NUR FUNDAMENTA quiz 10 evolve Questions And Answers. Complete Solution.

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NUR FUNDAMENTA quiz 10 evolve The nurse is teaching a precautionary method to a client who underwent surgery for the removal of uterine polyps. Which statement by the client needs correction? 2 ... "I should avoid having sexual intercourse." 3 "I should avoid douching for up to 1 week." 4 Which symptom in a woman who is using oral contraceptives should be reported to the physician immediately? 1 5-pound weight gain in a month Leg pain and edema 3 Decreased menstrual flow 4 Increased pigmentation of the face Which infection is prevented with the Cervarix and Gardasil vaccines? 1 Bacterial vaginosis (BV) 2 Vulvovaginal candidiasis (VVC) 3 Pelvic inflammatory disease (PID) Human papillomavirus (HPV) What type of breast cancer is characterized by rash and reddish skin on the breast? 1 Ductal cancer 2 Nipple cancer 3 Lobular cancer Inflammatory cancer The nurse is assessing a pregnant client with genital herpes simplex virus (HSV) infection, who is having labor pains. The nurse finds that the client was prescribed antiviral medications. Which assessment finding will determine that a vaginal birth is possible? 1 2 4 While speaking to a couple about child care, the nurse notices that the female partner has bruises on her forearm. What should the nurse do prior to assessment of intimate partner violence in the female partner? 1 Talk to the couple and find out more about their relationship at home. 2 Interview the male partner to assess for characteristics of a male batterer. Request the male partner leave the female partner alone with the nurse briefly. 4 The nurse is assessing a 40-year-old female client with fibrocystic changes in her breast. After reviewing the breast ultrasonography report, the nurse finds that the lump is a solid mass. What does the nurse tell the client? "You may need to get a mammogram." 2 "You may be required to take estrogen therapy." 3 "You may want to consider taking oral contraceptives." 4 "You may need to get the lump aspirated on a regular basis." A pregnant client in the first trimester has developed pregnancy complications and undergoes a medical abortion. The nurse finds from the client’s blood reports that the client is Rh negative. What is a priority action by the nurse? 1 2 3 Administer nonsteroidal antiinflammatory drugs. Correct4 Administer Rho(D) immune globulin after the abortion. The patient is given Rho(D) immune globulin within 72 hours of the abortion to prevent Rh isoimmunization. Methotrexate therapy is used for aborting the fetus in the first trimester and is not used after abortion. The client is instructed to avoid douches after an abortion, because they may increase the chance of infection. Nonsteroidal antiinflammatory drugs are prescribed for postabortion pain. A client who has undergone several failed attempts at in vitro fertilization discusses her feelings with the nurse. If the client says that her inability to conceive does not affect her worth as a human being, what behavioral characteristic is the client showing? 1 Guilt 2 Denial 3 Depression A male patient asks the nurse why it is better to purchase condoms that are not lubricated with nonoxynol-9 (a common spermicide). What is the nurse’s most appropriate response? 1 3 "The additional lubrication improves sex." 4 What is the procedure in which ova are removed by laparoscopy, mixed with sperm, and the embryo(s) returned to the woman's uterus? In vitro fertilization 2 Tubal embryo transfer 3 Therapeutic insemination 4 The nurse is teaching different groups of women about breast cancer screening. The groups are classified based on the age group and the risk of breast cancer. The nurse documents the instructions given to each group. Which group of women is above 30 years in age and at the highest risk of developing breast cancer? 1 2 4 The nurse is teaching hygienic measures to a client with vulvodynia. Which statement by the client indicates a need for further teaching? 2 "I should avoid wearing tight clothing." 3 "I should use cotton menstrual pads." 4 The nurse is assessing a pregnant woman who is complaining of milky, sticky discharge from her breasts. The laboratory reports of the client show elevated prolactin levels. What laboratory test does the nurse perform based on the primary health care provider’s advice? 1 3 Cardiac function test 4 When does a client develop a viremic influenza-like response after being infected with human immunodeficiency virus (HIV)? Immediately after the virus infects the body Correct2 Within 6 to 12 weeks after the virus infects the body 3 One year after initiating antiretroviral therapy for treatment 4 What are some ways to prevent genital tract infections? Select all that apply. Practice genital hygiene. 2 4 Select vinyl car seat covers instead of cloth. 5 Wear tight-fitting clothing (especially tight jeans). A client is diagnosed with neoplasia in the lower two-thirds of the epithelium of the cervix. Which type of cervical cancer is associated with this condition? 1 Carcinoma in situ (CIS) 2 Cervical intraepithelial neoplasia (CIN) 1 Cervical intraepithelial neoplasia (CIN) 2 4 The nurse is assessing a client who is taking oral contraceptives and reports severe pain in the legs. What symptoms should the nurse primarily assess for in the client? Thrombus formation 2 Severe muscle spasms 3 High creatinine levels 4 The nurse is caring for a client with breast cellulitis and suggests heat therapy. What is the reason for this suggestion? Correct1 3 To reduce nipple discharge 4 A client is prescribed a single-rod etonogestrel implant (Implanon) for contraception. The client informs the nurse, "I’m sure I can have multiple sexual partners now." What does the nurse tell the client? 1 "Your partners will have to use a condom lubricated with N-9." 2 "Encourage your partners to use a natural skin condom." 3 "It is better to use a condom, because there may be a risk for pregnancy." The nurse is caring for a sexually assaulted female client who has severe injuries. What is the priority action of the nurse? 1 3 Offering emergency contraception 4 1 Intranasal spray 2 Vaginal suppository Intramuscular injection 4 Sexual assault is considered what? 1 Limited to rape An act of force in which an unwanted and uncomfortable sexual act occurs 3 A legal term for sexual violence 4 A 13-year-old female expresses her wish to undergo breast augmentation surgery. After consulting with the nurse, the client decides not to undergo this surgery. What factor wouldmost likely lead to this decision? The client’s breasts are not fully developed. 2 The surgery may result in neck and shoulder pain. 3 The client may not be able to breastfeed later in life due to this surgery. 4 A client reports yellowish, frothy, and malodorous vaginal discharge. During the assessment the nurse observes strawberry spots in the cervix and inflammation of the vaginal walls and cervix. What will the nurse suggest that the client do in order to provide effective treatment? 1 "Add colloidal oatmeal powder to the bath water." "Your partner should also receive treatment for the infection." 3 "Avoid eating raw eggs and foods that are rich in carbohydrates." 4 The presence of yellowish, frothy, and malodorous vaginal discharge, strawberry spots, and inflammation of the vaginal walls and cervix indicates that the client has trichomoniasis. The A nulliparous woman has a history of cancer therapy, which had an adverse effect on her pituitary gland. What risk does the nurse expect in the client? 1 2 3 Liver disease Correct4 Difficulty conceiving Cancer therapy may have severely adverse effects on the body. If the therapy affects the pituitary gland, women may resume their menstrual cycles but are still at risk of having difficulty conceiving. Neurologic impairment is not directly related to the pituitary gland. Risk of recurrence is associated with many types of cancers. Cancer therapy also causes hepatotoxicity. STUDY TIP: Try to decrease your workload and maximize your time by handling items only once. Most of us spend a lot of time picking up things we put down rather than putting them away when we have them in hand. Going straight to the closet with your coat when you come in instead of throwing it on a chair saves you the time of hanging it up later. Discarding junk mail immediately and filing the rest of your bills and mail as they come in rather than creating an ever-growing stack saves time when you need to find something quickly. Filing all items requiring further attention in some fashion helps you remember to take care of things on time rather than being so engrossed in your schoolwork that you forget about them. Many nursing students have had their power or telephone service cut off because the bill simply was forgotten or buried in a pile of old mail. What is the gold standard for breast cancer screening and early detection? 1 3 4 The nurse finds that a client who underwent a hysterectomy has a positive Homans sign. Which postoperative measures help the client avoid further risk due to a positive Homans sign? 1 2 3 Maintaining electrolyte balance Correct4 Using antiembolic stockings Deep vein thrombosis is one of the complications that may occur after hysterectomy. A positive Homans sign indicates the risk of deep vein thrombosis. Antiembolic stockings are suggested to clients who are at risk of deep vein thrombosis after hysterectomy. Coughing and taking deep breaths with assistance helps the client prevent respiratory complications. Emptying the wound drainage tube is an intervention performed to avoid infection and to assess bleeding in the drainage. Maintenance of electrolyte balance is related to the use of antiembolic stockings. STUDY TIP: Answer every question. A question without an answer is the same as a wrong answer. Go ahead and guess. You have studied for the test and you know the material well. You are not making a random guess based on no information. You are guessing based on what you have learned and your best assessment of the question. Which is a true statement about the TNM system for clinical staging of breast cancer? 1 The TNM system is the relative location of malignant lesions of the breasts. Correct2 3 Nurses, certified nurse-midwives, and other advanced practice nurses have the knowledge and expertise to assist women in making informed choices regarding contraception. A multidisciplinary approach should ensure that the woman's social, cultural, and interpersonal needs are met. Which action should the nurse take first when meeting with a new client to discuss contraception? 1 3 Assess the woman's willingness to touch her genitals and cervical mucus. 4 Which condition in a client who is using a copper-bearing intrauterine device indicates a need for removal of the device? Correct1 Rashes 2 Nausea Occasional bleeding 4 The nurse teaches a client how to detect ovulation and suggests that the client have intercourse the day before and on the day of ovulation. Which patient need is the nurse addressing? 2 The client wants to prevent transmission of sexually transmitted diseases. 3 The client is researching methods of contraception to prevent a pregnancy. 4 A nurse is working with a male coworker who is whistling at her, talking about how pretty she is, and how big her breasts look in her uniform. What type of sexual violence is the nurse receiving from the male coworker? 1 Sexual assault 2 Sexual intimacy Sexual harassment 4 The sexual assault nurse examiner (SANE) is examining a client who was sexually assaulted. Which intervention is done in order to collect a specimen? Speculum examination 2 Bimanual pelvic assessment 3 Internal pelvic assessment 4 During a follow-up assessment of a client who had been a victim of sex trafficking, the nurse suspects that the patient has Stockholm Syndrome. Which client response indicates Stockholm Syndrome? 1 "I will immediately report to you if I am abused ever again." Correct2 "I want to see my abuser again. I just want him to know I’m OK." 3 "I feel more confident about sharing my thoughts with others about my experiences." The role of the nurse in initial family planning is to: Refer the couple to a reliable health care provider. 2 Decide on the best method for the couple. 3 Advise couples on which contraceptive to use. Correct4 The nurse is instructing a client on self-care after embolization of the uterine artery. Which statements should be included? Select all that apply. 1 3 "Consider the use of a vaginal dilator." Incorrect4 "Douche regularly." Correct5 "Avoid vaginal intercourse for up to 4 weeks." Uterine artery embolization is performed to cut off blood supply to fibroids, thereby reducing or eliminating them. After this procedure, clients are advised to eat a diet rich in fluids and fiber. Vaginal intercourse should be avoided until the uterus is healed, which may take about 4 weeks. Tampons should not be used, because they may aggravate the pain. A vaginal dilator is suggested for vaginal stenosis, which is a side effect of radiation therapy. Douching is not recommended after uterine artery embolization. STUDY TIP: Regular exercise, even if only a 10-minute brisk walk each day, aids in reducing stress. Although you may have been able to enjoy regular sessions at the health club or at an exercise class several times a week, you now may have to cut down on that time without giving up a set schedule for an exercise routine. Using an exercise bicycle that has a book rack on it at home, the YMCA, or a health club can help you accomplish two goals at once. You can exercise while beginning a reading assignment or while studying notes for an exam. Listening to lecture recordings while doing floor exercises is another option. At least a couple of times a week, however, the exercise routine should be done without the mental connection to school; time for the mind to unwind is necessary, too. The nurse is educating a client about how to use a condom. Which statement by the client indicates effective learning? 1 "Sticky and brittle condoms are effective for use." 2 "Condoms should be stored in warm, humid locations." "Condoms should be worn before the penis is erect." Correct4 The nurse is preparing a client for uterine artery embolization. After interacting with the client, the nurse asks the primary health provider to postpone the procedure for 24 hours. What factor would cause the nurse to make this this suggestion? 1 2 3 The client complains of pain in the lower abdomen. Correct4 The client took aspirin (Acuprin) before coming to the hospital. Uterine artery embolization is a procedure in which the primary health care provider injects polyvinyl alcohol (PVA) and blocks the blood supply to the body of the uterus. Aspirin (Acuprin) is a nonsteroidal antiinflammatory medication that increases the risk of bleeding. Therefore, the client should avoid taking aspirin 24 hours before the surgery. Laxatives increase bowel movements and prevent constipation, so the client is advised to take laxatives 24 hours before the surgery. Fasting will not adversely affect the surgery and would not be a reason to delay the procedure. Pain in the lower abdomen is a common symptom of uterine fibroids and would not cause complications during the surgery. The nurse is counselling a client who is at risk for a sexually transmitted infection (STI). What does the nurse include in her STI prevention teaching? Select all that apply. Correct1 Explains in detail how STIs are transmitted Correct2 Instructs the client on how to use a condom Correct3 Explains how to identify physical signs of STI 4 Advise the use of vaginal spermicides 5 Which examination is useful in detecting the luteinizing hormone (LH) surge 12 to 36 hours prior to ovulation? 1 2 3 Hysterosalpingogram Correct4 Ovulation detection kit An ovulation detection kit is used starting on day 11 of the 28-day cycle to detect the luteinizing hormone (LH) surge 12 to 36 hours prior to ovulation. Endometrial biopsy is used to check endometrial response to progesterone and adequacy of the luteal phase. Sonohysterography infuses fluid into the uterus via the cervix. It uses vaginal ultrasound to define the uterine cavity and the depth of the uterine lining. A hysterosalpingogram is useful for visualizing the uterine cavity in the late follicular and early proliferative phase. A client is planning to use the calendar rhythm method for contraception. On assessment, the nurse finds that the client has regular menstrual cycles of 28 days each. When should the couple abstain from sexual activity to avoid pregnancy? 1 On the 9th day 2 On the 16th day From days 10 through 17 4 When should the nurse give the emergency contraception to a victim of sexual abuse to prevent pregnancy? Within 120 hours after intercourse 2 Within 1 week after intercourse 3 Within 3 days after confirmation of pregnancy 4 Which nursing interventions are beneficial for a client preparing for uterine polyps removal?Select all that apply. 1 Advise the client to use tampons. Incorrect2 Advise the client to douche regularly. Correct3 Advise the client to perform relaxation exercises. Correct4 Provide psychologic support to the client during the removal procedure. Correct5 Advise the client to avoid sexual intercourse for up to 1 week after surgery. Uterine polyps may be removed via surgery. Nursing care includes preparing the woman for what to expect during the removal procedure. The nurse should encourage relaxation and breathing exercises to decrease stress in the client. The client may be anxious, and providing psychologic support is helpful. After the procedure, the woman is advised to avoid sexual intercourse for up to 1 week. Using tampons and douching should be avoided for up to 1 week or until the site is healed. An infertile woman is about to begin pharmacologic treatment. As part of the regimen, she will take purified follicle-stimulating hormone (FSH) (urofollitropin [Metrodin]). The nurse instructs her that this medication is administered in what form? 1 Intranasal spray 2 Vaginal suppository Intramuscular injection 4 A client has been sexually assaulted and is receiving an initial evaluation in the Emergency Department. She is concerned that she may become pregnant. Which priority action should the nurse implement to address the client’s concern? 1 Ask the client to provide information about the date of her LMP. 2 3 Have the client sign a consent form for a dilatation and curettage to be performed. The nurse should refer a 55-year-old woman for further testing if it is noted on inspection her breasts: 1 2 3 Bilateral symmetry of venous network, which is faintly visible Correct4 Small dimple located in the upper outer quadrant of the right breast A small dimple is an abnormal finding and should be further evaluated. In many women one breast is smaller than the other. Eversion of both nipples is a normal finding. A faintly visible venous network is a normal finding. Test-Taking Tip: Prepare for exams when and where you are most alert and able to concentrate. If you are most alert at night, study at night. If you are most alert at 2 am, study in the early morning hours. Study where you can focus your attention and avoid distractions. This may be in the library or in a quiet corner of your home. The key point is to keep on doing what is working for you. If you are distracted or falling asleep, you may want to change when and where you are studying. What does the nurse tell a pregnant client with genital herpes simplex virus (HSV) infection about the risk or adverse effect on her pregnancy? 1 "There is a high probability of stillbirth." Correct2 "The infant may have neonatal herpes after birth." "There is a risk for miscarriage in the last trimester." 4 The nurse is teaching a precautionary method to a client who underwent surgery for the removal of uterine polyps. Which statement by the client needs correction? 2 "I should avoid having sexual intercourse." 3 "I should avoid douching for up to 1 week." 4 Which symptom in a woman who is using oral contraceptives should be reported to the physician immediately? 1 5-pound weight gain in a month Leg pain and edema 3 Decreased menstrual flow 4 Increased pigmentation of the face Which infection is prevented with the Cervarix and Gardasil vaccines? 1 Bacterial vaginosis (BV) 2 Vulvovaginal candidiasis (VVC) 3 Pelvic inflammatory disease (PID) Human papillomavirus (HPV) What type of breast cancer is characterized by rash and reddish skin on the breast? 1 Ductal cancer 2 Nipple cancer 3 Lobular cancer Inflammatory cancer The nurse is assessing a pregnant client with genital herpes simplex virus (HSV) infection, who is having labor pains. The nurse finds that the client was prescribed antiviral medications. Which assessment finding will determine that a vaginal birth is possible? 1 2 4 While speaking to a couple about child care, the nurse notices that the female partner has bruises on her forearm. What should the nurse do prior to assessment of intimate partner violence in the female partner? 1 Talk to the couple and find out more about their relationship at home. 2 Interview the male partner to assess for characteristics of a male batterer. Request the male partner leave the female partner alone with the nurse briefly. 4 The nurse is assessing a 40-year-old female client with fibrocystic changes in her breast. After reviewing the breast ultrasonography report, the nurse finds that the lump is a solid mass. What does the nurse tell the client? "You may need to get a mammogram." 2 "You may be required to take estrogen therapy." 3 "You may want to consider taking oral contraceptives." 4 A pregnant client in the first trimester has developed pregnancy complications and undergoes a medical abortion. The nurse finds from the client’s blood reports that the client is Rh negative. What is a priority action by the nurse? 1 Initiate methotrexate therapy after the abortion. 2 Instruct the client to use douches after the abortion. 3 Administer nonsteroidal antiinflammatory drugs. A client who has undergone several failed attempts at in vitro fertilization discusses her feelings with the nurse. If the client says that her inability to conceive does not affect her worth as a human being, what behavioral characteristic is the client showing? 1 Guilt 2 Denial 3 Depression A male patient asks the nurse why it is better to purchase condoms that are not lubricated with nonoxynol-9 (a common spermicide). What is the nurse’s most appropriate response? 1 3 "The additional lubrication improves sex." 4 What is the procedure in which ova are removed by laparoscopy, mixed with sperm, and the embryo(s) returned to the woman's uterus? In vitro fertilization 2 Tubal embryo transfer 3 Therapeutic insemination 4 The nurse is teaching different groups of women about breast cancer screening. The groups are classified based on the age group and the risk of breast cancer. The nurse documents the instructions given to each group. Which group of women is above 30 years in age and at the highest risk of developing breast cancer? 1 2 4 The nurse is caring for a client who is scheduled to undergo a hysterosalpingogram. What possible abnormalities can be detected through the procedure? 1 Presence of infection Correct2 Blockage in the fallopian tubes 3 Decrease in ovarian reserve When a nursing instructor is teaching a group of nursing students about the signs of potential male batterers, which characteristics should be mentioned? 1 A high tolerance for frustration Correct2 A tendency toward jealousy 3 Unusually high self-esteem Which contraceptive method provides protection against sexually transmitted infections? 1 2 4 After reviewing the mammogram reports of a client, the primary health care provider refers the client for a positron emission tomography scan. What is the purpose of positron emission tomography in this scenario? 1 To determine whether the tumor is encapsulated 2 To determine whether the tumor size is more than 2 cm To determine whether the patient’s tumor has metastasized 4 The rate of fertility declines dramatically after the age of 35. While explaining the cause of this rapid decline in fertility to the client, the nurse is aware that the primary reason for this is related to what? 1 Endometriosis Abnormalities of oocytes 3 Infection 4 A woman has arrived for her preoperative testing appointment. She is scheduled for a myomectomy the following day. As the nurse involved in this woman's care you understand that this procedure is being performed for what? 1 2 4 A client is prescribed griseofulvin (Fulvicin P/G) for the treatment of ringworm. After reviewing the medical history of the client, the nurse finds that the client is taking oral contraceptives. What advice should the nurse gives to the client? 2 "Use a double dose of oral contraceptive." 3 "Take a lower dose of griseofulvin (Fulvicin P/G.)" 4 A client has a TNM status of T1-N0-M0 following a mammography. Which stage of breast cancer is the client likely to have? Stage 0 Correct2 Stage I 3 Stage IIA 4 Stage IIIA A 36-year-old client is taking ovulation-inducing drugs to conceive after having had one child previously. The client says, "I’ve been using ovulation-inducing drugs for a month now and still haven’t ovulated." How does the nurse respond? 1 Correct2 "When did you have your last menstrual cycle?" 3 "You may be sterile and unable to conceive naturally." An adolescent complains of postcoital bleeding and purulent cervical discharge. Upon assessment, the nurse finds that the adolescent has multiple sex partners. What is thepriority nursing action in this case? 1 Encourage the client to use a condom. 2 Obtain a thorough history of allergies. 3 Recommend that the client undergo yearly STI screening. Which of these behaviors place women at high risk for HIV? Select all that apply. 1 Abstinence Correct2 IV drug use Correct3 Multiple sex partners Correct4 6 A female client informs the nurse that she conceived in the first month after discontinuing oral contraceptives (COCs). The client is worried about the effect of possible COC use on this pregnancy. What does the nurse tell the client? 1 "The child may have a birth defect." 2 3 "The child may have iron deficiency anemia." The nurse suspects that a female client may have been abused. Which nursing action ismost appropriate in this situation? 1 Examine the client in her partner’s presence. 2 4 During assessment, the nurse finds that the client has many scars on her back and arms. The nurse also observes that the client seems scared of her husband and appears very timid and helpless. Which syndrome do these findings indicate in the client? 1 Correct3 Battered woman syndrome 4 Which method is used to determine the presence of varicoceles in the testes? 1 Semen analysis Scrotal ultrasound 3 Transrectal ultrasound 4 Researchers have described three phases of mental health consequences of sexual assault. How are the three phases described? 1 3 Acute phase: support, Psychologic phase, and Long-Term Process: recovery and renewal Correct4 The nurse is performing a physical examination of the vulva, the perineum, the anus, the vagina, and the cervix of a client with human papillomavirus (HPV) lesions. What is an important nursing action during the examination? 1 Avoid rotating the speculum blades during the examination. 2 Obtain saline and KOH wet smears and check vaginal pH. 3 Administer an anesthetic before starting the examination. A woman undergoing evaluation of infertility states, "At least when we're through with all of these tests and we will know what is wrong." What is the nurse's best response? 1 "I know the test will identify what is wrong." 2 "I’m sure that once you finish these tests, your problem will be resolved." "Even with diagnostic testing, infertility remains unexplained in about 20% of couples." 4 A client is worried about pregnancy after unprotected sex. Within how many hours can the client use emergency contraception to prevent pregnancy? 1 3 12 days 4 A nursing student is reviewing information relative to cultural beliefs about infertility. Which statement if made by a client would require intervention? "I want to consult my rabbi before going any further with an infertility work up." 2 "I will not be able to use IVF therapies, because it is against my Roman Catholic religion as." Correct3 "I have to take full responsibility for my failure to conceive." 4 A client has been prescribed raloxifene hydrochloride (Evista) for treatment of breast cancer. Which of the following, if found by the nurse prior to medication administration, would lead to immediate contact with the physician? 1 CBC result indicates a slight decrease in red blood cell count. Correct2 PMH noted of superficial thrombophlebitis of the left leg. 3 Family history of osteoporosis. When teaching self-care prevention of genital tract infections, the nurse should instruct the woman to: 1 3 Choose underwear or hosiery with a nylon crotch 4 Which sexual practices should be avoided to help prevent the spread of sexually transmitted infections? Select all that apply. Correct1 Oral-anal contact HIV and STI testing Correct4 Unprotected anal intercourse Protected vaginal intercourse Correct6 The nurse is caring for a client admitted to the emergency department with multiple lacerations; blunt trauma to the head; bruised, swollen eyes; and a stab wound to her right arm. What type of violence has this client suffered? 1 2 Correct4 When obtaining a health history, the nurse should be aware that the most common malignancy of the reproductive system is what? Correct1 3 Ovarian cancer 4 Which statement by a client indicates a risk of genital tract infection? 1 "I eat yogurt almost every day." 2 "I use hosiery with a cotton crotch." "I take a bubble bath once in a day." 4 The standard mammogram film of a client reveals the presence of microcalcifications that are clustered together and have irregular edges. Which diagnostic intervention would help to confirm the cause of the client’s condition? 1 3 Magnetic resonance imaging 4 The nurse is teaching a group of nursing students about intimate partner violence (IPV). Which statement made by the nurse is a myth? 1 "IPV victims are often fearful of assailants and try to avoid confrontation." 2 "A batterer can be a highly successful professional, like a politician." "Being pregnant will protect a woman from being an IPV victim." 4 A couple arrives for their first appointment at an infertility center. A noninvasive test done during initial diagnostic testing is called what? Hysterosalpingogram 2 Endometrial biopsy Correct3 Semen analysis 4 While assessing a pregnant client, the nurse advises the client to eat thoroughly cooked meat, wash hands thoroughly with soap and water, and avoid exposure to cat litter. What is the reason for giving this advice? Correct1 3 To reduce the risk of congenital rubella syndrome in the newborn 4 What are surgical approaches for the treatment of breast cancer? Select all that apply. Biopsy Correct2 Lumpectomy Mastectomy 4 Needle aspiration Correct5 Segmental mastectomy Correct6 Total simple mastectomy Surgical approaches for the treatment of breast cancer include: lumpectomy, mastectomy, segmental mastectomy, and a total simple mastectomy. A biopsy and needle aspiration are diagnostic tests for breast cancer. Which is a true statement about TORCH infections? 1 TORCH infections produce pneumonia symptoms in the mother. 2 TORCH infections do not affect the pregnant woman and her fetus. 3 TORCH infections form a group of organisms incapable of crossing the placenta. Correct4 TORCH infections include toxoplasmosis, other infections (e.g., hepatitis), rubella virus, cytomegalovirus (CMV), and herpes simplex virus. The true statement about TORCH infections is that they include toxoplasmosis, other infections (e.g., hepatitis), rubella virus, cytomegalovirus (CMV), and herpes simplex virus. TORCH infections produce flulike (not pneumonia) symptoms in the mother; TORCH infections do affect the pregnant woman and her fetus; and TORCH infections form a group of organisms capable of crossing the placenta. A 23-year-old client reports having severe pain in her breasts during and up to a week after menstruation." What does the nurse infer from the client’s condition? 1 The client has micromastia. 2 The client has macromastia. The client has fibrocystic changes. 4 A man and a woman who have not achieved a successful pregnancy are scheduled to meet with a fertility specialist. Which simple evaluation is usually the first test to be performed? Semen analysis 2 Testicular biopsy 3 Endometrial biopsy 4 The nurse is assessing a client who has fibrocystic changes in her breasts during menstruation. What comfort measures might the nurse suggest? 1 2 4 A client complains of pain, burning and irritation in the vulvar area, and reduced sexual desire. Which treatment best helps resolve the symptoms? 1 Vestibulectomy 2 Vaginal hysterectomy Correct3 Lidocaine 5% (Xylocaine Viscous) ointment A mother in late middle age who is certain she is not pregnant tells the nurse during an office visit that she has urinary problems, as well as sensations of bearing down and of something in her vagina. The nurse realizes that the woman most likely is suffering from what? 1 Pelvic relaxation Correct2 Cystoceles and/or rectoceles Uterine prolapse 4 Genital fistulas The nurse is assessing a client with leiomyomas. After reviewing the client’s diagnostic reports, the nurse believes the client has a risk of tumor cell necrosis. Which label represents the type of leiomyoma the nurse finds in the client’s diagnostic report? 1 A 2 B C 4 D A client comes to the clinic and the nurse uses the Five Ps approach for obtaining information about her sexual history. Which of these are included in the Five Ps approach? Select all that apply. Correct1 Partners Correct2 Practices Correct3 Past history of STIs Correct4 Prevention of pregnancy 5 Pleasures of sexual positions Correct6 Protection from sexually transmitted infections (STIs) The Five Ps include: Partners, Prevention of pregnancy, Protection from STIs, Practices, and Past history of STIs. This approach to obtaining a sexual history is an example of an effective strategy for eliciting information concerning five key areas of interest. Pleasures of sexual positions is not included in the Five Ps. The nurse is caring for a client who is a victim of intimate partner abuse. The client avoids interaction with the nurse and does not participate in the group therapy activities. Which action by the nurse will help the client express herself openly and honestly? 1 Correct3 Interact with the client individually in a private room. 4 Encourage the client’s family to spend time with the client. The nurse is assessing a 37-year-old client with secondary infertility. While reviewing the client’s laboratory reports, the nurse finds that the patient has a reduced ovarian reserve. Which laboratory report would the nurse have reviewed? 1 Correct3 Follicle-stimulating hormone levels 4 The nurse is caring for a client who has increased urinary frequency and reports, "Something is in my vagina." For what should the nurse assess in this client? 1 Rectocele Correct2 Cystocele Vaginal fistulas 4 Following a hysterectomy for endometrial cancer, a client presents with acute pain and impaired tissue integrity at the site of surgery. Which intervention does the nurse add to the care plan to reduce the risk of infection? 1 Correct2 Providing fruits rich in vitamin C to the client 3 Applying a warm compress to the client’s lower abdomen The nurse is assessing a client with fibroids on the outer wall of the uterus. Which treatment strategy would be most beneficial if the client wants to conceive in the future? 1 Hysterectomy Correct2 Myomectomy 3 Laser surgery What should nurses be aware of regarding infertility? Correct1 Infertility is perceived differently by women and men. 3 Infertility is more likely the result of a physical flaw in the woman than in her male partner. 4 While caring for a victim of physical abuse, the nurse spends time with the client, listens to the client, and maintains eye contact while interacting with the client. What is the rationale behind these interventions? 2 To provide ongoing support 3 To increase feeling of self-worth 4 The nurse is educating a client about a safety plan to escape from abuse. Which statement by the client indicates a misunderstanding and the need for further teaching? 1 "I should obtain a restraining order against my abuser." 2 "I should call 911 immediately if I am in imminent danger." 3 "I should hide a bag with personal items for a quick escape." A woman taking an oral contraceptive pill (OCP) as her birth control method of choice should notify her health care provider immediately if she notes what? 1 Breast tenderness and swelling 2 4 What is a symptom of macrocalcifications? Correct1 White dashes on the breast 2 White patches on the nails 3 White patches on the tongue A client’s medical history shows that she has undergone a uterine artery embolization. Which question does the nurse ask to assess for complications following this procedure? "Do you get regular periods?" 2 "Do you feel that you have excessive body hair growth?" 3 "Do you regularly experience abdominal pain after a meal?" 4 A 35-year-old client with one child does not respond to ovulation-inducing drugs. On assessing the client’s medical history, the nurse suspects early menopause. What could be the reason for the nurse’s suspicion? 1 The client has taken methyldopa. 2 3 The client had a major surgery. Correct4 The client had undergone chemotherapy. Cancer treatments like chemotherapy or radiotherapy may reduce or completely halt ovarian function. Methyldopa is used to reduce blood pressure to normal levels. Methyldopa may cause hyperprolactinemia as a side effect. However, it does not cause early menopause. Cranial injury and surgeries are physical stressors, which may result in increased prolactin levels. However, the conditions are unrelated to early menopause. Test-Taking Tip: Prepare for exams when and where you are most alert and able to concentrate. If you are most alert at night, study at night. If you are most alert at 2 am, study in the early morning hours. Study where you can focus your attention and avoid distractions. This may be in the library or in a quiet corner of your home. The key point is to keep on doing what is working for you. If you are distracted or falling asleep, you may want to change when and where you are studying. Your client has just returned from a uterine artery embolization (UAE Procedure). Prior to her discharge, it is very important to discuss symptoms that require a call to the health care provider. Which of the following would require contacting the physician? Select all that apply. Correct1 Fever of 39° C Correct2 Swelling or hematoma at the puncture site Correct3 Abnormal vaginal discharge 4 Urinary frequency 5 Which contraceptive method is contraindicated in a woman with a history of toxic shock syndrome? 1 Condom 2 Spermicide Cervical cap 4 Oral contraceptives A female client tells the nurse that her male partner prefers not to use condoms during intercourse. The client is worried that if she requests that he use a condom, her partner may be offended, and so she complies with his preference. What does the nurse advise the client? 1 2 3 "Carry condoms with you and demand that your partner use one if he wants to have sex." A female client is receiving treatment for gonorrhea. What does the nurse tell the client while providing care? Select all that apply. Recommend that the client be tested for human immunodeficiency virus (HIV) 2 Inform the client that the treatment has a poor success rate. Reinforce teaching of correct condom use during sexual activity. 4 Inform the client that the disease is not reportable. Which of the following, if found in both the male and female of a couple, could present an issue with regard to the couple’s fertility? 1 2 4 History of hypertension. Which statement defines the feminist theory of violence? 1 The feminist theory of violence explains the multigenerational transmission of violence. 2 The feminist theory of violence explains social belief and response to a particular behavior. The feminist theory of violence looks at victimization through a gender and power lens. 4 Which response by the nurse is most appropriate when a woman asks, "What contraceptive do you think I should use?" 1 "Your health care provider will know what is best for you." 2 "The male condom is probably the easiest for you to use." 3 "Because you are younger than 40, you should use oral contraceptives." "I can discuss the various methods so you can decide what is best for you. A pregnant client comes to the clinic 24 hours after being treated with penicillin for syphilis with a headache, myalgia, and arthralgia. The nurse recognizes that the client is having which reaction? 1 An anaphylactic reaction A penicillin allergic reaction 3 Correct4 What is another name for human sex trafficking? 1 Sex games 2 Licensed sexual act Correct3 Modern-day-slavery Prostitution The nurse is interviewing a female client who is a victim of intimate partner violence. What is the first step taken by the nurse after the interview? 1 Inform the legal authorities so they can take action. 2 Inform the client’s family about the abuse. Reassure the client that it is not her fault. 4 Ensure the client’s present and future safety. A woman is using the basal body temperature (BBT) method of contraception. She calls the clinic and tells the nurse, "My period is due in a few days, and my temperature has not gone up." The nurse’s most appropriate response is what? 1 "This probably means you’re pregnant." 2 "Don’t worry; it’s probably nothing." "Have you been sick this month?" Correct4 "You probably didn’t ovulate during this cycle. The nurse is caring for a victim of rape-trauma syndrome and finds that the client is in shocked disbelief. Which observation helped the nurse draw this conclusion? 1 The client answers the nurse’s questions in a matter-of-fact way. The client has difficulty concentrating and has poor recall of the events. 3 The client relives the scene and considers various possibilities. 4 The client has rapid changes in behavior, from continuous crying to being calm. Which of the following clinical presentations is consistent with the physical finding of carcinoma in situ (CIS)? 1 3 Endometriosis Correct4 Abnormal cells noted in the full thickness of the epithelium A client is scheduled for a skin punch biopsy of the breast. Which condition is the client likely to have? 1 Supernumerary nipples Reddish skin with rash 3 Greenish nipple discharge 4 Tenderness and pain in the breast If used consistently and correctly, which of the barrier methods of contraception has the lowest failure rate? Spermicides 2 Female condoms Correct3 Male condoms 4 Diaphragms Group B streptococci (GBS) are part of the normal vaginal flora in 20% to 30% of healthy pregnant women. GBS has been associated with poor pregnancy outcomes and is an important factor in neonatal morbidity and mortality. Which of the following would not be considered a risk factor for neonatal GBS infection? 1 Positive prenatal culture 2 Preterm birth less than 37 weeks 3 Maternal fever of 38° C or greater Premature rupture of membranes less than 18 hours A client diagnosed with a leiomyoma is prescribed a gonadotropin-releasing hormone (GnRH) agonist to decrease the size of the leiomyoma. What information regarding its long-term use should the nurse provide to the client before the medicine is administered? 1 Correct2 Explain the possibility of loss of bone mass and changes in lipid levels. 3 Explain the various methods of administering of the drug. A client with uterine fibroids is scheduled for uterine artery embolization (UAE). The nurse has explained the procedure to the client. Which statement by the client indicates effective understanding of the expected physical effects during injection of polyvinyl alcohol (PVA)? 1 "I may experience pelvic pain after receiving the PVA injection." 2 "I may have a high body temperature after receiving the PVA injection." "I may have abdominal cramps after receiving the PVA injection." 4 A couple at the fertility center ask the nurse, "What is the optimal time in the menstrual cycle for us to try to conceive?" What is the best response by the nurse? 1 In the luteal stage of the ovulation cycle 2 In the follicular stage of the ovulation cycle 3 3 to 4 days before and also after ovulation Correct4 12 to 24 hours before and after ovulation Sperm remain viable in the female reproductive tract for about 48 hours, and most of the sperm retain their fertilizing potential for about 24 hours. Hence, when intercourse takes place 12 hours before or 24 hours after ovulation, a sperm can successfully fertilize the ovum. The luteal stage occurs several days after ovulation. Having intercourse at this stage will not result in pregnancy, because there is no ovum available to fertilize. The time between the follicular stage and ovulation is more than 48 hours. If intercourse occurs in the follicular stage, the sperm may be degenerated by the time the ovum is available. Because the viability of sperm is 48 hours, having intercourse 3 to 4 days before or after ovulation cannot result in fertilization. Test-Taking Tip: Eat breakfast or lunch before an exam. Avoid greasy, heavy foods and overeating. This will help keep you calm and give you energy. What is the most common causative agent of ophthalmia neonatorum? 2 Human papillomavirus Correct3 Chlamydia trachomatis 4 Which statement by the student nurse about the advantages of fertility awareness-based methods (FABs) of contraception indicates effective learning? 1 "FABs protect against sexually transmitted infections (STIs)." "There is no difficulty with adherence to this contraceptive method." 3 "There is increased effectiveness in women with irregular cycles." Correct4 Which statement by the student nurse about spermicides indicates effective learning? Correct2 "Spermicides are reapplied for each additional act of intercourse." 3 "Spermicides are added to male condoms to prevent pregnancy." 4 1 "The client should be instructed to masturbate to obtain the semen sample." Correct2 "A cold environment or low temperature is suitable for storing the semen sample." "The test must be performed within 2 hours of collecting the semen sample." 4 A pregnant client is prescribed methotrexate (Rheumatrex) therapy. What is the purpose of this prescription? To treat vaginal infection 2 To decrease spotting Correct3 To facilitate medical abortion 4 A client has been sexually assaulted and presents to the Emergency Department for a sexual assault examination. Which action would be a priority for the nurse assigned to take care of the client? 1 Provide the client with a washcloth and allow her to provide needed hygiene measures. 2 Correct3 Maintain a chain of custody for collection of evidence. Incorrect4 Provide the client with contact information regarding psychologic resources that may help her with dealing with this situation. The nurse should place priority on maintaining the chain of custody for the collection ofevidence. Because the sexual assault examination is used as part of the evidentiary process when a suspected crime has been committed, the nurse should be mindful not to invalidate physical findings that might affect the course of legal action. Although it is important to obtain information relevant to insurance coverage, this is not the priority action at this time. Although psychologic referrals may be necessary, the priority action is to preserve the chain of evidence and assess physical and emotional well-being of the client. A client diagnosed with endometriosis expresses the desire to conceive. Which reproductive therapy would help the client to conceive? 1 Gestational carrier 2 Assisted hatching technique 3 Intrauterine insemination technique A client who is a chronic smoker tells the nurse that her breasts feel lumpy and the upper part of the breast becomes heavy and tender before her menstrual periods start. These symptoms fade away 7 days following the end of the menses. Upon examination, the nurse finds that the client’s breasts are extremely nodular. What does the nurse suggest to the clientto help relieve these symptoms? Select all that apply. Correct1 Correct3 5 The viral sexually transmitted infection (STI) that affects most people in the United States today is what? Correct2 Human papillomavirus (HPV) 3 Human immunodeficiency virus (HIV) 4 A client has undergone a vulvectomy. What instruction should the nurse provide to avoid pelvic congestion? Instruct the client to use a vaginal dilator. 2 Instruct the client to rinse the area after voiding. 3 Instruct the client to avoid crossing her legs. Correct4 Instruct the client to elevate her legs periodically. What are the teaching needs for the client undergoing adjuvant therapies for breast cancer and her family? Select all that apply. 1 The woman should be taught the importance of exercise periods when fatigue occurs. Correct2 Instruct the client regarding side effects and avoidance of possible complications of adjuvant treatment. Correct3 Soft, nonirritating clothing should be worn over the site, and the skin protected from exposure to sun and heat. Incorrect4 Skin markings that direct the placement of the radiation beam can be removed while bathing or showering. Correct5 Avoid using lotions, powders, or ointments on the skin at the radiation site unless instructed by the radiologist. Correct6 Instruct the client that common side effects of chemotherapy include alopecia, fatigue, nausea, vomiting, mouth sores, and immunosuppression. Teaching needs for the client undergoing adjuvant therapies for breast cancer and her family include: instructions regarding side effects and avoidance of possible complications of adjuvant treatment; soft, nonirritating clothing should be worn over the site, and the skin protected from exposure to sun and heat; avoid using lotions, powders, or ointments on the skin at the radiation site unless instructed by the radiologist; and instruction that common side effects of chemotherapy include alopecia, fatigue, nausea, vomiting, mouth sores, and immunosuppression. The woman should be taught the importance of rest, not exercise periods, when fatigue occurs. Skin markings that direct the placement of the radiation beam should not be removed while bathing or showering. Which instructions are important for a client who is being treated for genital warts? Select all that apply. Correct1 "Wear cotton underwear." Correct2 "Reduce stressful activities." Incorrect3 "Stay on bed rest until you recover." 4 Correct5 In the 1970s, rape-trauma syndrome (RTS) was identified as a cluster of characteristics, symptoms, and related behaviors seen in the weeks and months after a rape. Which pattern of responses would apply to a victim of rape? Select all that apply. Correct1 Acute phase: disorganization Incorrect2 Acute phase: rearranging Correct3 Outward adjustment phase Correct4 Long-term process: reorganization phase 5 Which client’s fibroadenoma is likely to increase in size? Correct1 A client who is pregnant 2 A client who has reached menopause A client who is taking estrogen therapy 4 A client who maintains a fatty diet on a regular basis A woman has preinvasive cancer of the cervix. In discussing available treatments, the nurse includes what? 2 Colposcopy 3 Hysterectomy 4 The nurse is teaching a client about the cervical mucus ovulation detection method to prevent pregnancy. What does the nurse tell the client? 1 "Antihistamines have no effect on the cervical mucus." 2 "There is no need to use contraceptive when the mucus is wet, clear, and slippery." "This method works accurately even if there is vaginal infection." Correct4 The nurse is caring for a client with endometrial cancer who is undergoing chemotherapy. The nurse creates a diet plan for the client that includes nutmeg and potassium-rich foods, and restricts milk intake to less than 500 ml. What is the goal of this diet plan? 1 To prevent nausea 2 Correct3 To prevent diarrhea Incorrect4 To prevent stomatitis Diarrhea is a common side effect of chemotherapy, so the nurse can create a diet plan for the client to help reduce this complication. The nurse adds nutmeg powder to reduce gastric irritation and potassium-rich foods to prevent fluid electrolyte imbalance. The nurse ensures that the client does not consume more than 500 ml of milk per day in order to prevent gastric irritation. The nurse would provide clear liquids, toast, and bland foods in order to prevent nausea and vomiting. The nurse would suggest that the client try new foods and exercise before meals to stimulate appetite and reduce anorexia. The nurse would provide bland foods and soft meals to alleviate the symptoms of stomatitis. Which interventions does the nurse implement while providing care for a client who is being treated for pelvic inflammatory disease (PID)? Select all that apply. Correct1 Refers the client to support groups Incorrect2 Places the client in Fowler position Correct3 Advises the client to get plenty of rest 4 Informs the client that there are no potential risks Correct5 Counsels the client to avoid sexual activity PID may affect a client’s self-concept and body image, and therefore the nurse needs to refer the client to support groups to discuss her feelings. The nurse promotes adequate rest and hydration to facilitate recovery. The nurse counsels the client to avoid sexual activity until the treatment is complete to prevent further risks. Placing the client in a semi-Fowler position helps promote drainage of the pelvic cavity through gravity, and may prevent the development of abscesses in the upper abdomen. The client can potentially lose her reproductive capabilities. Test-Taking Tip: Be aware that information from previously asked questions may help you respond to other examination questions. The nurse assessing a client with ductal carcinoma in situ (DCIS) and finds a 4-cm tumor in the mammography report. What further diagnostic procedure would the client need for confirmation of the diagnosis? 1 Skin punch biopsy 2 Ultrasound examination Sentinel lymph node biopsy 4 Magnetic resonance imaging (MRI) During a health history interview, a woman tells the nurse that her husband physically abuses her. The nurse's first response should be to do what? Advise the woman of mandatory state reporting laws pertaining to abuse and confidentiality Correct2 Reassure the woman that the abuse is not her fault 3 Give the woman referrals to local agencies and shelters where she can obtain help 4 A male client has been diagnosed with subfertility. Which instructions by the nurse are the most appropriate? Select all that apply. "Use lubricant during intercourse." 3 "Take baths in hot water regularly." Correct4 "Avoid keeping your cell phone on your belt." Which clients are most vulnerable to intimate partner violence (IPV)? Select all that apply. 2 4 A client who is stubborn and sticks to her decisions Correct5 A client who believes that the man is the head of the family Certain characteristics make a woman more vulnerable to IPV. An unemployed woman may be financially dependent on her partner and therefore less likely to defend herself against IPV. A woman who lacks family support is more prone to become a victim of IPV. A woman who believes that man is the head of the family may be more tolerant of abuse. Therefore, an unemployed client, a client who does not have any family members, and a client who believes that the man is the head of the family would most benefit from the nurse’s lecture. A woman who earns more than her husband is financially strong and is therefore less likely to be a victim of IPV. A woman who is more assertive and stubborn is less likely to be a victim of IPV. The nurse is assessing a couple for infertility problems. After reviewing the client’s history and laboratory results, the nurse finds that the client is being treated with clomiphene (Milophene). However, there has not been an increase in the sperm count. What else could be added to the prescription that would help the client to increase the sperm count? 1 3 Depot medroxyprogesterone acetate (DMPA) Correct4 Which medication would be helpful for a client with human papillomavirus (HPV) infection? Podofilox (Condylox) 0.5% solution 2 3 4 A client wants to have an abortion during the 18th week of pregnancy. What abortion technique should the nurse suggest to the patient? 2 A surgical (aspiration) abortion 3 Administration of methotrexate (Trexal) 4 When using the basal body temperature method of family planning, the woman should know that: 1 She will remain fertile for five days after ovulation. 2 She should take her temperature each night before going to bed. Her temperature will increase about 0.4° to 0.8° F after ovulation. 4 What does the nurse tell a patient who is using the ParaGard Copper T 380A? Correct1 "Report immediately if rashes occur." 2 "Drink warm water if you experience cramping." "Irregular spotting is a serious side effect and needs prompt treatment." 4 What is the most effective way to reduce the adverse consequences of STIs for women and for society? Correct1 Preventing infection (primary prevention) 2 Preventing risky drug-related and sexual behaviors 3 Preventing sexually transmitted infections during pregnancy Semen analysis is a common diagnostic procedure related to infertility. In instructing a male client regarding this test, the nurse would tell him to do what? 1 Ejaculate into a sterile container Obtain the specimen after a period of abstinence from ejaculation of 2 to 5 days 3 Transport specimen with container packed in ice 4 A client who was sexually assaulted is discharged. Which nursing intervention performed by the student nurse at discharge is inappropriate and needs correction? 1 Referring the client to a rape-awareness group Asking the client’s friends or family to check up on the client 3 Suggesting that the client take a self-defense class 4 Advising the client to speak to a primary health care provider as needed What does the nurse teach a client about the use of FemCap? 2 "You need to use a condom for contraceptive effectiveness." 3 "Apply spermicides for additional acts of intercourse." 4 A 25-year-old client has been unable to conceive after being diagnosed with chlamydia. What infertility treatment would help the client conceive? In vitro fertilization therapy (IVF) 2 Menotropin (Pergonal) therapy 3 Zygote intrafallopian transfer (ZIFT) 4 Gamete intrafallopian transfer (GIFT) Which finding in a mammogram report of a female client with lumps in the breasts indicates that the client is not at risk of developing breast cancer? The patient has fibroadenoma. 2 The patient has atypical ductal hyperplasia. 3 Correct4 A client comes to the clinic with complaints of purulent anal discharge, rectal pain, and blood in her stool. After taking a sexual history of the client, the nurse would determine that the client has which sexually transmitted infection? 1 Syphilis 2 Chlamydia Gonorrhea 4 A client complains about a foul-smelling vaginal discharge despite careful hygiene habits. On assessment the nurse notices the presence of fecal matter in the vagina. What suggestion should the nurse provide to prevent oozing of fecal matter in the vagina? Use an enema before leaving the house. 2 Avoid washing with soap, which may irritate the vagina. 3 Use a commercial deodorizing douche before leaving the house. 4 A nursing instructor is teaching student nurses about discharge planning and teaching for premenopausal women after hysterectomy. Which statement by the student nurses indicates a need for additional teaching? Correct1 "Teach the client the pros and cons of hormonal replacement." 2 "Instruct the client to avoid exercise for 6 weeks." 3 "Educate the client about the need for follow-up care." "Encourage the use of lubricants during vaginal intercourse." A client has been prescribed adjuvant tamoxifen therapy. What common side effect might she experience? Nausea, hot flashes, and vaginal bleeding 2 Vomiting, weight loss, and hair loss 3 Nausea, vomiting, and diarrhea 4 Which mastectomy is preferred when immediate reconstruction of the breast is to be done? Total simple mastectomy Correct2 Skin-sparing mastectomy 3 Prophylactic mastectomy 4 A client is diagnosed with adhesions in the uterine lining. Which assisted reproductive therapy may be beneficial to the client? 1 Correct2 Use of a surrogate mother 3 Gamete intrafallopian transfer A client is diagnosed with submucosal leiomyomas. Which statement should the nurse use to explain this to the client? 1 Tumors have developed within the wall of the uterus. 2 Tumors have protruded from the outer uterine surface. 3 Tumors have developed beneath the peritoneal surface of the uterus. Chlamydia increases the risk of which infection in clients? 1 Pneumonia 2 Condylomatalata infection 3 Ophthalmia neonatorum infection The nurse's best measure when evaluating the care of a woman in an abusive situation is based on what? 1 3 Couple's follow-through on a referral for counseling 4 The student nurse is helping a nurse care for a sexually assaulted client. Which nursing action by the student indicates the need for further teaching? 1 Provides printed instructions for the medication 2 Provides comfort by reassuring the client that fear is normal Correct3 Instructs the client to return to the hospital the next day to be tested for sexually transmitted infections (STIs) Incorrect4 Ensures that money and transportation is provided to wherever the client is staying During discharge the client should be instructed to visit any convenient facility for STD testing, but this would be done within 1 to 2 weeks rather than the next day, because the next day would be too soon to detect an STD. The nurse should provide printed instructions for medication at the time of discharge, because there is chance that the client may not remember the instructions. The nurse should ensure that the client is provided transportation to the client’s residence. Patients who were sexually assaulted may be angry, fearful, or guilty. The nurse can reassure clients that they are not alone and these feelings are normal. What does the nurse tell a client who takes combined oral contraceptives (COCs)? 2 "You may have increased menstrual blood flow 3 "Iron deficiency anemia is a side effect of the pill." 4 The nurse instructs a student nurse to administer depot medroxyprogesterone acetate (DMPA) to a client. What precaution should be taken by the student nurse to ensure safe administration of the drug? Do not: Correct1 massage the site after the administration. administer the injection at the deltoid muscle. 3 administer the injection subcutaneously. 4 aspirate a blood return prior to the injection. A client is being treated with oral metronidazole (Flagyl) for bacterial vaginosis. After a few days, the client experiences abdominal distress, nausea, vomiting, and headache. What can the nurse conclude from these problems in the client? 1 The client had engaged in sexual activity. 2 The client has developed an allergic reaction. Correct3 The client consumed alcohol with the drug. The client is experiencing side effects of the drug. The nurse is providing discharge teaching to a client who has undergone electrocauterization for the removal of uterine fibroids. Which statement by the client indicates effective teaching? 1 "I can try to conceive after 1 year." 2 "I may have vaginal discharge for 5 days." Correct3 After checking the laboratory report of a client, the nurse reports to the primary health care provider findings that the client has developed insulin resistance and anovulation. What should the nurse expect to be prescribed for the client? 2 Bromocriptine (Parlodel) and glyburide (Diabeta) 3 Progesterone (Prometrium) and acarbose (Precose) Correct4 Clomiphene (Clomid) and metformin (Glucophage) A client diagnosed with breast cancer is prescribed trastuzumab (Herceptin). What does the nurse inform the client to ensure safe drug administration? 1 To get serum potassium levels assessed frequently 2 To call the primary health care provider before taking a pain reliever 3 To schedule a regular eye examination during the course of therapy To be aware of the signs and symptoms of gastric ulceration A non–English speaking immigrant woman shows signs of abuse. Which program would most help the client leave the abusive relationship? 1 Students against violence everywhere (SAVE) 2 Informational activities for adolescents Correct3 Language education and skills-development classes Promoting legislation and policies against violent acts Which drugs are useful in the treatment of vasomotor symptoms? Select all that apply. Paroxetine (Paxil) 2 Letrozole (Femara) Correct3 Gabapentin (Gralise) Tamoxifen (Nolvadex) 5 he nurse advises a postpartum client with hepatitis B virus (HBV) to avoid sharing saliva through kissing or sharing dishes with her partner. However, breastfeeding her infant is encouraged if the client so desires. What could prevent the transmission of the virus to the infant? 1 3 The virus is not transmitted by breastfeeding. 4 The client was vaccinated during her pregnancy. A 35-year-old client is taking combined oral contraceptives (COCs). What should the nurse instruct this client? 1 "COCs can cause early menopause." Correct2 "Avoid herbal supplements." "There is a risk for iron deficiency anemia with COCs." 4 "There is a risk for increased menstrual blood loss. A client who is breastfeeding has been diagnosed with gonorrhea. Which treatment plan should be instituted? 1 Amoxicillin 500 mg three times a day for 1 week. Benzathine Penicillin G 2.4 million units one injection Correct3 4 The nurse educator is teaching a group of practicing nurses about the stages of endometrial carcinoma. Which description does the nurse include while describing stage II endometrial carcinoma? 1 Tumor limited to the corpus uteri 2 Invasion of bladder and/or bowel mucosa Tumor invading the serosa of the corpus uteri and/or adnexa Correct4 Which vaccinations can be used as preventive measures for sexually transmitted infections (STIs)? Select all that apply. 2 Pneumococcal conjugate 3 Meningococcal conjugate Human papillomavirus (HPV) 5 Pneumococcal polysaccharide A client diagnosed with polycystic ovary syndrome (PCOS) is prescribed spironolactone (Aldactone). What is the reason for prescribing this medication? 1 To induce ovulation in the client To prevent fluid retention in the client 3 To increase the production of estrogen Correct4 To suppress the production of androgens The nurse is assessing a 36-year-old client who is planning for a second pregnancy. After reviewing the client’s medical record, the nurse provides information about the egg donation process to the client. What would be the reason for providing this information to the client? 1 The client suffers from reduced fecundity. The client has age-related infertility. 3 The client has congenital disorders. 4 The client has premature ovarian failure. A 37-year-old client says, "I haven’t been able to conceive after trying for 3 months." Upon evaluating the client’s medical history, the nurse finds that the client has a history of endometriosis. What does the nurse tell the client? "Continue trying for another 3 months and come back for an evaluation." 2 "Continue trying for another 6 months and come back for an evaluation." 3 "Continue trying for another 9 months and come back for an evaluation." 4 "Continue trying for another year and come back for an evaluation. After having a discussion with a client, the nurse finds that the client has regular menstrual cycles every 28 days. What instructions should the nurse give to the client to prevent conception? 2 The couple should abstain from sexual intercourse from days 6 through 19. 3 It is safe to have unprotected sexual intercourse from days 11 through 17. 4 It is safe to have unprotected sexual intercourse from days 12 through 16. A sexual assault victim contacts the health care facility. The nurse responds in a helpful manner and provides emotional comfort. Further, the nurse helps the client contact the relevant support groups. What is the intended result of this type of intervention? 1 The client has a worsened mental condition. The client will adapt to normal life more slowly. 3 The client becomes reliant on the nurse for emotional support. Correct4 The client has a reduced risk of posttraumatic stress. A client is being treated for a defect in the luteal phase. The nurse instructs the patient to start taking a drug on the fifth day of menstruation and continue for the next 5 days. Which drug is prescribed for the patient? 1 Progesterone (Camila) Clomiphene citrate (Clomid) 3 Nafarelin acetate (Synarel) 4 Metformin (Glucophage On interacting with a client, the nurse finds that the client uses lubricants that contain nonoxynol-9 (N-9) at least twice a day. The nurse instructs the client to not use N-9. What is the reason for giving such advice to the client? 1 Frequent use can cause a significant decrease in the client’s libido. 2 Frequent use increases the client’s progesterone and estrogen levels. 3 Frequent use reduces bone mineral density and causes osteoporosis. A pregnant client has ovarian cysts and reports a feeling of pelvic fullness. Which type of functional ovarian cysts could this client have, given the description of symptoms? 1 3 Corpus luteum cysts 4 Polycystic ovary syndrome (PCOS) The nurse is caring for a client who is taking ganirelix acetate (Antagon) to treat infertility. Which adverse effects associated with the use of ganirelix acetate may be found in this client? Select all that apply. Headaches 2 Depression Abdominal pain Correct5 What is the significance of the clomiphene citrate challenge test (CCCT)? 1 To assess if the fallopian tubes are open and patent 2 3 To assess the amount of progesterone production Correct4 To assess follicle-stimulating hormone (FSH) levels The clomiphene citrate challenge test (CCCT) is used to assess follicle-stimulating hormone (FSH) levels. In this test, 100 mg of clomiphene (Clomid) are administered to the patient from day 3 to day 10 of the menstrual cycle. Follicle-stimulating hormone (FSH) levels are assessed on the 3rd day and the 10th day after clomiphene (Clomid) is administered. FSH levels greater than 20 indicate that the pregnancy will not occur with the woman’s own eggs. FSH levels less than 15 suggest an adequate ovarian reserve in the patient. Patency in the fallopian tubes is assessed by hysterosalpingogram, hysterosalpingo-contrast sonography, and chlamydia immunoglobulin G antibodies. Uterine abnormalities are assessed by hysterosalpingogram and hysterosalpingo-contrast sonography. Progesterone production is assessed by the serum progesterone test. The nurse suspects that a client with frequent complaints of diarrhea, weight loss, and rash has human immunodeficiency virus (HIV) infection. The client is afraid of having blood drawn for screening purposes. What does the nurse tell the client? 1 "You can take some time to prepare for this test." Correct2 "You can provide a saliva sample for testing." 3 "A blood test is the only means of detecting the virus." 1 A client with iron deficiency anemia Correct2 A client at risk for human immunodeficiency virus (HIV) 3 A client who uses a contraceptive diaphragm Incorrect4 A client whose partner uses a condom [Show More]

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