Obstetrics Exam 1
A woman diagnosed with breast cancer is to undergo a lumpectomy followed by radiation therapy. When reviewing the treatment plan with the client, the nurse determines that the woman has understood the information based on which client statement?
"After they remove the tumor and some of the normal tissue, I'll start radiation in about 2 to 4 weeks."
With sexual stimulation the penis becomes erect. What is the physiologic cause of an erection?
Penile sinuses fill up with blood.
Which body structure controls reproductive hormone production and function for both males and females?
Pituitary gland
The nurse is assessing a 9-year-old boy during a back-to-school checkup. Which finding is a factor for childhood injury?
Mother reports she has used alcohol and drugs.
At what age should a woman with no risk factors begin mammography screening for breast cancer?
40
The nurse is caring for several families enrolled in Medicaid in the prenatal settinng. Which statement by an expectant mother would alert the nurse to assess the family further?
"We just moved here from another state and I am still getting used to the new town."
A nurse is teaching a client how to use a pessary. The nurse determines that the teaching was successful based on which statement?
"I need to clean the pessary with soap and water."
It is important that couples who wish to practice natural forms of birth control understand that the mucus-secreting glands of the cervix can store live sperm for up to:
48 hours
A client who has had a mastectomy is to undergo breast reconstruction with augmentation. After teaching the client about the procedure, the nurse determines that the teaching was successful based on which client statement?
"I'll use the same technique for breast self-exam as before."
A client is to have a vaginal hysterectomy to repair her stage IV uterine prolapse. The nurse realizes she needs more education when she states:
"I'm not going home with a Foley catheter in place."
The nurse is presenting to a shelter for women and children who experienced intimate partner or family violience and is asked by a participant, "What does the No Child Left Behind Act mean?" How should the nurse best respond?
"It is a Federal program that will ensure all children in classrooms receive up-to-date research-based curriculum."
A nurse receives a phone call from the neighbor of the laboring client she is caring for, inquiring on the status of the baby. Which is the appropriate response by the nurse?
"Let me transfer you to the client."
The nurse is providing teaching to an adolescent girl on the function of the female reproductive system. Which statement by the client best reflects understanding of the material presented?
"My menstrual cycle lasts about 4 to 6 days each month but varies sometimes, which is normal."
The nurse is caring for a child who says, "I'm tired being in the hospital and I miss my own home." Which response by the nurse is most appropriate?
"What can we do to make your room seem more like home?"
A client asks the nurse questions about female hygiene and wants to know if she should douche to clean her vagina. Which response by the nurse would be most appropriate?
"You do not need to douche; the vagina is self-cleaning."
A nurse is caring for a client with pelvic organ prolapse. As part of the client's workup, the nurse obtains a postvoid residual urine specimen via catheterization. Which specimen amount would lead the nurse to suspect that additional testing will be needed?
120 mL
A nurse is preparing a presentation for a health fair at a local college. The nurse is creating a poster to emphasize the need for cervical cancer screening. The nurse would list which age to begin screening?
21 years
The maternal child health nurse is providing care to the following clients. Which client would the nurse assess as being in the health restoration phase?
A 29-year-old G1P1L1 is assessed for ongoing complications from eclampsia, one week postpartum. Blood pressure is 128/92 mm Hg, heart rate 78 bpm, respiratory rate 22 breaths/min, temperature 98.8° F (37° C). Client states no headaches, no vision changes, and no seizure activity.
What physician is known as the "father of pediatrics"
Abraham Jacobi
The nurse is teaching a preconception class. A participant asks how long after ovulation can the egg be fertilized. What is the best response by the nurse?
An egg can only be fertilized for about 24 hours after release from the ovary.
A nurse who specializes in maternal and child health care performs many varied functions in diverse settings over the course of a year. Which action would be outside the nurse's scope of practice?
Assist in the treatment and recovery of a woman with ovarian cancer.
Morbidity rates among children are most highly associated with which cause?
Environmental factors
The nurse is caring for a 16-year-old boy with injuries from a car accident. Which activity describes the nurse's manager role?
Facilitating return to school by working with the school nurse
Which nursing intervention would best demonstrate evidence-based practice in maternal-child health care?
Family-centered pediatric care
What is the most common type of cancer in women?
breast cancer
The client is reporting pain when the nurse begins the insertion of a urinary catheter. What measure can the nurse take to facilitate comfort for this client?
Identify the urethral meatus between the labia minora, avoiding the clitoris.
The nursing instructor is illustrating the various phases of the uterine cycle to a group of nursing students. The instructor determines the session is successful when the students correctly choose which action occuring during the secretory phase?
If fertilization does not occur, the corpus luteum degenerates and hormonal levels fall.
Which of a client's cells are most likely to reproduce by meiosis?
Ova
What cancer is known as the "silent killer" because women and health care providers often ignore or rationalize early symptoms?
Ovarian cancer
A nurse is doing a literature search on maternal mortality and finds that direct causes comprise the majority of maternal deaths. Direct causes are noted to be unpredictable reasons. Which action would be most appropriate to implement that would have the greatest impact on reducing these numbers?
Practicing high standards of infection control.
A 55-year-old client presents to the clinic with persistent vulvar pruritus, burning, and a lump. She states she has had the symptoms for 5 months and has been trying to treat them with over-the-counter creams. She has a history of multiple sexual partners and HPV and is a smoker. What should the nurse do next?
Prepare the client for a biopsy of the lesion
A nurse witnesses a peer tell a client, "You are a mother now and you have to do what is best for you baby. You have to breastfeed her!" Which is the best action by the nurse?
Pull the nurse aside and inquire as to the content of the conversation.
After teaching a health education class on the female reproductive cycle, the nurse determines that the teaching was effective when the group identifies which phase as belonging to the ovarian cycle?
follicular phase
The nurse is talking with the mother of a 2-year-old girl during a scheduled visit. Which teaching subject best supports the emphasis on preventive care?
Showing the mother how to teach hand washing to her child
What are local treatments for breast cancer?
Surgery or radiation therapy
To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups?
Teach injury prevention and proper safety practices.
The nurse is running an education program for early grade-school children. Which topic would address the number one cause of death for this age group?
The importance of crossing streets safely
A nurse is assessing a 45-year-old client. The client asks for information regarding the changes that are most likely to occur with menopause. Which should the nurse tell the client?
The uterus shrinks and gradually atrophies.
A 47-year-old woman was just diagnosed with a cancer of her reproductive tract. The public health nurse is aiding in counseling. Which nursing interventions would be supportive in counseling this woman? Select all that apply.
Use sincere, basic communication techniques. Validate the client's feelings and provide realistic hope. Give postoperative care and instructions when prescribed.
A woman with uterine prolapse is scheduled to undergo surgery. When providing preoperative teaching, the nurse reviews information about the type of surgery being planned. Based on the nurse's knowledge of the client's condition, the nurse would most likely include informaton about which surgery?
Vaginal hysterectomy
The client is a 1-year-old girl from a low-income family presenting with a vitamin D deficiency and anemia. What assistance program would you recommend to the child's young mother?
WIC
Which client should the nurse assess first?
a nonpregnant client with a cervical mucus pH level of 3.8
After teaching a local woman's community group about cervical cancer, the nurse understands that teaching has been successful when the group identifies which condition as a risk factor for cervical cancer?
genital herpes
A woman is scheduled to undergo a modified radical mastectomy. Which information would the nurse include when describing this surgery to the client?
removal of breast tissue, axillary nodes, and some chest muscles
The vagina is a hostile environment for sperm. What characteristic of semen protects sperm from the vaginal environment?
alkaline fluid
What is mastitis?
an infection of the connective tissue
A woman has been treated for a tumor of the left breast that has not responded to chemotherapy. The woman has just found out that she has the BRCA mutations and discusses her options with her primary care provider. Which treatment would be most difficult for this woman?
bilateral mastectomy
A nurse is conducting a health promotion program, encouraging lifestyle changes to help clients prevent various benign and treatable conditions. Which suggestions would the nurse most likely include? Select all that apply.
low-fat diet regular exercise high vegetable-fruit diet adequate fluid intake
What are effective system treatments for breast cancer?
chemotherapy, hormonal therapy, immunotherapy
A nurse is assisting with the pelvic exam of a woman who has come to the clinic with reports of abnormal vaginal bleeding. The client is diagnosed with an endocervical polyp. The nurse understands that the pelvic exam most likely revealed a polyp appearing as:
cherry red.
A group of nursing students are comparing the male and female reproductive organs. The instructor determines the class is successful when the students correctly deduce the male glans penis is complementary to which female structure?
clitoris
A nurse prepares a woman with an abnormal Papanicolau test result for further diagnostic evaluation. Which procedure would the nurse expect to be done?
colposcopy
What are fibroadenomas?
common solid breast tumors that can be stimulated by external estrogen, progesterone, lactation, and pregnancy
A client is considering breast augmentation. What would the nurse recommend to the client to ensure that there are no malignancies?
mammogram
When describing the phases of the endometrial cycle, the nurse would explain that the proliferative phase of the endometrial cycle corresponds to which phase in the ovarian cycle?
follicular
Edema and enlargement in the ducts and glands of the breast that occur as effects of hormones are called:
fibrocystic breast changes.
What is the most commonly encountered benign breast disorder?
fibrocystic breasts, fibroadenomas, and mastitis
A nurse assesses and suspects vulvar cancer based on which assessment finding?
fleshy, ulcerated mass on the labia majora
A nurse is reviewing the statistical outcomes related to fetal deaths nationwide and notes that the numbers have changed over the last several decades. The best explanation would be:
improved prenatal care has reduced the numbers of fetal deaths.
What is stress incontinence?
inadequate urinary sphincter fucnction
The client who has a uterine prolapse has been given a pessary. When teaching the client about the use of this device, the nurse should teach the client to monitor which common side effects? Select all that apply.
increased vaginal discharge UTI vaginitis odor
A 30-year-old client asks the nurse about risk factors for ovarian cancer. Which risk factor should be included in client education?
infertility
The nurse reviews the medical record of a woman diagnosed with ovarian cancer, stage II. The nurse interprets this information, understanding that the disease:
involves one or both ovaries and extends into the pelvis.
The external female organs contain what structures?
mons pubis, labia majora, labia minora, clitoris, prepuce
The nurse is preparing a client for breast biopsy of a lump. The nurse explains that a needle with a cutting edge will be inserted into a lump and rotated to remove a core sample. What type of breast biopsy is this client undergoing?
needle biopsy
The nurse working in a free health clinic is providing care to a 1-year-old girl and her single teenage mother. Which action would be most important initially?
observing the mother/child interaction
What is the management for mastitis?
oral antibiotics and Tylenol for fever
What is urge incontinence?
overactive bladder caused by detrusor muscle contractions.
A young couple have presented to the office with concerns of possible infertility. A physical examination and complete history of the woman reveals type 2 diabetes mellitus, obesity, sleep apnea, and hypertension. The nurse would suspect:
polycystic ovary syndrome.
A nurse is preparing a teaching plan for a woman who is planning to become pregnant. Which hormone secreted by the corpus luteum would the nurse include in the discussion when describing how the endometrium is prepped for egg implantation?
progesterone
What is the ovarian cycle?
series of events associated with a developing oocyte within the ovaries
A nurse is assisting with the pelvic examination of a female client. The client has given birth to two living children, ages 5 and 2 years. The nurse would expect the client's cervical os to appear as which shape on examination?
slit-like
What are vaginal pessaries?
synthetic devices inserted into the vagina to provide support to the bladder and other pelvic organs as a corrective measure for UI and/or POP
A nurse is conducting a health class for a group of adolescents about male and female reproduction. When describing the testes, the nurse would explain that these organs are important for manufacturing which hormone?
testosterone
What is pelvic organ prolapse (POP)?
the abnormal descent or herniation of the pelvic organs from their original attachment sites or their normal position in the pelvis.
Menstruation marks what?
the beginning and end of the cycle if fertilization does not occur
A prenatal nurse is developing a plan of care for a black woman who is at 34 weeks' gestation and visiting the community health clinic for the first time. Which factor would be a priority for the nurse to incorporate into the plan of care?
the ethnicity of the client
The nursing instructor is teaching a group of nursing students about the menstrual cycle. The instructor determines the session is successful when the students correctly choose which action as responsible for the increased thickness of the endometrium?
the increasing level of estrogen
What is menstruation?
the monthly shedding of the uterine lining
The postmenopausal woman who has bleeding and spotting and cannot tolerate a endometrial biopsy in the office would have which test done to rule out endometrial cancer?
transvaginal ultrasound
A nurse is providing care to a client diagnosed with stage II breast cancer. Which finding would the nurse interpret as characteristic of this stage?
tumor that is about 1.5 inches (3.8 centimeters) in diameter with positive lymph nodes
What are the major risk factors associated with the development of endometrial cancer?
unopposed endogenous and exogenous estrogens, obesity, nulliparity, menopause after 53 years, and diabetes.
A nurse is teaching a group of women at the local health clinic about reproduction. After describing the various internal structures involved, the nurse determines that the teaching was successful when the group identifies which structure as connecting the external structures with the cervix?
vagina
The internal female reproductive organs consist of what structures?
vagina, uterus, fallopian tubes, ovaries
A client diagnosed with uterine prolapse is to undergo surgery. The nurse would prepare a preoperative teaching plan for which surgery?
vaginal hysterectomy
A group of women are attending a community presentation regarding the leading health concerns of women. Which interventions should the nurse recommend to have the greatest impact on the leading cause of death?
weight control and being knowledgeable about family history of cardiovascular disease
What is cystocele?
when the posterior bladder wall protrudes downwards through the anterior vaginal wall
What is rectocele?
when the rectum sags and pushes against or into the posterior vaginal wall
What is enterocele?
when the small intestine bulges through the posterior vaginal wall
A healthy client without a primary care provider is exploring the options available for a health care provider to assist with her pregnancy. Which health care provider can the nurse point out as a best option?
Certified nurse midwife
A nurse is caring for a 45-year-old client using a pessary to help decrease leakage of urine and support a prolapsed vagina. Which recommendation is most commonly provided to a client regarding pessary care?
Remove the pessary twice weekly, and clean it with soap and water.
The nurse at a health fair is teaching about the various changes of puberty. Which sequence of events will be best for the nurse to present when illustrating pubertal changes in females?
breast budding, appearance of pubic hair, menarche
What are the four phases of the endometrial cycle?
follicular, luteal, ischemic, and then menstrual
The school nurse is teaching middle-school students about cervical cancer and the HPV virus. She is planning on administering the vaccine to protect them from this precursor of cervical cancer. Which vaccine will she administer to the young girls for this purpose?
recombinant human papillomavirus vaccine
