NUR 300 WI Maternity & Women’s Health Care 12th Edition (2019/2020) - Chapter 4 – Central Michigan University | Assessment and Health Promotion

Document Content and Description Below

NUR 300 WI Maternity & Women’s Health Care 12th Edition - Chapter 4 – Central Michigan University Chapter 4: Assessment and Health Promotion MULTIPLE CHOICE 1. Due to the effects of c... yclic ovarian changes in the breast, when is the best time for breast self- examination (BSE)? a. Between 5 and 7 days after menses ceases b. Day 1 of the endometrial cycle c. Midmenstrual cycle d. Any time during a shower or bath The physiologic alterations in breast size and activity reach their minimal level approximately 5 to 7 days after menstruation ceases. Therefore, BSE is best performed during this phase of the menstrual cycle. Day 1 of the endometrial cycle is too early to perform an accurate BSE. After the midmenstrual cycle, breasts are likely to become tender and increase in size, which is not the ideal time to perform BSE. Lying down after a shower or bath with a small towel under the shoulder of the side being examined is appropriate teaching for BSE. A secondary BSE may be performed while in the shower. DIF: Cognitive Level: Understand REF: IMS: 63 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 2. Individual irregularities in the ovarian (menstrual) cycle are most often caused by what? a. Variations in the follicular (preovulatory) phase b. Intact hypothalamic-pituitary feedback mechanism c. Functioning corpus luteum d. Prolonged ischemic phase Almost all variations in the length of the ovarian cycle are the result of variations in the length of the follicular phase. An intact hypothalamic-pituitary feedback mechanism would be regular, not irregular. The luteal phase begins after ovulation. The corpus luteum is dependent on the ovulatory phase and fertilization. During the ischemic phase, the blood supply to the functional endometrium is blocked, and necrosis develops. The functional layer separates from the basal layer, and menstrual bleeding begins. DIF: Cognitive Level: Understand REF: pp. 66-67 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 3. How would the physiologic process of the sexual response best be characterized? a. Coitus, masturbation, and fantasy b. Myotonia and vasocongestion c. Erection and orgasm d. Excitement, plateau, and orgasm Physiologically, according to Masters (1992), sexual response can be analyzed in terms of two processes: vasocongestion and myotonia. Coitus, masturbation, and fantasy are forms of stimulation for the physical manifestation of the sexual response. Erection and orgasm occur in two of the four phases of the sexual response cycle. Excitement, plateau, and orgasm are three of the four phases of the sexual response cycle. DIF: Cognitive Level: Knowledge REF: IMS: 68 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 4. Which action would be inappropriate for the nurse to perform before beginning the health history interview? a. Smile and ask the client whether she has any special concerns. b. Speak in a relaxed manner with an even, nonjudgmental tone. c. Make the client comfortable. d. Tell the client her questions are irrelevant. The woman should be assured that all of her questions are relevant and important. Beginning any client interaction with a smile is important and assists in putting the client at ease. If the nurse speaks in a relaxed manner, then the client will likely be more relaxed during the interview. The clients comfort should always be ensured before beginning the interview. DIF: Cognitive Level: Understand REF: pp. 78-79 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 5. The nurse guides a woman to the examination room and asks her to remove her clothes and put on an examination gown with the front open. The woman replies, I have special undergarments that I do not remove for religious reasons. Which is the most appropriate response from the nurse? a. You cant have an examination without removing all your clothes. b. Ill ask the physician to modify the examination. c. Tell me about your undergarments. Ill explain the examination procedure, and then we can discuss how you can comfortably have your examination. d. I have no idea how we can accommodate your beliefs. Explaining the examination procedure reflects cultural competence by the nurse and shows respect for the womans religious practices. The nurse must respect the rich and unique qualities that cultural diversity brings to individuals. The examination can be modified to ensure that modesty is maintained. In recognizing the value of cultural differences, the nurse can modify the plan of care to meet the needs of each woman. Telling the client that her religious practices are different or strange is inappropriate and disrespectful to the client. DIF: Cognitive Level: Apply REF: pp. 79-80 TOP: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity 6. A woman arrives at the clinic for her annual examination. She tells the nurse that she thinks she has a vaginal infection, and she has been using an over-the-counter cream for the past 2 days to treat it. How should the nurse initially respond? a. Inform the woman that vaginal creams may interfere with the Papanicolaou (Pap) test for which she is scheduled. b. Reassure the woman that using vaginal cream is not a problem for the examination. c. Ask the woman to describe the symptoms that indicate to her that she has a vaginal infection. d. Ask the woman to reschedule the appointment for the examination. An important element of the health history and physical examination is the clients description of any symptoms she may be experiencing. The best response is for the nurse to inquire about the symptoms the woman is experiencing. Women should not douche, use vaginal medications, or have sexual intercourse for 24 to 48 hours before obtaining a Pap test. Although the woman may need to reschedule a visit for her Pap test, her current symptoms should still be addressed. DIF: Cognitive Level: Apply REF: IMS: 79 TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity - - - - - - - - - - - - - - - - - - - - - - - - - 26. Which statement regarding female sexual response is inaccurate? a. Women and men are more alike than different in their physiologic response to sexual arousal and orgasm. b. Vasocongestion is the congestion of blood vessels. c. Orgasmic phase is the final state of the sexual response cycle. d. Facial grimaces and spasms of the hands and feet are often part of arousal. The final state of the sexual response cycle is the resolution phase after orgasm. Men and women are surprisingly alike. Vasocongestion causes vaginal lubrication and engorgement of the genitals. Arousal is characterized by increased muscular tension (myotonia). DIF: Cognitive Level: Remember REF: IMS: 68 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 27. A client at 24 weeks of gestation says she has a glass of wine with dinner every evening. Why should the nurse counsel her to eliminate all alcohol intake? a. Daily consumption of alcohol indicates a risk for alcoholism. b. She is at risk for abusing other substances as well. c. Alcohol places the fetus at risk for altered brain growth. d. Alcohol places the fetus at risk for multiple organ anomalies. No period during pregnancy is safe to consume alcohol. The documented effects of alcohol consumption during pregnancy include fetal mental retardation, learning disabilities, high activity level, and short attention span. The fetal brain grows most rapidly in the third trimester and is vulnerable to alcohol exposure during this time. Abuse of other substances has not been linked to alcohol use. DIF: Cognitive Level: Understand REF: IMS: 74 TOP: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity 28. Which statement by the client indicates that she understands BSE? a. I will examine both breasts in two different positions. b. I will examine my breasts 1 week after my menstrual period starts. c. I will examine only the outer upper area of the breast. d. I will use the palm of the hand to perform the examination. The woman should examine her breasts when hormonal influences are at their lowest level. The client should be instructed to use four positions: standing with arms at her sides, standing with arms raised above her head, standing with hands pressed against hips, and lying down. The entire breast needs to be examined, including the outer upper area. The client should use the sensitive pads of the middle three fingers. DIF: Cognitive Level: Analyze REF: IMS: 63 TOP: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance 29. What is the primary reason why a woman who is older than 35 years may have difficulty achieving pregnancy? a. Personal risk behaviors influence fertility. b. Mature women have often used contraceptives for an extended time. c. Her ovaries may be affected by the aging process. d. Prepregnancy medical attention is lacking. Once the mature woman decides to conceive, a delay in becoming pregnant may occur because of the normal aging of the ovaries. Older adults participate in fewer risk behaviors than younger adults. The past use of contraceptives is not the problem. Prepregnancy medical care is both available and encouraged. DIF: Cognitive Level: Knowledge REF: IMS: 73 TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity 30. What is the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant? a. Genetic changes and anomalies b. Extensive central nervous system damage c. Fetal addiction to the substance inhaled d. Intrauterine growth restriction The major consequences of smoking tobacco during pregnancy are low-birth-weight infants, prematurity, and increased perinatal loss. Cigarettes will not normally cause genetic changes or extensive central nervous system damage. Addiction to tobacco is not usually a concern related to the neonate. DIF: Cognitive Level: Comprehend REF: IMS: 74 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance [Show More]

Last updated: 2 years ago

Preview 1 out of 36 pages