WOMEN’S HEALTH NR 602 FINAL
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+
A 25-year-old woman comes to the clinic complaining of increased vaginal
discharge, milky gray in color with a "fishy" odor that both she and her husband
have noticed. A wet smear is performed and the presence of "clue cells"
confirmed. Which type of infection does the nurse suspect?
Candidiasis
Trichomoniasis
Bacterial vaginosis
Group B Streptococcus
-Bacterial vaginosis
Signs of bacterial vaginosis include a milky gray vaginal discharge that has a
characteristic fishy odor. "Clue cells" noted on wet smear are indicative of BV.
Candidiasis is a yeast infection caused by the organism Candida albicans. The
most common symptom of a yeast infection is vulvar and vaginal pruritus.
Vaginaldischarge in a candidal infection is thick, white, and lumpy. A woman
with a trichomoniasis infection may present with a frothy yellowish-green
vaginal discharge. Vulvar irritation, pruritus, and dyspareunia are usually
present. Group B Streptococcus may be considered part of the normal vaginal
flora in a woman who is not pregnant, and no treatment is necessary.
A 20-year-old woman visiting the clinic says that she wishes to begin using
depotmedroxyprogesterone acetate (Depo-Provera) as a form of birth control.
What important information should the nurse include when teaching the
client about Depo-Provera?
,Depo-Provera offers protection against the herpes simplex
virus.
To continue the contraceptive effects the client will need to return for another
injection in 6 months.
Women using Depo-Provera may lose more blood each month with their
periods,so it is important to add iron-rich foods to the diet to help prevent
anemia.
Calcium intake and exercise should be increased because of possible loss of bone
mineral density with increasing duration of use
-Calcium intake and exercise should be increased because of possible loss of bone
mineral density with increasing duration of use
Loss of bone mineral density is a significant side effect of Depo-Provera, and
increased calcium intake and exercise should be encouraged. Depo-Provera
should be administered every 11 to 13 weeks; 6 months is too long before the
next dose. Menstrual periods usually lighten or disappear over time. Depo-
Provera confers no protection against herpes simplex virus.
A 24-year-old woman wants to use her basal body temperature (BBT) in
natural family planning but is unsure when to take her temperature. The
nurse informsher that an accurate BBT is best taken:
1Each night right before bed
2On the first day of her next menstrual cycle
3Each morning prior to getting out of bed or
increasing her activity
4At bedtime beginning on day 14 of her menstrual
cycle and continuing until hernext period
-Each morning prior to getting out of bed or increasing her activity
The most accurate BBT is taken before a woman gets out of bed and begins any
type of activity that could increase the body's temperature even slightly. BBT
,should be charted daily on a calendar to permit interpretation of temperature
fluctuations. A BBT taken in the evening may be increased after a day of activity.
Daily assessment and recording of BBT during the first half of the menstrual
cycleis also crucial, because a woman's BBT is lower then than during the
second half of her cycle. The BBT temperature may rise slightly with ovulation.
A 37-year-old woman is admitted to the unit with severe menorrhagia. During
assessment the nurse learns that she has a history of fibroids, menorrhagia,
pelvicpain, and depression. The client has been undergoing hormone therapy in
hopes of easing the symptoms and reducing the size of the fibroids, without
success. Thelab reports hemoglobin and hematocrit readings of 6.8 and 20.2,
respectively. Theclient begins to sob and cries, "I don't know what to do—the
doctor is recommending a hysterectomy, but I haven't had children yet!" What
is the best response by the nurse?
1
"There are so many orphans looking for a
mother."2
"This must be so difficult for you. Children are really important to
you?"3
"You really have no choice but to follow the recommendation; the doctor is
right."4
"Believe me when I tell you that kids are so difficult to raise—you're better off
without them."
-"This must be so difficult for you. Children are really important to you?"
Validating the client's feelings and including an open-ended question will
encourage further expression. Previous problems and health conditions could
later be included in the conversation to help the client make the best decision.
Adoption is certainly an option for this person, but this is not what she needs to
hear at this time. This statement also closes down communication. The client
does have a choice, and telling her that she does not could close down
communication and cause anger and defensiveness. Telling the client that she's
better off without children is not what the client needs to hear, especially when
she is facing an operation that could end her chance of giving birth to children.
, 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?
1
Obesity2
High-fat diet3
Hypertension4
Late-onset menarche
-Late-onset menarche
Early-onset, not late-onset, menarche is a risk factor for endometrial cancer.
Ahigh-fat diet, hypertension, and obesity are all risk factors
A 32-year-old woman is admitted to the unit with a history of fibroids and
menorrhagia. Which findings does the nurse expect to encounter during
assessment of the client? Select all that apply.
1
Fluid overload2
Intermittent diarrhea3
Pale mucous membranes4
Difficulty emptying the
bladder5
High hemoglobin and hematocrit
-Pale mucous membranes, Difficulty emptying the bladder
Menorrhagia (heavy menstrual bleeding) can cause anemia (acute or chronic).
Because this client has a history of menorrhagia, the nurse can anticipate chronic
anemia. Urinary frequency, urgency, and incontinence are symptoms of fibroids,
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+
A 25-year-old woman comes to the clinic complaining of increased vaginal
discharge, milky gray in color with a "fishy" odor that both she and her husband
have noticed. A wet smear is performed and the presence of "clue cells"
confirmed. Which type of infection does the nurse suspect?
Candidiasis
Trichomoniasis
Bacterial vaginosis
Group B Streptococcus
-Bacterial vaginosis
Signs of bacterial vaginosis include a milky gray vaginal discharge that has a
characteristic fishy odor. "Clue cells" noted on wet smear are indicative of BV.
Candidiasis is a yeast infection caused by the organism Candida albicans. The
most common symptom of a yeast infection is vulvar and vaginal pruritus.
Vaginaldischarge in a candidal infection is thick, white, and lumpy. A woman
with a trichomoniasis infection may present with a frothy yellowish-green
vaginal discharge. Vulvar irritation, pruritus, and dyspareunia are usually
present. Group B Streptococcus may be considered part of the normal vaginal
flora in a woman who is not pregnant, and no treatment is necessary.
A 20-year-old woman visiting the clinic says that she wishes to begin using
depotmedroxyprogesterone acetate (Depo-Provera) as a form of birth control.
What important information should the nurse include when teaching the
client about Depo-Provera?
,Depo-Provera offers protection against the herpes simplex
virus.
To continue the contraceptive effects the client will need to return for another
injection in 6 months.
Women using Depo-Provera may lose more blood each month with their
periods,so it is important to add iron-rich foods to the diet to help prevent
anemia.
Calcium intake and exercise should be increased because of possible loss of bone
mineral density with increasing duration of use
-Calcium intake and exercise should be increased because of possible loss of bone
mineral density with increasing duration of use
Loss of bone mineral density is a significant side effect of Depo-Provera, and
increased calcium intake and exercise should be encouraged. Depo-Provera
should be administered every 11 to 13 weeks; 6 months is too long before the
next dose. Menstrual periods usually lighten or disappear over time. Depo-
Provera confers no protection against herpes simplex virus.
A 24-year-old woman wants to use her basal body temperature (BBT) in
natural family planning but is unsure when to take her temperature. The
nurse informsher that an accurate BBT is best taken:
1Each night right before bed
2On the first day of her next menstrual cycle
3Each morning prior to getting out of bed or
increasing her activity
4At bedtime beginning on day 14 of her menstrual
cycle and continuing until hernext period
-Each morning prior to getting out of bed or increasing her activity
The most accurate BBT is taken before a woman gets out of bed and begins any
type of activity that could increase the body's temperature even slightly. BBT
,should be charted daily on a calendar to permit interpretation of temperature
fluctuations. A BBT taken in the evening may be increased after a day of activity.
Daily assessment and recording of BBT during the first half of the menstrual
cycleis also crucial, because a woman's BBT is lower then than during the
second half of her cycle. The BBT temperature may rise slightly with ovulation.
A 37-year-old woman is admitted to the unit with severe menorrhagia. During
assessment the nurse learns that she has a history of fibroids, menorrhagia,
pelvicpain, and depression. The client has been undergoing hormone therapy in
hopes of easing the symptoms and reducing the size of the fibroids, without
success. Thelab reports hemoglobin and hematocrit readings of 6.8 and 20.2,
respectively. Theclient begins to sob and cries, "I don't know what to do—the
doctor is recommending a hysterectomy, but I haven't had children yet!" What
is the best response by the nurse?
1
"There are so many orphans looking for a
mother."2
"This must be so difficult for you. Children are really important to
you?"3
"You really have no choice but to follow the recommendation; the doctor is
right."4
"Believe me when I tell you that kids are so difficult to raise—you're better off
without them."
-"This must be so difficult for you. Children are really important to you?"
Validating the client's feelings and including an open-ended question will
encourage further expression. Previous problems and health conditions could
later be included in the conversation to help the client make the best decision.
Adoption is certainly an option for this person, but this is not what she needs to
hear at this time. This statement also closes down communication. The client
does have a choice, and telling her that she does not could close down
communication and cause anger and defensiveness. Telling the client that she's
better off without children is not what the client needs to hear, especially when
she is facing an operation that could end her chance of giving birth to children.
, 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?
1
Obesity2
High-fat diet3
Hypertension4
Late-onset menarche
-Late-onset menarche
Early-onset, not late-onset, menarche is a risk factor for endometrial cancer.
Ahigh-fat diet, hypertension, and obesity are all risk factors
A 32-year-old woman is admitted to the unit with a history of fibroids and
menorrhagia. Which findings does the nurse expect to encounter during
assessment of the client? Select all that apply.
1
Fluid overload2
Intermittent diarrhea3
Pale mucous membranes4
Difficulty emptying the
bladder5
High hemoglobin and hematocrit
-Pale mucous membranes, Difficulty emptying the bladder
Menorrhagia (heavy menstrual bleeding) can cause anemia (acute or chronic).
Because this client has a history of menorrhagia, the nurse can anticipate chronic
anemia. Urinary frequency, urgency, and incontinence are symptoms of fibroids,
