma, estrogen-dependent breast cancers, chronic liver disorders, thromboembolic disease, and seizure disorders
The nurse is preparing to examine a client who is experiencing menopause. Which information should the nurse obtain when performing a health history? (Select all that apply.) A. Menstrual history B. Sleep pattern C. Posture D. Vital signs E. Medications
A. Menstrual history B. Sleep pattern E. Medications Rationale: When performing a health history on a client experiencing menopause, the nurse should obtain information about the client's menstrual history, medications, and sleep pattern. Posture and vital signs are assessments that the nurse will include when completing the physical examination.
Which intervention should the nurse discuss with a client newly diagnosed with herpes regarding viral shedding? A. Not sharing bath towels B. Abstaining from sex C. Following a low-protein diet D. Taking antivirals
A. Not sharing bath towels Rationale: Health teaching for clients with genital herpes involves helping them manage their condition with the least possible disruption in lifestyle and relationships. The use of hygiene practices, including not sharing towels or other personal items, and the use of latex condoms, will protect others from viral shedding. Abstaining from sex will help keep the virus from spreading, but there is still risk involved with viral shedding. A low-protein diet is not related to viral shedding. Taking antivirals helps decrease the length of the outbreak but is not related to viral shedding.
The nurse is caring for an adolescent client who has been diagnosed with a sexually transmitted infection (STI). Which problem should the nurse assess in this client? (Select all that apply.) A. Pain B. Impaired skin integrity C. Deficient knowledge D. Disturbed body image E. Risk of altered parenting
A. Pain B. Impaired skin integrity C. Deficient knowledge D. Disturbed body image Rationale: The nurse should assess the client for pain, deficient knowledge, disturbed body image, and impaired skin integrity. There is no need to assess the client for risk of altered parenting.
The nurse should understand that which physiological screening tests for sexual health are appropriate for both men and women? (Select all that apply.) A. Physical examination B. Lipid panel C. Mammography D. Blood pressure E. Prostate-specific antigen
A. Physical examination B. Lipid panel D. Blood pressure Rationale: The nurse understands that the physiological screening tests for the sexual health of men and women include a lipid panel, blood pressure, and a physical assessment. Mammography is a specific test for women, and prostate-specific antigen is a screening for men.
A middle-aged female client experiencing symptoms of menopause has increased follicle-stimulating hormone and luteinizing hormone levels. Which intervention should the nurse initiate? (Select all that apply.) A. Providing information about medications that might be prescribed to help with menopausal symptoms B. Asking open-ended questions about the client's body image C. Explaining physiologic manifestations of menopause D. Instructing the client to avoid over-the-counter vaginal lubricants E. Encouraging discussion of how menopausal symptoms are affecting sexual functioning
A. Providing information about medications that might be prescribed to help with menopausal symptoms B. Asking open-ended questions about the client's body image C. Explaining physiologic manifestations of menopause E. Encouraging discussion of how menopausal symptoms are affecting sexual functioning Rationale: The client is experiencing menopause and may have problems understanding the natural female aging process, sexual dysfunction, low self-esteem, or disturbed body image. Interventions to help the client with these problems include explaining the physiologic manifestations of menopause, providing information about medications that might be prescribed to help with menopausal symptoms, encouraging discussion of how menopausal symptoms are affecting sexual functioning, and instructing the client to use vaginal lubricants if experiencing decreased lubrication. Asking open-ended questions will further explore the client's thoughts and feelings about body image in a therapeutic manner.
The nurse is preparing to obtain a history on a new client. Which information should the nurse include that is specific to the sexual history? (Select all that apply.) A. Psychosocial history B. Activity level C. Relationship status D. Past medical history E. Nutritional status
A. Psychosocial history B. Relationship status D. Past medical history Rationale: Information collected during the sexual history includes the client's medical history, psychosocial history, and relationship status. The activity level and nutritional status are not specifically included in the sexual history.
The nurse is providing information to a client deciding on a form of contraception. Which aspect should be considered when determining the best contraceptive method? (Select all that apply.) A. Safety B. Affordability C. Ease of use D. Effectiveness E. Accountability
A. Safety B. Affordability C. Ease of use D. Effectiveness Rationale: Nurses should provide contraceptive information to the client to assist in making a decision. For determining the best method, the client will need to consider safety, effectiveness, ease of use, side effects, whether it is easily available, and whether it is affordable. The nurse will not make judgments about the client's accountability.
The nurse is caring for a client diagnosed with syphilis. The client has a rash covering both palms of the hands. The nurse explains that the client is in which stage of syphilis? A. Secondary stage B. Primary stage C. Tertiary stage D. Latent stage
A. Secondary stage Rationale: Manifestations of secondary syphilis after the initial chancre include a rash, especially on the palms of the hands or soles of the feet; mucous patches in the oral cavity; sore throat; generalized lymphadenopathy; condyloma lata (flat, broad-based papules) on the labia, anus, or corner of the mouth; flulike symptoms; and alopecia. The primary stage of syphilis is characterized by the appearance of a chancre and by regional enlargement of lymph nodes; little or no pain accompanies these warning signs. During the latent period a client has no symptoms, however, during the early part of this stage, sexual transmission is possible. Roughly 15% of untreated individuals progress to late-stage or tertiary syphilis.
While conducting a physical assessment, the nurse notes a red rash in the axillary region of a young adult client. Which factor may be associated with the assessment finding? (Select all that apply.) A. Shaving B. Systemic disease C. Infection of the hair follicles D. Allergies E. Breast malignancy
A. Shaving C. Infection of the hair follicles D. Allergies Rationale: Redness, rash, irritation, or lesions of the axillary region may be due to allergies, shaving, or infection of the sweat glands or hair follicles. Systemic disease and breast malignancy do not manifest as an axillary rash.
The nurse is reviewing the chart of a client with osteoporosis. Which physical assessment finding should the nurse anticipate? A. Spinal curvature B. Poor posture C. Generalized pain D. Unsteady gait
A. Spinal curvature Rationale: The assessment findings associated with osteoporosis include spinal curvature. An unsteady gait, poor posture, and generalized pain are not findings associated with the physical assessment findings of osteoporosis.
The nurse is caring for an older adult who is visually impaired and at risk for osteoporosis. Which activity is most appropriate to implement for the prevention of osteoporosis? A. Strength and balance training B. Aerobics C. Swimming D. Walking on a treadmill
A. Strength and balance training Rationale: Strength and balance training is the safest, most appropriate plan for exercise for the visually impaired client at risk for osteoporosis. Aerobics and walking on a treadmill are not the safest choices for a visually impaired client. The client may lose balance as well as not be able to adjust or stop a treadmill if needed. Swimming is not a weight-bearing exercise. Weight-bearing exercises influence the bone metabolism necessary to prevent osteoporosis.
Which group has experienced the GREATEST rise in the incidence of STDs over the past two decades? A. Teenagers B. Divorced people C. Young married couples D. Older adults
A. Teenagers Rationale: Statistics show that incidence of STDs are rising rapidly among teenagers, more-so than any other age group.
The nurse is preparing information about sexual development for a group of parents with school-age children. Which factor does the nurse attribute to puberty? (Select all that apply.) A. The appearance of female breast buds B. The beginning of purposeful masturbation C. Growth of pubic hair D. Menstruation beginning about 2 years after breast buds develops in girls E. Nocturnal emissions signaling the beginning of puberty in boys
A. The appearance of female breast buds C. Growth of pubic hair D. Menstruation beginning about 2 years after breast buds develops in girls Rationale: Between the ages of 9 and 10, evidence of puberty begins. The production of testosterone, a hormone from the adrenal glands, contributes to the growth of pubic hair in both sexes. Girls develop breast buds, or thelarche, and menstruation begins about 2 years after the appearance of breast buds. Nocturnal emissions typically begin around age 13 to 15. Puberty typically begins with the development of pubic hair around age 10 in boys.
Check which options are hormonal methods of birth control: (Select all that apply) A. The patch B. The pill C. The sponge D. The shot
A. The patch B. The pill D. The shot
Dual protection is the most effective protection. A. True B. False
A. True
If you are sexually active, you should get tested every three-six months, and after every possible exposure (meaning, after unprotected sex). A. True B. False
A. True
Many people who have an STI don't have any obvious symptoms or signs A. True B. False
A. True
The patch is typically applied once a week. A. True B. False
A. True
The nurse is reviewing the prescription for laboratory tests on a male client experiencing a sexual disorder. Which laboratory test is appropriate? (Select all that apply.) A. Urinalysis B. Serum hormone levels C. Papanicolaou test D. Hysteroscopic examination E. Complete blood count
A. Urinalysis B. Serum hormone levels E. Complete blood count Rationale: The prescribed laboratory tests that are most appropriate for the male client experiencing a sexual disorder include a urinalysis, complete blood count, and serum hormone levels. A Papanicolaou test and hysteroscopy examination are tests for a female client.
What is the most important informartion for the nurse to teach a client newly diagnosed with genital herpes? A. Use condoms at all times during sexual intercourse B. A urologist should be seen only when lesions occur C. Oral sex is permissable without a barrier D. Determine if your partner has received a vaccination against herpes
A. Use condoms at all times during sexual intercourse Rationale: The client should be taught to abstain from sexual intercourse while lesions are present. Condoms should be used at all times as the virus can be shed without lesions present. Multiple partners would promote spread of genital herpes. There is no vaccine available to prevent genital herpes. Although periodic examination should be advised, a urologist does not necessarily need to be seen when lesions occur.
The nurse is assessing a client experiencing menopause. Which findings should the nurse expect in this client? (Select all that apply.) A. Vaginal dryness B. Cold intolerance C. Thinning hair D. Hot flashes E. Headaches
A. Vaginal dryness C. Thinning hair D. Hot flashes E. Headaches Rationale: The physical manifestations of menopause are thought to be related to diminishing estrogen. This accounts for the hot flashes, vaginal dryness, thinning hair, and headaches. Women experiencing menopause do not typically experience cold intolerance.
A client experiencing menopause is being counseled about bone health and exercise. Which exercise should be recommended for bone health? A. Walking B. Swimming C. Cycling D. Stretching
A. Walking Rationale: Walking is the best method of maintaining bone health for a client in menopause. Weight-bearing exercise reduces the rate of bone loss, helps maintain optimum weight, and reduces cardiovascular risk. Swimming, cycling, and stretching are not weight-bearing exercises.
A client experiencing menopause does not want to take any prescribed medications for the symptoms. Which alternative or complementary therapy should the nurse review with the client? (Select all that apply.) A. Yoga B. Soy and ginseng C. Bioidentical hormones D. Massage E. Hormone replacement therapy
A. Yoga B. Soy and ginseng C. Bioidentical hormones D. Massage Rationale: Soy, ginseng, yoga, bioidentical hormones, and massage are all considered alternative or complementary therapies to manage menopausal symptoms. Hormone replacement therapy is not considered an alternative or complementary therapy.
The nurse is discussing cervical mucus changes with a woman who wishes to use natural family planning methods. The nurse determines the woman understands the information presented when she says the changes in cervical mucus at ovulation: a. enhance the motility of the sperm. b. indicate endometrial readiness for implantation. c. facilitate movement of the ovum through the fallopian tube. d. provide vaginal lubrication during intercourse.
A. enhance the motility of the sperm. Around the time of ovulation, the slippery, clear cervical mucus enhances the motility of the sperm.
A 48-year-old woman tells the nurse, "I missed my period last month. Am I in menopause?" The nurse would respond that a woman is considered to be menopausal when: a. her periods have stopped for 1 year. b. her periods have been irregular and light for 12 months. c. she has symptoms of vasomotor instability. d. she experiences symptoms of decreased estrogen, such as dyspareunia.
A. her periods have stopped for 1 year. When a woman's menstrual periods have stopped for 1 year, she is considered menopausal.
The nurse explains that the drug clomiphene (Clomid) is used in infertility treatment because it: a. induces ovulation. b. reduces endometriosis. c. promotes implantation of a fertilized ovum. d. inhibits excess prolactin secretion.
A. induces ovulation. Clomiphene (Clomid) induces ovulation. It may also increase sperm production, although this is an unlabeled use.
Parathyroid hormone plays an important role in bone health. When the parathyroid gland secretes PTH (parathyroid hormone) it causes: A. the body to increase the calcium levels by stimulating the osteoclast activity. B. the body to decrease the calcium levels by inhibiting osteoclast activity. C. the body to increase the calcium levels by stimulating osteoblast activity. D. the body to decrease the calcium levels by inhibiting osteoblast activity.
A. the body to increase the calcium levels by stimulating the osteoclast activity. When the calcium levels are low this stimulates the parathyroid gland to secrete PTH, which stimulates osteoCLAST activity. Remember osteoCLASTS break down the bone matrix within the spongy bone. This will cause calcium to enter the blood stream, hence increasing calcium levels.
A client in menopause is experiencing sexual issues. Which information should the nurse provide to the client? A. Water-based gels are helpful for vaginal lubrication. B. Dietary changes are not needed during menopause due to hormone changes. C. Oil-based lubricants can make sexual activity more enjoyable. D. Foreplay is not needed after menopause.
A. Water-based gels are helpful for vaginal lubrication. Rationale: Water-soluble gels are helpful for vaginal lubrication in the client experiencing symptoms of menopause. Increased foreplay might be needed in menopause to allow more time for vaginal lubrication. Oil-based lubricants are not recommended. Dietary changes can be used to help with vaginal dryness and weight gain associated with menopause.
Which of the following instructions should be included in the nurse's teaching regarding oral contraceptives? A. Weight gain should be reported to the physician. B. An alternate method of birth control is needed when taking antibiotics. C. If the client misses one or more pills. two pills should be taken per day for 1 week. D. Changes in the menstrual flow should be reported to the physician.
An alternate method of birth control is needed when taking antibiotics. When the client is taking oral contraceptives and begins antibiotics. another method of birth control should be used. Antibiotics decrease the effectiveness of oral contraceptives. Approximately 510 pounds of weight gain is not unusual. so answer A is incorrect. If the client misses a birth control pill. she should be instructed to take the pill as soon as she remembers the pill. Answer C is incorrect. If she misses two. she should take two; if she misses more than two. she should take the missed pills but use another method of birth control for the remainder of the cycle. Answer D is incorrect because changes in menstrual flow are expected in clients using oral contraceptives. Often these clients have lighter menses.
Which statement by the nurse indicates an understanding of the effects of vitamin D and calcium on osteoporosis? A. "Vitamin D is needed for renal absorption of phosphorus and calcium." B. "Impaired vitamin D activation reduces the serum calcium level." C. "A high intake of high-phosphate foods can help increase serum calcium." D. "Acidosis causes calcium to be deposited into bone."
B. "Impaired vitamin D activation reduces the serum calcium level." Rationale: The statement made by the nurse, "Impaired vitamin D activation reduces the serum calcium level," demonstrates an understanding of the effects of vitamin D and calcium and their association with osteoporosis. Vitamin D is essential because it facilitates calcium absorption from the intestines into the blood. Acidosis does not cause calcium to be deposited in the bone. Vitamin D increases renal absorption of calcium in the distal tubule, but the phosphate level is not affected by vitamin D. Foods high in phosphate decrease serum calcium.
A client diagnosed with osteoporosis indicates reluctance to taking medication on a daily basis. Which class of medication should the nurse anticipate will be prescribed? A. Tetracycline B. Bisphosphonate C. Oral calcium supplement D. Calcium channel blocker
B. Bisphosphonate Rationale: Recent studies suggest that once-weekly dosing with bisphosphonates may give the same bone density benefits as daily dosing because of the extended duration of drug action. Tetracyclines and calcium channel blockers are not used to treat osteoporosis. Oral calcium supplements are typically taken on a daily basis.
Women who have HPV are at risk for development of: A. Sterility B. Cervical Cancer C. Uterine Fibroid tumors D. Irregular menses
B. Cervical Cancer Rationale: Women who have HPV are much more likely to contract cervical cancer than women who have never had the disease. Cervical cancer is now considered a sexually transmitted disease because of the high incidences in women with HPV.
The nurse is addressing sexual functioning for a male client prescribed an anti-anxiety medication. Which information should the nurse include in the teaching? (Select all that apply.) A. Painful erection B. Decreased sexual desire C. Erectile dysfunction D. Delayed ejaculation E. Orgasmic dysfunction
B. Decreased sexual desire D. Delayed ejaculation Rationale: The effects of anti-anxiety medications on the sexual function of a male client include delayed ejaculation and decreased sexual desire. A painful erection and erectile dysfunction are adverse effects associated with antidepressants. Orgasmic dysfunction may occur in women.
The nurse is obtaining a history on an adolescent client. Which reported behavior should be concerning? A. Verbalizing how to identify the warning signs of dating violence and date rape B. Engaging in sex with a diaphragm with a non-monogamous partner C. Asking a partner in a monogamous relationship to be tested for STDs D. Practicing abstinence for the first 6 months of a monogamous relationship
B. Engaging in sex with a diaphragm with a non-monogamous partner Rationale: While a diaphragm prevents pregnancy, it does not prevent transmission of infection. This method of birth control should not be used alone in non-monogamous relationships. This statement would be concerning. A person can be infected with HIV and able to infect others for 6 months before seroconversion. Practicing abstinence for the first 6 months of a monogamous relationship, then being retested would be ideal. Asking a partner in a monogamous relationship to be tested for STDs is not a concerning behavior. Verbalizing how to identify the warning signs of dating violence and date rape would demonstrate that the client is exhibiting responsible sexual behavior.
A client is experiencing the menopausal symptom of vaginal dryness. Which medication should the nurse anticipate being prescribed for this client? A. Vitamin D supplement B. Estrogen preparation C. Bisphosphonate D. Psychotropic
B. Estrogen preparation Rationale: Vaginal dryness can be treated with low-dose vaginal estrogen. Psychotropic medications are used to treat mental health disorders. Bisphosphonates are medications for osteoporosis. Vitamin D supplements are used to help increase calcium absorption.
Emergency contraception can only be prescribed by a doctor. A. True B. False
B. False
Spermicide is the same as the sponge. A. True B. False
B. False
The Family Planning method--a method when a couple has sex according to non-fertile times during the month--is a safe method for teens and young adults to use. A. True B. False
B. False
Withdrawal is an effective method to use considering there is no possible way for any semen to enter a woman's vagina. A. True B. False
B. False
Women can only get pregnant during ovulation: A. True B. False
B. False
True or False: Osteoporosis is a disease process that results in the thinning of the matrix of pore-like structures within the compact bone. A. True B. False
B. False Osteoporosis is a disease process that results in the thinning of the matrix of pore-like structures within the SPONGY (not compact) bone. The compact bone is the outside part of the bone, and the spongy bone is found inside the compact bone. It contains a matrix of pore-like components such as protein and minerals...this starts to thin and becomes more porous in osteoporosis.
The nurse explains the importance of testing for sexually transmitted infections (STIs) to a newly pregnant client. During which time period should the nurse explain that this test will take place? A. Second prenatal visit B. First prenatal visit C. Only if the client has symptoms D. Immediately after finding out she is pregnant
B. First prenatal visit Rationale: Very few early manifestations of an infection are experienced, so clients may not know whether they are infected or not. All pregnant women should therefore be tested for STIs, including HIV, as part of routine medical care during their first prenatal visit.
Which birth control lasts for five years? A. The patch B. IUD C. Depo D. Sponge
B. IUD
A client calls the nurse into the room and the nurse finds the client naked in bed. Based on the client's behavior, which nursing action is appropriate? (Select all that apply.) A. Ask if the client is ready for morning care. B. Instruct the client that you will come back when the client is dressed. C. Cover the client with a bed sheet. D. Remind the client that clothing is required to be worn during hospitalization. E. Inform the charge nurse of the client's behavior.
B. Instruct the client that you will come back when the client is dressed. D. Remind the client that clothing is required to be worn during hospitalization. E. Inform the charge nurse of the client's behavior. Rationale: The most appropriate actions would be informing the charge nurse of the client's behavior, instructing the client you will return when the client is dressed, and reminding the client that clothing is required to be worn during hospitalization. Covering the client with a bedsheet and asking if the client is ready for morning care are not appropriate nursing actions for a client exhibiting inappropriate sexual behavior, because they do not directly and assertively address the issue.
A client in the family planning clinic asks the nurse about the most likely time for her to conceive. The nurse explains that conception is most likely to occur when: conception is most likely to occur when: A. Estrogen levels are low. B. Luteinizing hormone is high. C. The endometrial lining is thin. D. The progesterone level is low.
B. Luteinizing hormone is high.
A client presents with a sore tip of the penis. The client reveals having sex with two partners. Upon examination the nurse notices swelling in the client's groin, along with chancre. How should the nurse interpret this swelling in the groin? A. Allergic reaction B. Lymphadenopathy C. Necrosis D. Retention
B. Lymphadenopathy Rationale: Lymphadenopathy is a swelling or abnormal number of lymph nodes in a specific area of the body. Lymphadenopathy is inflammatory and usually caused by an infection. Necrosis is death of tissue. Retention is holding pockets of fluid. An allergic reaction produces hives, rash, fever, difficulty breathing, and itching.
The nurse is performing a health history on a client with family planning needs. Which data should the nurse collect? (Select all that apply.) A. Vital signs B. Medication history C. Genital exam D. Number of sexual partners E. Family history of breast cancer
B. Medication history D. Number of sexual partners E. Family history of breast cancer Rationale: When performing a health history on a client with family planning needs, the nurse needs to obtain information on the client's medication history, family history of breast cancer, and number of sexual partners. Vital signs and genital exam are part of the physical examination of a client with family planning needs.
The nurse is interviewing a client with newly diagnosed syphilis. In order to prevent the spread of the disease, the nurse should focus the interview by: A. Motivating the client to undergo treatment B. Obtaining a list of the client's sexual contacts C. Increasing the client's knowledge of the disease D. Reassuring the client that medical records are confidential
B. Obtaining a list of the client's sexual contacts Rationale: An important aspect of controlling the spread of STDs is obtaining a list of sexual contacts who may have been exposed to the infected client. Many people with STDs are reluctant to reveal their sexual contacts which makes controlling STDs difficult.
The nurse assesses the mouth and oral cavity of a client with HIV because the MOST common opportunistic infection initially presents as: A. Herpes simplex virus lesions on the lips B. Oral candidiasis C. Cytomegalovirus (CMV) infection D. Aphthae on the gingiva
B. Oral candidiasis Rationale: The most common opportunistic infection in HIV initially presents as oral candidiasis or THRUSH. Apthous stomatitis (recurrent canker sores) is not an opportunistic infection. HSV and CMV are opportunistic infections that present later in AIDS.
A client has been prescribed an estrogen-progestin combination contraceptive. The nurse should monitor the client for which risk? (Select all that apply.) A. Acne B. Over age 35 C. Menstrual pain D. Smoking E. Increased menstrual bleeding
B. Over age 35 D. Smoking Rationale: A client who smokes or is over 35 years old is at an increased risk of thromboembolic disorders when using an estrogen-progestin combination contraceptive. Estrogen-progestin combination contraceptives often decrease acne, menstrual bleeding, and menstrual pain.
The nurse is caring for a client with osteoporosis. Which medication taken by the client may have contributed to this diagnosis? A. Acetaminophen B. Prednisone C. Calcium Supplements D. Vitamin D Supplements
B. Prednisone Rationale: Glucocorticoids such as prednisone may have contributed to the development of osteoporosis. Calcium supplements and vitamin D supplements are both used to treat osteoporosis. Acetaminophen is a pain reliever; it is not associated with the development of osteoporosis.
A woman asks the nurse, "How do oral contraceptives prevent pregnancy?" The nurse explains that the combination of estrogen and progesterone in oral contraceptives: a. makes cervical mucus hostile to sperm. b. prevents ovulation. c. prohibits implantation of the egg. d. acts as a barrier by destroying sperm.
B. Prevents ovulation Oral contraceptives contain a combination of estrogen and progesterone that suppress ovulation.
The nurse recognizes that family planning care involves more than preventing pregnancy. Which goal should the nurse consider to be a part of family planning care? (Select all that apply.) A. Encouraging acceptance of all available forms of contraception methods B. Promoting a healthy body image C. Providing knowledge about sexual and reproductive health D. Promoting healthy sexual function E. Encouraging the use of preferred contraceptive methods
B. Promoting a healthy body image C. Providing knowledge about sexual and reproductive health D. Promoting healthy sexual function Rationale: The role of the nurse is to help the client by promoting a healthy body image, promoting healthy sexual function, and providing knowledge of sexual and reproductive health. The nurse does not encourage one contraceptive practice over another or try to influence a client to accept all available forms of fertility treatment or contraception. Nurses should present all the options available to the client.
The nurse is caring for a client who was diagnosed with chlamydia. Which action by the nurse is appropriate for this client? A. Visiting the home to follow up B. Reporting the sexually transmitted infection C. Tracking that the client filled a prescription D. Contacting sexual partners
B. Reporting the sexually transmitted infection Rationale: Sexually transmitted infections like chlamydia, gonorrhea, and syphilis are all reportable STIs, so the nurse may be involved with the reporting process. The nurse would not visit the client's home to follow up. Contacting sexual partners and filling prescriptions are the responsibility of the client.
The nurse is caring for a woman who is taking the infertility medication clomiphene. Which assessment finding would indicate to the nurse that the client is potentially experiencing adverse effects from the medication? (Select all that apply.) A. Reduction in urine output B. Reports of mood swings C. Weight gain of 10 pounds in 1 month D. Hot flashes E. Changes in the client's vision
B. Reports of mood swings D. Hot flashes E. Changes in the client's vision Rationale: For the female infertility medication clomiphene, visual changes, mood swings, and hot flashes are some of the adverse effects. Reduction in urine output and weight gain are not adverse effects of this medication.
The nurse is caring for a client experiencing sexual difficulty. The client was sexually assaulted in the past. Which intervention is most appropriate for this client? A. Recommending hormonal replacement therapy B. Requesting a referral for a therapist C. Encouraging the client to increase foreplay D. Obtaining a prescription for an LS and FSH level
B. Requesting a referral for a therapist Rationale: The intervention by the nurse that is most appropriate for the client who has a history of sexual assault and is experiencing sexual difficulty is referring the client to a therapist. Based on the client's concern and history, encouraging the client to increase foreplay, obtaining a prescription for LS and FSH levels, and hormonal replacement therapies are not appropriate.
The nurse is providing teaching on the prevention of osteoporosis. Which modifiable risk factor can increase a client's risk of developing osteoporosis? (Select all that apply.) A. Consumption of milk products B. Sedentary lifestyle C. Excessive alcohol consumption D. Moderate exercise E. Smoking
B. Sedentary Lifestyle C. Excessive alcohol consumption E. Smoking Rationale: Individuals who spend a lot of time sitting have a higher risk of osteoporosis than do their more active counterparts. Excessive alcohol consumption can interfere with the body's ability to absorb calcium. Tobacco use contributes to weak bones. The consumption of milk products and moderate exercise are both lifestyle choices that decrease the risk of osteoporosis, not contribute to the development of osteoporosis.
The nurse is teaching a client with osteoporosis who has been prescribed calcium citrate supplements. Which information should the nurse include in the teaching? A. Take the calcium on an empty stomach. B. Take the calcium with meals. C. Take the calcium within 2 hours after meals. D. Take the calcium in the morning.
B. Take the calcium with meals. Rationale: The client prescribed calcium citrate supplementation should be instructed to take the calcium with meals. It does not matter what time of day the client takes the calcium.
The nurse is teaching a client diagnosed with genital herpes simplex virus (HSV). How should the nurse describe the signs of an outbreak? (Select all that apply.) A. Bleeding B. Ulcerations C. Small, flat, flesh-colored warts D. Burning E. Itching
B. Ulcerations D. Burning E. Itching Rationale: Itching and burning in the affected area are common manifestations of an HSV outbreak. The lesions are small ulcerations. Small, flat, flesh-colored warts are a symptom of HPV.
Benzathine penicillin G, 2.4 million units IM, is prescribed as treatment for an adult client with primary syphilis. The nurse should administer the injection in the: A. Deltoid B. Upper, outer quadrant of the buttock C. Quadriceps lateralis of the thigh D. Midlateral aspect of the thigh
B. Upper, outer quadrant of the buttock Rationale: Because of the large dose, the upper, outer quadrant of the buttock provides the best and largest area for this IM injection.
The nurse prepares teaching material for a client experiencing menopause. Which health promotion intervention should the nurse discuss with the client? (Select all that apply.) A. Wearing fitted clothing B. Using water-soluble gels to increase vaginal lubrication C. Undergoing hormone replacement therapy (HRT) as soon as possible D. Avoiding alcohol and cigarette use E. Eating more estrogenic food, such as brown rice, sweet potatoes, carrots, apples, corn, green beans, and tofu
B. Using water-soluble gels to increase vaginal lubrication D. Avoiding alcohol and cigarette use E. Eating more estrogenic food, such as brown rice, sweet potatoes, carrots, apples, corn, green beans, and tofu Rationale: Health promotion interventions for menopause include teaching the client about the use of water-soluble gels that increase vaginal lubrication and other ways to help her continue or resume a mutually satisfying sexual relationship with her partner. Eating foods that are mildly estrogenic, such as brown rice, sweet potatoes, carrots, apples, corn, green beans, and tofu, may also improve vaginal dryness. Avoiding alcohol and tobacco use is beneficial as well. The nurse should teach the client about dressing in loose layers, not in fitted clothing. The nurse should teach the client about the risks and the benefits of HRT but emphasize that not every woman needs or wants it.
The nurse is speaking to a group of young women about methods of contraception. The nurse asks the group to name a barrier method of contraception. Which response from a participant indicates the need for further teaching? A. Contraceptive sponge B. Vaginal contraceptive ring C. Spermicide D. Diaphragm
B. Vaginal contraceptive ring Rationale: The vaginal contraceptive ring is a sustained-release hormonal method and is not considered a barrier method of contraception. Spermicide, the diaphragm, and the contraceptive sponge are barrier methods. Either they prevent the transportation of sperm to the ovum, immobilize the sperm, or kill the sperm.
When a woman starts hormone replacement therapy (HRT), the nurse would instruct her to look for the side effect of: a. fatigue. b. headache. c. weight loss. d. amenorrhea.
B. headache. Patients initiating HRT are reminded to have regular follow-up care and report headaches, vision changes, and symptoms of thrombophlebitis or cardiac symptoms.
The woman using a diaphragm correctly would tell the nurse that the diaphragm: a. does not require the use of a spermicidal cream or jelly with it. b. should be left in place for at least 6 hours after intercourse. c. is removed immediately after intercourse for douching. d. is effective for up to 48 hours if positioned properly.
B. should be left in place for at least 6 hours after intercourse. To act as a barrier, the diaphragm must be left in place for at least 6 hours after intercourse and can be left in place up to 24 hours.
The nurse instructing a man considering a vasectomy should state that after a vasectomy: a. intercourse should be delayed for 6 weeks. b. sperm will still be ejaculated for a month. c. erections will be difficult to maintain. d. monthly sperm counts for a year will be necessary.
B. sperm will still be ejaculated for a month Because sperm are distal to the severed vas deferens, sperm will be in the ejaculate for about a month. A sperm count after that period of time should be performed to confirm the absence of sperm. Intercourse does not have to be delayed, but an alternate method of contraception should be used. Erections and sexual pleasure are not affected by a vasectomy.
When a woman asks what she can do to reduce the discomfort of hot flashes, the nurse advises: a. "Aerobic exercise helps control hot flashes." b. "Increase the amount of calcium and vitamin D in your diet." c. "Dress in layers of cotton clothing." d. "Drink plenty of fluids, particularly caffeinated beverages."
C. "Dress in layers of cotton clothing." Cotton allows easier passage of air than synthetic fabrics. Layering allows the woman to take off or put on clothes when symptoms occur.
The nurse is caring for a middle-age female client who states, "Sexual intercourse has become painful." Which is the best response from the nurse? A. "Pain during sexual activity is normal with aging." B. "A sex therapist might be able to help you with your problem." C. "I would like to perform an exam and offer some suggestions." D. "Pain is a warning sign that something is wrong."
C. "I would like to perform an exam and offer some suggestions." Rationale: The most appropriate response by the nurse would be to suggest the client undergo an exam before being able to offer any suggestion about decreasing the discomfort during sexual intercourse. Pain with sexual activity is not associated with aging. It is inappropriate to refer to a sex therapist prior to assessing the client.
The nurse is caring for a client newly diagnosed with osteoporosis who states, "I know I need the extra calcium, but I don't eat any dairy products." Which statement by the nurse provides the client with information for obtaining additional dietary calcium? A. "Seafood is an excellent source of calcium." B. "Many types of pasta are an excellent source of calcium." C. "Increase your consumption of vegetables." D. "You can increase your consumption of meat."
C. "Increase your consumption of vegetables." Rationale: The statement, "Increase your consumption of vegetables," provides information on an excellent source of calcium. Seafood, meat, and pasta are not excellent sources of calcium. Seafood should be consumed cautiously during pregnancy, as it contains high levels of mercury.
On day 13 of a 28-day cycle, a woman's basal body temperature is 36.5 C (97.7 F). If she ovulates on day 14, her temperature measurement on day 14 would most likely be: a. 35.9 C (96.7 F). b. 36.3 C (97.3 F). c. 36.7 C (98.1 F). d. 37.1 C (98.9 F).
C. 36.7 C (98.1 F). At the time of ovulation, body temperature will increase slightly, about 0.2° C (0.4° F).
A male client is dianosed with chlamydia. Azythromycin 1 g is prescribed. The supply of azithromycin is in 250-mg tablets. How many tablets should the nurse administer? A. 6 Tablets B. 2 Tablets C. 4 Tablets D. 1/2 Tablet
C. 4 tablets Rationale: 250 x 4 = 1000mg = 1 g
Which patient below is NOT at risk for osteoporosis?* A. A 50 year old female whose last menstrual period was 7 years ago. B. A 45 year old male patient who has been taking glucocorticoids for the last 6 months. C. A 30 year old male who drinks alcohol occasionally and has a BMI of 28. D. A 35 year old female who has a history of seizures and takes Dilantin regularly.
C. A 30 year old male who drinks alcohol occasionally and has a BMI of 28. All these patients are at risk for osteoporosis except the patient in option C. Remember the risk factors include: older age (45+), being a woman, Caucasian or Asian, post-menopause, glucocorticoids therapy, anticonvulsants (Dilantin), REGULAR alcohol usage, smoking, sedentary lifestyle, BMI <19, family history. Option C is not at risk.
The typical chancre of syphilis appears as: A. A grouping of small, tender pimples B. An elevated wart C. A painless, moist ulcer D. An itching, crusted area
C. A painless, moist ulcer Rationale: The chancre of syphilis is characteristically a painless, moist ulcer. The serous discharge is very infections. Because the chancre is usually painless and disappears, the client may not be aware of it or may not seek care.
The nurse would tell the patient to expect what after she had an intrauterine device (IUD) inserted? a. Menstrual flow will be lighter. b. Menstrual cramps will be eliminated. c. A string should be felt in the vagina. d. The device should be changed every 2 years
C. A string should be felt in the vagina. A woman should feel for the string periodically, especially after her period, to confirm the presence of the IUD.
The nurse is caring for an older adult with a history of fractures as a result of osteoporosis. The client currently has a right radial fracture. Which is the priority nursing diagnosis for the client? A. Pain, Chronic B. Mobility: Physical, Impaired C. Activity Intolerance D. Nutrition, Imbalanced: Less than Body Requirements
C. Activity Intolerance Rationale: The priority nursing diagnosis for the client with right radial fracture is Activity Intolerance. The pain the client will experience with a new fracture is acute. The client's mobility should not be impaired with a right radial fracture. The nutritional status of the client can be assessed after the activity intolerance is addressed. (NANDA-I © 2014)
The nurse is preparing to administer an intramuscular injection of one antibiotic and an oral dose of another antibiotic for a client with gonorrhea. The client wants to know why both are needed. Which rationale for dual treatment should the nurse include in the explanation? A. Specific portal of entry B. Strength of the bacteria C. Antimicrobial resistance D. Client's immunity
C. Antimicrobial resistance Rationale: The goals of treatment for the client with gonorrhea include eradication of the organism and any coexisting disease, and prevention of reinfection or transmission. Due to concerns about antimicrobial resistance in N. gonorrhoeae, the Centers for Disease Control and Prevention (CDC) recommends dual treatment that includes a single injection of an antibiotic and a single oral dose of another antibiotic. These medications should be administered at the same time, if possible.
The nurse is teaching a pregnant client about nutritional needs during pregnancy. Which menu selection will best meet the nutritional needs of the pregnant client? A. Hamburger patty, green beans, French fries, and iced tea B. Roast beef sandwich, potato chips, baked beans, and cola C. Baked chicken, fruit cup, potato salad, coleslaw, yogurt, and iced tea D. Fish sandwich, gelatin with fruit, and coffee
C. Baked chicken, fruit cup, potato salad, coleslaw, yogurt, and iced tea All of the choices are tasty. but the pregnant client needs a diet that is balanced and has increased amounts of calcium. Answer A is lacking in fruits and milk. Answer B contains the potato chips. which contain a large amount of sodium. Answer C contains meat. fruit. potato salad. and yogurt. which has about 360 mg of calcium. Answer D is not the best diet because it lacks vegetables and milk products.
A client presents for evaluation of a possible sexually transmitted infection (STI). Which assessment finding should the nurse consider a potential indication of an STI? A. Thick, cottage cheese-like vaginal discharge B. Absence of expected menses C. Burning and frequency of urination D. Vaginal dryness
C. Burning and frequency of urination Rationale: Common symptoms of an STI include burning and increased frequency of urination. Vaginal dryness and absence of expected menses are not symptoms of STI. Thick, cottage cheese-like vaginal discharge is indicative of a yeast infection, not an STI.
A client with diabetes asks the nurse for advice regarding methods of birth control. Which method of birth control is most suitable for the client with diabetes? A. Intrauterine device B. Oral contraceptives C. Diaphragm D. Contraceptive sponge
C. Diaphragm The best method of birth control for the client with diabetes is the diaphragm. A permanent intrauterine device can cause a continuing inflammatory response in diabetics that should be avoided. oral contraceptives tend to elevate blood glucose levels. and contraceptive sponges are not good at preventing pregnancy. Therefore. answers A. B. and D are incorrect.
When performing a preconception visit, which assessment finding by the nurse would necessitate a recommendation for genetic counseling? A. Exposure to secondhand smoke B. Client is 33 years old C. Family history of genetic disorders D. History of heavy alcohol use 2 years prior
C. Family history of genetic disorders Rationale: The nurse should recommend genetic counseling based on the couple's family history of genetic disorders. Genetic counseling should be suggested for a woman over 35 years. Genetic counseling is not recommended for a client exposed to secondhand smoke or with a history of alcohol use.
A patient is taking Calcitonin for osteoporosis. The patient should be monitored for?* A. Hyperkalemia B. Hypokalemia C. Hypocalcemia D. Hypercalcemia
C. Hypocalcemia Calcitonin is made from salmon calcitonin and acts like the hormone calcitonin which is produced naturally by the thyroid gland. It decreases osteoclast activity, which can decrease calcium levels. Therefore, the patient is at risk HYPOcalcemia.
A client is experiencing signs of menopause. Which change in hormone level should the nurse use to confirm the client's health status? A. Increased androstenedione B. Increased estradiol (E2) C. Increased luteinizing hormone (LH) D. Increased progesterone
C. Increased luteinizing hormone (LH) Rationale: During the menopausal period, ovarian production of estradiol (E2) decreases. With decreased ovarian function, progesterone production is also markedly reduced. Levels of the hormone androstenedione also decrease during menopause. Luteinizing hormone and follicle-stimulating hormone (FSH) levels increase during menopause. Estradiol controls the amount of FSH and LH released by the pituitary gland via a negative feedback system; when estradiol production decreases, this feedback system ceases to function.
Which intervention by the nurse can help decrease the burning upon urination for a female client with gonorrhea? A. Running ice water over the perineal area B. Providing a Sitz bath C. Increasing fluids D. Taking diuretics
C. Increasing fluids Rationale: Drinking additional fluids helps dilute the urine and reduce the burning sensation. For dysuria and urinary retention, pouring water over the genitals to start urination and dilute the urine may be suggested. Sitz baths (with tepid water) for 15-30 minutes, several times a day, is soothing and decreases pain from ulcers and an irritated urethral meatus. Taking diuretics would not be an appropriate treatment for gonorrhea.
The nurse is teaching health promotion behaviors to a client diagnosed with osteoporosis. Which behavior should the nurse include? A. Decreasing smoking B. Exercising four times a week C. Limiting alcohol intake D. Avoiding foods high in purine
C. Limiting alcohol intake Rationale: The client should be instructed to limit alcohol intake. Alcohol has a direct toxic effect on osteoblast activity, suppressing bone formation during periods of alcohol intoxication. The client should be instructed to stop smoking altogether, not just decrease smoking. Smoking decreases the blood supply to bones, and nicotine slows the production of osteoblasts and impairs the absorption of calcium, contributing to decreased bone density. The instruction on exercising needs to be specified. Foods high in purine are associated with gout. Weight-bearing exercises are recommended for approximately 30 minutes four times a week.
Check which methods protect against STIs: (Select all that apply) A. IUD B. The patch C. Male condom D. The ring E. Female condom
C. Male condom E. Female condom
A client experiencing menopause is concerned about a loss in height. Which change should the nurse explain as being responsible for this finding? A. Menopause leads to hormone changes that affect muscle strength in the body. B. Menopause leads to bone changes that can cause scoliosis. C. Menopause can lead to osteoporosis, which in turn can lead to fractures and kyphosis. D. Menopause can lead to poor nutrition and decreased bone density.
C. Menopause can lead to osteoporosis, which in turn can lead to fractures and kyphosis. Rationale: Long-term estrogen deprivation results in an imbalance in bone remodeling and osteoporosis, leading to fractures and kyphosis. Scoliosis is curvature of the spine. Poor nutrition can affect how a woman responds to menopause, but menopause does not cause poor nutrition. Muscle weakness is not associated with menopause.
A couple who is going through fertility treatment is reviewing the process of in vitro fertilization (IVF) with the nurse. Which statement by the couple indicates that the teaching has been effective? (Select all that apply.) A. "The embryos will be placed in my uterus 7-10 days after retrieval." B. "The sperm will be deposited into my uterus." C. "My wife will have to have injections prior to the procedure." D. "An ultrasound will be used during the procedure to remove my eggs." E. "We can freeze embryos if we have extras."
C. My wife will have to have injections prior to the procedure." D. "An ultrasound will be used during the procedure to remove my eggs." E. "We can freeze embryos if we have extras." Rationale: For IVF, the woman will have to have injections to help the ova develop and to help prepare them for retrieval. Any extra embryos remaining after the IVF procedure can be frozen for use at a later date. With IVF, the ova and sperm will be manipulated in the lab for fertilization. The embryos will be placed in the uterus 2-3 days after retrieval. With IVF, ultrasound is used during the procedure to remove the woman's eggs.
The nurse is assessing a client with syphilis. Which stage of syphilis is characterized by a chancre, painless ulcerations on the genital area? A. Secondary stage B. Tertiary stage C. Primary stage D. Latent stage
C. Primary stage Rationale: During the primary stage of syphilis, the client will experience chancre-like, painless ulcerations that last for up to 5 weeks. The second stage occurs up to 10 weeks after initial infection. The client will experience fever, malaise, lymphadenopathy, patchy alopecia, and a diffuse rash. During the latent stage, the client is asymptomatic for years to a lifetime. The tertiary stage can occur 2 years after the onset of symptoms and includes changes in the cardiovascular system, bone, skin, and viscera.
A client tells the nurse that she plans to use the rhythm method of birth control. The nurse is aware that the success of the rhythm method depends on the: A. Age of the client B. Frequency of intercourse C. Regularity of the menses D. Range of the client's temperature
C. Regularity of the menses The success of the rhythm method of birth control is dependent on the client's menses being regular. It is not dependent on the age of the client. frequency of intercourse. or range of the client's temperature; therefore. answers A. B. and D are incorrect.
The nurse is caring for a client with advanced osteoporosis who implemented the use of a heating pad in the treatment of pain. Which action by the nurse demonstrates appropriate use of the heating pad? A. Alternating the heat with an ice pack every 30 minutes B. Utilizing the heat if the prescribed pain medication does not work C. Removing the heat every 20 to 30 minutes D. Encouraging the use of the heat before the client ambulates
C. Removing the heat every 20 to 30 minutes Rationale: The heat should be removed every 20 to 30 minutes to avoid a rebound effect from too much heat. Ice is not used in the treatment of pain for the client with osteoporosis. The heat should be utilized when the client experiences discomfort and can be used with or without the use of pain medication.
The nurse is reviewing the orders for a client with osteoporosis who has been prescribed a bisphosphonate. Which test should the nurse anticipate will be ordered while the client is on the medication? A. Alkaline phosphatase B. Ultrasound C. Serum bone Gla protein (osteocalcin) D. Dual-energy x-ray absorptiometry (DEXA)
C. Serum bone Gla protein (osteocalcin) Rationale: Serum bone Gla protein (osteocalcin) is most useful for evaluating the effects of treatment rather than to indicate the severity of the disease. Dual-energy x-ray absorptiometry (DEXA) and ultrasound both measure bone density, not efficacy of treatment. Alkaline phosphatase also does not indicate efficacy of treatment.
The nurse is discussing the need for therapeutic donor insemination (TDI) with a client. Which finding should the nurse identify as an indication for TDI? (Select all that apply.) A. Erectile dysfunction B. Epispadias C. Severe oligospermia D. Azoospermia E. Genetic male sex-linked disorder
C. Severe oligospermia D. Azoospermia E. Genetic male sex-linked disorder Rationale: TDI is used in cases of severe oligospermia (low sperm count), in cases of azoospermia (absence of sperm), or in those with a history of genetic male sex-linked disorders. Epispadias is a penile anatomic abnormality. The male's sperm can be used for insemination; donor sperm is not needed. Sperm from men with erectile dysfunction can still be used for insemination; donor sperm is not needed.
A client with HIV is taking zidovudine (AZT). the expected outcome of AZT is to: A. destroy the virus B. enhance the body's antibody production C. slow replication of the virus D. Neutralize toxins produced by the virus
C. Slow replication of the virus Rationale: AZT interferes with replication of HIV and thereby slows the progression of HIV to AIDS. There is no known cure to HIV. AZT does not destroy the virus, enhance the body's antibody production, or neutralize toxins produced by the virus.
The nurse is reviewing the chart of an older adult client with a BMI of 19 kg/m2. Which implication does this clinical finding have on the risk for osteoporosis? A. The client's gender needs to be taken into consideration. B. The client's age in relation to the BMI should be factored in. C. The client is at risk for osteoporosis. D. The client is not at risk for osteoporosis.
C. The client is at risk for osteoporosis. Rationale: Any individual with a BMI less than 20 kg/m2, regardless of age, sex, or weight loss, is at a greater risk for both bone loss and subsequent risk for fracture.
The nurse is caring for several clients on the unit. Which client is at the greatest risk for osteoporosis? A. The client treated for an eating disorder B. The client with early onset Alzheimer disease C. The client treated for withdrawal delirium tremens D. The client with impaired vision
C. The client treated for withdrawal delirium tremens Rationale: The client being treated for withdrawal delirium tremens is at the greatest risk for osteoporosis. Delirium tremens occurs as a result of alcohol withdrawal. The client who is an alcoholic is at risk for osteoporosis. Impaired vision does not place the client at risk for osteoporosis. The client with an eating disorder will require counseling and a nutritional consultation. The client with early onset Alzheimer disease is mobile and can walk.
The nurse is caring for a pregnant client who has syphilis. Which is a priority intervention? A. Treating the client with an antifungal B. Screening and treating the client's partner C. Treating the client with an antibiotic D. Scheduling treatment after birth of the baby
C. Treating the client with an antibiotic Rationale: Syphilis is a bacterial infection and can be safely treated and cured during pregnancy with an antibiotic. An antifungal does not treat bacterial infections. The client's partner should be screened and treated, but treating the client is a priority. There is no need to wait until the baby is born to treat the client; the client can safely take antibiotics during pregnancy.
The nurse is caring for a client from Southeast Asia who has HIV/AIDS. The client does not speak or comprehend English. What should the nurse do? A. Contact the hospital's chaplain B. Do an internet search for the Joint United Nations Programme on HIV/AIDS C. Utilize language-appropriate interpreters D. Ask a family member to obtain informed consent.
C. Utilize language-appropriate interpreters Interpreters are essential in enabling the nurses' communications to be understood accurately. It is not necessary for the family member to obtain informed consent.
The nurse is caring for an older adult couple who express concern about the lack of intimacy in their relationship. Which initial strategy should the nurse use to address the couple's concern? A. Offer specific suggestions regarding sexual positioning. B. Refer the couple to the healthcare provider for further assessment. C. Validate desire for sexual activity in older adult couples. D. Determine the history of sexually transmitted diseases.
C. Validate desire for sexual activity in older adult couples. Rationale: The initial strategy that the nurse will use to address the couple's concern about the lack of intimacy in their relationship is to ask permission to validate their desire for sexual activity. Older adults often benefit from teaching related to sexuality; however, they may be hesitant to bring up sexual topics with the nurse. To help facilitate such discussion, the nurse can first validate the older adults' desire for sexual activity. Determining a history of sexually transmitted diseases does not address the concern. Offering specific suggestions regarding sexual positioning is an assumption that positioning is the problem. Referral of the couple to their healthcare provider may be appropriate after a thorough history has been obtained.
The nurse is preparing medication teaching on a bisphosphonate for a client newly diagnosed with osteoporosis. The nurse should teach the client to monitor for which adverse effect? A. Anorexia B. Tinnitus C. Vomiting D. Headaches
C. Vomiting Rationale: Adverse effects that may occur in a client taking a bisphosphonate include gastrointestinal problems such as nausea, vomiting, abdominal pain, and esophageal irritation. Tinnitus, anorexia, and headaches are not adverse effects of taking bisphosphonates.
During discharge teaching to a patient at risk for developing osteoporosis, you discuss the types of exercise the patient should perform. Which type of exercise is not the best to perform to prevent osteoporosis?* A. Tennis B. Weight-lifting C. Walking D. Hiking
C. Walking Low-impact exercises are not as beneficial in building bone mass as compared to weight-bearing exercises such as tennis, lifting weights, and hiking etc. The patient should perform exercises that put stress on the bones against gravity, which will help increase bone strength and build muscle.
The nurse is caring for a couple experiencing infertility who will have follicular stimulation and retrieval of ovum, followed by mixing with washed donor sperm. One day later, the fertilized ovum will be placed in the fallopian tube. Which procedure should the nurse identify the couple is scheduled to have? A. Tubal embryo transfer (TET) B. In vitro fertilization (IVF) C. Zygote intrafallopian transfer (ZIFT) D. Gamete intrafallopian transfer (GIFT)
C. Zygote intrafallopian transfer (ZIFT) Rationale: ZIFT is the return of fertilized ovum, at the zygote stage, into the fallopian tube 18-24 hours after retrieval. GIFT is placing retrieved ovum and washed sperm into the fimbriated end of the fallopian tube. TET is placing embryos into the fallopian tube 42-72 hours after retrieval. IVF is the placement of embryos into the uterus 2-3 days after the ova are retrieved.
At her regular gynecological examination, a woman tells the nurse that she is concerned about osteoporosis. The nurse could suggest to the patient to: a. take a vitamin E supplement daily. b. do isometric exercises that can be practiced every day. c. include more dairy products and green, leafy vegetables in her diet. d. try to limit her intake of caffeine. .
C. include more dairy products and green, leafy vegetables in her diet. Foods rich in calcium include milk, dairy products, and green, leafy vegetables.
The nurse is caring for a postmenopausal client prescribed estrogen therapy to reduce the risk of osteoporosis. Which client statement indicates the need for further teaching? A. "I have completed my smoking cessation program." B. "I understand that I may experience hot flashes." C. "I will be sure to maintain all follow-up appointments for evaluation." D. "I am glad I am not at risk for osteoporosis anymore."
D. "I am glad I am not at risk for osteoporosis anymore." Rationale: The client prescribed a selective estrogen receptor modulator to reduce the risk of osteoporosis should address other modifiable risk factors attributed to osteoporosis. Medication alone will not prevent osteoporosis. Hot flashes are a side effect of the medication. Smoking is a risk factor for osteoporosis. The client should maintain all follow-up appointments.
A male client with HIV becomes depressed and tells the nurse "I have nothing to live for now." Which statement would be the best response by the nurse? A. "You are a young person and have a great deal to live for" B. "You should not be too depressed; we are close to finding a cure for AIDS" C. "You are right; it is very depressing to have HIV" D. "Tell me more about how you are feeling about being HIV positive"
D. "Tell me more about how you are feeling about being HIV positive" Rationale: The nurse should respond with a statement that allows the client to express his thoughts and feelings. Statements of encouragement or agreement do not provide an opportunity for the client to express himself.
The nurse is providing teaching to an adolescent female. Which instruction by the nurse promotes safe sexual behavior? (Select all that apply.) A. "Latex condoms lubricated with petroleum jelly provide for comfort and additional barrier protection." B. "Insist that your sex partner use birth control to reduce the risk of HIV." C. "If your partner insists on having sex even though you don't want to, you should comply to show you really love him." D. "Women can carry and use female condoms." E. "You can choose to say 'No' to sex even if your long-term partner says that your relationship has matured beyond the mutual masturbation stage."
D. "Women can carry and use female condoms." E. "You can choose to say 'No' to sex even if your long-term partner says that your relationship has matured beyond the mutual masturbation stage." Rationale: The information provided to the adolescent female client that promotes safe sexual behavior includes carrying and using female condoms and encouraging the client in exercising independence in saying yes or no to sex if the long-term partner says that the relationship has matured beyond the mutual masturbation stage. Birth control does not reduce the risk of HIV, petroleum jelly does not provide additional barrier protection, and the client should never feel pressured to have sex to show love to the partner.
An 18-year-old man presents to the neighborhood clinic for an exam and requests a male nurse. Which aspect should the nurse keep in mind while taking the client's medical history and preparing to discuss contraceptive use? A. Remembering that teenagers will not be truthful about their sexual history B. Obtaining the client's height and weight when obtaining the health history C. Influencing the client so that he makes the choice recommended by the nurse D. Being aware of the client's cultural and religious beliefs
D. Being aware of the client's cultural and religious beliefs Rationale: The nurse needs to keep the client's cultural and religious beliefs in mind when discussing contraception. The nurse should provide useful information that allows the client to make an informed decision regarding contraception. Teenagers will be truthful about their sexual history when treated with respect. The client's height and weight are obtained during a physical examination.
A female client with gonorrhea informs the nurse that she ahd sexual intercourse with her boyfriend and asks the nurse, "Would he have any symptoms?" The nurse responds that in men, the symptoms of gonorrhea include: A. Impotence B. Scrotal swelling C. Urine retention D. Dysuria
D. Dysuria Rationale: Dysuria and mucopurulent urethral discharge characterize gonorrhea in men. These symptoms are usually so painful in men that they seek treatment right away.
A nurse is planning care for a 25 y.o. female client who has just been diagnosed with HIV. THe client asks the nurse, "How could this have happened?" The nurse responds to the question based on the most frequent mode of HIV transmission, which is: A. Hugging an HIV-positive sexual partner without using barrier protection B. Inhaling cocaine C. Sharing food utensils with an HIV-positive person without proper cleaning of the utensils D. Having sexual intercourse with an HIV-positive person without using a condom
D. Having sexual intercourse with an HIV-positive person without using a condom Rationale: HIV is transmitted through blood and body fluids, particularly vaginal and seminal fluids. A blood transfusion is one way the disease can be contracted. Other modes of transmission are sexual intercourse with an infected partner and sharing IV needles with an infected person. Women now have the highest rate of newly diagnosed HIV. Many of these women have contracted HIV from unprotected sex with male partners. HIV cannot be transmitted by hugging, inhaling cocaine, or sharing utensils.
A client has just been fitted for a diaphragm. Which information about the diaphragm should the nurse include in the client teaching? A. It must be left in place for 12 hours after intercourse. B. It can be used during a menstrual period. C. It should be replaced every 3 years. D. It must be refitted after childbirth.
D. It must be refitted after childbirth. Rationale: The nurse needs to teach the client being fitted for a diaphragm that it must be refitted after childbirth. The diaphragm must be left in place for 6 hours after intercourse. Diaphragms should not be used during a menstrual period. The diaphragm should be replaced every 2 years.
When educating a female client with gonorrhea, the nurse should emphasize that for women, gonorrhea: A. Is often marked by symptoms of dysuria or vaginal bleeding B. Does not lead to serious complications C. Can be treated, but not cured D. May not cause symptoms until serious complications occur
D. May not cause symptoms until serious complications occur Rationale: Many women do not seek treatment because they are unaware that they have gonorrhea. They may be symptom-free or have only mild symptoms until the disease progresses to PID.
The nurse is planning a presentation on osteoporosis to clients in an assisted-living center. Which group would be appropriate for the nurse to exclude from the presentation as being at risk of developing this disease process? A. Asian American women B. Smokers C. Postmenopausal women D. Men with high testosterone levels
D. Men with high testosterone levels Rationale: Men with high testosterone levels are not at risk of developing osteoporosis; therefore, this SHOULD NOT be included in the presentation. Women, especially those who are postmenopausal and of Asian descent, are much more likely to develop osteoporosis. Smoking increases the client's risk of osteoporosis.
When teaching a client about HIV, the nurse should take into account the fact that the MOST effective method know to control the spread of the infection is: A. Premarital serologic screening B. Prophylactic treatment of exposed people C. Lab screening of pregnant women D. Ongoing sex education about preventative behaviors
D. Ongoing sex education about preventative behaviors Rationale: Education to prevent behaviors that cause HIV transmission is the primary method for controlling the spread of HIV. Educating clients about using condoms during sex is a priority in controlling HIV transmission.
________ are found within the spongy bone and are responsible for building up the bone matrix. While ________, which are also found in the spongy bone, breakdown the bone matrix. A. Osteocytes, osteoclasts B. Osteoclasts, osteoblasts C. Osteocytes, osteoblasts D. Osteoblasts, osteoclasts
D. Osteoblasts, osteoclasts OsteoBLASTS are found within the spongy bone and are responsible for building up the bone matrix, while osteoCLASTS, which are also found in the spongy bone as well, breakdown the bone matrix.
The nurse is caring for a client with osteoporosis with a primary focus on preventing injury at night. Which is the best nursing intervention for the nurse to implement to maintain the safety of the client? A. Keeping the side rails up on the bed at all times B. Restricting fluids at night to decrease nocturia C. Increasing the client's use of assistive devices D. Providing lighting in toilet facilities
D. Providing lighting in toilet facilities Rationale: The nursing intervention that will maintain the safety of the client with osteoporosis is to provide lighting in the toilet facilities. Increasing the use of assistive devices would be dependent on the client's overall health. The client should only use the assistive devices that are necessary on which she has been properly fitted and trained. Restricting fluids to decrease nocturia is inappropriate and places the client at risk for dehydration and hypovolemia. It is not necessary to keep the side rails up on the bed at all times. The side rails should be kept up if indicated to prevent the client from getting out of bed alone.
You're caring for a patient who has a health history of severe osteoporosis. On assessment you note the patient has severe kyphosis of the upper back. Which nursing diagnosis takes priority for this patient's care?* A. Risk for skin breakdown B. Knowledge deficient regarding disease process C. Limited mobility D. Risk for falls
D. Risk for falls When assessing the options you want to select the option that is a priority for this patient and risk for falls is the priority. The patient is at risk for falls due to severe kyphosis, which is common in severe osteoporosis (also called Dowager's Hump). This deformity of the spine limits mobility and increases the chances of falls In addition, it is important the nurse takes precautions in preventing falls because the patient will most likely experience a fracture due to severe osteoporosis.
A client with a history of bone fractures is experiencing severe hot flashes from menopause. Which medication should the nurse anticipate being prescribed for this client? A. Selective serotonin reuptake inhibitor (SSRI) B. Serotonin-norepinephrine reuptake inhibitor (SNRI) C. Monoamine oxidase inhibitor (MAOI) D. Selective estrogen receptor modulator (SERM)
D. Selective estrogen receptor modulator (SERM) Rationale: A SERM combined with conjugated estrogen is used to treat hot flashes and reduce risk of bone fractures. Recent research also suggests that SSRIs and SNRIs are effective in relieving hot flashes and night sweats, but they do not reduce the risk of bone fracture. MAOIs are a class of antidepressants.
The nurse has completed the history of a client who reports erectile dysfunction. Which action should the nurse take next? A. Teach the client about surgical procedures. B. Refer the client to a psychotherapist. C. Provide information on adaptions to the physical impairment. D. Tell the client that a physical assessment will be performed.
D. Tell the client that a physical assessment will be performed. Rationale: After obtaining the history, the nurse will tell the client that a physical assessment will be performed. An assessment and diagnosis should be formulated prior to referring the client to a psychotherapist or scheduling a surgery. There is no indication the client has any physical impairment.
The nurse is screening clients in the clinic for osteoporosis. Which client has the greatest risk factor for osteoporosis? A. The client who walks at the park for 30 minutes each day B. The client who occasionally drinks a diet soda C. The client with a BMI greater than 25 kg/m2 D. The client taking selective serotonin reuptake inhibitors (SSRIs)
D. The client taking selective serotonin reuptake inhibitors (SSRIs) Rationale: Prolonged use of certain medications such as SSRIs increases the risk of developing osteoporosis. UNDERWEIGHT individuals have a two-fold increased risk for fracture when compared to people with a BMI greater than 25 kg/m2. A high intake of diet soda, not occasional consumption, can contribute to the development of osteoporosis. An individual who walks for 30 minutes in the park every day most likely gets sufficient vitamin D, which also helps prevent osteoporosis.
The nurse warns that the effectiveness of oral contraceptives is decreased in women who are taking: a. antihistamines for seasonal allergies. b. iron preparations for treatment of anemia. c. appetite suppressants for weight reduction. d. anticonvulsants for treatment of epilepsy.
D. anticonvulsants for treatment of epilepsy. Anticonvulsants decrease the effectiveness of oral contraceptives.
The nurse tells a woman who is trying to conceive to check her cervical mucus for changes. A few days before ovulation, the cervical mucus is: a. cloudy and tacky. b. scant and thick. c. thin and white. d. clear and slippery.
D. clear and slippery. Within a few days of ovulation, cervical mucus will become clear and slippery to aid the passage of sperm into the cervix.
The nurse is teaching a client about oral contraceptives. Which client statement indicates a need for additional teaching? (Select all that apply.) A. "Oral contraceptives are not very effective at preventing pregnancy." B. "Oral contraceptives require a medical prescription." C. "Oral contraceptives require daily use of medication." D. "Oral contraceptives often increase menstrual cramping." E. "Oral contraceptives carry an increased risk of blood clots."
A. "Oral contraceptives are not very effective at preventing pregnancy." D. "Oral contraceptives often increase menstrual cramping." Rationale: Reduction of menstrual cramping and the effectiveness of oral contraceptives are advantages of oral contraceptives so further education would be needed if clients state otherwise. Disadvantages include the need for medical care, the need for a prescription, the use of a daily medication, and the potential risks and side effects, such as developing blood clots with use of oral contraception.
The nurse is teaching a client about caring for herpes lesions. Which statement made by the client expresses understanding? A. "I should wash the lesions with antibacterial soap." B. "I should dry the lesions with a hair dryer on a cool setting." C. "I should wear jeans, not shorts, to keep the lesions covered." D. "I should wear nylon underwear."
B. "I should dry the lesions with a hair dryer on a cool setting." Rationale: Teach the client how to keep herpes blisters clean and dry. The area should be washed daily with mild soap and water. Lesions should be dried using a hair dryer turned to a cool setting. The client should wear loose cotton clothing that will not trap moisture and avoid wearing panty hose and tight jeans. Keeping the lesions clean and dry reduces the possibility of secondary infection and speeds the healing process.
The nurse has completed discharge teaching for a client treated for genital herpes. Which statement by the client indicates teaching was effective? (Select all that apply.) A. "I'm glad the medication prescribed will cure this infection." B. "I understand this antiviral medication will help shorten and prevent outbreaks." C. "I don't need to use a condom." D. "I'll try to keep my stress level down." E. "I will notify my sex partners so they can get treatment."
B. "I understand this antiviral medication will help shorten and prevent outbreaks." D. "I'll try to keep my stress level down." E. "I will notify my sex partners so they can get treatment." Rationale: The client acknowledging the need to keep stress levels down, planning to notify sexual partners, and understanding about the antiviral medication, which will help shorten and prevent outbreaks, indicates correct understanding. The client's ability to describe preventive behaviors, health practices, and treatment modalities indicates goal achievement. The conceptions that unprotected sex is safe and that the medication will cure herpes are incorrect; herpes is a virus and cannot be cured.
The nurse is teaching the middle-age female client ways to promote healthy sexual functioning. Which client statement indicates an understanding of sexual health promotion? A. "I will cut back on smoking marijuana." B. "I will cut down on the amount of fat in my diet." C. "I will try and get some exercise twice a week." D. "I will drink only two alcoholic beverages in the evening."
B. "I will cut down on the amount of fat in my diet." Rationale: Healthy sexuality depends upon the implementation of lifestyle choices that support heart health, including good nutrition. Lowering the amount of fat in the diet indicates the client understands sexual health promotion. Avoiding tobacco or marijuana, exercising daily, and avoiding alcohol promote healthy sexual functioning.
A client is trying to prevent complications of menopause such as osteoporosis and cardiovascular problems. Which intervention should the nurse suggest as most beneficial? A. Take 900 mg of calcium daily to prevent osteoporosis. B. Weight-bearing exercise reduces the rate of bone loss and reduces cardiovascular risk. C. Black cohosh can reduce cardiovascular risk during menopause. D. Hormone replacement therapy is essential for avoiding the complications of menopause.
B. Weight-bearing exercise reduces the rate of bone loss and reduces cardiovascular risk. Rationale: The nurse should emphasize the importance of weight-bearing exercise, which reduces the rate of bone loss, helps maintain optimum weight, and reduces cardiovascular risk. The recommended daily calcium intake for women over age 50 is 1200 mg to help prevent osteoporosis. While there are benefits to undergoing HRT, osteoporosis and cardiovascular problems are still possible. Researchers studying black cohosh, which is often used to treat hot flashes and other symptoms (not cardiovascular problems), have concluded that evidence for its effectiveness is lacking and further research is needed.
Which statement should the nurse include in preconception counseling for the individual or couple of childbearing age? (Select all that apply.) A. "Preconception counseling must be started at least 6 months before attempting to conceive." B. "Once you become pregnant, it will be helpful to start working on good exercise habits." C. "Even if you do not want to have children now, it is helpful to discuss future goals with your partner." D. "There are many different methods of birth control; you can choose which fits your lifestyle and plan." E. "Maintaining a healthy weight for your height is important for both partners."
C. "Even if you do not want to have children now, it is helpful to discuss future goals with your partner." D. "There are many different methods of birth control; you can choose which fits your lifestyle and plan." E. "Maintaining a healthy weight for your height is important for both partners." Rationale: Each partner benefits from understanding how each will be affected by a family-planning decision, whether it is to have a pregnancy or to prevent one. Future and present goals are both important to discuss. There are a variety of types of birth control, and one may be better suited for a client than the others. Healthy lifestyle choices are important for both partners. Preconception counseling doesn't have to start 6 months before conceiving. The mother does not need to wait until she is pregnant to start exercising; it is more beneficial to establish exercise routines before becoming pregnant.
The nurse is discussing contraceptive options with a woman who is interested in information about intrauterine contraception (IUC). Which statement should the nurse include when discussing the disadvantages of these devices? A. "You will need to insert the device daily." B. "These require the use of daily medication." C. "The device may cause cramping and heavier bleeding." D. "This type of contraceptive causes loss of bone density."
C. "The device may cause cramping and heavier bleeding." Rationale: An IUC requires the client to check the string after each menstrual cycle. Disadvantages of these devices include increased cramping and heavier bleeding. Oral contraception requires the use of daily medication. An IUC remains in place for years and is not inserted daily. An IUC does not lead to a reduction in bone density.
The nurse is caring for a client with erectile dysfunction (ED) resulting from vascular and nerve damage. The client relays concern of the inability to express sexual intimacy. Which statement by the nurse will provide support for the client? A. "I am going to obtain a prescription for an erectile dysfunction medication." B. "We can contact your healthcare provider to see what alternatives you have." C. "We can discuss other ways you can express your sexuality." D. "I encourage you to consider treatment with an androgen."
C. "We can discuss other ways you can express your sexuality." Rationale: The statement that will provide the most support to the client that has experienced vascular and nerve damage is, "We can discuss other ways you can express your sexuality." Androgens are not used for the treatment of ED. A referral does not immediately address the client's concern about the inability to express sexual intimacy. An ED medication will not work after nerve damage has occurred.
