Test bank For Womens Health Care in Advanced Practice Nursing 2nd Edition by Ivy M Alexander Chapter 146 Complete Questions and Answers A

Test bank For Women's Health Care in Advanced Practice Nursing 2nd Edition by Ivy M Alexander | 2017/2018 | 9780826190017 | Chapter 1-46 | Complete Questions and Answers 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? 1 Candidiasis 2 Trichomoniasis 3 Bacterial vaginosis 4 Group B Streptococcus A 20-year-old woman visiting the clinic says that she wishes to begin using depot medroxyprogesterone acetate (Depo-Provera) as a form of birth control. What important information should the nurse include when teaching the client about Depo-Provera? 1 Depo-Provera offers protection against the herpes simplex virus. 2 To continue the contraceptive effects the client will need to return for another injection in 6 months. 3 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. 4 Calcium intake and exercise should be increased because of possible loss of bone mineral density with increasing duration of use 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 informs her that an accurate BBT is best taken: 1 Each night right before bed 2 On the first day of her next menstrual cycle 3 Each morning prior to getting out of bed or increasing her activity 4 At bedtime beginning on day 14 of her menstrual cycle and continuing until her next period 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, pelvic pain, and depression. The client has been undergoing hormone therapy in hopes of easing the symptoms and reducing the size of the fibroids, without success. The lab reports hemoglobin and hematocrit readings of 6.8 and 20.2, respectively. The client 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." 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 Obesity 2 High-fat diet 3 Hypertension 4 Late-onset menarche 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 overload 2 Intermittent diarrhea 3 Pale mucous membranes 4 Difficulty emptying the bladder 5 High hemoglobin and hematocrit After treatment for a bladder infection, a client asks whether there is anything she can do to prevent cystitis in the future. What is the best response by the nurse? 1 Avoid regular use of tampons. 2 Decrease intake of prune juice. 3 Increase daily fluid consumption. 4 Cleanse the perineum from back to front. A nurse in the family planning clinic reviews the health history of a sexually active 16-year-old girl whose chief concern is a thick, burning discharge accompanied by a burning sensation and lower abdominal pain. After an examination the girl is informed that she may have a sexually transmitted infection (STI) that requires treatment. The adolescent is concerned that her parents will discover that she has been sexually active and asks the nurse whether her parents will be contacted. The nurse explains that her parents will: Incorrect1 Need to know to sign a consent form for testing and treatment 2 Not be contacted, because treatment at the clinic is confidential 3 Be notified when the insurance company is billed for testing and treatment 4 Remain uninformed if the adolescent ensures that her sexual contacts will come for testing A client asks the nurse at the family planning clinic whether contraception is needed while she is breastfeeding. How should the nurse reply? 1 "As long as you aren't having periods, you won't need a contraceptive." 2 "It would be best to delay sexual relations until you have your first period." Correct3 "You should use contraceptives, because ovulation may occur without a period." 4 "Breastfeeding suppresses ovulation, so you don't need to worry about pregnancy." A client with active genital herpes has a cesarean birth. The nurse teaches the mother how to limit transmission of the virus to her newborn. The nurse concludes that the instructions have been understood when the mother states: 1 "I should avoid kissing the baby on the lips." 2 "I have to wear gloves when I'm holding the baby." 3 "I should wash my clothes and my baby's clothes separately." 4 "I have to wash my hands with soap and water before handling the baby." nurse is planning care with a client for the recovery period after a laparoscopic hysterectomy and bilateral salpingo-oophorectomy. What should be included among the changes that the client should expect after surgery? 1 Depression 2 Weight gain 3 Urine retention 4 Surgical menopause After a mastectomy or hysterectomy, the client may feel incomplete as a woman. Which statement causes the nurse to realize that a client may be experiencing this concern? 1 "I can't wait to see my friends." 2 "I want to go home soon to see my grandchild." 3 "I feel washed out; there isn't much left for my family." 4 "My husband arranged for me to recuperate at our daughter's home." A postpartum client is scheduled to have a tubal ligation. She has asked that her husband not be told about the procedure because she has told him that she is having exploratory surgery. The client's husband asks the nurse why his wife needs to have exploratory surgery. How should the nurse respond? "What has the physician told you?" 2 "I don't know the answer to that question." 3 "I'm not allowed to give you that information." 4 "Have you talked to your wife about your concerns?" A woman questions the nurse about the effectiveness of oral contraceptives. What most important factor about the effectiveness of oral contraceptives should be included in the reply to this question? 1 User motivation 2 Simplicity of use 3 Reliability record 4 Identified risk factors A woman visits the clinic for an annual physical examination, and herpes genitalis is diagnosed. The client asks how the disease can be diagnosed without any tests. How should the nurse reply? 1 "There's a sore in your vagina." 2 "There's a rash near your vagina." 3 "You have a typical discharge from your vagina." 4 "You have blisters on the skin around your vagina." While being admitted for a lumpectomy the client begins to cry and says, "I found the lump a few months ago, but I didn't go to the doctor because of what it could be." How should the nurse reply? 1 "This has been frightening for you." 2 "About 80% of breast lumps are benign." 3 "Cry as long as you like and get it out of your system." 4 "More than 95% of breast lumps are discovered by the woman herself." A nurse is assessing a 55-year-old client who is experiencing postmenopausal bleeding. The tentative diagnosis is endometrial cancer. Which findings in the client's history are risk factors associated with endometrial cancer? Select all that apply. 1 Obesity 2 Multiparity 3 Cigarette smoking 4 Early onset of menopause 5 Family history of endometrial cancer 6 Previous hormone replacement therapy A nurse is caring for a client who has contracted a trichomonal infection. Which oral drug should the nurse anticipate that the health care provider will most likely prescribe? 1 Penicillin G 2 Gentian violet 3 Nystatin (Mycostatin) 4 Metronidazole (Flagyl) A female client who has been sexually active for 5 years is found to have gonorrhea. The client is upset and asks the nurse, "What can I do to keep from getting another infection in the future?" Which statement by the client indicates that the teaching by the nurse was effective? 1 "I'll douche after each time I have sex." 2 "Having sex is a thing of the past for me." 3 "My partner has to use a condom all the time." 4 "I'll be using a spermicidal cream from now on." A nurse is counseling an obese postmenopausal client how to prevent bone loss. Which statements indicate understanding of the strategies to prevent bone loss? Select all that apply. 1 "I need to go on a strict diet." 2 "I'll take 400 mg of vitamin D every day." 3 "I should take 1200 mg of calcium every day." 4 "Swimming or bike riding five times a week is good for me." 5 "Going to an aerobics class three times a week will help my bones." A thin older adult client is found to have osteoporosis. What should the nurse include in the discharge plan for this client? 1 Encouraging gradual weight gain 2 Monitoring for decreased urine calcium 3 Providing instructions relative to diet and exercise 4 Teaching about safety factors in the use of opioids and nonsteroidal antiinflammatory drugs A nurse is assessing a client for the potential for osteoporosis. Which factor in the client's history increases the risk for this disorder? 1 Estrogen therapy 2 Hypoparathyroidism 3 Prolonged immobility 4 Excessive calcium intake After an abdominal hysterectomy the client returns to the unit with an indwelling catheter. The nurse notes that the urine in the client's collection bag has become increasingly sanguineous. What complication does the nurse suspect? 1 An incisional nick in the bladder 2 A urinary infection from the catheter 3 Disseminated intravascular coagulopathy 4 Uterine relaxation with increased bleeding A 45-year-old client is to undergo a hysterectomy and expresses concern because she has heard from friends that she will experience severe symptoms of menopause after surgery. What is the nurse's most appropriate response? 1 "You're right, but there are medicines you can take that will ease the symptoms." 2 "Sometimes that happens in women of your age, but you don't need to worry about it right now." 3 "You should probably talk to your surgeon, because I am not allowed to discuss this with you." 4 "Women may experience symptoms of menopause if their ovaries are removed with their uterus." A 35-year-old client is scheduled for conization of the cervix to remove dysplastic cervical cells and to determine the extent of involvement. Effective teaching of postoperative instructions by the nurse would be evident if the client says: 1 "I'll abstain from sex for 48 hours." Correct2 "I know I'll have blood-tinged vaginal discharge for 3 to 5 days." 3 "I know I need to use sterile gloves for the sterile dressing change." 4 "I'll be sterile after the procedure, but I already have my children." The clinic nurse is planning care for a client found to have Chlamydia. Which treatment should the nurse plan to implement? 1 Administration of acyclovir (Zovirax) 250 mg orally in a single dose 2 Administration of azithromycin (Zithromax) 1 g orally in a single dose 3 Administration of ceftriaxone (Rocephin) 250 mg intramuscularly in a single dose 4 Administration of Benzathine penicillin G 2.4 million units intramuscularly in a single dose A client has just been told that she has cervical erosion. The nurse would expect to help explain that early treatment of the erosion can help prevent: 1 Cancer of the cervix 2 Pelvic inflammatory disease 3 Unexpected vaginal bleeding 4 Additional cervical erosions 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. 1 Insomnia 2 Ecchymosis 3 Rectal pressure 4 Abdominal pain 5 Skipped periods 6 Pelvic infections A 15-year-old client tells a school nurse, "I have this awful pain during my periods—it never stops." What should the nurse encourage her to do? 1 Continue daily activities. 2 Have a gynecologic examination. 3 Eat a nutritious diet containing iron. 4 Practice relaxation of abdominal muscles. A client who menstruates regularly every 30 days asks a nurse on what day she is most likely to ovulate. Because the client's last menses started on January 1, the nurse should tell her that ovulation should occur on which day in January? 7 , 16, 24 or 29