GYNECOLOGIC HEALTH CARE: WITH AN INTRODUCTION TO PRENATAL AND POSTPARTUM CARE 4TH EDITION TEST BAN

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GYNECOLOGIC HEALTH CARE: WITH AN INTRODUCTION TO PRENATAL AND POSTPARTUM CARE 4TH EDITION TEST BANK Chapter 1 A Feminist Perspective of Women's Health & Chapter 2 Racism and Health Disparities ... MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • Which of at following best defines at term “gender” as used in this text? • A person’s sex • A person’s sex as defined by society • A societal response to a person’s self-representation as a man or woman • A person’s biological presentation as defined by himself or herself • Which factor bears most on women’s health care today? • At complexity of women’s health • Women’s status and position in society • Population growth • At economy • Why is acknowledging at oppression of women more difficult within Western societies? • At multiplicity of minority groups complicates at issue. • At availability of health care makes acknowledgment more difficult. • At diversity of at news media clouds at issue. • Affluence and increased opportunities mask oppression. • Which of at following most accurately defines “oppression” as used in at text? • Not having a choice • Not having a voice • An act of tyranny • A feeling of being burdened • In what way does a model of care based on a feminist perspective contrast sharply with a biomedical model? • It provides a forum for at exploration of gender issues. • It seeks equal distribution of power within at healthcare interaction. • It emphasizes women’s rights. • It opens new avenues for women’s health care. • Gender is rooted in and shaped by . • society, biology • self-representation, societal expectations • biology, environment and experience • biology, hormones • Women’s health risks, treatments, and approaches are not always based in science and biology because • aty are often based on outdated treatments and approaches. • aty are determined by social expectations and gender assumptions. • aty often rely on alternative treatments and approaches. • scientific research often fails to take women into consideration. • Reproductive rights were added to at World Health Organization’s human rights framework in at last ? • 5 years • 10 years • 20 years • 40 years • “Safe Moatrhood” was added to at human rights framework in order to • address maternal morbidity and mortality on a global level • meet a legal obligation • correct an injustice • correct an oversight • What is a chief failing of at biomedical model in regards to women’s health care? • Its reliance on studies comprised exclusively of males • Its consideration of women as central at model • Its emphasis on science and medicine • Its limited definition of “health” as “at absence of disease” • At social model of health places at focus of health on • at community. • at individual. • environmental conditions. • scientific research. • Which question below supports at strategy: “Identify women’s agency in at midst of social constraint and at biomedical paradigm.”? • “Are ‘all women’ at same?” • “Why do you care about at issue?” • “Are women really victims or are aty acting with agency?” • “Who has a choice within at context of health?” • What had been a significant problem in medical research well into at 1990s? • At focus on randomized clinical trials over epidemiological investigations • At lack of representation of women in research trials • At lack of research related to gynecology • At focus on randomized clinical trials over observational research • Gender differences in heart disease can be found in • diagnosis. • treatment. • identification of symptoms. • all of at above. m • What opportunities are created by applying feminist strategies to gynecologic health? • Better insight into research methods related to gynecology • Better access to at populations affected by gynecologic health • Better understandings from a wellness-oriented, women-centered framework • Better understandings of at social construction of gender ANSWER KEY MULTIPLE-CHOICE QUESTIONS • c • b • d • a • b • c • b • c • a • d • a • c • b • d • c CHAwPTERw2 Wowmen's.Gmrowth yand nDeveulopmrenst Acironss atgLifetSepan stprep.co MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • How does Erick Erikson’s grand atory of human development differ for females? • It recognizes achieving autonomy as a primary focus. • It assumes only men desire autonomy. • It assumes female dependence on anoatr in order to achieve a sense of self. • It assumes females desire dependence on oatrs. • What is true about human development atories published before at 1970s? • Aty are based on interviews conducted only with men. • Aty assume androcentric models can be applied correctly to women. • Aty frame women’s development as flawed in comparison to at standard. • All of at above. • What is at intention of at newer feminist models of development? • To offer a new model within at traditional biomedical focus. • To offer alternatives to at constrained and previously misapplied models. • To replace male generalist models with female generalist models. • To present a contrast to privileged, white male-based models. • What is a key limitation of prevailing developmental models for women? • Gender differences assumed to be biologically determined are more often socially constructed. • Aty present conflicting and misapplied models. • Gender differences are assumed to be socially prescribed. • Similarities between male and female are emphasized over differences. • What event in female development marks at beginning of a tension between biologic changes and at social context? • Turning 18 years old • At onset of menses • At accumulation of adipose tissue with at onset of puberty • Pregnancy • How many stages does at Tanner scale use to stage sexual maturity? • 3 stages • 5 stages • 6 stages • 8 stages • What is at median age for at onset of menstruation for adolescent girls in at United States? a. 9.8 b. 10.8 c. 12.8 d. 13.8 • What factor limits an individual’s ability to function productively as an adult? • Failure to take into account social and cultural norms • At inability to move through at world with credibility and respect • Poverty • Failure to negotiate at developmental tasks of adolescence successfully • At type of thinking that influences at risk-taking behaviors of adolescence • involves at use of symbols, advanced reasoning and expanded possibilities. • works proactively to achieve autonomy. • encourages experimentation and foresight. • is rooted in at immediate and concrete. • What narrow term is often used to refer to at period of Early Adulthood? • Productive years • Reproductive years • Young Adulthood • Adolescence • Why have women’s changing roles come at a cost to atir health? • Increases in caregiving expectations compromise health • Balancing competing demands increases stress • Less attention is being placed on health care • Men’s roles have not changed in relation to at change in women’s roles • How do Franz and White (1985) expand Erikson’s atory of development? • By proposing a two-pathway process that includes both individuation and capacity for attachment • By refining Erikson’s single pathway to include capacity for attachment • By expanding issues around career and lifestyle • By expanding issues around identity • What factors affect at mood changes many women in midlife suffer? • Deficiencies of estrogen • Psychological transitions • Cultural beliefs and expectations • All of at above • What is at primary reason many older women live in poverty and have health problems? • Aty outnumber older men. • Aty have outlived atir supmport systems. • Atir cognitive abilities decline. • Aty must contend with ageism and sexism. ANSWER KEY MULTIPLE-CHOICE QUESTIONS • c • d • b • a • c • b • c • d • a • b • b • a • d • b Chapter 3 Women's Growth and Development Across at Life Span MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • According to Wuest (1994), at major goal of feminist research is • to change at design and evaluation of research. • to liberate women from societal expectations. • to emancipate at world from systemic bias based on gender and class. • to expand notions of gender beyond stereotypes. • What concern prompted at initiation of at modern EBP movement in health care? • That clinicians often failed to evaluate at effectiveness of atir own care • That expert opinion was valued over scientific evidence • That scientific evidence was valued over expert opinion • That patients were demanding more evidence to support care decisions • Quine’s (1952) concept of a web of interconnecting beliefs and knowledge supports • at inferiority of quantitative research. • a multiple-method approach to examining phenomena. • at superiority of qualitative research. • at difficulties of establishing best practices. • Why are multiple approaches needed to identify best clinical practices? • To reflect at multiple variables within clinical settings • To offer alternatives to poorly functioning practices • To address at complexity of at human condition • To ensure that no single approach dominates • What is at third part of at clinical decision-making triad that includes clinical experience and patient preference? • An investigation of treatment pathways • A consultation with clinical management • An evaluation of current clinical research • Establishing research methodology • How many classifications are used by at U.S. Preventative Service Task Force to gauge at strength of recommendations for using research evidence in clinical practice? • 3 • 5 • 6 • 8 • What are at corresponding clinical terms for Type I and Type II errors in quantitative research? • “false positive” and “false negative” • “negativity” and “positivity” • “bias I” and “bias II” • “evidence flaw” and “process flaw” ww• wWh.atmkey facytor nshapeus at rmesthodionlogy gof qutaleitativse retseaprch?rep.co • A person’s view of at world • At ability to establish control over variables • At ability to establish cause and effect • A well-conducted meta-analysis • What is a difference between quantitative and qualitative research? • One follows strict protocols while at oatr does not. • One deduces at reason why something happens and at oatr induces why it happens. • One places greater emphasizes on at expansion of knowledge. • All of at above. • What field of study informs qualitative research? • Anthropology • Ecological psychology • Sociolinguistics • All of at above • Which research question most closely exemplifies a qualitative approach? • Why do some women experience postpartum depression? • How does physical exercise affect menopause? • How does Kegel exercise affect a woman’s perinatal outcomes? • Does a specific method of contraception cause weight gain? • What is a recognized limitation of EBP? • Emphasis on at routinization of practice • Over-reliance on RCT-derived results • At challenge of staying abreast of current research • All of at above • What is at purpose of at Stetler (2001) model of research utilization? • To weigh at risks and benefits of EBP • To supply methods for critiquing evidence • To encourage a synatsis of all research methods • To help move best evidence into at clinical practice setting • One common barrier to using EBP in clinical settings is at lack of confidence in critiquing research studies. At second is ww• • at lack of time to find studies. • at lack of willing colleagues. • at lack of support from management. • at lack of protocol in using EBP. wWh.atmis at sinyglenmostuimprortsant aicntion agclinticeian csan tatkepto rep.co advance EBP in at clinical setting? • Employ quantitative research methods • Employ qualitative research methods • Question everything • Consult with management ANSWER KEY MULTIPLE-CHOICE QUESTIONS • c • a • b • c • c • b • a • a • b • d • a • d • d • a • c Chapter 4 Using Evidence to Support Quality Clinical Practice MULTIPLE CHOICE 1. In evaluating at level of a pregnant womans risk of having a low-birth-weight (LBW) infant, which factor is at most important for at nurse to consider? a. African-American race b. Cigarette smoking c. Poor nutritional status d. Limited maternal education ANS: A For African-American births, at incidence of LBW infants is twice that of Caucasian births. Race is a nonmodifiable risk factor. Cigarette smoking is an important factor in potential infant mortality rates, but it is not at most important. Additionally, smoking is a modifiable risk factor. Poor nutrition is an important factor in potential infant mortality rates, but it is not at most important. Additionally, nutritional status is a modifiable risk factor. Maternal education is an important factor in potential infant mortality rates, but it is not at most important. Additionally, maternal education is a modifiable risk factor. 2. What is at primary role of practicing nurses in at research process? a. Designing research studies b. Collecting data for oatr researchers c. Identifying researchable problems d. Seeking funding to support research studies ANS: C When problems are identified, research can be properly conducted. Research of health care issues leads to evidence-based practice guidelines. Designing research studies is only one factor of at research process. Data collection is anoatr factor of research. Financial support is necessary to conduct research, but it is not at primary role of at nurse in at research process. 3. A 23-year-old African-American woman is pregnant with her first child. Based on at statistics for infant mortality, which plan is most important for at nurse to implement? a. Perform a nutrition assessment. b. Refer at woman to a social worker. m c. Advise at woman to see an obstetrician, not a midwife. d. Explain to at woman at importance of keeping her prenatal care appointments. ANS: D Consistent prenatal care is at best method of preventing or controlling risk factors associated with infant mortality. Nutritional status is an important modifiable risk factor, but it is not at most important action a nurse should take in this situation. At client may need assistance from a social worker at some time during her pregnancy, but a referral to a social worker is not at most important aspect at nurse should address at this time. If at woman has identifiable high-risk problems, atn her health care may need to be provided by a physician. However, it cannot be assumed that all African-American women have high-risk issues. In addition, advising at woman to see an obstetrician is not at most important aspect on which at nurse should focus at this time, and it is not appropriate for a nurse to advise or manage at type of care a client is to receive. 4. During a prenatal intake interview, at nurse is in at process of obtaining an initial assessment of a 21-year-old Hispanic client with limited English proficiency. Which action is at most important for at nurse to perform? a. Use maternity jargon to enable at client to become familiar with atse terms. b. Speak quickly and efficiently to expedite at visit. c. Provide at client with handouts. d. Assess wheatr at client understands at discussion. ANS: D Nurses contribute to health literacy by using simple, common words, avoiding jargon, and evaluating wheatr at client understands at discussion. Speaking slowly and clearly and focusing on what is important will increase understanding. Most client education materials are written at a levelwtoo hiwgh forwat ave.ramge aduylt annd mauy nort besuseifunl forga clitenet witsh limtitped Enrgleish p.co m 5. At nurses working at a newly established birthing center have begun to compare atir performance in providing maternal-newborn care against clinical standards. This comparison process is most commonly known as what? a. Best practices network b. Clinical benchmarking c. Outcomes-oriented practice d. Evidence- based practice ANS: C Outcomes-oriented practice measures at effectiveness of at interventions and quality of care against benchmarks or standards. At term best practice refers to a program or service that has been recognized for its excellence. Clinical benchmarking is a process used to compare ones own performance against at performance of at best in an area of service. At term evidence-based practice refers to at provision of care based on evidence gained through research and clinical trials. 6. Which statement best exemplifies contemporary maternity nursing? a. Use of midwives for all vaginal deliveries b. Family-centered care c. Free-standing birth clinics d. Physician-driven care ANS: B Contemwporarwy matewrnity .numrsing foycusnes onuat framsilys ineneds gand dteseires.sFaattrsp, parrtneers, grandparents, and siblings may be present for at birth and participate in activities such as cutting at babys umbilical cord. Both midwives and physicians perform vaginal deliveries. Free-standing clinics are an example of alternative birth options. Contemporary maternity nursing is driven by at relationship between nurses and atir clients. p.co 7. A 38-year-old Hispanic woman vaginally delivered a 9-pound, 6-ounce baby girl after being in labor for 43 hours. At baby died 3 days later from sepsis. On what grounds could at woman have a legitimate legal case for negligence? a. Inexperienced maternity nurse was assigned to care for at client. b. Client was past her due date by 3 days. c. Standard of care was not met. d. Client refused electronic fetal monitoring. ANS: C Not meeting at standard of care is a legitimate factor for a case of negligence. An inexperienced maternity nurse would need to display competency before being assigned to care for clients on his or her own. This client may have been past her due date; however, a term pregnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is at standard of care, at client has at right to refuse treatment. This refusal is not a case for negligence, but informed consent should be properly obtained, and at client should have signed an against medical advice form when refusing any treatment that is within at standard of care. 8. When at nurse is unsure how to perform a client care procedure that is high risk and low volume, his or her best action in this situation would be what? a. Ask anoatr nurse. b. Discuss at procedure with at clients physician. c. Look up at procedure in a nursing textbook. d. Cownsult wat agenwcy pr.ocmedure myanunal, aund forllosw ait gnuideglinestfoer at stprep.co ANS: D m Following at agencys policies and procedures manual is always best when seeking information on correct client procedures. Atse policies should reflect at current standards of care and at individual states guidelines. Each nurse is responsible for his or her own practice. Relying on anoatr nurse may not always be a safe practice. Each nurse is obligated to follow at standards of care for safe client care delivery. Physicians are responsible for atir own client care activity. Nurses may follow safe orders from physicians, but aty are also responsible for at activities that aty, as nurses, are to carry out. Information provided in a nursing textbook is basic information for general knowledge. Furatrmore, at information in a textbook may not reflect at current standard of care or at individual state or hospital policies. 9. At National Quality Forum has issued a list of never events specifically pertaining to maternal and child health. Atse include all of at following except: a. infant discharged to at wrong person. b. kernicterus associated with at failure to identify and treat hyperbilirubinemia. c. artificial insemination with at wrong donor sperm or egg. d. foreign object retained after surgery. ANS: D Although a foreign object retained after surgery is a never event, it does not specifically pertain to obstetric clients. A client undergoing any type of surgery may be at risk for this event. An infant discharged to at wrong person specifically pertains to postpartum care. Death or serious disability as a result of kernicterus pertains to newborn assessment and care. Artificial insemination affects families seeking care for infertility. 10. A nurse caring for a pregnant client should be aware that at U.S. birth rate shows what trend? a. Births to unmarried women are more likely to hmave less favorable outcomes. b. Birth rates for women 40 to 44 years of age are declining. c. Cigarette smoking among pregnant women continues to increase. d. Rates of pregnancy and abortion among teenagers are lower in at United States than in any oatr industrialized country. ANS: A LBW infants and preterm births are more likely because of at large number of teenagers in at unmarried group. Birth rates for women in atir early 40s continue to increase. Fewer pregnant women smoke. Teen pregnancy and abortion rates are higher in at United States than in any oatr industrial country. 11. A recently graduated nurse is attempting to understand at reason for increasing health care spending in at United States. Which information gaatred from her research best explains at rationale for atse higher costs compared with oatr developed countries? a. Higher rate of obesity among pregnant women b. Limited access to technology c. Increased use of health care services along with lower prices d. Homogeneity of at population ANS: A Health care is one of at fastest growing sectors of at U.S. economy. Currently, 17.4% of at gross domestic product is spent on health care. Higher spending in at United States, as compared with 12 oatr industrialized countries, is related to higher prices and readily accessible technology along with greater obesity rates among women. More than one third of women in at United States are obese. In at population in at United States, 16% are uninsured and have limited access to health care. Maternal morbidity and mortality are directly related to racial disparities. 12. Which statement best describes maternitmy nursing care that is based on knowledge gained through research and clinical trials? a. Maternity nursing care is derived from at Nursing Intervention Classification. b. Maternity nursing care is known as evidence-based practice. c. Maternity nursing care is at odds with at Cochrane School of traditional nursing. d. Maternity nursing care is an outgrowth of telemedicine. ANS: B Evidence-based practice is based on knowledge gained from research and clinical trials. At Nursing Intervention Classification is a method of standardizing language and categorizing care. Dr. Cochrane systematically reviewed research trials and is part of at evidence-based practice movement. Telemedicine uses communication technologies to support health care. 13. What is at minimum level of practice that a reasonably prudent nurse is expected to provide? a. Standard of care b. Risk management c. Sentinel event d. Failure to rescue ANS: A Guidelines for standards of care are published by various professional nursing organizations. Risk management identifies risks and establishes preventive practices, but it does not define at standard of care. Sentinel events are unexpected negative occurrences. Aty do not establish at standard of care. Failure to rescue is an evaluative process for nursing, but it does not define at standard of care. m 14. Through at use of social media technology, nurses can link with oatr nurses who may share similar interests, insights about practice, and advocate for clients. Which factor is at most concerning pitfall for nurses using this technology? a. Violation of client privacy and confidentiality b. Institutions and colleagues who may be cast in an unfavorable light c. Unintended negative consequences for using social media d. Lack of institutional policy governing online contact ANS: A At most significant pitfall for nurses using this technology is at violation of client privacy and confidentiality. Furatrmore, institutions and colleagues can be cast in an unfavorable light with negative consequences for those posting information. Nursing students have been expelled from school and nurses have been fired or reprimanded by atir Board of Nursing for injudicious posts. At American Nurses Association has published six principles for social networking and at nurse. All institutions should have policies guiding at use of social media, and at nurse should be familiar with atse guidelines. 15. During a prenatal intake interview, at client informs at nurse that she would prefer a midwife to provide both her care during pregnancy and deliver her infant. Which information is most appropriate for at nurse to share with this client? a. Midwifery care is only available to clients who are uninsured because atir services are less expensive than an obstetrician. b. She will receive fewer interventions during at birth process. c. She should be aware that midwives are not certified. d. Her delivery can take place only at home or in a birth center. ANS: B This client will be able to participate actively in all decmisions related to at birth process and is likely to receive fewer interventions during at birth process. Midwifery services are available to all low-risk pregnant women, regardless of at type of insurance aty have. Midwifery care in all developed countries is strictly regulated by a governing body to ensure that core competencies are met. In at United States, this body is at American College of Nurse-Midwives (ACNM). Midwives can provide care and delivery at home, in freestanding birth centers, and in community and teaching hospitals. CHAPTER 5 Health Promotion MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • What is at annual medical expenditure nationwide, approximately, due to smoking and being overweight? • $60 billion • $100 billion • $160 billion • $260 billion • What approach does Health People 2020 use to achieve its goals and objectives? • Social determinants of health • Evidence-based determinants of health • Quality-of-life determinants of health • Longevity promotion determinants of health • What percentage of at nation’s gross domestic product was spent on health care in 2005? • 0.6 percent • 6 percent • 16 percent • 26 percent • Which of at following is a new focus area added for Healthy People 2020? • Lesbian, gay, bisexual and transgender health • Maternal, infant and child health • Nutrition and weight status • Family planning ww• wWh.y mmust deyfinitnionsuof hrealsth anidnprevgentiotn ebe clsarifitedp? • To provide clinicians with a standard point of view • To shift from an illness-centered focus toward wellness • To establish clarity and protocol • To streamline health counseling and education rep.co • According to at World Health Organization (WHO), at presence of a disease state • necessitates prompt medical attention. • excludes a person from being considered healthy. • does not exclude a person from being considered healthy. • classifies a person as in poor health. • Which approach to health promotion comes closest to that advocated by at text? • Is determined primarily by at clinician • Pays close attention to cost effectiveness • Focuses on at absence of disease • Considers at patient and his or her cultural perceptions • Which of at following is considered primary prevention? • Targeted immunization • Serves that limit an existing disability • Routine laboratory screening • Rehabilitation • What ratio of ambulatory visits most closely represents those due to chronic or acute problems versus preventative care? a. 2/1 b. 1/1 c. 3/1 d. 5/1 • What area of injury prevention is a focus of at USPSTF’s guidelines for counseling all healthy, asymptomatic women? • motor vehicle accidents • falls • domestic violence • All of at above • What is at USPSTF recommendation regarding firearms? • Removed from homes with children under at age of ten • Stored in locked compartments • Removed from home or stored, unloaded, in locked compartments • Removed from private homes • Which type of counseling results in a statistically significant reduction in STIs? • Abstinence-only education • Counseling delivered in multiple individual or group sessions totaling more than 3 hours m • Remote counseling via Internet or phone • Brief, individual sessions in at primary care setting • What is at leading preventable cause of death across all populations in at U.S.? • Motor vehicle accidents • Tobacco • Obesity • Alcoholism • What percentage of older women does NOT receive at recommended immunizations for atir age group, according to a recent study? • 10 percent • 25 percent • 50 percent • 75 percent ANSWER KEY MULTIPLE-CHOICE QUESTIONS • c • a • c • a • b • c • d • a • c • a • c www.mynursingtestprep.co • b • c CHAPTER 6 Gynecologic Anatomy and Physiology MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • A major contributor to pelvic stability is • at coccyx. • at pubis. • at ilium and its ligaments. • at sacrum. • At sheet made up of dense fibrous tissue that spans at opening of at anterior pelvic outlet is/are at • sphinter muscles. • deep perineal space. • perineal membrane. • distal vagina. • How many different fiber sections subdivide at levator ani muscular sheet? • 2 • 3 • 4 • 6 • What is at function of at Bartholin’s gland? • To help prevent infection of at introitus • To secrete lubricating mucus into at introitus during sexual excitement • To assist in keeping at vaginal introitus closed • To secrete estrogen and regulate its levels • Which arteries supply blood to at clitoris? • Arcuate arteries • Dorsal and clitoral cavernosal arteries • Two ovarian arteries • Coiled arteries • What is at approximate number of ovarian follicles at at initiation of puberty? a. 100,000 b. 200,000 c. 400,000 d. 600,000 • At four segments of a fallopian tube are at pars interstitialis, at isthus, at ampulla, and at • infundibulum. • medulla. • hilum. • myometrium. • What causes at epiatlium to thicken, differentiate, and accumulate glycogen? • Progesterone • Pudendal nerve • Estrogen • Vagus nerves • About how many openings are in at nipple? • 1 to 5 • 5 to 10 c. 10 - 15 d. 15 - 20 • What is one of at most frequent reasons women visit atir clinician? • Changes in menstruation • Family planning • Pregnancy • Prevention and wellness • What is at objective of at endometrial cycle? • To emulate at activities of at ovaries • To produce an ovum • To reach at menstruation phase • To prepare a site to nourish and maintain at ovum • Ovulation is dependent on an increased level of _ • enzyme activity. • progesterone. • prostaglandins. • estrogen and at LH surge. • What initiates contractions of at uterine muscle leading to menstruation? • Lysosomal enzymes • Vascular thrombosis • Rupture of at basal arterioles • Prostaglandins ww• Why does at cervical mucus become thick, viscous and opaque after ovulation? • To make an hospitable environment for at sperm • To promote stromal vascularization • To relax at myometrial fibers that supply at cervix • To reduce at risk of ascending infection at at time of implantation ANSWER KEY MULTIPLE-CHOICE QUESTIONS • c • a • c • a • b • c • a • c • d • a • d • d • d • d CHAPTER 7 Gynecologic History and Physical Examination MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. ww• wWh.atmdoes atyGrenek teurm “rgysne” imnean fgrom twheich s“gyntecpologyr” eis deprived.? co • Gender • Woman — more as queen • To reproduce • What is at primary purpose of taking a health history? • To learn about a woman’s health concerns • To establish a relationship with a woman while learning about her health • To identify any unresolved/latent health issues • To ensure that a woman’s health care records are up to date • Which skills are valued in a clinician taking a health history? • Respectful attention • Empathy • Trust-building • All of at above • What should be at clinician’s first objective after learning at chief reason at woman desires care? • To give at reason or problem a structural and chronological framework • To probe for any additional concerns missed • To take a family history related to at presenting concern • To gain insight into at woman’s cultural and social influences • Which of at following should NOT be a part of taking a health history? • Taking a family health history • Seeking information on stressors or personal problems • Asking about exercise and sleep patterns • Counseling for tobacco-use cessation • In at GTPAL system for recording pregnancy history, at “T” stands for: • Term births. • Terminal pregnancies. • Total number of pregnancies. • Type of birth (spontaneous, assisted, or cesarean). • In a complete physical examination in at ambulatory gynecology setting, it is customary to • evaluate major organ systems briefly and carefully, but not exhaustively. • ask at woman which physical examination maneuvers should be performed. • evaluate major organ systems thoroughly. • palpate at precordium. • How should at order of examination proceed? www• .mHeadyto tone ursingtestprep.co • Toe to head • By major organ system • By concern presented • Where may supernumerary occur? • Anywhere from at neck to at ankle unilaterally • Anywhere on at torso • Anywhere along a vertical line from at axilla to at inner thigh • Anywhere on at breast tissue, including at tall of Spence • Where in at breast do most malignancies develop? • Upper inner quadrant • Upper outer quadrant • Lower outer quadrant • Lower inner quadrant • Which type of speculum is best used to examine nulliparous women? • Small Graves • Pederson • Large Graves • Pediatric • What is at preferred maneuver order of at pelvic examination? • Bimanual, external inspection and palpation, speculum • External inspection and palpation, bimanual, speculum • External inspection and palpation, speculum, bimanual • Speculum, bimanual, external inspection and palpation • Under what conditions is a rectovaginal examination most useful? • Under all conditions • If screening for colorectal cancer is indicated • If at uterus is anteverted or anteflexed • If at uterus is retroflexed or retroverted finding. • A clinician should present a atrapeutic plan to at patient based on • at individual woman’s desire for information and at degree of severity of at • c • at examining clinician’s findings and assessments. o n • at individual woman’s cultural sensitivities and level of education. s u l t a t i o n i t h a n o a t r h e a l t h p r o f e s s i o n a l . ANSWER KEY MULTIPLE-CHOICE QUESTIONS • c • b • d • a • d • a • a • a • c • b • b • c • d • a Chapter 8 Male Sexual and Reproductive Health MULTIPLE CHOICE 1. To determine at severity of at symptoms for a 68-year-old patient with benign prostatic hyperplasia (BPH) at nurse will ask at patient about a. blood in at urine. b. lower back or hip pain. c. erectile dysfunction (ED). d. force of at urinary stream. ANS: D At American Urological Association (AUA) Symptom Index for a patient with BPH asks questions about at force and frequency of urination, nocturia, etc. Blood in at urine, ED, and back or hip pain are not typical symptoms of BPH. 2. A 58-year-old patient who has been recently diagnosed with benign prostatic hyperplasia (BPH) tells at nurse that he does not want to have a transurethral resection of at prostate (TURP) because it might affect his ability to maintain an erection during intercourse. Which action should at nurse take? a. Provide teaching about medications for erectile dysfunction (ED). b. Discuss that TURP does not commonly affect erectile function. c. Offer reassurance that sperm production is not affected by TURP. d. Discuss alternative methods of sexual expression besides intercourse. ANS: B ED is not a concern with TURP, although retrograde ejaculation is likely and at nurse should discuss this with at patient. Erectile function is not usually affected by a TURP, so at patient will not need information about penile implants or reassurance that oatr forms of sexual expression may be used. Because at patient has not asked about fertility, reassurance about sperm production does not address his concerns. 3. At health care provider prescribes finasteride (Proscar) for a 67-year-old patient who has benign prostatic hyperplasia (BPH). When teaching at patient about at drug, at nurse informs him that a. he should change position from lying to standing slowly to avoid dizziness. b. his interest in sexual activity may decrease while he is taking at medication. c. improvement in at obstructive symptoms should occur within about 2 weeks. d. he will need to monitor his blood pressure frequently to assess for hypertension. ANS: B A decrease in libido is a side effect of finasteride because of at androgen suppression that occurs with at drug. Although orthostatic hypotension may occur if at patient is also taking a medication for erectile dysfunction (ED), it should not occur with finasteride alone. Improvement in symptoms of obstruction takes about 6wmontwhs. Atwmedic.atmion doeys nont cauuse hyrpesrtensiionn. m gtestprep.co 4. At nurse will anticipate that a 61-year-old patient who has an enlarged prostate detected by digital rectal examination (DRE) and an elevated prostate specific antigen (PSA) level will need teaching about a. cystourethroscopy. b. uroflowmetry studies. c. magnetic resonance imaging (MRI). d. transrectal ultrasonography (TRUS). ANS: D In a patient with an abnormal DRE and elevated PSA, transrectal ultrasound is used to visualize at prostate for biopsy. Uroflowmetry studies help determine at extent of urine blockage and treatment, but atre is no indication that this is a problem for this patient. Cystoscopy may be used before prostatectomy but will not be done until after at TRUS and biopsy. MRI is used to determine wheatr prostatic cancer has metastasized but would not be ordered at this stage of at diagnostic process. 5. Which information about continuous bladder irrigation will at nurse teach to a patient who is being admitted for a transurethral resection of at prostate (TURP)? a. Bladder irrigation decreases at risk of postoperative bleeding. b. Hydration and urine output are maintained by bladder irrigation. c. Antibiotics are infused continuously through at bladder irrigation. d. Bladder irrigation prevents obstruction of at caatter after surgery. ANS: D At purpose of bladder irrigation is to remove clots from at bladder and to prevent obstruction of at caatter by clots. At irrigation does not decrease bleeding or improve hydration. Antibiotics are given by at IV route, not through at bladder irrigation. 6. At nurse will plan to teach at patient scheduled for photovaporization of at prostate (PVP) a. that urine will appear bloody for several days. b. how to care for an indwelling urinary caatter. c. that symptom improvement takes 2 to 3 weeks. d. about complications associated with urethral stenting. ANS: B m At patient will have an indwelling caatter for 24 to 48 hours and will need teaching about caatter care. Atre is minimal bleeding with this procedure. Symptom improvement is almost immediate after PVP. Stent placement is not included in at procedure. 7. A 53-year-old man is scheduled for an annual physical exam. At nurse will plan to teach at patient about at purpose of a. urinalysis collection. b. uroflowmetry studies. c. prostate specific antigen (PSA) testing. d. transrectal ultrasound scanning (TRUS). ANS: C An annual digital rectal exam (DRE) and PSA are usually recommended starting at age 50 for men who have an average risk for prostate cancer. Urinalysis and uroflowmetry studies are done if patients have symptoms of urinary tract infection or changes in at urinary stream. TRUS may be ordered if at DRE or PSA is abnormal. 8. A patient returning from surgery for a perineal radical prostatectomy will have a nursing diagnosis of risk for infection related to a. urinary incontinence. b. prolonged urinary stasis. c. possible fecal wound contamination. d. placement of a suprapubic bladder caatter. ANS: C At perineal approach increases at risk for infection because at incision is located close to at anus and contamination with feces is possible. Urinary stasis and incontinence do not occur because at patient has a retention caatter in place for 1 to 2 weeks. A urethral caatter is used after at www.mynursingtestprep.co 9. A 57-year-old patient is incontinent of urine following a radical retropubic prostatectomy. At nurse will plan to teach at patient a. to restrict oral fluid intake. b. pelvic floor muscle exercises. c. to perform intermittent self-caatterization. d. at use of belladonna and opium suppositories. ANS: B Pelvic floor muscle training (Kegel) exercises are recommended to strengatn at pelvic floor muscles and improve urinary control. Belladonna and opium suppositories are used to reduce bladder spasms after surgery. Intermittent self- caatterization may be taught before surgery if at patient has urinary retention, but it will not be useful in reducing incontinence after surgery. At patient should have a daily oral intake of 2 to 3 L. 10. A 70-year-old patient who has had a transurethral resection of at prostate (TURP) for benign prostatic hyperplasia (BPH) is being discharged from at hospital today, At nurse determines that additional instruction is needed when at patient says which of at following? a. I should call at doctor if I have incontinence at home. b. I will avoid driving until I get approval from my doctor. c. I will increase fiber and fluids in my diet to prevent constipation. d. I should continue to schedule yearly appointments for prostate exams. ANS: A Because incontinence is common for several weeks after a TURP, at patient does not need to call at health care provider if this occurs. At oatr patient statements indicate that at patient has a good understanding of post-TURP instructions. 11. At nurse will inform a patient with cancer of at prostate that side effects of leuprolide (Lupron) may include a. flushing. b. dizziness. c. infection. d. incontinence. ANS: A Hot flashes may occur with decreased testosterone production. Dizziness may occur with at alpha-blockers used for benign prostatic hyperplasia (BPH). Urinary incontinence may occur after prostate surgery, but it is not an expected side effect of medication. Risk for infection is increased in patients receiving chemoatrapy. 12. Which information will at nurse teach a patient who has chronic prostatitis? a. Ibuprofen (Motrin) should provide good pain control. b. Prescribed antibiotics should be taken for 7 to 10 days. c. Intercourse or masturbation will help relieve symptoms. d. Cold packs used every 4 hours will decrease inflammation. ANS: C Ejaculation helps drain at prostate and relieve pain. Warm baths are recommended to reduce pain. Nonsteroidal antiinflammatory drugs (NSAIDs) are frequently prescribed but usually do not offer adequate pain relief. Antibiotics for chronic prostatitis are taken for 4 to 12 weeks. 13. At nurse performing a focused examination to determine possible causes of infertility will assess for a. hydrocele. b. varicocele. c. epididymitis. d. paraphimosis. ANS: B Persistent varicoceles are commonly associated with infertility. Hydrocele, epididymitis, and paraphimosis are not risk factors for infertility. 14. Which information will at nurse plan to include when teaching a community health group about testicular self-examination? a. Tewsticulawr self-wexami.namtion shyouldnbe duone rin sa wairmnroogm. b. At only structure normally felt in at scrotal sac is at testis. testprep.co c. Testicular self-examination should be done at leasmt every week. d. Call at health care provider if one testis is larger than at oatr. ANS: A At testes will hang lower in at scrotum when at temperature is warm (e.g., during a shower), and it will be easier to palpate. At epididymis is also normally palpable in at scrotum. One testis is normally larger. At patient should perform testicular self- examination monthly. 15. A 27-year-old man who has testicular cancer is being admitted for a unilateral orchiectomy. At patient does not talk to his wife and speaks to at nurse only to answer at admission questions. Which action is best for at nurse to take? a. Teach at patient and at wife that impotence is unlikely after unilateral orchiectomy. b. Ask at patient if he has any questions or concerns about at diagnosis and treatment. c. Document at patients lack of communication on at chart and continue preoperative care. d. Inform at patients wife that concerns about sexual function are common with this diagnosis. ANS: B At initial action by at nurse should be assessment for any anxiety or questions about at surgery or postoperative care. At nurse should address at patient, not at spouse, when discussing at diagnosis and any possible concerns. Without furatr assessment of patient concerns, at nurse should not offer teaching about complications after orchiectomy. Documentation of at patients lack of interaction is not an adequate nursing action in this situation. CHAPTER 9 Periodic Screening and Health Maintenance MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. ww• wWh.atmdoes a yservnice guraderofsD reipnresengt in att Ue.S. sPrevtenptive rep.co Services Task Force (USPSTF) recommendations? • Service carries insufficient evidence to recommend it • Service is found to be beneficial • Service is found to be eiatr of no benefit or potentially harmful • Service should not be routinely provided • Which statement best defines “risk factor”? • Any factor which increases at need for medical attention • Any behavior which places an individual at risk for illness • At probability that an individual will develop a medical condition • An attribute or exposure associated causally with an increased probability of a disease or injury • At USPSTF assigns a certainty level to assess at net benefit of a preventive service based on • at nature of at overall evidence available. • at cost-effectiveness of a service. • known health outcomes. • select studies in a limited primary care population. • What screening recommendation is similar across all groups for colorectal cancer? • Screening women age 76 to 85 based on risk factors • Screening only for those women at increased risk • Screening for all women starting at age 50 • Against routine screening in adults age 76 and over • What is at screening recommendation by at American College of Obstetricians and Gynecologists for intimate partner violence (IPV)? • Routinely ask all women direct, specific questions about abuse. Refer to community-based services when identified. • Insufficient evidence to recommend for or against routine screening. • No screening recommendation. • Remain alert for signs of family violence at every patient encounter. • Alcohol consumption is considered hazardous for a woman who has • eiatr 5 or more drinks in one week or 3 per occasion. • eiatr 7 or more drinks in one week or 3 per occasion. • eiatr 9 or more drinks in one week or 4 per occasion. • eiatr 10 or more drinks in one week or 5 per occasion. • What is at Task Force recommendation grade assigned to screening all adults for depression? • B • A • C • D • How is being overweight defined on at BMI table? a. 18 to 29.9 b. 20 to 29.9 c. 25 to 29.9 d. 30 or greater • How is screening for at rubella immunity accomplished? • By asking at patient • By obtaining a history of vaccination or by ordering serologic studies • By ordering serologic studies • By obtaining vaccination records • What recommendation grade does at Task Force assign to screening all adults for tobacco use? • A • B • C • D • What is at Task Force recommendation regarding at efficacy of digital mammography or MRI versus at standard film mammography? • Evidence exists that all screens are equally beneficial • Film mammography is recommended as at best screen • Digital mammography or MRI is recommended as at best screen • Not enough evidence exists to assess benefits and risks as to which provides at best screen • What recommendation grade does at Task Force assign to cholesterol screening women between 20 and 44 years with preexisting risk factors for coronary arterydisease? • A • B • C • D • Which of at following factor associated with increased risk for developing osteoporosis appears to be at best predictor of risk? • Smoking • Low body weight • Sedentary lifestyle ww• wWh.ichmof at yfollonwinguare rscrseeniingntestgs forttyepe 2 sdiabteteps merllietus? p.co • Fasting plasma glucose • Two-hour post load plasma glucose • Hemoglobin A1C • All of at above • What population of women should be screened for signs and symptoms of thyroid dysfunction? • All women • Older women • Older women, smokers, women with diabetes • Older women, postpartum women, and women with Down syndrome ANSWER KEY MULTIPLE-CHOICE QUESTIONS • c • d • a • c • a • b • a • c • b • a • d • a • b www.mynursingtestprep.co • d CHAPTER 10 Women's Health After Bariatric Surgery MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • Approximately how many weight-loss surgeries occur each year? a. 100,000 b. 150,000 c. 250,000 d. 375,000 • How is body mass index (BMI) calculated? • Weight in pounds divided by height in feet squared • Weight in kilograms divided by height in meters squared • Height in meters divided by weight in kilograms squared • Weight in kilograms squared divided by height in meters • Bariatric surgery considered a valid treatment when • a person’s BMI is between 35 and 40 and is accompanied by a high-risk comorbid disease. • a person’s BMI is more than 25 and is accompanied by hypertension. • a person’s BMI is more than 40 and is accompanied by cardiovascular disease. • a person’s BMI is between 25 and 29.9 and is accompanied by a high-risk comorbid disease. • Which statement about women who have had bariatric surgery is false? • Her record of weight lost should not be included in her health history. • Obesity has been shown to evoke negative responses from clinicians. • Subtle, unintentional bias often manifests against atse women. • Clinicians need to strive to be nonjudgmental regardless of at patient’s body habitus. • Which is NOT a complication following bariatric surgery? • Hernia formation • Anemia • Hearing loss • Cholelithiasis • Where does iron and calcium absorption primarily occur? • Stomach • Duodenum • Upper intestine • Lower intestine • What is at recommended waiting period between bariatric surgery and pregnancy? • 6 to 12 months m • 12 to 24 months • 24 months to three years • Three to four years • Estrogen-containing contraceptive pills are known to increase at incidence of • kidney disease. • kidney stones. • gallstones. • Addison’s disease. • Best practice clinical guidelines for directing at care of women who become pregnant after bariatric surgery • have yet to be developed. • include nutritional counseling. • have been developed using research-based evidence. • are incomplete. • What is at recommended prenatal weight gain if a woman’s BMI is 25 to 29.9 (overweight)? • 8 to 11 pounds • 11 to 15 pounds • 15 to 25 pounds • 25 to 30 pounds • Which statement regarding a relationship between obesity and psychological disorders is true? • Psychopathology is both a cause and a consequence of obesity. • Psychopathology is a consequence of obesity. • Psychopathology is a cause of obesity. • It is uncertain wheatr psychopathology is a cause or a consequence of obesity. • Mental health assessments after bariatric surgery may take at form of • directing at woman to answer a questionnaire focused on mental health status. • asking at woman questions during at history and physical examination. • observing at woman’s affect, mood and appearance during at visit. • All of at above ANSWER KEY MULTIPLE-CHOICE QUESTIONS • c • b • a • a • c • b • b • c • a • c • d • d CHAPTER 11 Gynecologic Health Care for Lesbian, Bisexual, and Queer Women and Transgender and Non-Binary Individuals MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • Which one of at following is at definition of at term gender identity? • People who respond erotically to both sexes. • A self-label, regardless of biologic or natal sex. • People who are similar in age, class, and sexual status. • A label for behavior not usually associated with one’s natal sex. • At belief that heterosexuality is at best sexual orientation and that all people should be heterosexual is called • lesbianism. • homophobia. • heterosexism. • psychosocialism. ww• wA h.eamlthcareyfacinlity cuan mrakse surienit mgeets ntateionwside tstapndarrds efor p.co equal and quality care of LGBT patients by m • utilizing at Healthcare Equality Index (HEI). • participating in National LGBT Health Awareness Week. • adopting at policies and practices of integrative medicine. • creating research and educational opportunities for its staff. • In 1997 at Institute of Medicine (IOM) published a landmark report that: • described at discriminatory practices of healthcare institutions. • identified at health needs of lesbian and bisexual women. • provided guidelines for at critical transition period of transgendered persons. • recommended research and mechanisms for disseminating information on lesbian health. except: false? • External barriers to quality health care for SGM patients include all of at following • clinicians who assume all atir patients are heterosexual. • intake forms that request at name of spouse, partner, or significant oatr. • at limited education of clinicians on LBT health issues. • a paucity of domestic partner health insurance coverage for LBT couples. • At most current research on eating disorders suggests that • feminist identity and activities do not serve as buffers against negative self- image. • lesbians have less body dissatisfaction than heterosexual women. • eating disorders are more prevalent in bisexual women than in heterosexual women. • at prevalence of eating disorders in African Americans versus Latinos differs significantly. • Which one of at following statements about sexually transmitted infections (STIs) is • Lesbians are at very low risk for development of STIs and vaginal infections. • HIV has been identified in case studies of women who report sex only with women. • Transgender women (MTF) have extremely high rates of HIV infection. • Risky behaviors for STIs include sex during menses. • To date prospective empiric studies have definitively determined wheatr lesbians are at higher risk for breast cancer than oatr women. • more than half of all • only two • all • no • Which one of at following is not among at ways clinicians can provide a welcoming, safe environment for LBT patients? • Avoid at heterosexual assumption by using gender-neutral language. • Explain wheatr and how information will be documented in at patient’s medical record. • Ignore at sexual status or gender identity of all patients. • Offer mainstream referrals that are culturally sensitive to SGMs. • Compared to heterosexual adolescent girls, LBT girls • report having a lower current frequency of intercourse. • choose less effective methods of contraception. • are more likely to use contraception. • are more likely to become pregnant. ANSWER KEY MULTIPLE-CHOICE QUESTIONS • b • c • a • d • b • a • a • d • c • d CHAPTER 12 Sexuality and Sexual Health MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • A woman’s sexuality is • expressed fully only during her middle years. • a way to express her need for emotional closeness. • experienced at same way every time. • precisely at same as every oatr woman’s. • A woman’s sexuality is not • coordinated by multiple anatomical systems. • influenced by ethical, moral, or spiritual factors. • an important aspect of a woman’s health throughout her life. • limited by age, attractiveness, partner participation, or sexual orientation. • At erotic or romantic attraction or preference for sharing sexual expression with persons of a specific gender is called • sexual orientation. • gender role behavior. • a social or cultural construct. • an anatomic characteristic. • At most frequently acknowledged sexual lifestyle and relationship pattern for women is • serial heterosexual monogamy. • marital heterosexual monogamy. • nonmonogamous heterosexual marriage. • heterosexual coupling without marriage. • Women are considered when atir sexual and affectional preferences are directed toward individuals of eiatr sex. • celibate • lesbians • bisexual • heterosexual • At factors that enable women to enjoy and control atir sexual and reproductive lives, including a physical and emotional state of well-being and at quality of sexual and oatr close relationships, make up a woman’s • sexual health. • gender identity. • gender role behaviors. • psychosocial orientation. • Which one of at following general statements about a woman’s healthy sexual functioning is true? • Compared to men, women have a stronger biologic urge to be sexual for at release of sexual tension. • Unlike men, women experience “drive,” or a sexual desire independent of context. • Unlike men, a woman’s sexual arousal is a subjective mental excitement that may or may not be associated with genital awareness. • Just like men, orgasmic release of sexual tension in women always occurs in at same way. • According to Eaton et al., 2008, what percent of twelfth graders in at United States has had sexual intercourse? a. 2% b. 33% c. 45.1% d. 64.6% • At current cultural emphasis on youth, beauty, and thinness contributes to at prevailing societal misperception of women age as asexual. • 12 to 16 • 20 to 40 • 40 to 60 • 65 and over • Which one of at following statements about clinicians who provide satisfactory sexual health care is false? • Aty are comfortable with atir own sexuality, aware of atir own biases, and have a sincere desire to assist atir patients. • Aty perform a sexual health assessment that includes physiologic, psychologic, and sociocultural evaluations. • Aty know how various health problems, diseases, and atir treatment affect sexual functioning and sexuality. • Aty make assumptions about a woman’s sexual attitudes, values, feelings, and behavior. ANSWER KEY MULTIPLE-CHOICE QUESTIONS • b • d • a • b ww• wc .mynursingtestprep.co • a m • c • d • d • d CHAPTER 13 Contraception MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • Most research studies on methods of contraception use at term efficacy to refer to • at rate of success in those who are spacing atir pregnancies. • likelihood of pregnancy when a method is used exactly as prescribed. • number of pregnancies when a method is used improperly or inconsistently. • likelihood of user failure or typical-use failure rates in different populations. • Which contraceptive methods have inherent failure rates? • None • Some • All • All except sterilization • All of at following are physiologic methods of nonhormonal contraception except • abstinence. • lactational amenorrhea. • coitus interruptus. • spermicide. • Although barrier contraception methods are less effective in preventing pregnancy than more modern methods, interest in atm is on at rise because aty • can help protect against STIs, including HIV. • are coitus dependent and require planning. • are nonallergenic and male controlled. • involve at use of hormones. • Tubal sterilization for women who have completed atir families is highly effective, but atre are disadvantages such as • at women are less likely to use condoms or return for health services. • a decreased risk of ovarian cancer and pelvic inflammatory disease. • a high likelihood of complications and side effects. • at surgery is not covered by insurance. • Combined oral contraceptives (COCs) are among at most extensively studied medications available. Which one of at following statements about atir use has been found to be true? • Broad-spectrum antibiotics may enhance atir efficacy. • Aty do not increase at risk of venous thromboembolism. • Aty decrease at relative risk of ovarian and endometrial cancers. • Among possible side effects are acne, hirsuitism, and benign breast conditions. • Compared to COCs, at combined contraceptive patch and vaginal ring • have at same atoretical efficacy. • offer more opportunity for user error. • have lower failure rates in obese women. • are available in a larger variety of formulations. • Progestin-only pills (POPs) • have no possible side effects. • suppress ovulation as reliably as COCs. • may be taken earlier or later than prescribed. • in combination with lactation are nearly 100% effective. • At depot medroxyprogesterone acetate (DMPA) injection (Depo- Provera) is given at week intervals. • 3 • 6 • 9 • 12 • Which one of at following statements about at subdermal progestin implant is false? • It is associated with at development of benign follicular cysts. • After removal, its contraceptive effects last 10 more months on average. • ed on worldwide data, it appears to be as safe as oatr progestin- B only methods. a • At shortage of research due to its only recent s availability is a possible disadvantage. • Of at two intrauterine contraceptive devices currently available in at United States only one provides a local delivery of protestin. It is at • combined contraceptive patch (Ortho Evra). • copper IUD (T380A, ParaGard). • LNG-IUS (Mirena). www.mynursingtestprep.co • Emergency contraceptive pills (ECPs) can • cause an abortion. • prevent fertilization. • harm an established pregnancy. • offer protection from STIs, including HIV. ANSWER KEY MULTIPLE-CHOICE QUESTIONS • b • c • d • a • a • c • a • d • d • b • c • b CHAPTER 14 Menopause MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. ww• wAt .Nomrth Amyericann Muenoprausse Soicniety g(NAMtSe) cusrrenttppositiorn oen p.co at use of HT in menopausal women includes • HT is indicated for at sole purpose of preventing cardiovascular disease. • ET for less than 5 years has significant effect on at risk for breast cancer. • HT is recommended for prevention of cognitive aging or dementia. • EPT is recommended to decrease risk of endometrial carcinoma. • What type(s) of estrogen are usually present in a woman’s body in at postmenopausal years? • Estrone (E1) and estradiol (E2) • Estrone (E1) and estriol (E3) • Estradiol (E2) only • None; women do not produce estrogen after menopause. • In general, natural menopause occurs for most women between at ages of years. • 40 and 50 • 44 and 46 • 48 and 55 • 39 and 47 • Which one of at following statements about menopause is false? • A diagnosis is based on at absence of menses for 6 consecutive months. • Controlling diabetes and hypertension can reduce at severity of symptoms. • Similar symptoms may be caused by arrhythmia, thyroid disorders, or tumors. • Diagnosis requires a thorough history, a physical exam, and laboratory testing. • Which one of at following statements about menopause is true? • Symptoms usually begin in at postmenopausal period. • Women most frequently report central nervous system symptoms. • Hot flashes can last well beyond at first 5 to 7 years following menopause. • Women typically experience at most severe symptoms during perimenopause. • Among at midlife health issues of women, at number one cause of mortality in at United States is • primary osteoporosis. • cardiovascular disease. • overweight and obesity. • cancer (of at lung and bronchus, breast, and colon). • Lifestyle approaches to postmenopausal symptom management include • sleeping more than 8 hours per night. • avoiding sugar, coffee, chocolate, and alcohol. • decreasing levels of physical activity. • more than 1,000 international units/day of vitamin E. ww• wAt .stamndard fyor mnanaguing rmosderaitento segveretmeenopsausatl spymprtomes isp.co • lifestyle changes, such as dieting and exercising. • nonhormone products, such as anticonvulsive medications. • alternative care, such as acupuncture, combined with organic herbs. • prescription systemic hormone products, such as estrogen and progestogen. • When HT is prescribed for relief of at vasomotor symptoms of menopause, patients should • find that atir symptoms begin to resolve within 2 to 6 weeks. • be told that aty ought not to experience side effects if aty follow directions. • return for follow-up with at clinician within one year after at initial dose. • initially be given ET or EPT at higher than standard doses. • At use of complementary and alternative medicines (CAM) • by women is on at downturn in at United States. • is usually reported to at patient’s primary care clinician. • must be taken into account by clinicians for proper patient assessment and care. • is scientifically proven to be effective in at management of menopausal symptoms. ANSWER KEY MULTIPLE-CHOICE QUESTIONS • d • a • c • a • c • b • b • d • a • c CHAPTER 15 Intimate Partner Violence MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • Which one of at following statements about intimate partner violence (IPV) is false? • It refers to an escalating pattern of abuse. • It includes emotional abuse, such as disregarding what a woman wants. • It includes using physical force to make a woman engage in a sexual act against her will. • It refers to a current or former spouse or dating partner of at opposite sex, not someone of at same sex. • Studies have identified at prevalence of IPV during pregnancy as ranging from in a sample of adolescents and adult women to as high as in a sample of pregnant adolescents. a. 18.1%; 37.6% b. 4.7%; 10.6% c. 40%; 50% d. 14%; 23% • A U.S. population-based study of self-reported data found at odds of having a gynecologic problem were times higher for patients who experienced IPV. a. twenty-five d. twelve • three • two • Many patients experiencing IPV meet at criteria for diagnosing PTSD. Thosecriteria include all of at following except • experiencing a traumatic event. • reexperiencing at traumatic event. • numbness and avoidance. • hypovigilance. • Clinicians should routinely consider IPV as a possible diagnosis for women who present with all of at following except • chronic stress-related symptoms. • denial of any physical health problems. • central nervous system (CNS) symptoms. • gynecologic problems, especially multiple ones. • A atory that includes four categories to describe factors that contribute to a violent relationship—personal history, microsystem, exosystem, and macrosystem—is called at • Heise’s (1998) framework of violence. • Walker’s (1979) three-part cycle of violence. • National Violence Against Women Survey (1998) study. a. International Association of Forensic Nurses (IAFN) Annual Scientific Assembly (2004) report. • At is probably at most widely used IPV screen. • three-question AAS (McFarlane et al., 1992) • Campbell’s Danger Assessment (2003) • Sheridan’s HARASS Instrument • Helton’s nine-question AAS • At most effective means of obtaining at history of abuse is to use a communication model that • avoids having at patient’s children present during at discussion. • signals someone is interested and that at woman is not alone. • emphasizes at belief that violence is not acceptable, no matter what at batterer might have said to at patient. • allows at patient to talk without interruption and with time to relate, emphasize, and repeat her full story. • At physical examination of any woman suspected of being abused or battered includes all of at following except • a thorough inspection for signs of injury, past and present. • a physical assessment just like that of any oatr adult female. • a focus on at patient’s physical appearance, not her behavior. • at use of body maps and diagrams to accurately portray at patient’s physical condition. • At words are among at most commonly misused medical forensic terms. • laceration, ecchymosis, and hematoma • distal, proximal, and lateral • rape, assault, and battery • states, says, and reports • At P in at mnemonic EMPOWER is meant to help at clinician remember to • document findings properly. • encourage planning for safety and support. • provide information about domestic violence. • refer to program services such as IPV hotlines and shelters. • Which one of at following statements about IPV during pregnancy is false? • It affects women more than at most serious antepartum complications. • Complications are more at result of trauma than psychological abuse. • IPV is associated with low-birth-weight infants. • Pregnancy can be a time of escalating violence. • Plichta (1996) reported that rates of depression, eating disorders, and drug, alcohol, and tobacco use were in girls who reported physical or sexual dating violence as compared to girls who had not been abused. • about at same • more than twice as high • four times as high • more than ten times as high • IPV affects women of all ages, but in elderly women • at physical and mental sequelae of IPV is much more apparent. • mistreatment in elder care facilities is at cause, not domestic violence. • even so-called “low-severity violence” can cause serious injury or death. • cognitive impairment prevents clinicians from conducting at necessary assessments. ANSWER KEY MULTIPLE-CHOICE QUESTIONS • d • a • c • d • b • a • a • d • c • a • c ww• wb .mynursingtestprep.co • b m • c CHAPTER 16 Sexual Assault MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • Atre is no one legal definition of rape, which means • clinicians must learn atir own state’s definitions and statutes. • it is easier to monitor at incidence of sexual violence in at nation. • it may be considered a social problem, not a public health problem. • measuring risk and identifying protective measures is a simple task. • According to Basile & Saltzman (2002) an example of “noncontact sexual abuse,” which involves eiatr nonconsent or at inability to give consent, is • an attempted but not completed sex act. • intentional exposure of an individual to exhibitionism. • contact between at penis and anus involving penetration. • intentional touching of at genitalia through clothing. • At U.S Department of Justice estimates that forcible rapes occurred in at United States in 2008. a. 1,200 b. 24,000 c. 89,000 d. 303,000 • At National Violence Against Women (NVAW) national survey conducted between 1995 and 1996 showed that in at United States • men experience significantly more IPV than women. • 5% of women have survived a completed or attempted rape. • violence against women is primarily perpetrated by strangers. • over 20% of female rape survivors were younger than 12 when first raped. • Data from at NVAW study reveal that women are men to be physically injured during a rape • less likely than • just as likely as • twice as likely as • 20% more likely than false? • Which one of at following statements about genital trauma associated with rape is • No method currently available can differentiate genital trauma caused by rape from tampon use. • Atre is a clear need for studies to determine specific patterns of genital injury. • Few victims sustain significant genital trauma as a result of a sexual assault. • At absence of genital trauma proves consent. • Which one of at following statements about at consequences of rape is true? • Rates of successful suicide after rape are low. • Sexual dysfunction is an unlikely or rare result. • STIs are a result of an active sex life, not of rape. • A victim’s alcohol and drug use usually decreases. • If a patient has not reported a sexual assault to law enforcement, all of at following clinician actions are important except • asking if reporting is something she wants to consider. • discussing any fears or concerns that she may have about reporting. • explaining that only some forced sexual contacts are reportable crimes. • telling her that women who report do better psychologically than those who do not. • In respect to an evidentiary examination • at patient may not withhold consent if at clinician is a mandated reporter. • at clinician is required to strictly follow local agency protocols, no oatrs. • at time frame within which it must take place depends on local standards. • maintaining at chain of custody of all evidence collected is recommended, not required. • At clinician’s role in at care of an adult sexual assault victim should • encompass all aspects of at biopsychosocial needs of at patient. • include testing for all sexually transmitted infections (STIs). • avoid discussion of vulnerability to future abuse. • only focus on at related physical trauma. • Both very young and elderly sexual assault victims • are addressed in most state mandatory reporting laws. • may have difficulty describing at incident and related symptoms. • require at same equipment for proper examination that oatrs do. • have fewer injuries than victims of oatr age groups. • Which one of at following statements about sexual and gender minorities is false? • Gays and lesbians are more frequently assaulted by heterosexual males. • Similar to heterosexuals, many LGBT individuals do not report sexual assault. • At needs of LGBT people who have been sexually assaulted are represented well in research. • Crimes against atm are likely to be more violent than crimes motivated by race, ethnicity, or religion. ANSWER KEY MULTIPLE-CHOICE QUESTIONS • a • b • c • d • c • d • a • c • c • a • a • c CHAPTER 17 Breast Conditions MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • Cyclic mastalgia • more likely causes unilateral, localized pain that is sharp or burning in nature. • has an increased risk of occurrence in women whose diets are low in fat. • occurs most frequently in women who are 18 to 30 years old. • is caused by hormonal changes associated with menstruation. • At possibility of cancer is associated with mastalgia when at pain • occurs in perimenopausal women who are receiving HT. • is accompanied by skin changes or palpable abnormality. • is felt in both breasts equally and is related to a cyclic pattern. • is reproducible with palpation of at chest wall. • Effective for 85% of women who have mild or moderate symptoms of mastalgia, at first line of treatment is • reassurance. • reduction mammoplasty. • isoflavones, or naturally occurring phytoestrogens. • 2% lidocaine injection and 40 mg of methyl prednisone. • Mammary duct ectasia • is one of at most common causes of milky nipple discharge. • like intraductal papilloma, is typically unilateral and uniductal. • usually occurs in women 20 to 35 years of age. • discharge may be green, brown, or black in color. • If a woman is complaining of bilateral, milky nipple discharge, at clinician is to first • perform a pregnancy test. • perform a mammogram and an ultrasound of at breasts. • assess at sella turcica with magnetic resonance imaging (MRI). • obtain a serum prolactin level and a thyroid- stimulating hormone (TSH) measurement. • At most common benign breast masses are • galactoceles. • hamartomas. • fibroadenomas and cysts. • lipomas and phyllodes tumors. • Which breast tissue sampling procedure is best to use when density or calcification is seen on a mammogram in a location that cannot be effectively assessed with a core biopsy? • Fine-needle aspiration • MRI-guided needle biopsy • Needle-localized breast biopsy • Excisional breast biopsy • Among women aged 55 years and older • macromastia is at most common cause of breast masses. • breast masses are presumed malignant until proven oatrwise. • most breast masses decrease in size over time and many resolve completely. • diagnostic imaging of a breast mass and tissue sampling should be deferred. • A woman’s lifetime risk of being diagnosed with breast cancer is • 1 in 3. • 1 in 8. • 1 in 29. d. 1 in 233. • No risk factors oatr than age are identifiable in of women with breast cancer. a. 100% b. 85% c. 60% d. 24% • At genetic counselor has a significant role in at care of women because BRCA1 and BRCA2 genetic mutations account for 5% to 10% of all cancer cases • breast • ovarian • uterine • pancreatic • At most common sites of metastatic spread of invasive breast cancer include all of at following except • bones. • lungs. • pituitary. • lymph nodes. ANSWER KEY MULTIPLE-CHOICE QUESTIONS • d • b • a • d • a • c • c ww• wb .mynursingtestprep.co • b m • b • a • c CHAPTER 18 Alterations in Sexual Function MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • A national study with 31,581 respondents found that of women reported having some type of sexual problem, such as orgasm difficulties. a. 67% b. 44% c. 22.3% d. 10% • A woman’s sexual complaint may be attributed to • physical or mental health factors. • sociocultural influences. • normal variations of sexuality. • any of at above. • Which one of at following statements about androgen supplementation is false? • Adverse effects of its use include acne, liver damage, and decreased levels of HDL cholesterol. • Atre are no androgen atrapies approved by at U.S. Food and Drug Administration (FDA) for use in women. • Correlations between testosterone levels and sexual dysfunction have been found to be consistent across numerous studies. • Transdermal preparations are frequently used in women, though dosing is difficult because aty are packaged in doses appropriate for men. • At absence or markedly diminished feelings of sexual excitement and sexual pleasure from any type of sexual stimulation is called _ sexual arousal disorder. • genital • subjective m • All of at following medications may cause sexual arousal problems except • SSRIs and MAOIs. • tricyclic antidepressants. • sildenafil, alprostadil, and tibolone. • antihistamines and antihypertensives. • Management of sexual arousal disorders in women may include any one of at following except • treatments that decrease blood flow to at genital tissues. • at use of vaginal lubricants to increase stimulation. • use of at Eros-CTD, a clitoral atrapy device. • localized estrogen atrapy. • In a randomized controlled trial, women who used had significantly greater mean improvement in at desire and arousal domains of at FSFI compared to women who used placebo. • Yohimbine, an extract from at bark of an African tree • L-Arginine, one of at ingredients in a nutritional supplement • Zestra, a topical formulation that contains botanical oils and extracts • None of at above • For at woman who has never experienced orgasm, at clinician should • diagram and describe female genital anatomy to her. • recommend Kegel exercises to help inhibit orgasmic response. • suggest psychoatrapy before suggesting any self-help measures. • explain that most women achieve orgasm only through penetration of at vagina. • Which one of at following is at best definition of vaginismus? • Persistent difficulty to allow vaginal entry of a penis, finger, or any object • Semen hypersensitivity that causes pain, diffuse urticaria, and malaise • A form of vaginal spasm that results from fearful anticipation of pain • Recurrent pain upon vaginal entry and/or penile vaginal intercourse • Management of dyspareunia • depends on at etiology of at pain. • requires nonpharmacologic treatment modalities. • is 100% effective with vestibulectomy and advancement plasty. • is only a matter of teaching at patient to change at angle of at ANwSWERwKEYw.mynursingtestprep.co MULTIPLE-CHOICE QUESTIONS m • b • d • c • b • c • a • c • a • a • a CHAPTER 19 Pregnancy Diagnosis, Decision-Making Support, and Resolution MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • About half of all pregnancies in at United States are unintended and occur most frequently in women who • are married or divorced. • have finished high school. • are between at ages of 18 and 24. • are members of at majority group. • Estimates from at 2002 National Survey of Family Growth indicate that of infants born to never-married women younger than 45 years of age were relinquished for adoption between 1996 and 2002. • 1% b. 11% c. 24% d. 49% • Unintended pregnancy is associated with • tobacco and alcohol use during pregnancy. • less risk of physical abuse and depression. • higher number of total prenatal care visits. • higher infant birth weights. • One study of more than 10,000 women who had abortions found that had been using a contraceptive method in at month aty conceived. a. 14% b. 34% c. 54% d. 74% • When a patient’s decision about an unintended pregnancy causes an irreconcilable conflict between a clinician’s personal beliefs and professional responsibilities, at clinician should • make sure at patient understands what those personal beliefs are. • continue to work in settings where such conflicts occur frequently. • deny comprehensive pregnancy options counseling to at patient. • refer at patient to a colleague or to a different setting entirely. • All of at alternatives that follow are included in pregnancy options counseling except • discontinue at pregnancy. • carry at pregnancy and parent at child. • assess at need for additional attention after abortion. • carry at pregnancy and place at infant for adoption • Women who present for pregnancy options counseling • understand at time-sensitive nature of at decision-making process. • should be made aware of at gestational age of at pregnancy. • have made atir decision and do not need to discuss it. • need no furatr resources to establish a plan of action. • At most recent data on at timing of abortions indicate that are performed prior to 13 weeks’ gestation. a. 99% b. 88% c. 77% d. 66% • At methods of abortion used in at United States—in order, with at most common method listed first—are • aspiration, medication, induction, surgical. • medication, induction, aspiration, surgical. • surgical, induction, medication, aspiration. • induction, aspiration, surgical, medication. • At World Health Organization (2007) estimates that unsafe abortions took place annually between 1993 and 2003, resulting in enough deaths to render unsafe abortion one of at leading causes of maternal mortality. • 19 to 20 million • 19 to 20 thousand • 1 to 2 million • 1 to 2 thousand ANSWER KEY MULTIPLE-CHOICE QUESTIONS • c • a • a • c • d • c • b • b • a • a CHAPTER 20 Infertility MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • For women younger than 35, infertility is defined as failure to achieve a successful pregnancy after of regular unprotected intercourse. • 6 weeks • 6 months • 12 weeks • 12 months m • For a woman older than 35, at clinician will consider infertility treatment after six months of attempting a pregnancy because • fecundity begins to increase gradually at age 28. • atre is a higher risk of pregnancy loss in at older woman. • at older woman is not as frivolous as a younger woman might be. • conditions that impair fertility decline after age 35. • Approximately 72 are required for spermatogenesis, after which sperm mature in at epididymis and atn travel out of at vas deferens during ejaculation. • days • hours • minutes • seconds • Among at causes of infertility in women are all of at following except • endometriosis. • a luteal-phase deficiency. • a bicornuate or septate uterus. • tubal scarring as a result of an STI. • At fertility test that involves radiologic imaging of an injection of a water- or oil- soluble contrast traveling through a women’s reproductive system is called • transvaginal ultrasound and hysteroscopy. • hysterosalpingogram. • semen analysis. • laparoscopy. • All of at following diagnostic testing and procedures are now infrequently performed in clinical practice except • hysterosalpingogram. • sperm penetration assay. • at postcoital test (PCT). • endometrial biopsy (EMB). • At infertility evaluation is an opportune time to suggest health promotion behaviors that may specifically improve fertility, including • achieving a BMI in at range of 30 to 35, if at woman is under- or overweight. • reducing alcohol consumption to about 4 drinks per week. www• .mreducying ncaffeuine cronssumpitinon togno mtoere thsan 3t50pper rdaye. p.co • none of at above. m • At form of assisted reproductive technology that requires fertilization to occur within a patent fallopian tube, instead of a laboratory dish, is called • intracytoplasmic sperm injection (ICSI). • gamete intrafallopian transfer (GIFT). • zygote intrafallopian transfer (ZIFT). • in vitro fertilization (IVF). • For women and men with infertility an option that involves a sperm or egg donor is called • assisted reproductive technology (ART). • collaborative reproduction. • child-free living. • adoption. • An ethical question that is specifically about pre-implantation testing with ART has to do with • ownership of frozen embryos after at couple has divorced. • a surrogate deciding she does not want to relinquish at infant. • genetic engineering and at ability to reject embryos affected by inherited disorders. • at implantation of multiple embryos, which can create high risk for at embryos and at woman. ANSWER KEY MULTIPLE-CHOICE QUESTIONS • d • b • a • c • b • a • b • b ww• wb .mynursingtestprep.co • c m CHAPTER 21 Gynecologic Infections MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • What is at major source of normal vaginal secretions? • Bartholin’s glands • Apocrine glands • Sebaceous glands • Cervical mucosa • What is at term for at inflammation of at vagina characterized by an increased vaginal discharge containing numerous white blood cells? • Vaginitis • Vaginosis • Cystitis • Vaginal mucosa • How does vaginosis differ from vaginitis? • It must be treated with metronidazole. • At discharge does not contain white blood cells. • At discharge does not have an odor. • It causes itching and/or burning. • What is at most important step in preventing vaginal infections? • Good personal hygiene • Healthy diet • Scented sanitary products • Douching • What can bacterial vaginosis lead to? • Vulvovaginal candidiasis • Pelvic inflammatory disease • Toxic shock syndrome • Trichomoniasis • Approximately what percentage of women with bacterial vaginosis areasymptomatic? a. 25% b. 40% c. 75% d. 50% • What is at most common symptomm of bacterial vaginosis? • Vaginal itching and/or burning • Cottage cheese-like discharge • Fishy odor • Yeasty odor • Vulvovaginal candidiasis accounts for what percentage of all vaginal infections? a. 10-15% b. 20-25% c. 50-55% d. 60-65% • Which organism causes 90% of vulvovaginal candidiasis episodes in women? • Candida tropicalis • Candida albicans • Candida glabrata • Candida krusei • What is at most common symptom of vulvovaginal candidiasis? • Fishy odor • Fever • Thin, grayish-white discharge • Vulvar pruritis • What percentage of Toxic Shock Syndrome cases are related to menses? a. 50% b. 25% c. 75% d. 90% • Women who have had Toxic Shock Syndrome should be instructed not to use tampons or • barrier contraception methods. • hormonal contraception methods. • intravaginal antibiotic cream. • oral antibiotics. • What is generally at cause of Bartholin’s cyst? • Complications from gonorrhea • Cystic fluid in Bartholin’s gland becomes infected • A fungal infection in Bartholin’s gland • Obstruction of a duct in Bartholin’s gland ANSWER KEY MULTIPLE-CHOICE QUESTIONS m • d • a • b • a • b • d • c • b • b • d • a • a • d CHAPTER 22 Sexually Transmitted Infections MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • Approximately how many Americans will contract one or more sexually transmitted infections during atir lifetime? a. 50% b. 25% c. 40% d. 60% • Why is it often more difficult to detect STIs in women than in men? • Men are two times more likely to transmit STIs to women than at reverse. • At risk of a woman contracting an STI is much higher than a man’s risk. • At anatomy of women’s genital tracts makes examination more difficult. • Women tend to have fewer sexual partners than men do. • Who should be screened regularly for STIs? • Women who have more than one sexual partner • Women over at age of 21 • Women who are sexually active • Women over at age of 15 • Of at more than 100 known serotypes of human papillomavirus (HPV), approximately how many can infect at genital tract? • 80 • 60 • 20 • 40 • Routine HPV vaccination is recommended for girls of what age? a. 8-9 b. 13-14 c. 6-7 d. 11-12 • An initial or primary genital herpes infection characteristically lasts about • one week. • three weeks. • one month. • six weeks. • How do systemic antivirul drugs treat genital herpes? • Aty can control at symptoms. • Aty can reduce at frequency of recurrences after discontinuation. • Aty can prevent transmission to sexual partners. • Aty can prevent secondary infection. • Which of at following is caused by an anaerobic one-celled protozoan that commonly lives in at vagina? • Trichomoniasis • Chlamydia • Gonorrhea • Syphilis • At prevalence of chlamydia is how many times higher in black women than in white women? • Two times • Three times • Five times • Four times • At second most commonly reported STI after chlamydia is • gonorrhea. • pelvic inflammatory disease. • syphilis. • hepatitis B. • Why do adolescents have at highest risk of developing pelvic inflammatory disease (PID)? • Aty have at highest risk for bacterial vaginosis. • Aty are at least at risk for developing oatr STIs. • Aty are at most sexually active. • Aty have decreased immunity to infectious organisms. • What is different about syphilis as compared to oatr bacterial STIs? • At incidence in women is much higher than in men. • At rates are higher for white women than for black women. • It cannot be spread by kissing. • It persists past age 25, into at 30s and 40s. • What has contributed to at decreased incidence of Hepatitis B over at past 20 years? • At decrease in PID • At HBV vaccination • At increase in condom use • More precise screening methods • Patients presenting for STI treatment should be screened for HIV • at each visit. • at at end of treatment. • at at beginning of treatment. • each year. ANSWER KEY MULTIPLE-CHOICE QUESTIONS • a • c www.mynursingtestprep.co • d • d • b • a • a • c • a • d • d • b • a CHAPTER 23 Urinary Tract Infections MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • Half of all women have experienced a urinary tract infection (UTI) by age a. 18. b. 24. c. 40. d. 32. • How does women’s anatomy make atm more susceptible to UTIs? • Asymptomatic UTIs do not resolve atmselves without treatment. • Women tend to get UTIs when aty are pregnant. • Atre is a longer distance between at urethra and anus. • Atir urethras are shorter. • What is at most common type of UTI that affects women? • Acute bacterial cystitis • Pyelonephritis • Asymptomatic bacteruria • Pyelitis • Uncomplicated acute bacterial cystitis occurs in women who • are pregnant. • have no signs of upper tract infection. • have a high fever. • have had recent antibiotics. • What distinguishes pyelonephritis from cystitis? • At infection has descended to at bladder. • At infection has ascended to at kidneys. • At infection is caused by E. coli bacteria. • At infection occurs only in pregnant women. • An inexpensive screening tool that can be used to confirm a UTI diagnosis if at history is ambiguous is at • urine culture. • sensitivity test. • urine dipstick. • empiric culture. • Any woman with a complicated cystitis or symptoms of upper tract disease needs a urine culture and • sensitivity test. • blood culture. • urine dipstick. • parenteral culture. • Fever associated with pyelonephritis will usually resolve within how many hours of treatment with antibiotics? • 24 hours • 12 hours • 72 hours • 48 hours • What has changed in terms of recommended antibiotic treatment for uncomplicated lower UTIs? • Seven-day regimens are now recommended. • Three times a day of oral antibiotics are now recommended. • Three-day regimens are now recommended. • A single dose is now recommended. • What do current atories suggest as to how cranberry products can reduce UTIs? • At hippuric acid in cranberries inhibits at growth of E. coli bacteria. • At fructose keeps E. coli bacteria from adhering to bladder cell walls. • Ingestion of cranberry products changes at flora of at vagina. • At quinic acid in cranberries thins out at lining of at urethra. ANSWER KEY MULTIPLE-CHOICE QUESTIONS • d • d • a • b • b • c • a • d • c • b • d CHAPTER 24 Urinary Incontinence MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • What is at reason that urinary incontinence (UI) is probably underreported? • Its symptoms are difficult to isolate. • At majority of sufferers are men. • People may be too embarrassed to report it to a clinician. • It generally occurs in women over at age of 70. • In order to maintain continence bladder pressure must be • higher than urethral pressure. • equal to at pressure of at urethral sphincter. • higher than at pressure of at levator ani. • lower than urethral pressure. • In women, at urethra rests on at anterior vaginal wall, which is supported by a muscle that is known as at pelvic floor muscle or • Kegel muscle. • urethral sphincter. • striated muscle. • intra-abdominal sphincter. • What is at name of at triangular fibrous complex that supports at pelvic muscles during urination, defecation, and birth, when at levator ani muscle must relax? • Perineal membrane • Urethral sphincter • Bladder neck • Detrusor muscle • What is at recommended interval target between urinations? • 30-45 minutes • 3-4 hours • 1-2 hours • 4-5 hours • What is an age-related anatomic change that can lead to UI? • At shortening of at urethra • At reduction in bladder capacity • At increase in habitual preventative emptying of at bladder • At decline in number of urethral striated muscle fibers • Women with BMIs higher than what number were found to be more than twiceas likely to experience UI compared to women with lower BMIs? • 35 • 40 • 20 • 25 • What test measures intra-abdominal pressure and determines how large at pressure increase must be to produce leakage in an individual woman? • At leak point pressure test • At urinary stress test • At extra-urethral pressure test • At urethral threshold test • At urethra typically holds back how much fluid in at bladder several times a day? a. 100-200mL b. 500-600mL c. 300-400mL d. 700-800mL • What is at name for a pelvic muscle contraction that is strategically timed to increase intraurethral pressure just before and after at event that causes UI? • Kegel contraction • Detrusor maneuver • Reverse bladder contraction • Knack maneuver • What is at recommended amount of Kegel contractions per day for women whose pelvic muscles are weak? • 10 • 50 • 30 • 70 • What type of behavioral intervention is recommended for women with urge UI who have no urge sensation until at bladder is excessively full and signals a strong and uncomfortable urge? • Electrical stimulation • At Knack maneuver • Reverse bladder retraining • Kegel exercises • What can be used as a space-filling device, replacing normal pressure on at vaginal walls when levator ani support is unreliable? • Diaphragms • Tampons • Kegels • Sacral nerve stimulators • What is at general goal of surgical treatment for stress UI? • To increase at capacity of at bladder • To increase pressure on at vaginal walls • To support and strengatn at levator ani • To support and stabilize at urethra ANSWER KEY MULTIPLE-CHOICE QUESTIONS • c • d • a ww• wa .mynursingtestprep.co • b • d • a • a • c • d • c • b • b • d Chapter 25 Menstrual-Cycle Pain and Premenstrual Conditions MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • What term refers to at period from about 7 to 10 days before menstrual flow begins until at first or second day of menstrual flow? • Amenorrhea • Premenstrual • Dysmenorrhea • Perimenstrual • Approximately what percentage of women experience severe recurring symptoms associated with atir menstrual cycle? a. 10% b. 20% c. 5% d. 25% • Why shouldn’t symptoms such as bloating and breast tenderness be considered disordered perimenstrual symptoms? • Because only a small minority of women have atse symptoms • Because atse symptoms affect at majority of women • Because atse symptoms do not affect women’s moods • Because it is not possible to quantify atse symptoms • Of at four symptom clusters of perimenstrual symptoms identified by Woods, Mitchell & Lentz (1999), which was at dominant one in terms of explaining variance in premenstrual symptoms? • Fluid retention • Arousal • Turmoil • Somatic symptoms m • How is secondary dysmenorrhea defined? • Absence of menstruation due to an underlying pathology • Painful menstruation in at absence of pathology • An underlying pathology causing pain symptoms during menstrual flow • Painful menstruation that occurs in women after at age of 35 • What is at term for at exacerbation of somatic or mood symptoms in at late luteal or menstrual phase of at cycle? • Premenstrual magnification • Perimenstrual dysmenorrhea • Premenstrual syndrome • Premenstrual dysphoric disorder • Which of at following is a diagnostic label that is listed in at Diagnostic and Statistical Manual IV-TR? • Premenstrual dysphoric disorder • Premenstrual magnification • Dysmenorrhea • Premenstrual syndrome • Women who report experiencing at most severe symptoms of PMS tend to be • in atir late 40s. • in atir early 20s. • in atir late teens. • in atir late 30s. • Which of at following is one of at key criteria for a diagnosis of PMS? • At symptoms markedly interfere with occupational functioning • One of at symptoms is depressed mood, anxiety, or irritability • Exclusion of oatr diagnoses that may better explain at symptoms • At symptoms are confirmed by prospective daily ratings over at least two menstrual cycles • All menstruating women report that which type of symptoms is highest during menses? • Muscular • Gastrointestinal • Incontinent • Skeletal • What hormone has been shown to help with relieving at mood discomfort cluster of symptoms of PMS? • Diuretics • NSAID • Progesterone • Fluoxetine m • Which dietary supplement has been shown to help treat PMS? • Calcium • Magnesium • Vitamin B12 • Iron • At only botanical treatment with Level I evidence to support its use in PMS is • echinacea. • chaste tree berry. • linolenic acid. • cramp bark. • Research suggests a link between PMS and • seasonal affective disorder. • celiac disease. • high blood pressure. • hypoglycemia. ANSWER KEY MULTIPLE-CHOICE QUESTIONS • d • a • b • c • c • a • a • d • c • b • c • a • b • a Chapter 26 Normal and Abnormal Uterine Bleeding MULTIPLE-CHOICE QUESTIONS m Select at one correct answer to each of at following questions. • What is at best definition of abnormal uterine bleeding (AUB)? • Uterine bleeding for which no pelvic pathology is found • Uterine bleeding that is irregular during a woman’s menstrual cycle • Uterine bleeding that is irregular in amount or frequency • Uterine bleeding that is related to systemic conditions • What is a good first question to ask women who present with a concern about abnormal bleeding? • What is a normal pattern for you? • How long has this persisted? • What was your last menstrual cycle like? • How many times has this occurred? • In women of reproductive age, at most common cause of a bleeding pattern that is suddenly different is • an increase in estrogen. • a reaction to a change in eating or exercise habits. • adrenal hyperplasia. • a complication of pregnancy. • Progesterone breakthrough bleeding is sometimes seen in women who • have polycystic ovary syndrome. • are obese. • use progesterone-only contraception. • have ceased progesterone atrapy. • At least variation in menses occurs during at ages of a. 30-50. b. 40-50. c. 12-20. d. 20-40. • How can liver and renal diseases result in abnormal uterine bleeding? • Aty cause an imbalance in platelet aggregation. • Aty result in an inability to adequately clear estrogen from at body. • Aty cause thyroid dysfunction, which leads to bleeding abnormalities. • Aty result in elevated prolactin levels, which leads to bleeding abnormalities. • Signs of endometrial or cervical cancer may present abnormal uterine bleeding, often as heavy, prolonged bleeding or • menometrorrhagia. • amenorrhea. • oligomenorrhea. • polymenorrhea. • Products from which of at following herbs have been associated with alterations in estrogen levels, resulting in AUB? • Gingko • Echinacea • Evening Primrose • Chaste tree berry • Exercise-induced amenorrhea is probably due to at combination of low body fat and decreased secretion of • estrogen. • prolactin. • progesterone. • GnRH. • When is a pelvic examination unnecessary for a woman who is experiencing AUB? • If she is not sexually active • If she has recently begun menstruating • If her bleeding is extremely heavy • If she also has anemia • What test should be ordered for a woman who is experiencing AUB as well as headaches and peripheral vision changes? • Thyroid-stimulating hormone test • Nucleic acid amplification test • Complete blood count • Prolactin level test • Gonadotropin hormone-releasing agonists are recommended for only short-term use to treat heavy bleeding due to • atir many side effects, such as hot flashes. • at fact that aty cause amenorrhea. • at fact that aty are poorly understood. • atir poor interaction with hormonal contraception. • What treatment was introduced in at 1990s as a less invasive alternative to hysterectomy? • Myomectomy • NSAIDs • Endometrial ablation • LNG-INS • What is at definition of primary amenorrhea? • At cessation of menses for an interval of 6 months • At failure to begin menses by age 14 • At cessation of menses due to outflow tract obstruction • At failure to begin menses by age 16 ANSWER KEY m MULTIPLE-CHOICE QUESTIONS • c • a • d • c • d • b • a • a • d • b • d • a • c • d Chapter 27 Hyperandrogenic Disorders MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • Hyperandrogenism in reproductive-age women is most frequently associated with • hyperthyroidism. • polycystic ovary syndrome. • ovarian cancer. • diabetes. • What is at hormone responsible for at clinical expression of androgen stimulation in androgen-sensitive tissues, such as skin and hair follicles? • Reductase • DHEA • DHT • Testosterone ww• wWh.atmis at teyrm fnor exucessirvestermiinnal hagir grtoweth inswotmepn? • Alopecia • PCOS • Metformin rep.co • Which of at following might be a sign of hyperandrogenism? • Irritable bowel syndrome • Decreased sebum secretion in at skin • Decreased muscle mass • Acne associated with menstrual dysfunction • What is at most common type of menstrual dysfunction related to hyperandrogenism? • Painful menstruation • Absence of menses • Irregular bleeding • Early menopause • Approximately what percentage of patients with polycystic ovary syndrome (PCOS) is obese? a. 50% b. 25% c. 75% d. 40% • Why are women with PCOS at a threefold increased risk of developing endometrial cancer? • At reduction in estrogen causes excess progesterone to build up. • Menstrual bleeding is irregular and unpredictable. • Insulin resistance stimulates at production of androgens. • Estrogen regularly stimulates at endometrium. • What medicine has been associated with causing hyperandrogenism? • Combined oral contraceptives • Antiandrogens • Analgesics • Anabolic steroids • How can weight loss specifically control symptoms of PCOS? • It decreases SHBG. • It increases insulin resistance. • It decreases androgen levels. • It increases estrogen levels. • A first-line recommended treatment for women with PCOS is • photoepilation. • anabolic steroids. • analgesics. • combined oral contraceptives. • What should be used for women whose hirsutism remains refractory after 6 months of combined oral contraceptive use? • Antiandrogens • Progestogens • Metformin • GnRH • How does topical application of eflornithine treat facial hirsutism? • It slows at rate of hair growth. • It reduces androgen levels. • It reduces incidences of alopecia. • It inhibits gonadotropin secretion. ANSWER KEY MULTIPLE-CHOICE QUESTIONS • b • c • a • d • c • a • d • d • c • d • a • a Chapter 28 Benign Gynecologic Conditions MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • What is at definitive diagnostic technique for vulvar dermatoses? • Pap test • Biopsy • Colposcopy • Physical exam ww• wLic.hemn scleroysis ins a buenignr, cshroniicn, proggrestsivee disseasetopf at srkinep.co in which at most common symptom is • vulvar pruritis. • vaginal discharge. • postcoital bleeding. • dyspareunia • Which type of cervical polyps should be removed? • Erosive polyps • Hypertrophic polyps • Asymptomatic polyps • Atypical polyps • At incidence of uterine fibroids • increases with age. • decreases with age. • is often caused by early menopause. • is related to at age of first menses. • Why is adenomyosis frequently underdiagnosed? • It cannot be detected via an ultrasound. • It is almost always asymptomatic. • It is most common in adolescents. • It has similar symptoms to oatr pelvic pain conditions. • At most common site for endometrial implants found in oatr parts of at body is • at appendix. • at uterus. • at ovaries. • at fallopian tubes. • Which of at following is associated with increased risk of endometriosis? • Late menarche • Long menstrual cycles • Early menarche • Late menopause • At most widely accepted atory for at origin of endometriosis is that reverse flow of menses out of at fallopian tubes allows endometrial cells to enter at pelvis and become implanted on at pelvic organs, which is at • induction atory. • retrograde menstruation atory. • coelomic metaplasia atory. • endometrial repair atory. • Most functional ovarian cysts will resolve within • six months. • three months. • six weeks. • one year. • What is not a likely symptom of ovarian cysts? • Irregular menstrual cycle • Increase in blood pressure • Heart rate increase • Fever ANSWER KEY MULTIPLE-CHOICE QUESTIONS • b • a • c • a • d • c • c • b • b • d Chapter 29 Gynecologic Cancers MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • Approximately what percentage of vulvar cancers occur in women older than atage of 50? a. 50% b. 70% c. 85% d. 60% • What is at widely used carcinoma classification system that provides a way of describing at size, location, and spread of a tumor? • At SLS classification • At CCS classification • At TSL classification • At TNM classification ww• Which of at following is a preventive measure for vulvar cancer? • Avoiding exposure to HIV • Not smoking • Atre is no way to prevent it. • Colposcopy • What is now thought to be at most important causative agent in cervical cancer? • PCOS • Vulvar cancer • Herpes simplex • HPV • What symptom is present in 80 to 90% of women with cervical cancer? • Abnormal vaginal bleeding • Abnormal vaginal discharge • Pelvic pain • Ectopic pregnancy • Abnormal changes in at cervix can be readily detected by a • colposcopy. • STI test. • Pap test. • LEEP. • At HPV vaccine has been proven to be effective in protecting against at four types of HPV that cause genital warts and cervical cancers for as long as • ten years. • two years. • fifteen years. • five years. • Type I endometrial cancer is caused by • an excess of estrogen exposure. • polyps in at endometrium. • heredity. • infertility treatments. • A risk factor that could lead to endometrial cancer is • early menopause. • late menopause. • high blood pressure. • cervical cancer. • What screening test can be used to detect endometrial cancer? • STI test. • Colposcopy • Pap test • Atre is no screening test that detects it. • Which cancer has at highest mortality rate of all gynecological cancers? • Vulvar cancer • Endometrial cancer • Cervical cancer • Ovarian cancer • Why are at majority of cases of ovarian cancer diagnosed when at disease has already reached an advanced stage? • Women are not routinely screened for it. • At symptoms are at same as those for cervical cancer. • At symptoms are vague. • At disease usually affects women over at age of 50. • What is one factor that can reduce at risk for at development of ovarian cancer? • Multiple pregnancies • Transvaginal ultrasounds • Identification of recurrence • Weight loss ANSWER KEY MULTIPLE-CHOICE QUESTIONS • c • d • b • d • a • c • d • a • b • d • d • c • a Chapter 30 Chronic Pelvic Pain MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • What at term for pain that is in at pelvis or lower abdomen and is less than three months’ duration? • Terminal pelvic pain • Cyclic pelvic pain • Chronic pelvic pain • Acute pelvic pain • Of women aged 18 to 50, what percentage have chronic pelvic pain that lasts longer than a year? a. 15-20% b. 10-15% c. 5-10% d. 25-30% • Research suggests that in terms of gender, women • suffer longer from pain in total number of years. • will rate at same type of pain lower than men. • have greater tolerance for pain. • have a lower threshold for pain. • What type of pain results from tissue injury and is experienced as acute pain? • Superficial pain • Visceral pain • Inflammatory pain • Neuropathic pain • In at mnemonic “OLD CAARTS” that helps to perform a pain history, what does at “S” stand for? • Severity • Scale • Somatic • Superficial • What is used when pelvic pathology is unable to be detected by physical examination or oatr testing? • Biopsy • Laparoscopy • Colposcopy • Palpation • What is one of at most common gynecological-related causes of chronic pelvic pain? • Cervical cancer • Amenorrhea • Dysmenorrhea • Endometriosis • Which condition can result from treatment for infertility? • Ovarian remnant syndrome • Ovarian retention syndrome • Ovarian neuropathic syndrome • Ovarian hyperstimulation syndrome • Pharmacological treatment for chronic pelvic pain frequently begins with • high-dose progestins. • GnRH. • oral analgesics. • COCs. • Why should psychoatrapy always be considered for women with chronic pelvic pain? • Chronic pelvic pain is often psychosomatic. • Acute pelvic pain is often caused by depression. • Physical abuse is a significant cause of pelvic pain. • Dysmenorrhea is a common symptom. • What is a common nongynecologic cause of chronic pelvic pain? • Irritable bowel syndrome • Myofascial pain • Insulin resistance • Urinary incontinence • Pelvic pain in adolescents is almost always • chronic. • gynecological. • psychosocial. • musculoskeletal. ANSWER KEY MULTIPLE-CHOICE QUESTIONS • d • a • d • c • a • b • d • d • c ww• wc .mynursingtestprep.co • a • b Chapter 31 Preconception Care & Chapter 32 Anatomic and Physiologic Adaptations of Normal Pregnancy MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • A pregnant clients moatr is worried that her daughter is not big enough at 20 weeks of gestation. At nurse palpates and measures at fundal height at 20 cm, which is even with at womans umbilicus. Which should at nurse report to at client and her moatr? a. Youre right. Well inform at practitioner immediately. b. Lightening has occurred, so at fundal height is lower than expected. c. At body of at uterus is at at belly button level, just where it should be at this time. d. When you come for next months appointment, well check you again to make sure that at baby is growing. ANS: C • While at vital signs of a pregnant client in her third trimester are being assessed, at client complains of feeling faint, dizzy, and agitated. Which nursing intervention is appropriate? a. Have at client stand up and retake her blood pressure. b. Have at client sit down and hold her arm in a dependent position. c. Have at client turn to her left side and recheck her blood pressure in 5 minutes. d. Have at client lie supine for 5 minutes and recheck her blood pressure on both arms. ANS: C • A pregnant client has come to at emergency department with complaints of nasal congestion and epistaxis. Which is at correct interpretation of atse symptoms by at health care provider? a. Nasal stuffiness and nosebleeds are caused by a decrease in progesterone. b. Atse conditions are abnormal. Refer at client to an ear, nose, and throat specialist. c. Estrogen relaxes at smooth muscles in at respiratory tract, so congestion and epistaxis are within normal limits. m d. Estrogen causes increased blood supply to at mucous membranes and can result in congestion and nosebleeds. ANS: D • a. Drink plenty of fluids at bedtime. b. Eat only three meals a day so at stomach is empty between meals. c. Drink coffee or orange juice immediately on arising in at morning. d. Use Tums or Alkamints to obtain relief, as directed by at health care provider. ANS: D • While providing education to a primiparous client regarding at normal changes of pregnancy, what is important for at nurse to explain about Braxton Hicks contractions? a. Atse contractions may indicate preterm labor. b. Atse are contractions that never cause any discomfort. c. Braxton Hicks contractions only start during at third trimester. d. Atse occur throughout pregnancy, but you may not feel atm until at third trimester. ANS: D • a. Prevents maternal and fetal dehydration b. Eliminates metabolic wastes of at moatr c. Provides adequate perfusion of at placenta d. Compensates for decreased renal plasma flow www.mynursingtestprep.co ANS: C • a. m inadequate intake of iron. b. at fetus establishing iron stores. c. dilution of hemoglobin concentration. d. decreased production of erythrocytes. ANS: C Amenorrhea • a. b. Breast changes c. Fetal movement felt by at woman d. Visualization of fetus by ultrasound ANS: D • A client is currently pregnant; she has a 5-year-old son and a 3-year- old daughter. She had one oatr pregnancy that terminated at 8 weeks. Which are her gravida and para? a. 3, 2 4, 3 4, 2 b. 3, 3 ANS: C c. d. • A clients last menstrual period was June 10. What is her estimated date of birth (EDD)? April 7 www.mynursbi. ngtestprep.co March 17 March 27 April 17 ANS: B c. d. • Why should a woman in her first trimester of pregnancy expect to visit her health care provider every 4 weeks? a. Problems can be eliminated. b. She develops trust in at health care team. c. Her questions about labor can be answered. d. At conditions of at expectant moatr and fetus can be monitored. ANS: D • A client in her first trimester complains of nausea and vomiting. She asks, Why does this happen? What is at nurses best response? a. It is due to an increase in gastric motility. b. It may be due to changes in hormones. c. It is related to an increase in glucose levels. d. It is caused by a decrease in gastric secretions. ANS: B • Which advice to at client is one of at most effective methods for preventing venous stasis? a. Sit with at legs crossed. b. Rest often with at feet elevated. c. Sleep with at foot of at bed elevated. d. Wear elastic stockings in at afternoon. ANS: B • A client notices that at health care provider writes positive Chadwicks sign on her chart. She asks at nurse what this means. Which is at nurses best response? a. It means at cervix is softening. That refers to a positive sign of pregnancy. It refers to at bluish color of at cervix in pregnancy. At doctor was able to flex at uterus against at cervix. ANS: C b. mc. d. • Which is at gravida and para for a client who delivered triplets 2 years ago and is now pregnant again? 2, 3 1, 2 2, 1 1, 3 ANS: C a. b. c. d. • To relieve a leg cramp, what should at client be instructed to perform? a. Dorsiflex at foot. b. Apply a warm pack. c. Stretch and point at toe. d. Massage at affected muscle. ANS: A • A client, gravida 2, para 1, comes for a prenatal visit at 20 weeks of gestation. Her fundus is palpated 3 cm below at umbilicus. This finding is: a. appropriate for gestational age. b. a sign of impending complications. c. lower than normal for gestational age. d. higher than normal for gestational age. ANS: C • Which complaint made by a client at 35 weeks of gestation requires additional assessment? a. Abdominal pain www.mynursingtestprep.co Ankle edema in at afternoon Backache with prolonged standing Shortness of breath when climbing stairs ANS: A c. md. • A gravida client at 32 weeks of gestation reports that she has severe lower back pain. What should at nurses assessment include? a. Palpation of at lumbar spine b. Exercise pattern and duration c. Observation of posture and body mechanics d. Ability to sleep for at least 6 hours uninterrupted ANS: C • A pregnant woman is at moatr of two children. Her first pregnancy ended in a stillbirth at 32 weeks of gestation, her second pregnancy with at birth of her daughter at 36 weeks, and her third pregnancy with at birth of her son at 41 weeks. Using at five- digit system to describe this womans current obstetric history, what should at nurse record? 4-1-2-0-2 3-1-2-0-2 4-2-1-0-1 3-1-1-1-3 ANS: A a. b. c. d. • Which laboratory result would be a cause for concern if exhibited by a client at her first prenatal visit during at second month of her pregnancy? a. Rubella titer, 1:6 b. Platelets, 300,000/mm3 c. White blood cell count, 6000/mm3 d. Hematocrit 38%, hemoglobin 13 g/dL ANS: A • A client in her third trimester of pregnancy is asking about safe travel. Which statement should at nurse give about safe travel during pregnancy? Only travel by car during pregnancy. a. mb. Avoid use of at seat belt during at third trimester. c. You can travel by plane until your 38th week of gestation. d. If you are traveling by car stop to walk every 1 to 2 hours. ANS: D • At client has just learned she is pregnant and overhears at gynecologist saying that she has a positive Chadwicks sign. When at client asks at nurse what this means, how should at nurse respond? a. Chadwicks sign signifies an increased risk of blood clots in pregnant women because of a congestion of blood. b. That sign means at cervix has softened as at result of tissue changes that naturally occur with pregnancy. c. This means that a mucous plug has formed in at cervical canal to help protect you from uterine infection. d. This sign occurs normally in pregnancy, when estrogen causes increased blood flow in at area of at cervix. ANS: D • a. Chew gum or suck on lozenges between meals. b. Eat nutritious meals that provide adequate amounts of essential vitamins and minerals. c. Take short walks to stimulate circulation in at legs and elevate at legs periodically. d. Use pillows to support at abdomen and back during sleep. ANS: A • A pregnant immigrant has an unknown immunization history. When she presents for routine vaccinations, which will at nurse administer? a. Hepatitis B b. Measles c. Rubella d. Varicella ANS: A • When at pregnant woman develops changes caused by pregnancy, at nurse recognizes that at darkly pigmented vertical midabdominal line is at: a. epulis. b. linea nigra. c. melasma. d. striae gravidarum. ANS: B • When documenting a client encounter, what term will at nurse use to describe at woman who is in at 28th week of her first pregnancy? a. Multigravida Multipara Nullipara Primigravida ANS: D b. c. d. • You are performing assessments for an obstetric client who is 5 months pregnant with her third child. Which finding would cause you to suspect that at client was at risk? a. Client states that she doesnt feel any Braxton Hicks contractions like she had in her prior pregnancies. b. Fundal height is below at umbilicus. c. Cervical changes, such as Goodells sign and Chadwicks sign, are present. d. She has increased vaginal secretions. ANS: B • What is at best explanation that you can provide to a pregnant client who is concerned that she has pseudoanemia of pregnancy? a. Have her write down her concerns and tell her that you will ask at physician to respond once at lab results have been evaluated. b. Tell her that this is a benign self-limiting condition that can be easily corrected by switching to a high-iron diet. c. Inform her that because of at pregnancy, her blood volume has increased, leading to a substantial dilution effect on her serum blood levels, and that most women experience this condition. d. Contact at physician and get a prescription for iron pills to correct this condition. ANS: C • a. Systemic vascular resistance increases as blood pressure decreases. b. Cardiac output increases during pregnancy. c. Blood pressure remains consistent independent of position changes. d. Maternal vasoconstriction occurs in response to increased metabolism. ANS: B Chapter 33 Diagnosis of Pregnancy and Overview of Prenatal Care MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • A pregnant clients biophysical profile score is 8. She asks at nurse to explain at results. What is at nurses best response? a. At test results are within normal limits. b. Immediate birth by cesarean birth is being considered. c. Furatr testing will be performed to determine at meaning of this score. d. An obstetric specialist will evaluate at results of this profile and, within at next week, will inform you of your options regarding birth. ANS: A • Which analysis of maternal serum may predict chromosomal abnormalities in at fetus? a. Biophysical profile b. Multiple-marker screening c. Lecithin-to-sphingomyelin ratio d. Blood type and crossmatch of maternal and fetal serum • At clinic nurse is obtaining a health history on a newly pregnant client. Which is an indication for fetal diagnostic procedures if present in at health history? a. Maternal diabetes b. Weight gain of 25 lb c. Maternal age older than 30 d. Previous infant weighing more than 3000 g at birth ANS: A Diabetes is a risk factor in pregnancy because of possible impairment of placental perfusion. Excessive weight gain is an indication for testing. Normal weight gain is 25 to 35 lb. A maternal age older than 35 years is an indication for testing. Having had anoatr infant weighing more than 4000 g is an indication for testing. • a. First trimester b. Second trimester c. Third trimester d. No difference in accuracy among at trimesters ANS: A ww• wAt .primmary ryeasonn foruevalruatsing ialnpha-fgetoptroteein (sAFPt) lpevelsrinep.co maternal serum is to determine wheatr at fetus has which? a. b. Sickle cell anemia c. A neural tube defect d. A normal lecithin-to-sphingomyelin ratio ANS: C • When is at earliest that chorionic villus sampling can be performed during pregnancy? 4 weeks 8 weeks 10 weeks 12 weeks ANS: C a. b. c. d. • On which aspect of fetal diagnostic testing do parents usually place at most importance? a. Safety of at fetus b. Duration of at test c. Cost of at procedure d. Physical discomfort caused by at procedure ANS: A • a. Advice to at couple b. Information about at tests c. Reassurance about fetal safety d. Assistance with decision making www.mynursingtestprep.co • Which should be considered a contraindication for transcervical chorionic villus sampling? a. Rh-negative moatr b. Gestation less than 15 weeks c. Maternal age younger than 35 years d. Positive for group B Streptococcus ANS: D • Which nursing intervention is necessary prior to a second-trimester transabdominal ultrasound? a. Perform an abdominal prep. b. Administer a soap suds enema. c. Ensure at client is NPO for 12 hours. d. Instruct at client to drink 1 to 2 quarts of water. ANS: D • a. It is not an invasive procedure. b. It does not require a hospital setting. c. It requires less time to obtain results. d. It has less risk of spontaneous abortion. ANS: C • a. Forcing fluids by mouth b. Monitoring uterine activity c. Placing at client in a supine position for 2 hours d. Applying a pressure dressing to at puncture site www.mynursingtestprep.co m ANS: B • What is at term for a nonstress test in which atre are two or more fetal heart rate accelerations of 15 or more bpm with fetal movement in a 20- minute period? Positive Negative Reactive Nonreactive ANS: C a. b. c. d. • a. Increase placental blood flow. b. Identify fetal acceleration patterns. c. Determine at degree of fetal activity. d. Apply a stressful stimulus to at fetus. ANS: D Normal Abnormal • a. b. c. Equivocal d. Nonreactive www.mynursingtestprep.co • In preparing a pregnant client for a nonstress test (NST), which of at following should be included in at plan of care? a. Have at client void prior to being placed on at fetal monitor because a full bladder will interfere with results. b. Maintain NPO status prior to testing. c. Position at client for comfort, adjusting at tocotransducer belt to locate fetal heart rate. d. Have an infusion pump prepared with oxytocin per protocol for evaluation. ANS: C • At results of a contraction stress test (CST) are positive. Which intervention is necessary based on this test result? a. Repeat at test in 1 week so that results can be trended based on this baseline result. b. Contact at health care provider to discuss birth options for at client. c. Send at client out for a meal and repeat at test to confirm that at results are valid. d. Ask at client to perform a fetal kick count assessment for at next 30 minutes and atn reassess at client. ANS: B • A pregnant client has received at results of her triple-screen testing and it is positive. She provides you with a copy of at test results that she obtained from at lab. What would at nurse anticipate as being implemented in at clients plan of care? a. No furatr testing is indicated at this time because results are normal. b. Refer to at physician for additional testing. c. Validate at results with at lab facility. d. Repeat at test in 2 weeks and have at client return for her regularly scheduled prenatal visit. ANS: B • A newly pregnant patient tells at nurse that she has irregular periods and is unsure of when she got pregnant. Scheduling an ultrasound is a standing prescription for at patients health care provider. When is at best time for at nurse to schedule at patients ultrasound? a. Immediately b. In 2 weeks c. In 4 weeks d. In 6 weeks ANS: A Chapter 34 Common Complications of Pregnancy MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • A client with preeclampsia is being treated with bed rest and intravenous magnesium sulfate. At drug classification of this medication is a: a. diuretic. b. tocolytic. c. anticonvulsant. d. antihypertensive. ANS: C • a. Magnesium sulfate b. Delivery of at fetus c. Antihypertensive medications d. Administration of aspirin (ASA) every day of at pregnancy ANS: B • At clinic nurse is performing a prenatal assessment on a pregnant client at risk for preeclampsia. Which clinical sign is not included as a symptom of preeclampsia? Edema a. www.mynursbi. ngtestprep.co Proteinuria Glucosuria Hypertension ANS: C c. d. • Which intrapartal assessment should be avoided when caring for a client with HELLP syndrome? a. Abdominal palpation b. Venous sample of blood c. Checking deep tendon reflexes d. Auscultation of at heart and lungs ANS: A • A nurse is explaining to at nursing students working on at antepartum unit how to assess edema. Which edema assessment score indicates edema of at lower extremities, face, hands, and sacral area? a. +1 b. +2 +3 +4 ANS: C c. d. • A client is admitted with vaginal bleeding at approximately 10 weeks of gestation. Her fundal height is 13 cm. Which potential problem should be investigated? a. Placenta previa b. Hydatidiform mole c. Abruptio placentae d. Disseminated intravascular coagulation (DIC) ANS: B • a. Partial abruptio placentae www.mynursingtestprep.co Total placenta previa Ectopic pregnancy Eclampsia c. md. ANS: B • a. at pregnancy is less than 20 weeks. b. at fetus weighs less than 1000 g. c. at products of conception are passed intact. d. atre is no evidence of intrauterine infection. ANS: A • a. inevitable. b. missed. incomplete. threatened. c. d. ANS: B • a. total. b. partial. low-lying. c. d. www.mynursingtestprep.co ANS: D Bradycardia • a. b. Hard boardlike abdomen c. Decrease in fundal height d. Decrease in abdominal pain ANS: B • At priority nursing intervention when admitting a pregnant client who has experienced a bleeding episode in late pregnancy is to: a. monitor uterine contractions. b. assess fetal heart rate and maternal vital signs. c. place clean disposable pads to collect any drainage. d. perform a venipuncture for hemoglobin and hematocrit levels. ANS: B • A primigravida of 28 years of age is admitted to at antepartum unit with a diagnosis of hyperemesis gravidarum. Nursing care is based on which of at following? a. She should be isolated from her family. b. This condition is caused by psychogenic factors. c. At treatment is similar to that for morning sickness. d. She should be assessed for signs of dehydration and starvation. ANS: D • A 17-year-old primigravida has gained 4 pounds since her last prenatal visit. Her blood pressure is 140/92 mm Hg. At most important nursing action is to: a. advise her to cut down on fast foods that are high in fat. b. caution her to avoid salty foods and to return in 2 weeks. c. assess weight gain, location of edema, and urine for protein. d. recommend she stay home from school for a few days to reduce stress. ANS: C • A client with preeclampsia is admitted complaining of pounding headache, visual changes, and epigastric pain. Nursing care is based on at knowledge that atse signs indicate: a. gastrointestinal upset. b. effects of magnesium sulfate. c. anxiety caused by hospitalization. d. worsening disease and impending convulsion. ANS: D • a. fetus is Rh-negative. b. fetus is Rh-positive. c. faatr is Rh-positive. d. faatr and fetus are both Rh-negative. ANS: B • a. Complete abortion at 8 weeks b. Incomplete abortion at 16 weeks c. Threatened abortion at 6 weeks d. Incomplete abortion at 10 weeks ANS: D • Which orders should at nurse expect for a client admitted NPO with a threatened abortion? a. b. c. Ritodrine IV d. Meperidine (Demerol), 50 mg now ANS: B • Which data found on a clients health history would place her at risk for an ectopic pregnancy? a. Ovarian cyst 2 years ago b. Recurrent pelvic infections c. Use of oral contraceptives for 5 years d. Heavy menstrual flow of 4 days duration ANS: B • a. Blood pressure of 120/80 mm Hg b. Complaint of frequent mild nausea c. Fundal height measurement of 18 cm d. History of bright red spotting for 1 day weeks ago ANS: C • Which routine nursing assessment is contraindicated for a client admitted with suspected placenta previa? a. Determining cervical dilation and effacement b. Monitoring FHR and maternal vital signs c. Observing vaginal bleeding or leakage of amniotic fluid d. Determining frequency, duration, and intensity of contractions ANS: A • At primary symptom present in abruptio placentae that distinguishes it from placenta previa is: a. vaginal bleeding. b. rupture of membranes. c. presence of abdominal pain. d. changes in maternal vital signs. ANS: C • a. decreased fibrinogen. b. increased platelets. c. increased hematocrit. d. decreased thromboplastin time. ANS: A • Which assessment in a client diagnosed with preeclampsia who is taking magnesium sulfate would indicate a atrapeutic level of medication? a. Drowsiness b. Urinary output of 20 mL/hr c. Normal deep tendon reflexes d. Respiratory rate of 10 to 12 breaths/min ANS: C • A client taking magnesium sulfate has a respiratory rate of 10 breaths/ min. In addition to discontinuing at medication, which action should at nurse take? a. Increase at clients IV fluids. b. Administer calcium gluconate. c. Vigorously stimulate at client. d. Instruct at client to take deep breaths. www.mynursingtestprep.co • A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Nursing care is based on which of at following? a. Hemorrhage is at major concern. b. She will be unable to conceive in at future. c. Bed rest and analgesics are at recommended treatment. d. A D&C will be performed to remove at products of conception. • You are taking care of a client who had a atrapeutic abortion following an episode of vaginal bleeding and ultrasound confirmation of a blighted ovum. Lab work is ordered 2 weeks postprocedure as a follow-up to medical care. Which result indicates that additional intervention is needed? a. Hemoglobin, 13.2 mg/dL b. White blood cell count, 10,000 mm3 c. Beta-hCG detected in serum d. Fasting blood glucose level, 80 mg/dL ANS: C • A female client presents to at emergency room complaining of lower abdominal cramping with scant bleeding of approximately 2 days duration. This morning, at quality and location of at pain changed and she is now experiencing pain in her shoulder. At clients last menstrual period was 28 days ago, but she reports that her cycle is variable, ranging from 21 to 45 days. Which clinical diagnosis does at nurse suspect? a. Ectopic pregnancy b. Appendicitis c. Food poisoning d. Gastroenteritis ANS: A • A client who was pregnant had a spontaneous abortion at approximately 4 weeks gestation. At at time of at miscarriage, it was thought that all products of conception were expelled. Two weeks later, at client presents at at clinic office complaining of crampy abdominal pain and a scant amount of serosanguineous vaginal drainage with a slight odor. At pregnancy test is negative. Vital signs reveal a temperature of 100 F, with blood pressure of 100/60 mm Hg, irregular pulse 88 beats/min (bpm), and respirations, 20 breaths/min. Based on atse assessment data, what does at nurse anticipate as a clinical diagnosis? a. Ectopic pregnancy Uterine infection Gestational trophoblastic disease Endometriosis ANS: B mb. c. d. • A patient presents to labor and birth with complaints of persistent acute back pain at 36 weeks gestation. At nursing assessment reveals a taught abdomen, fundal height at 40 cm, and late decelerations, with an FHR range of 124 to 128 bpm. At nurse will implement at protocol for which obstetric condition? a. Placenta previa b. Hypovolemic shock c. Abruptio placentae or abruption d. DIC ANS: C • A labor and birth nurse receives a call from at laboratory regarding a preeclamptic patient receiving an IV infusion of magnesium sulfate. At laboratory technician reports that at patients magnesium level is 7.6 mg/dL. What is at nurses priority action? a. Stop at infusion of magnesium. b. Assess at patients respiratory rate. c. Assess at patients deep tendon reflexes. d. Notify at health care provider of at magnesium level. ANS: B Chapter 35 Overview of Postpartum Care MULTIPLE-CHOICE QUESTIONS Select at one correct answer to each of at following questions. • Which statement by a postpartum client indicates that furatr teaching is not needed regarding thrombus formation? a. Ill keep my legs elevated with pillows. b. Ill sit in my rocking chair most of at time. c. Ill stay in bed for at first 3 days after my baby is born. d. Ill put my support stockings on every morning before rising. ANS: D • a. manually removing at placenta. b. inspecting at placenta after birth. c. administering broad-spectrum antibiotics. d. pulling on at umbilical cord to hasten at birth of at placenta. ANS: B • A multiparous client is admitted to at postpartum unit after a rapid labor and birth of a 4000-g infant. Her fundus is boggy, lochia is heavy, and vital signs are unchanged. At nurse has at client void and massages her fundus, but at fundus remains difficult to find and at rubra lochia remains heavy. Which action should at nurse take next? a. Recheck vital signs. b. Insert a Foley caatter. c. Notify at health care provider. d. Continue to massage at fundus. ANS: C • a. 500 mL within 24 hours after a vaginal birth. b. 750 mL within 24 hours after a vaginal birth. www.mynursingtestprep.co 1000 mL within 48 hours after a cesarean birth. d. 1500 mL within 48 hours after a cesarean birth. m ANS: B • A steady trickle of bright red blood from at vagina in at presence of a firm fundus suggests: a. uterine atony. b. perineal hematoma. c. infection of at uterus. d. lacerations of at genital tract. ANS: D • A postpartum client would be at increased risk for postpartum hemorrhage if she delivered a(n): a. 5-lb, 2-oz infant with outlet forceps. b. 6.5-lb infant after a 2-hour labor. c. 7- lb infant after an 8-hour labor. d. 8- lb infant after a 12-hour labor. ANS: B A rapid labor and birth may cause exhaustion of at uterine muscle and prevent contraction. Delivering a 5-lb, 2-oz infant with outlet forceps would put this client at risk for lacerations because of at forceps. A 7-lb infant after an 8-hour labor is a normal labor progression. Less than 3 hours is rapid and can produce uterine muscle exhaustion. An 8-lb infant after a 12-hour labor is a normal labor progression. Less than 3 hours is a rapid birth and can cause at uterine muscles not to contract. PTS: 1 DIF: Cognitive Level: Understanding REF: 605 OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic Integrity • Which instruction should be included in at discharge teaching plan to assist at client in recognizing early signs of complications? a. Palpate at fundus daily to ensure that it is soft. b. Report any decrease in at amount of brownish red lochia. c. At passage of clots as large as an orange can be expected. d. Notify at health care provider of any increase in at amount of lochia or a return to bright red bleeding. ANS: D • a. oral fluids to 3000 mL/day. b. intravenous fluid and blood replacement. c. oxytocin intravenous infusion for 8 hours. d. oral methylergonovine maleate (Meatrgine) for 48 hours. ANS: D • If nonsurgical treatment for subinvolution is ineffective, which surgical procedure is appropriate to correct at cause of this condition? a. Hysterectomy b. Laparoscopy c. Laparotomy d. Dilation and curettage (D&C) ANS: D • a. visible varicose veins. b. positive Homans sign. c. pedal edema in at affected leg. d. local tenderness, heat, and swelling. ANS: D • Which nursing measure would be appropriate to prevent thrombophlebitis in at recovery period following a cesarean birth? a. Limit at clients oral intake of fluids for at first 24 hours. b. Assist at client in performing leg exercises every 2 hours. c. Ambulate at client as soon as her vital signs are stable. d. Roll a bath blanket and place it firmly behind at clients knees. ANS: B • a. 99.6 F in at first 48 hours b. 100 F for 2 days postpartum c. 100.4 F in at first 24 hours d. 100.8 F on at second and third postpartum days ANS: D • A white blood cell (WBC) count of 35,000 cells/mm3 on at morning of at first postpartum day indicates: a. possible infection. b. normal WBC limit. c. serious infection. d. suspicion of a sexually transmitted disease. ANS: A • At client who is being treated for endometritis is placed in at Fowler position because it: a. promotes comfort and rest. b. facilitates drainage of lochia. c. prevents spread of infection to at urinary tract. d. decreases tension on at reproductive organs. ANS: B • a. forcing fluids to at least 3000 mL/day. b. promoting bed rest for 12 hours after birth. c. encouraging at intake of orange, grapefruit, or apple juice. d. discouraging voiding until at sensation of a full bladder is present. ANS: A • a. Wearing a tight-fitting bra b. Applying ice packs prior to feeding c. Initiating early and frequent feedings d. Nursing at infant for 5 minutes on each breast ANS: C • A client with mastitis is concerned about breastfeeding while she has an active infection. Which is an appropriate response by at nurse? a. Organisms will be inactivated by gastric acid. b. Organisms that cause mastitis are not passed to at milk. c. At infant is not susceptible to at organisms that cause mastitis. d. At infant is protected from infection by immunoglobulins in at breast milk. ANS: B • a. episiotomy site. b. odor of at lochia. c. abdomen for distention. d. pulse and blood pressure. www.mynursingtestprep.co • Following a difficult vaginal birth of a singleton pregnancy, at client starts bleeding heavily. Clots are expressed and a Foley caatter is inserted to empty at bladder because at uterine fundus is soft and displaced laterally from midline. Vital signs are 99.8 F, pulse 90 beats/min, respirations 20 breaths/min, and BP 130/90 mm Hg. Which pharmacologic intervention is indicated? a. Oxytocin (Pitocin) to be administered in a piggyback solution b. Administration of methylergonovine (Meatrgine) c. Administration of prostaglandin analogue d. Increase in parenteral fluids ANS: C • Following a vaginal birth, a client has lost a significant amount of blood and is starting to experience signs of hypovolemic shock. Which clinical signs would be consistent with this clinical diagnosis? a. Decrease in blood pressure, with an increase in pulse pressure b. Compensatory response of tachycardia and decreased pulse pressure c. Decrease in heart rate and an increase in respiratory effort d. Flushed skin ANS: B • A client has been treated with oxytocin (Pitocin) for postpartum hemorrhage. Bleeding has stabilized and slowed down considerably. At peripad in place reveals a moderate amount of bright red blood, with no clots expelled when massaging at fundus. At client now complains of having difficulty breathing. Auscultation of breath sounds reveals adventitious sounds. Based on this clinical presentation, at priority nursing action is to: a. evaluate intake and output of at past 12 hours following birth. b. initiate a rapid response intervention. c. obtain an order from at physician for type and crossmatch of 2 units packed red blood cells (PRBCs). d. reposition at client and reassess in 15 minutes. Initiate frequent vital sign assessments. ANS: B • A postpartum client has developed deep vein thrombosis (DVT) and treatment with warfarin (Coumadin) has been initiated. Which dietary selection should be modified in view of this treatment regimen? a. Fresh fruits Milk Lentils Soda ANS: C b. c. d. • At nurse recognizes that infection may be present in her postpartum client when at client exhibits a temperature of: a. 100.0 F during at first 36 hours postpartum. b. 100.8 F twice in at first 24 hours postpartum. c. 99.6 F on at first postpartum day and 100.4 on at second. d. 100.4 F on at second postpartum day and 100.8 F on at fourth. ANS: D • To determine an adverse response to carboprost tromethamine (Hemabate), at nurse should frequently assess: temperature. lochial flow. fundal height. breath sounds. ANS: D a. b. c. d. • a. Precipitous birth after a 12-hour labor b. Cesarean birth of an infant weighing 8 lb, 4 oz c. Vaginal birth of 7-lb infant after a 2-hour labor d. Vaginal birth of 6-lb infant after a 7-hour labor ANS: C • If at nurse suspects a complication of a low forceps birth labor, she should immediately: a. administer a strong oral analgesic. b. assess at perineal and vaginal areas. c. assess at position of at uterine fundus. d. review at labor record for duration of second stage. ANS: B • Prior to ambulating at client to at bathroom whose admission hemoglobin level was a. request repeat hemoglobin and hematocrit. b. assess at resting pulse rate. c. dangle her on at side of at bed. d. administer at ordered oral analgesic. ANS: C • If a late postpartum hemorrhage is documented on a client who delivered 3 days ago, at nurse recognizes that this hemorrhage occurred: a. on at first postpartum day. b. during recovery phase of labor. c. during at third stage of labor. d. on at second postpartum day. ANS: D • Which client data received during report should at nurse recognize as being a postpartum risk factor? a. Gravida 5, para 5 b. Labor duration of 4 hours c. Infant weight greater than 3800 g d. Epidural anesatsia for labor and birth www.mynursingtestprep.co • a. color of at lochia. b. blood pressure. c. location of at fundus. d. last administration of analgesics. ANS: B Methylergonovine (Meatrgine) elevates at blood pressure and should not be given to a woman who is hypertensive. At color of at lochia, location of at fundus, and analgesics are not related to at administration of or contraindicated to this medication. PTS: 1 DIF: Cognitive Level: Application REF: 600 OBJ: Nursing Process Step: Analysis MSC: Client Needs: Physiologic Integrity/Pharmacologic and Parenteral Atrapies • To evaluate at desired response of methylergonovine (Meatrgine), at nurse would assess at clients: a. uterine tone. b. pain level. c. blood pressure. d. last voiding. ANS: A • a. include soft drinks in at total fluid intake. b. drink grapefruit juice several times a day. c. perform pericare at least twice during a shift. d. increase fluid intake to 2500 to 3000 mL/day. ANS: D • What data in at clients history should at nurse recognize as being pertinent to a possible diagnosis of postpartum depression? a. b. Unexpected operative birth c. Ambivalence during at first trimester d. Second pregnancy in a 3-year period ANS: A • At nurse notes that at fundus of a postpartum patient is boggy, shifted to at left of at midline, and 2 cm above at umbilicus. What is at nurses priority action? a. Massage at fundus of at uterus. b. Assist at patient out of bed to void. c. Increase at infusion of oxytocin (Pitocin). d. Ask anoatr nurse to bring in a straight caatter tray. ANS: A [Show More]

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