Women's Health/Disorders and Childbearing Health Promotion

A 16-year-old high school student is referred to a community health center by a local hotline because of the fear of contracting herpes. The teenager is upset and shares this information with the community health center nurse. What should be the nurse's initial response?

"You sound worried. Let me make arrangements to have you examined."

On the second postpartum day a client mentions that her nipples are becoming sore from breastfeeding. What is the nurse's initial action in response to this information?

Assess her breastfeeding techniques to identify possible causes.

A client is receiving antibiotics and antifungal medications for the treatment of a recurring vaginal infection. What should the nurse encourage the client to do to compensate for the effect of these medications?

Eat yogurt daily.

A 23-year-old woman comes to the clinic for a Pap smear. After the examination, the client confides that her mother died of endometrial cancer 1 year ago and says that she is afraid that she will die of the same cancer. Which risk factor stated by the client after an education session on risk factors indicates that further teaching is needed?

Late-onset menarche

A client who is visiting the prenatal clinic for the first time has a serology test for toxoplasmosis. What information about the client's activities in the history indicates to the nurse that there is a need for this test?

The client takes care of a cat.

A pregnant client with iron-deficiency anemia is prescribed iron supplements daily. To help the client increase iron absorption, the nurse should suggest that the client eat foods high in:

Vitamin C

A 39-year-old woman who is Rh negative is seen by her primary health care provider during the first trimester of pregnancy. At which week of gestation should the nurse explain to the client that Rho(D) immune globulin (RhoGAM) will be administered?

28 weeks

The nurse is providing nutrition teaching to a 22-year-old primipara who is 6 weeks pregnant. To decrease the occurrence of neural tube defects in newborns, the nurse would encourage the adequate intake of:

Folic acid

A client with mild preeclampsia is told that she must remain on bedrest at home. The client starts to cry and tells the nurse that she has two small children at home who need her. How should the nurse respond?

"Let's explore your available current support and opportunities for child care."

A new mother wishes to breastfeed her infant and asks the nurse whether she needs to alter her diet. How should the nurse respond?

"You'll need greater amounts of the same foods you've been eating and more fluids."

A nurse is teaching a class of premenopausal women how to perform breast self-examination correctly. What is the best time of the month for breast self-examination?

About a week after menses ends

What is the priority nursing intervention during the 2 hours after a cesarean birth?

Assessing the lochia to identify the complication of hemorrhage

Immediately after a client has completed the third stage of labor, the nurse adds the prescribed 10 units of oxytocin (Pitocin) to the IV. What is the desired response to this medication?

Prevention of the occurrence of profuse bleeding after placental separation

A nurse is obtaining a health history from a client with newly diagnosed cervical cancer. What aspect of the client's life is most important for the nurse to explore at this time?

Support system

What client behavior indicates to the nurse that a woman needs further teaching about breastfeeding her newborn?

When she leans forward to place her breast in the infant's mouth

A nurse teaches a postpartum client how to care for her episiotomy at home. What statement indicates to the nurse that the client understands the priority instruction?

"I need to continue perineal care after I go to the bathroom until everything is healed."

A nurse is teaching breast care to a client who is breastfeeding. Which statement by the client indicates that the teaching has been effective?

"I should air-dry my nipples after each feeding."

A client who is visiting the family planning clinic is prescribed an oral contraceptive. As part of teaching, the nurse plans to inform the client of the possibility of:

Breakthrough bleeding

Cancer of the breast is diagnosed in a 37-year-old woman. She decides on a modified radical mastectomy followed by a combination therapy protocol that includes DOXOrubicin (Adriamycin). What toxic effect is most important for the nurse to monitor and report?

Cardiac dysrhythmias

A pregnant client tells the nurse that her husband is a chain smoker. What information should the nurse's teaching include?

Continued exposure to secondhand smoke is related to fetal growth restriction.

After a mastectomy, a client returns from surgery with a closed suction drainage system in place and a dry sterile dressing covering the incision. What should the nurse do when observing this client for signs of bleeding?

Inspect the bedclothes under the client's axillary area for signs of drainage.

A 23-year-old woman arrives at the prenatal clinic because she thinks that she is pregnant. Her last menstrual period began on March 31, and her pregnancy test reveals a positive result. According to Nägele's rule, what is this client's expected date of birth (EDB)?

January 7

A client visits the prenatal clinic for the first time. The client tells the nurse that her last menstrual period began June 10. The nurse uses Nägele's rule to calculate the EDB. What is the EDB?

March 17

The plan of care for a client with osteoporosis includes active and passive exercises, calcium supplements, and daily vitamins. How does a nurse determine that the desired effect of therapy has been achieved?

Mobility increases.

A 4-day-old male infant with exstrophy of the bladder and ambiguous genitalia is in the neonatal intensive care unit. The everted bladder is inflamed, and there is continual leakage of urine onto the surrounding skin. What is the nurse's initial concern in trying to support the infant's mother?

Promoting her acceptance of her baby as he is

A client at the women's health clinic tells the nurse that she has endometriosis. What factors associated with endometriosis does the nurse anticipate the client will report? Select all that apply

Rectal pressure Abdominal pain

A nurse is assessing a postpartum client for signs of hemorrhage by evaluating the degree of perineal pad saturation. What other parameter can the nurse use to estimate blood loss in a postpartum client?

Time elapsed between pad changes

A nurse is caring for a client who is being given intravenous magnesium sulfate to treat preeclampsia. Which adverse side effect alerts the nurse to notify the health care provider?

Urine output of less than 100 mL in 4 hours

A client who is scheduled for an amniocentesis says, "I'm glad that this test will show if my baby is well." How should the nurse respond?

"Potential defects caused by chromosomal errors can be detected."

A client has just been informed by the health care provider that she has cervical polyps. The client asks the nurse whether she should worry about them. How should the nurse respond?

"They're usually benign, and a biopsy rules out a malignancy."

A primipara who had a prolonged labor states that she is very tired and asks the nurse to place her newborn son in the nursery while she sleeps. After awakening and having the infant brought back to her, she asks whether she may undress him. How should the nurse respond?

"This is important for you. Of course you can undress your baby."

An older female client tells the nurse in the clinic that she has a cystocele that was diagnosed a year ago. She has urinary frequency and burning on urination. The client asks, "The doctor wanted me to have surgery for the cystocele last year, but I can manage with peripads. It won't hurt not to have surgery, will it?" How should the nurse respond?

"Yes, you're risking kidney damage."

A client gives birth to a healthy girl. Her husband expresses delight but appears anxious and tends to avoid physical contact with his newborn. Later he says to the nurse, "My wife seems so wrapped up in the baby—I hope she has time for me." How should the nurse respond?

"You feel that you'll have to fend for yourself. Tell me more about your concerns."

A client who has breast cancer had postlumpectomy chemotherapy and is now scheduled for radiation on an outpatient basis. What is an important nursing intervention while the client is receiving radiation?

Assessing the irradiated site daily for redness or irritation

A nurse is counseling a pregnant client with iron-deficiency anemia about when and how to take supplemental iron. What time of day and with what drink is iron absorption most efficient?

Before breakfast with orange juice

A client in labor is receiving an oxytocin (Pitocin) infusion. What should the nurse do first when repetitive late decelerations of the fetal heart rate are observed?

Discontinue the oxytocin infusion.

A nurse in the fertility clinic works with couples who have been trying to become pregnant for more than 1 year. How can the nurse help ease the feeling of isolation that infertile couples often experience?

Explore ways to promote communication with family and friends.

The clinic nurse is providing home care instructions for a client with pelvic inflammatory disease. What resting position should be recommended by the nurse?

Fowler

A client who has syphilis tells the nurse that it must have been contracted from a toilet seat. The nurse knows that this cannot be true because the causative agent of syphilis is:

Inactivated when exposed to a dry environment

A mother is concerned that her newborn will be exposed to communicable diseases when she goes home. While teaching the mother ways to decrease the risk of infection, what type of immunity should the nurse explain was transferred to her baby through the placenta?

Passive natural

A nurse is teaching arm exercises to a woman who has undergone a right mastectomy. The nurse instructs the client to:

Perform exercises with both arms simultaneously when possible.

The school nurse discusses herpes genitalis as part of a high school sex education program. The nurse explains to the students that herpes genitalis is:

Responsible for local as well as systemic reactions

An adolescent who gave birth one day ago confides to the nurse that she hopes that her baby will be good and sleep through the night. What should the nurse include in the plan of care to facilitate a realistic expectation of a nighttime newborn schedule?

Talk softly and cuddle the baby when crying occurs.

After giving birth to a 7-lb 2-oz baby, a client decides to breastfeed. What should the nurse tell the client to expect regarding breastfeeding?

An increase in flow is expected.

A couple at the prenatal clinic for a first visit tells the nurse that their 2-year-old child has just been found to have cystic fibrosis. They state there is no family history of this disorder. They ask the nurse about the chances of their having another child with cystic fibrosis. Knowing that this disorder has an autosomal recessive mode of inheritance, how should the nurse respond?

"There is a 25% chance the baby will be affected and a 50% chance that the baby will be a carrier.

A nurse is giving discharge instructions to an anemic postpartum client. The nurse concludes that the client understands the instructions when she states, "The fluid that I should drink with my iron supplement that will enhance its absorption is

orange juice

The nurse in a women's health clinic is counseling a 34-year-old client who has requested a prescription for oral contraceptives. The nurse determines that more discussion is necessary if the client's health history reveals:

Hypertension

A nurse is interviewing a female client with a tentative diagnosis of cystitis pending laboratory results. The nurse anticipates that the causative agent of the cystitis is Escherichia coli. The nurse anticipates this microorganism because it:

Inhabits the intestinal tract

What should be included in nursing care immediately after a sexual assault?

Obtaining the assault history from the client