Essentials of Maternity Newborn and Women's Health Nursing PDF

Essentials of Maternity Newborn and Women's Health Nursing 5th Edition Ricci Test Bank Chapter 1 Perspectives on Maternal, Newborn, and Women's Health Care The United States ranks 50th in the world for maternal mortality and 41st among industrialized nations for infant mortality rate. When developin...

Essentials of Maternity Newborn and Women's Health Nursing 5th Edition Ricci Test Bank Chapter 1 Perspectives on Maternal, Newborn, and Women's Health Care The United States ranks 50th in the world for maternal mortality and 41st among industrialized nations for infant mortality rate. When developing programs to assist in decreasing these rates, which factor would most likely need to be addressed as having the greatest impact? A ) Resolving all language and cultural differences B ) Assuring early and adequate prenatal care C ) Providing more extensive womens shelters D ) Encouraging all women to eat a balanced diet 2. When integrating the principles of family-centered care, the nurse would include which of the following? A ) Childbirth is viewed as a procedural event pr es t gt yn ur si n.m w w w B ) ep.c om 1. Families are unable to make informed choices C ) Childbirth results in changes in relationships D ) Families require little information to make appropriate decisions When preparing a teaching plan for a group of first-time pregnant women, the nurse expects to review how maternity care has changed over the years. Which of the following would the nurse include when discussing events of the 20th century? A ) Epidemics of puerperal fever B ) Performance of the first cesarean birth C ) Development of the x-ray to assess pelvic size D ) Creation of free-standing birth centers 4. After teaching a group of students about pregnancy-related mortality, the instructor determines that additional teaching is needed when the students identify which condition as a leading cause? A ) Hemorrhage B ) Embolism C ) Obstructed labor ep.c pr es t gt yn ur si n.m w w w D ) E om 3. Infection 5. The nurse is working with a group of community health members to develop a plan to address the special health needs of women. Which of the following conditions would the group address as the major problem? A ) Smoking B ) Heart disease The nurse is working with a group of community health members to develop a plan to address the special health needs of women. Which of the following conditions would the group address as the major problem? A ) Smoking B ) Heart disease C ) Diabetes D ) Cancer 6. When assessing a family for possible barriers to health care, the nurse would consider which factor to be most important? A ) Language B ) Health care workers attitudes C ) Transportation D ) Finances 7. After teaching a group of nursing students about the issue of informed consent. Which of the following, if identified by the student, would indicate an understanding of a violation of informed consent? w w w.m yn ur si n gt es t pr ep.c om 5. A ) Performing a procedure on a 15-year-old without consent B ) Serving as a witness to the signature process C ) Asking whether the client understands what she is signing D ) Getting verbal consent over the phone for emergency procedures Performing a procedure on a 15-year-old without consent B ) Serving as a witness to the signature process C ) Asking whether the client understands what she is signing D ) Getting verbal consent over the phone for emergency procedures 8. The nurse is trying to get consent to care for an 11-year-old boy with diabetic ketoacidosis. His parents are out of town on vacation, and the child is staying with a neighbor. Which action would be the priority? A ) Getting telephone consent with two people listening to the verbal consent B ) Providing emergency care without parental consent C ) Contacting the childs aunt or uncle to obtain their consent D ) Advocating for termination of parental rights for this situation 9. After teaching nursing students about the basic concepts of family-centered care, the instructor determines that the teaching was successful when the students state which of the following? A ) Childbirth affects the entire family, and relationships will change. w w w.m yn ur si n gt es t pr ep.c om A ) B ) Families are not capable of making health care decisions for themselves. C ) Mothers are the family members affected by childbirth. D ) Childbirth is a medical procedure. A nursing instructor is preparing a class discussion on the trends in health care and health care delivery over the past several centuries. When discussing the changes during the past century, which of the following would the instructor be least likely to include? A ) Disease prevention B ) Health promotion C ) Wellness E ep.c nI om 1 0. Analysis of morbidity and mortality 1 1. A nurse is assigned to care for an Asian American client. The nurse develops a plan of care with the understanding that based on this clients cultural background, the client most likely views illness as which of the following? A ) Caused by supernatural forces. B ) A punishment for sins. C ) Due to spirits or demons. D ) es t w w w.m yn ur si n gt y BeingUnwellMortalityDeath pr D ) From an imbalance of yin and yang A nurse is developing a plan of care for a woman to ensure continuity of care during pregnancy, labor, and childbirth. Which of the following would be most important for the nurse to incorporate into that plan? A ) Adhering to strict, specific routines B ) Involving a pediatric physician C ) Educating the client about the importance of a support person D ) Assigning several nurses as a support team 1 3. A nursing instructor is preparing a class discussion on case management in maternal and newborn health care. Which of the following would the instructor include as a key component? Select all that apply. A ) Advocacy B ) Coordination C ) Communication E ) ep.c pr es t gt yn ur si n.m w w w D ) om 1 2. Resource management Event managed care After teaching a group of students about the concept of maternal mortality, the instructor determines that additional teaching is needed when the students state which of the following? A ) The rate includes accidental causes for deaths. B ) It addresses pregnancy-related causes. C ) The duration of the pregnancy is not a concern. D ) The time frame is typically for a specified year. 1 5. A group of students are reviewing the historical aspects about childbirth. The students demonstrate understanding of the information when they identify the use of twilight sleep as a key event during which time frame? A ) 1700s B ) 1800s C ) 1900s ep.c pr es t gt yn ur si n.m w w w D ) om 1 4. 2000s 1 6. A nurse is providing care to a woman who has just delivered a healthy newborn. Which action would least likely demonstrate application of the concept of family-centered care? A ) Focusing on the birth as a normal healthy event for the family B ) Creating opportunities for the family to make informed decisions 1 6. A nurse is providing care to a woman who has just delivered a healthy newborn. Which action would least likely demonstrate application of the concept of family-centered care? A ) Focusing on the birth as a normal healthy event for the family B ) Creating opportunities for the family to make informed decisions C ) Encouraging the woman to keep her other children at home D ) Fostering a sense of respect for the mother and the family 1 7. When discussing fetal mortality with a group of students, a nurse addresses maternal factors. Which of the following would the nurse most likely include? Select all that apply. A ) Chromosomal abnormalities B ) Malnutrition C ) Preterm cervical dilation D ) Underlying disease condition E ) Poor placental attachment w w w.m yn ur si n gt es t pr ep.c om E 1 8. A nurse is preparing a presentation for a local community group about health status and childrens health. Which of the following would the nurse include as one of the most significant measures? A ) Fetal mortality rate B ) Neonatal mortality rate C ) Infant mortality rate following would the nurse include as one of the most significant measures? A ) Fetal mortality rate B ) Neonatal mortality rate C ) Infant mortality rate D ) Maternal mortality rate 1 9. A group of students are reviewing an article describing information related to indicators for womens health and the results of a national study. Which of the following would the students identify as being satisfactory for women? Select all that apply. A ) Smoking cessation B ) Colorectal cancer screening C ) Violence against women D ) Health insurance coverage E ) Mammograms ep.c pr es t gt yn ur si n.m w w w 2 0. om. A nurse is preparing a presentation for a local womens group about heart disease and women. Which of the following would the nurse expect to address when discussing measures to promote health. A ) Women have similar symptoms as men for a heart attack. B ) Heart disease is no longer viewed as a mans disease. C ) Women experiencing a heart attack are at greater risk for dying. the nurse expect to address when discussing measures to promote health. A ) Women have similar symptoms as men for a heart attack. B ) Heart disease is no longer viewed as a mans disease. C ) Women experiencing a heart attack are at greater risk for E dying. D ) Heart attacks in women are more easily diagnosed. 2 1. A nurse is working to develop a health education program for a local community to address breast cancer awareness. Which of the following would the nurse expect to include when describing this problem to the group? Select all that apply. A ) White women have higher rates of breast cancer than African American women. B ) African American women are more likely to die from breast cancer at any age. C ) Survival at any stage is worse among white women. D ) Women living in South America have the highest rates of breast cancer. E ) Breast cancer is the leading cause of cancer mortality in women. ep.c pr es t gt yn ur si n w w.m EEE w 2 2. om. A group of nursing students are reviewing information about factors affecting maternal, newborn, and womens health. The students demonstrate understanding of the information when they identify which of the following deficiencies as being associated with poverty? Select all that apply. A ) Literacy B ) Employment opportunities C ) Mobility they identify which of the following deficiencies as being associated with poverty? Select all that apply. A ) Literacy B ) Employment opportunities C ) Mobility D ) Political representation 3. D 4. B pr C es t 2. gt B yn ur si n 1. ep.c om E Skills ) Answer Key 5. B 6. D A.m 7. 9. w 10. w w 8. A A D 11. D 12. C 13. A, B, C, D 14. A 15. C 16. C 17. B, C, D 18. C 14. A 15. C 16. C 17. B, C, D 18. C 19. B, E 20. C 21. A, B 22. A, B, C, D, E Chapter 2 Family-Centered Community-Based Care om A, B, C, D ep.c 13. The nurse is caring for a 2-week-old newborn girl with a metabolic disorder. Which of the following activities would deviate from the characteristics of family-centered care? A ) Softening unpleasant information or prognoses B ) Evaluating and changing the nursing plan of care C ) Collaborating with the child and family as equals D ) Showing respect for the familys beliefs and wishes w w w.m yn ur si n gt es t pr 1. 2. The nurse is providing home care for a 6-year-old girl with multiple medical challenges. Which of the following activities would be considered the tertiary level of prevention? A ) Arranging for a physical therapy session Primary Preventionsecondary screening TertiaryTreatment B Teaching parents to administer albuterol ) C ) Reminding parent to give a full course of antibiotics D Giving a DTaP vaccination at the proper interval multiple medical challenges. Which of the following activities would be considered the tertiary level of prevention? A ) Arranging for a physical therapy session B ) Teaching parents to administer albuterol C ) Reminding parent to give a full course of antibiotics D ) Giving a DTaP vaccination at the proper interval 3. A nursing student is reviewing information about documenting client care and education in the medical record and the purposes that it serves. The student demonstrates a need for additional study when the nurse identifies which of the following as a reason? A ) Serves as a communication tool for the interdisciplinary team. B ) Demonstrates education the family has received if legal matters arise. C ) Permits others access to allow refusal of medical insurance coverage. D ) Verifies meeting client education standards set by the Joint Commission. 4. A pregnant client tells her nurse that she is interested in arranging a home birth. After educating the client on the advantages and disadvantages, which statement would indicate that the client understood the information? w w w.m yn ur si n gt es t pr ep.c om. A ) I like having the privacy, but it might be too expensive for me to set up in my home. B ) I want to have more control, but I am concerned if an emergency would arise. C ) It is safer because I will have a midwife. D ) The midwife is trained to resolve any emergency, and she can bring any pain meds. I like having the privacy, but it might be too expensive for me to set up in my home. B ) I want to have more control, but I am concerned if an emergency would arise. C ) It is safer because I will have a midwife. D ) The midwife is trained to resolve any emergency, and she can bring any pain meds. 5. The nurse is making a home visit to a client who had a cesarean birth 3 days ago. Assessment reveals that the client is complaining of intermittent pain, rating it as 8 on a scale of 1 to 10. She states, Im pretty tired. And with this pain, I havent been drinking and eating like I should. The medication helps a bit but not much. My mom has been helping with the baby. Her incision is clean, dry, and intact. Which nursing diagnosis would the nurse identify as the priority for this client? A ) Impaired skin integrity related to cesarean birth incision B ) Fatigue related to effects of surgery and caretaking activities C ) Imbalanced nutrition, less than body requirements related to poor fluid and food intake D ) Acute pain related to incision and cesarean birth 6. When caring for childbearing families from cultures different from ones own, which of the following must be accomplished first? es t pr ep.c om A ) w w w.m yn ur si n gt E A ) Adapt to the practices of the familys culture B ) Determine similarities between both cultures C ) Assess personal feelings about that culture D ) Learn as much as possible about that culture Adapt to the practices of the familys culture B ) Determine similarities between both cultures C ) Assess personal feelings about that culture D ) Learn as much as possible about that culture 7. After teaching a group of students about the changes in health care delivery and funding, which of the following, if identified by the group as a current trend seen in the maternal and child health care settings, would indicate that the teaching was successful? A ) Increase in community settings for care B ) Decrease in family poverty level C ) Increase in hospitalization of children D ) Decrease in managed care 8. The nurse would recommend the use of which supplement as a primary prevention strategy to prevent neural tube defects with pregnant women? A ) Calcium w w w.m yn ur si n gt es t pr ep.c om A ) B ) Folic acid C ) Vitamin C D ) Iron ) Iron 9. Which action would the nurse include in a primary prevention program in the community to help reduce the incidence of HIV infection? A ) Provide treatment for clients who test positive for HIV B ) Monitor viral load counts periodically C ) Educate clients in how to practice safe sex D ) Offer testing for clients who practice unsafe sex 1 0. When assuming the role of discharge planner for a woman requiring ventilator support at home, the nurse would do which of the following? A ) Confer with the clients mother B ) Teach new self-care skills to the client C ) Determine if there is a need for back-up power D ) Discuss coverage with the insurance company w w w.m yn ur si n gt es t pr ep.c om D ) 1 1. When comparing community-based nursing with nursing in the acute care setting to a group of nursing students, the nurse describes the challenges associated with community-based nursing. Which of the following would the nurse include? A ) Increased time available for education B ) Improved access to resources When comparing community-based nursing with nursing in the acute care setting to a group of nursing students, the nurse describes the challenges associated with community-based nursing. Which of the following would the nurse include? A ) Increased time available for education B ) Improved access to resources C ) Decision making in isolation D ) Greater environmental structure 1 2. After teaching a group of students about the different levels of prevention, the instructor determines a need for additional teaching when the students identify which of the following as a secondary prevention level activity in community-based health care? A ) Teaching women to take folic acid supplements to prevent neural tube defects B ) Working with women who are victims of domestic violence C ) Working with clients at an HIV clinic to provide nutritional and CAM therapies D ) Teaching hypertensive clients to monitor blood pressure ep.c pr es t gt yn ur si n.m w w w 1 3. om 1 1. A nursing instructor is describing trends in maternal and newborn health care. The instructor addresses the length of stay for vaginal births during the past decade, citing that which of the following denotes the average stay? A ) 2448 hours or less B ) 7296 hours or less C ) 4872 hours or less stay for vaginal births during the past decade, citing that which of the following denotes the average stay? A ) 2448 hours or less B ) 7296 hours or less C ) 4872 hours or less D ) 96120 hours or less 1 4. Which of the following statements is accurate regarding womens health care in todays system? A ) Women spend 95 cents of every dollar spent on health care. B ) Women make almost 90% of all health care decisions. C ) Women are still the minority in the United States. D ) Men use more health services than women. 1 5. A nurse is educating a client about a care plan. Which of the following statements would be appropriate to assess the clients learning ability? A ) Did you graduate from high school; how many years of schooling did you have? w w w.m yn ur si n gt es t pr ep.c om. B ) Do you have someone in your family who would understand this information? C ) Many people have trouble remembering information; is this a problem for you? D ) Would you prefer that the doctor give you more detailed medical information? Do you have someone in your family who would understand this information? C ) Many people have trouble remembering information; is this a problem for you? D ) Would you prefer that the doctor give you more detailed medical information? 1 6. A nurse is developing cultural competence. Which of the following indicates that the nurse is in the process of developing cultural knowledge? Select all that apply. A ) Examining personal sociocultural heritage B ) Reviewing personal biases and prejudices C ) Seeking resources to further understanding of other cultures D ) Becoming familiar with other culturally diverse lifestyles E ) Performing a competent cultural assessment F ) Advocating for social justice to eliminate disparities. 1 7. A nurse is engaged in providing family-centered care for a woman and her family. The nurse is providing instrumental support with which activity? ep.c pr es t gt yn ur si n.m w w w A ) om B ) Explaining to the woman and family what to expect during the birth process. B ) Assisting the woman in breathing techniques to cope with labor contractions. C ) Reinforcing the womans role as a mother after birth D ) Helping the family obtain extra financial help for prescribed phototherapy Assisting the woman in breathing techniques to cope with labor contractions. C ) Reinforcing the womans role as a mother after birth D ) Helping the family obtain extra financial help for prescribed phototherapy 1 8. A nurse is considering a change in employment from the acute care setting to community-based nursing. The nurse is focusing her job search on ambulatory care settings. Which of the following would the nurse most likely find as a possible setting? Select all that apply. A ) Urgent care center B ) Hospice care C ) Immunization clinic D ) Physicians office E ) Day surgery center F ) Nursing home 1 9. A nursing instructor is presenting a class for a group of students about community-based nursing interventions. The instructor determines that additional teaching is needed when the students identify which of the following? w w w.m yn ur si n gt es t pr ep.c om B ) A ) Conducting childbirth education classes B ) Counseling a pregnant teen with anemia C ) Consulting with a parent of a child who is vomiting D ) Performing epidemiologic investigations Conducting childbirth education classes B ) Counseling a pregnant teen with anemia C ) Consulting with a parent of a child who is vomiting D ) Performing epidemiologic investigations 2 0. During class, a nursing student asks, I read an article that was talking about integrative medicine. What is that? Which response by the instructor would be most appropriate? A ) It refers to the use of complementary and alternative medicine in place of traditional therapies for a condition. B ) It means that complementary and alternative medicine is used together with conventional therapies to reduce pain or discomfort. C ) It means that mainstream medical therapies and complementary and alternative therapies are combined based on scientific evidence for being effective. D ) It refers to situations when a client and his or her family prefer to use an unproven method of treatment over a proven one. 2 1. While a nurse is obtaining a health history, the client tells the nurse that she practices aromatherapy. The nurse interprets this as which of the following? A ) Use of essential oils to stimulate the sense of smell to balance the mind and body ep.c pr es t w w w.m yn ur si n gt E om A ) B ) Application of pressure to specific points to allow self-healing C ) Use of deep massage of areas on the foot or hand to rebalance body parts D ) Participation in chanting and praying to promote healing. Application of pressure to specific points to allow self-healing C ) Use of deep massage of areas on the foot or hand to rebalance body parts D ) Participation in chanting and praying to promote healing. 2 2. A pregnant woman asks the nurse about giving birth in a birthing center. She says, Im thinking about using one but Im not sure. Which of the following would the nurse need to integrate into the explanation about this birth setting? (Select all that apply.) A ) An alternative for women who are uncomfortable with a home birth. B ) The longer length of stay needed when compared to hospital births C ) Focus on supporting women through labor instead of managing labor D ) View of labor and birth as a normal process requiring no intervention E ) Care provided primarily by obstetricians with midwives as backup care 2 3. A nurse practicing in the community is preparing a presentation for a group of nursing students about this practice setting. Which of the following would the nurse include as characteristic of this role? ep.c pr es t gt yn ur si n.m w w w A ) om B ) Greater emphasis on direct physical care B ) Broader assessment to include the environment C ) Increased dependency on physician D ) Limited decision making and support Broader assessment to include the environment C ) Increased dependency on physician D ) Limited decision making and support 2 4. A nurse is preparing a teaching plan for a woman who is pregnant for the first time. Which of the following would the nurse incorporate into the teaching plan to foster the clients learning? (Select all that apply.) A ) Teach survival skills first B ) Use simple, nonmedical language C ) Refrain from using a hands-on approach D ) Avoid repeating information E ) Use visual materials such as photos and videos 2 5. A group of nurses are reviewing the steps for developing cultural competence. The students demonstrate understanding when they identify which of the following as the final step? A ) Cultural knowledge ep.c pr es t gt yn ur si n.m w w w B ) om B ) Cultural skills C ) Cultural encounter D ) Cultural awareness C ) Cultural encounter C 4. B 5. D 6. C 7. A 8. B 9. C 10. C 11. C 12. A 13. A B.m 14. w 17. w w 15. 16. ep.c 3. pr A es t 2. gt A yn ur si n 1. om D Cultural awareness ) Answer Key C C, D D 18. A, D, E 19. D 20. C 21. A 22. A, C, D 23. B 24. A, B, E 25. C 20. C 21. A 22. A, C, D 23. B 24. A, B, E 25. C Chapter 3 Anatomy and Physiology of the Reproductive Systems When describing the menstrual cycle to a group of young women, the nurse explains that estrogen levels are highest during which phase of the endometrial cycle? A ) Menstrual B ) Proliferative C ) Secretory D ) Ischemic 2. After teaching a group of adolescent girls about female reproductive development, the nurse determines that teaching was successful when the girls state that menarche is defined as a womans first: A ) Sexual experience w w w.m yn ur si n gt es t pr ep.c om 1. B ) Full hormonal cycle C ) Menstrual period D ) Sign of breast development Full hormonal cycle C ) Menstrual period D ) Sign of breast development 3. A client with a 28-day cycle reports that she ovulated on May 10. The nurse would expect the clients next menses to begin on: A ) May 24 B ) May 26 C ) May 30 D ) June 1 4. Which female reproductive tract structure would the nurse describe to a group of young women as containing rugae that enable it to dilate during labor and birth? A ) Cervix B ) Fallopian tube C ) Vagina D ) w w w.m yn ur si n gt es t pr ep.c om B ) Vulva After teaching a group of pregnant women about breastfeeding, the nurse determines that the teaching was successful when the group identifies which hormone as important for the production of breast milk after childbirth? A ) Placental estrogen B ) Progesterone C ) Gonadotropin-releasing hormone D ) Prolactin 6. The nurse is assessing a 13-year-old girl who has had her first menses. Which of the following events would the nurse expect to have occurred first? A ) Evidence of pubic hair B ) Development of breast buds C ) Onset of menses D ) Growth spurt w w w.m yn ur si n gt es t pr ep.c om 5. 7. When describing the ovarian cycle to a group of students, which phase would the instructor include? A ) Luteal phase B ) Proliferative phase C ) Menstrual phase When describing the ovarian cycle to a group of students, which phase would the instructor include? A ) Luteal phase B ) Proliferative phase C ) Menstrual phase D ) Secretory phase 8. The nurse is explaining the events that lead up to ovulation. Which hormone would the nurse identify as being primarily responsible for ovulation? A ) Estrogen B ) Progesterone C ) Follicle-stimulating hormone D ) Luteinizing hormone 9. The nurse is teaching a health education class on male reproductive anatomy and asks the students to identify the site of sperm production. Which structure, if identified by the group, would indicate to the nurse that the teaching was successful? ep.c om 7. w w w.m yn ur si n gt es t pr mmmm A ) Testes B ) Seminal vesicles C ) Scrotum D ) Prostate gland ) Scrotum D ) Prostate gland 1 0. The nurse is creating a diagram that illustrates the components of the male reproductive system. Which structure would be inappropriate for the nurse to include as an accessory gland? A ) Seminal vesicles B ) Prostate gland C ) Cowpers glands D ) Vas deferens 1 1. The nurse is preparing an outline for a class on the physiology of the male sexual response. Which event would the nurse identify as occurring first? A ) Sperm emission B ) Penile vasodilation C ) Psychological release w w w.m yn ur si n gt es t pr ep.c om C ) D ) Ejaculation 1 2. A woman comes to the clinic complaining that she has little sexual desire. As part of the clients evaluation, the nurse would anticipate the need to evaluate which hormone level? A ) Progesterone B Estrogen A woman comes to the clinic complaining that she has little sexual desire. As part of the clients evaluation, the nurse would anticipate the need to evaluate which hormone level? A ) Progesterone B ) Estrogen C ) Gonadotropin-releasing hormone D ) Testosterone 1 3. A nurse is conducting a class for a group of teenage girls about female reproductive anatomy and physiology. Which of the following would the nurse include as an external female reproductive organ? Select all that apply. A ) Mons pubis B ) Labia C ) Vagina D ) Clitoris E ) Uterus w w w.m yn ur si n gt es t pr ep.c om 1 2. 1 4. When describing the hormones involved in the menstrual cycle, a nurse identifies which hormone as responsible for initiating the cycle? A ) Estrogen B ) Luteinizing hormone C ) Progesterone cycle, a nurse identifies which hormone as responsible for initiating the cycle? A ) Estrogen B ) Luteinizing hormone C ) Progesterone D ) Prolactin 1 5. A nursing instructor is describing the hormones involved in the menstrual cycle to a group of nursing students. The instructor determines the teaching was successful when the students identify follicle-stimulating hormone as being secreted by which of the following? A ) Hypothalamus B ) Anterior pituitary gland C ) Ovaries D ) Corpus luteum 1 6. A woman comes to the clinic for an evaluation. During the visit, the woman tells the nurse that her menstrual cycles have become irregular. Ive also been waking up at night feeling really hot and sweating. The nurse interprets these findings as which of the following? es t pr ep.c om 4. ADH yn ur si n gt posterior is justoxytocin w w w.m FSHLHTSHGnRHCTRH A ) Menopause B ) Perimenopause C ) Climacteric D ) Menarche Menopause B ) Perimenopause C ) Climacteric D ) Menarche 1 7. After teaching a group of students about female reproductive anatomy, the instructor determines that the teaching was successful when the students identify which of the following as the site of fertilization? A ) Vagina B ) Uterus C ) Fallopian tubes D ) Vestibule 1 8. A woman comes to the clinic complaining of a vaginal discharge. The nurse suspects that the client has an infection. When gathering additional information, which of the following would the nurse be least likely to identify as placing the client at risk for an infection? A ) w w w.m yn ur si n gt es t pr ep.c om A ) Recent antibiotic therapy for an upper respiratory infection B ) Last menstrual period about 5 days ago. C ) Weekly douching D ) Frequent use of feminine hygiene sprays. B ) Last menstrual period about 5 days ago. C ) Weekly douching D ) Frequent use of feminine hygiene sprays. 1 9. A group of nursing students are reviewing information about the male reproductive structures. The students demonstrate understanding of the information when they identify which of the following as accessory organs? (Select all that apply.) A ) Testes B ) Vas deferens C ) Bulbourethral glands D ) Prostate gland E ) Penis 2 0. A nurse is examining a female client and tests the clients vaginal pH. Which finding would the nurse interpret as normal? A ) 4.5 7 C ) 8.5 D ) 10 om ep.c pr es t gt yn ur si n.m w w w B ) O When describing the male sexual response to a group of students, the instructor determines that the teaching was successful when they identify emission as which of the following? A ) Semen forced through the urethra to the outside B ) Movement of sperm from the testes and fluid into the urethras C ) Dilation of the penile arteries with increased blood flow to the tissues. D ) Bodys return to the physiologic nonstimulated state 2 2. A nurse is describing the structure and function of the reproductive system to an adolescent health class. The nurse describes the secretion of the seminal vesicles as which of the following? A ) Mucus-like B ) Alkaline C ) Acidic w w w.m yn ur si n gt es t pr ep.c om 2 1. D Semen ) Answer Key 1. B 2. C 3. A 4. C 5. D B 2. C 3. A 4. C 5. D 6. B 7. A 8. D 9. A 10. D 11. B 12. D 13. A, B, D 14. B 15. B ep.c C w w w.m 18. B B, C, D A 21. B 22. B Chapter 4 Common Reproductive Issues pr es t B 17. 20. gt yn ur si n 16. 19. om 1. After discussing various methods of contraception with a client and her partner, the nurse determines that the teaching was successful when they identify which contraceptive method as providing protection against sexually transmitted infections (STIs)? A ) Oral contraceptives B ) Tubal ligation C ) Condoms D ) Intrauterine system 2. When discussing contraceptive options, which method would the nurse recommend as being the most reliable? A ) Coitus interruptus B ) Lactational amenorrheal method (LAM) C ) Natural family planning D ) Intrauterine system w w w.m yn ur si n gt es t pr ep.c om 1. 3. A client comes to the clinic with abdominal pain. Based on her history the nurse suspects endometriosis. The nurse expects to prepare the client for which of the following to confirm this suspicion? A ) Pelvic examination B ) Transvaginal ultrasound A client comes to the clinic with abdominal pain. Based on her history the nurse suspects endometriosis. The nurse expects to prepare the client for which of the following to confirm this suspicion? A ) Pelvic examination B ) Transvaginal ultrasound C ) Laparoscopy D ) Hysterosalpingogram 4. A client is to receive an implantable contraceptive. The nurse describes this contraceptive as containing: A ) Synthetic progestin B ) Combined estrogen and progestin C ) Concentrated spermicide D ) Concentrated estrogen 5. The nurse discusses various contraceptive methods with a client and her partner. Which method would the nurse explain as being available only with a prescription? w w w.m yn ur si n gt es t pr ep.c om 3. A ) Condom B ) Spermicide C ) Diaphragm D ) Basal body temperature Spermicide C ) Diaphragm D ) Basal body temperature 6. When developing a teaching plan for a couple considering contraception options, which of the following statements would the nurse include? A ) You should select one that is considered to be 100% effective. B ) The best one is the one that is the least expensive and most convenient. C ) A good contraceptive doesnt require a physicians prescription. D ) The best contraceptive is one that you will use correctly and consistently. 7. Which of the following measures would the nurse include in the teaching plan for a woman to reduce the risk of osteoporosis after menopause? A ) Taking vitamin supplements B ) Eating high-fiber, high-calorie foods D ).m w w w C ) yn ur si n gt es t pr ep.c om B ) Restricting fluid to 1,000 mL daily Participating in regular daily exercise When teaching a group of postmenopausal women about hot flashes and night sweats, the nurse would address which of the following as the primary cause? A ) Poor dietary intake B ) Estrogen deficiency C ) Active lifestyle D ) Changes in vaginal pH 9. A client states that she is to have a test to measure bone mass to help diagnose osteoporosis. The nurse would most likely plan to prepare the client for: A ) DEXA scan B ) Ultrasound C ) MRI D ) Pelvic x-ray w w w.m yn ur si n gt es t pr ep.c om 8. 1 0. The nurse is reviewing the medical records of several clients. Which client would the nurse expect to have an increased risk for developing osteoporosis? A ) A woman of African American descent B ) A woman who plays tennis twice a week C ) A thin woman with small bones Which client would the nurse expect to have an increased risk for developing osteoporosis? A ) A woman of African American descent B ) A woman who plays tennis twice a week C ) A thin woman with small bones D ) A woman who drinks one cup of coffee a day 1 1. Which of the following would the nurse emphasize when teaching postmenopausal women about ways to reduce the risk of osteoporosis? A ) Swimming daily B ) Taking vitamin A C ) Following a low-fat diet D ) Taking calcium supplements ep.c pr es t gt yn ur si n.m w w A ) Which finding would the nurse expect to find in a client with endometriosis? Hot flashes w 1 2. om 0. B ) Dysuria C ) Fluid retention D ) Fever B ) Dysuria C ) Fluid retention D ) Fever After the nurse teaches a client about ways to reduce the symptoms of premenstrual syndrome, which client statement indicates a need for additional teaching? A ) I will make sure to take my estrogen supplements a week before my period. B ) Ive signed up for an aerobic exercise class three times a week. C ) Ill cut down on the amount of coffee and colas I drink. D ) I quit smoking about a month ago, so that should help. 1 4. A woman has opted to use the basal body temperature method for contraception. The nurse instructs the client that a rise in basal body temperature indicates which of the following? A ) Onset of menses B ) Ovulation C ) Pregnancy D ) w w w.m yn ur si n gt es t pr ep.c om 1 3. Safe period for intercourse A woman using the cervical mucus ovulation method of fertility awareness reports that her cervical mucus looks like egg whites. The nurse interprets this as which of the following? A ) Spinnbarkeit mucus B ) Purulent mucus C ) Postovulatory mucus D ) Normal preovulation mucus 1 6. The nurse is reviewing the laboratory test results of a client with dysfunctional uterine bleeding (DUB). Which finding would be of concern? A ) Negative pregnancy test B ) Hemoglobin level of 10.1 g/dL C ) Prothrombin time of 60 seconds D ) Serum cholesterol of 140 mg/dL 12 16 is Normal w w w.m yn ur si n gt es t pr ep.c om 1 5. 1 7. A nurse is preparing a class for a group of women at a family planning clinic about contraceptives. When describing the health benefits of oral contraceptives, which of the following would the nurse most likely include? (Select all that apply.) A ) Protection against pelvic inflammatory disease B ) Reduced risk for endometrial cancer C Decreased risk for depression would the nurse most likely include? (Select all that apply.) Protection against pelvic inflammatory disease B ) Reduced risk for endometrial cancer C ) Decreased risk for depression D ) Reduced risk for migraine headaches E ) Improvement in acne 1 8. After teaching a group of students about the different methods for contraception, the instructor determines that the teaching was successful when the students identify which of the following as a mechanical barrier method? (Select all that apply.) A ) Condom B ) Cervical cap C ) Cervical sponge D ) Diaphragm E ) Vaginal ring w w w.m yn ur si n gt es t pr ep.c om A ) 1 9. After assessing a woman who has come to the clinic, the nurse suspects that the woman is experiencing dysfunctional uterine bleeding. Which statement by the client would support the nurses suspicions? A ) Ive been having bleeding off and on thats irregular and sometimes heavy. B ) I get sharp pain in my lower abdomen usually starting soon after my period comes. After assessing a woman who has come to the clinic, the nurse suspects that the woman is experiencing dysfunctional uterine bleeding. Which statement by the client would support the nurses suspicions? A ) Ive been having bleeding off and on thats irregular and sometimes heavy. B ) I get sharp pain in my lower abdomen usually starting soon after my period comes. C ) I get really irritable and moody about a week before my period. D ) My periods have been unusually long and heavy lately. 2 0. After teaching a group of students about premenstrual syndrome, the instructor determines that additional teaching is needed when the students identify which of the following as a prominent assessment finding? A ) Bloating B ) Tension C ) Dysphoria D ) Weight loss 2 1. A nurse is describing the criteria needed for the diagnosis of premenstrual dysphoric disorder (PMDD). Which of the following would the nurse include as a mandatory requirement for the diagnosis? w w w.m yn ur si n gt es t pr ep.c om 1 9. A ) Appetite changes B ) Sleep difficulties C ) Persistent anger D Chronic fatigue ) Sleep difficulties C ) Persistent anger D ) Chronic fatigue 2 2. When reviewing the medical record of a client diagnosed with endometriosis, which of the following would the nurse identify as a risk factor for this woman? A ) Low fat in the diet B ) Age of 14 years for menarche C ) Menstrual cycles of 24 days D ) Short menstrual flow 2 3. A client who has come to the clinic is diagnosed with endometriosis. Which of the following would the nurse expect the physician to prescribe as a first-line treatment? A ) Progestins B ) Antiestrogens es t pr ep.c om B ) w w w.m yn ur si n gt short menstrual cycles C ) Gonadotropin-releasing hormone analogues D ) NSAIDs A woman comes to the clinic because she has been unable to conceive. When reviewing the womans history, which of the following would the nurse least likely identify as a possible risk factor? A ) Age of 25 years B ) History of smoking C ) Diabetes since age 15 years D ) Weight below standard for height and age 2 5. A couple comes to the clinic for a fertility evaluation. The male partner is to undergo a semen analysis. After teaching the partner about this test, which client statement indicates that the client has understood the instructions? A ) I need to bring the specimen to the lab the day after collecting it. B ) I will place the specimen in a special plastic bag to transport it. C ) I have to abstain from sexual activity for about 12 days before the sample. ep.c pr es t gt yn ur si n.m It w w w D ) om 2 4. I will withdraw before I ejaculate during sex to collect the specimen. A nurse is preparing a class for a group of young adult women about emergency contraceptives (ECs). Which of the following would the nurse need to stress to the group. Select all that apply. A ) ECs induce an abortion like reaction. B ) ECs provide some protection against STIs C ) ECs are birth control pills in higher, more frequent doses D ) ECs are not to be used in place of regular birth control pr ep.c om 2 6. yn ur si n gt es t E ECs provide little protection for future pregnancies. ) Answer Key 1. C 2. D.m 3. w w 4. 6. w 5. C A C D 7. D 8. B 9. A 10. C 11. D 12. B 13. A 14. B A 10. C 11. D 12. B 13. A 14. B 15. A 16. B 17. A, B, E 18. A, B, C, D 19. A 20. D 21. C 22. C 23. D om 9. ep.c B yn ur si n gt es t pr 8. 24. A 25. C C, D, E w w.m 26. 1. w Chapter 5 Sexually Transmitted Infections The nurse is developing a plan of care for a client who is receiving highly active antiretroviral therapy (HAART) for treatment of HIV. The goal of this therapy is to: A ) Promote the progression of disease B ) Intervene in late-stage AIDS C ) Improve survival rates D ) Conduct additional drug research Promote the progression of disease B ) Intervene in late-stage AIDS C ) Improve survival rates D ) Conduct additional drug research 2. A woman who is HIV-positive is receiving HAART and is having difficulty with compliance. To promote adherence, which of the following areas would be most important to assess initially? A ) The womans beliefs and education B ) The womans financial situation and insurance C ) The womans activity level and nutrition D ) The womans family and living arrangements 3. When developing a teaching plan for a community group about HIV infection, which group would the nurse identify as an emerging risk group for HIV infection? A ) Native Americans ep.c pr es t gt yn ur si n.m w w w B ) om A ) Heterosexual women C ) New health care workers D ) Asian immigrants After teaching a group of adolescents about HIV, the nurse asks them to identify the major means by which adolescents are exposed to the virus. The nurse determines that the teaching was successful when the group identifies which of the following? A ) Sexual intercourse B ) Sharing needles for IV drug use C ) Perinatal transmission D ) Blood transfusion 5. The nurse reviews the CD4 cell count of a client who is HIVpositive. A result less than which of the following would indicate to the nurse that the client has AIDS? A ) 1,000 cells/mm3 B ) 700 cells/mm3 C ) 450 cells/mm3 ep.c pr es t gt yn ur si n.m w w w D ) om 4. 200 cells/mm3 6. When obtaining the health history from a client, which factor would lead the nurse to suspect that the client has an increased risk for sexually transmitted infections (STIs)? A ) Hive-like rash for the past 2 days B ) Five different sexual partners When obtaining the health history from a client, which factor would lead the nurse to suspect that the client has an increased risk for sexually transmitted infections (STIs)? A ) Hive-like rash for the past 2 days B ) Five different sexual partners C ) Weight gain of 5 lbs in 1 year D ) Clear vaginal discharge 7. Assessment of a female client reveals a thick, white vaginal discharge. She also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has: A ) Trichomoniasis B ) Bacterial vaginosis C ) Candidiasis D ) Genital herpes simplex 8. A client with trichomoniasis is to receive metronidazole (Flagyl). The nurse instructs the client to avoid which of the following while taking this drug? w w w.m yn ur si n gt es t pr ep.c om 6. A ) Alcohol B ) Nicotine C ) Chocolate D ) Caffeine A ) Alcohol B ) Nicotine C ) Chocolate D ) Caffeine 9. A woman gives birth to a healthy newborn. As part of the newborns care, the nurse instills erythromycin ophthalmic ointment as a preventive measure related to which STI? A ) Genital herpes B ) Hepatitis B C ) Syphilis D ) Gonorrhea yn ur si n gt es t pr ep.c om I Which findings would the nurse expect to find in a client with bacterial vaginosis? A ) Vaginal pH of 3 w w Fish-like odor of discharge w B ).m 1 0. C ) Yellowish-green discharge D ) Cervical bleeding on contact A pregnant woman diagnosed with syphilis comes to the clinic for a visit. The nurse discusses the risk of transmitting the infection to her newborn, explaining that this infection is transmitted to the newborn through the: A ) Amniotic fluid B ) Placenta C ) Birth canal D ) Breast milk 1 2. The nurse encourages a female client with human papillomavirus (HPV) to receive continued follow-up care because she is at risk for: A ) Infertility B ) Dyspareunia C ) Cervical cancer D ) Dysmenorrhea w w w.m yn ur si n gt es t pr ep.c om 1 1. 1 3. A client is diagnosed with pelvic inflammatory disease (PID). When reviewing the clients medical record, which of the following would the nurse expect to find? (Select all that apply.) A ) Oral temperature of 100.4 degrees F B ) Dysmenorrhea A client is diagnosed with pelvic inflammatory disease (PID). When reviewing the clients medical record, which of the following would the nurse expect to find? (Select all that apply.) A ) Oral temperature of 100.4 degrees F B ) Dysmenorrhea C ) Dysuria D ) Lower abdominal tenderness E ) Discomfort with cervical motion F ) Multiparity 1 4. Which instructions would the nurse include when teaching a woman with pediculosis pubis? A ) Take the antibiotic until you feel better. B ) Wash your bed linens in bleach and cold water. C ) Your partner doesnt need treatment at this time. ep.c pr es t gt yn ur si n.m w w w D ) om 1 3. Remove the nits with a fine-toothed comb. 1 5. A client with genital herpes simplex infection asks the nurse, Will I ever be cured of this infection? Which response by the nurse would be most appropriate? A ) There is a new vaccine available that prevents the infection from returning. B ) All you need is a dose of penicillin and the infection will be gone. C There is no cure, but drug therapy helps to reduce symptoms A client with genital herpes simplex infection asks the nurse, Will I ever be cured of this infection? Which response by the nurse would be most appropriate? A ) There is a new vaccine available that prevents the infection from returning. B ) All you need is a dose of penicillin and the infection will be gone. C ) There is no cure, but drug therapy helps to reduce symptoms and recurrences. D ) Once you have the infection, you develop an immunity to it. 1 6. A nurse is preparing a presentation for a group of women at the clinic who have been diagnosed with genital herpes. Which of the following would the nurse expect to include as a possible precipitating factor for a recurrent outbreak? (Select all that apply.) A ) Exposure to ultraviolet light B ) Exercise C ) Use of corticosteroids D ) Emotional stress E ) Sexual intercourse. w w w.m yn ur si n gt es t pr ep.c om 1 5. 1 7. After teaching a class on sexually transmitted infections, the instructor determines that the teaching was successful when the class identifies which statement as true? A ) STIs can affect anyone if exposed to the infectious organism. B ) STIs have been addressed more on a global scale. C Clients readily view the diagnosis of STI openly. class identifies which statement as true? A ) STIs can affect anyone if exposed to the infectious organism. B ) STIs have been addressed more on a global scale. C ) Clients readily view the diagnosis of STI openly. D ) Most individuals with STIs are over the age of 30. 1 8. A group of students are reviewing information about STIs. The students demonstrate understanding of the information when they identify which of the following as the most common bacterial STI in the United States? A ) Gonorrhea B ) Chlamydia C ) Syphilis D ) Candidiasis 1 9. A nurse is assessing a client for possible risk factors for chlamydia and gonorrhea. Which of the following would the nurse identify? ep.c pr es t gt yn ur si n.m w w w A ) om. Asian American ethnicity B ) Age under 25 years C ) Married D ) Consistent use of barrier contraception Age under 25 years C ) Married D ) Consistent use of barrier contraception 2 0. A nurse at a local community clinic is developing a program to address STI prevention. Which of the following would the nurse least likely include in the program? A ) Outlining safer sexual behavior B ) Recommending screening for symptomatic individuals C ) Promoting the use of barrier contraceptives D ) Offering education about STI transmission 2 1. After teaching a class on preventing pelvic inflammatory disease, the instructor determines that the teaching was successful when the class identifies which of the following as an effective method? A ) Advising sexually active females to use hormonal contraception B ) Encouraging vaginal douching on a weekly basis. D ) ep.c pr es t gt yn ur si n.m w w w C ) om B ) Emphasizing the need for infected sexual partners to receive treatment Promoting routine treatment for asymptomatic females as risk A group of nursing students are reviewing information about vaccines used to prevent STIs. The students would expect to find information about which of the following? A ) HIV B ) HSV C ) HPV D ) HAV E ) HBV 2 3. A mother brings her 12-year-old daughter in for well-visit checkup. During the visit, the nurse is discussing the use of prophylactic HPV vaccine for the daughter. The mother agrees and the daughter receives her first dose. The nurse schedules the daughter for the next dose, which would be given at which time? A ) In 2 month B ) In 2 months w w w.m yn ur si n gt es t pr ep.c om 2 2. C ) In 3 months D ) In 4 months A woman comes to the clinic complaining of a vaginal discharge. The nurse suspects trichomoniasis based on which of the following? (Select all that apply.) A ) Urinary frequency B ) Yellow/green discharge C ) Joint pain D ) Blister-like lesions E ) Muscle aches 2 5. A nurse is teaching a women with genital ulcers how to care for them. Which statement by the client indicates a need for additional teaching? A ) I need to wash my hands after touching any of the ulcers. B ) I need to abstain from intercourse primarily when the lesions are present. C ) I should avoid applying ice or heat to my genital area. w w w.m yn ur si n gt es t pr ep.c om 2 4. D I can try lukewarm sitz baths to help ease the discomfort. ) Answer Key 1. C 2. A 3. B 4. A 5. D C 2. A 3. B 4. A 5. D 6. B 7. C 8. A 9. D 10. B 11. B 12. C 13. B, C, D, E 14. D ep.c pr es t C 16. A, C, D, E w w w.m 17. 19. gt yn ur si n 15. 18. om 1. A B B 20. B 21. C 22. C, D, E 23. B 24. A, B 25. B Chapter 6 Disorders of the Breasts The nurse is developing the discharge plan for a woman who has had a left-sided modified radical mastectomy. The nurse is including instructions for ways to minimize lymphedema. Which suggestion would most likely increase the womans symptoms? A ) Wear gloves when you are doing any gardening. B ) Have your blood pressure taken in your right arm. C ) Wear clothing with elasticized sleeves. D ) Avoid driving to and from work every day. 2. A laboratory technician arrives to draw blood for a complete blood count (CBC. for a client who had a right-sided mastectomy 8 hours ago. The client has an intravenous line with fluid infusing in her left antecubital space. To obtain the blood specimen, the technician places a tourniquet on the clients right arm. Which action by the nurse would be most appropriate? A ) w w w.m yn ur si n gt es t pr ep.c om 1. Assist in holding the clients arm still. B ) Suggest a finger stick be done on one of the clients left fingers. C ) Tell the technician to obtain the blood sample from the clients left arm. D ) Call the surgeon to perform a femoral puncture. Suggest a finger stick be done on one of the clients left fingers. C ) Tell the technician to obtain the blood sample from the clients left arm. D ) Call the surgeon to perform a femoral puncture. 3. The nurse determines that a woman has implemented prescribed therapy for her fibrocystic breast disease when the client reports that she has eliminated what from her diet? A ) Caffeine B ) Cigarettes C ) Dairy products D ) Sweets 4. When assessing a client with suspected breast cancer, which of the following would the nurse expect to find? A ) Painful lump B ) Absence of dimpling C ) Regularly shaped mass w w w.m yn ur si n gt es t pr ep.c om B ) D ) Nipple retraction 5. A woman who has undergone a right modified-radical mastectomy returns from surgery. Which nursing intervention would be most appropriate at this time? A ) Ask the client how she feels about having her breast removed. B ) Attach a sign above her bed to have BP, IV lines, and lab work in her right arm. A woman who has undergone a right modified-radical mastectomy returns from surgery. Which nursing intervention would be most appropriate at this time? A ) Ask the client how she feels about having her breast removed. B ) Attach a sign above her bed to have BP, IV lines, and lab work in her right arm. C ) Encourage her to turn, cough, and deep breathe at frequent intervals. D ) Position her right arm below heart level. 6. A breast biopsy indicates the presence of malignant cells, and the client is scheduled for a mastectomy. Which nursing diagnosis would the nurse most likely include in the clients preoperative plan of care as the priority? A ) Risk for deficient fluid volume B ) Activity intolerance C ) Disturbed body image D ) Impaired urinary elimination 7. A 42-year-old woman is scheduled for a mammogram. Which of the following would the nurse include when teaching the woman about the procedure? w w w.m yn ur si n gt es t pr ep.c om 5. A ) The room will be darkened throughout the procedure. B ) Each breast will be firmly compressed between two plates. C ) Make sure to refrain from eating or drinking after midnight. D ) A small needle will be inserted to get a sample for evaluation. The room will be darkened throughout the procedure. B ) Each breast will be firmly compressed between two plates. C ) Make sure to refrain from eating or drinking after midnight. D ) A small needle will be inserted to get a sample for evaluation. 8. During a clinical breast examination, the nurse palpates a welldefined, firm, mobile lump in a 60-year-old womans left breast. The nurse notifies the physician. Which of the following would the nurse anticipate the physician to order next? A ) Mammogram B ) Hormone receptor status C ) Fine-needle aspiration D ) Genetic testing for BRCA 9. A client with advanced breast cancer, who has had both chemotherapy and radiation therapy, is to start hormonal therapy. Which agent would the nurse expect the client to receive? A ) Progestins w w w.m yn ur si n gt es t pr ep.c om A ) B ) Tamoxifen C ) Cortisone D ) Estrogen ) Estrogen 1 0. As part of discharge planning, the nurse refers a woman to Reach to Recovery. This groups primary purpose is to: A ) Help support women who have undergone mastectomies B ) Raise funds to support early breast cancer detection programs C ) Provide all supplies needed after breast surgery for no cost D ) Collect statistics for research for the American Cancer Society 1 1. A woman with breast cancer is undergoing chemotherapy. Which of the following side effects would the nurse interpret as being most serious? A ) Vomiting B ) Hair loss C ) Fatigue D ) Myelosuppression w w w.m yn ur si n gt es t pr ep.c om D ) 1 2. A woman comes to the clinic reporting a nipple discharge. On examination, the area below the areola is red and slightly swollen, with tortuous tubular swelling. The nurse interprets these findings as suggestive of which of the following? A ) Fibrocystic breast disorder B ) Intraductal papilloma A woman comes to the clinic reporting a nipple discharge. On examination, the area below the areola is red and slightly swollen, with tortuous tubular swelling. The nurse interprets these findings as suggestive of which of the following? A ) Fibrocystic breast disorder B ) Intraductal papilloma C ) Duct ectasia D ) Fibroadenoma ep.c om 1 2. When performing a clinical breast examination, which would the nurse do first? A ) Palpate the axillary area. B ) Compress the nipple for a discharge. C ) Palpate the breasts. D ) Inspect the breasts. es t gt yn ur si n.m w w Evaluation of a woman with breast cancer reveals that her mass is approximately 1.25 inches in diameter. Three adjacent lymph nodes are positive. The nurse interprets this as indicating that the woman has which stage of breast cancer? w 1 4. pr 1 3. A ) 0 B ) I C ) II D ) III 0 B ) I C ) II D ) III 1 5. After teaching a woman how to perform breast selfexamination, which statement would indicate that the nurses instructions were successful? A ) I should lie down with my arms at my side when looking at my breasts. B ) I should use the fingerpads of my three middle fingers to apply pressure to my breast. C ) I dont need to check under my arm on that side if my breast feels fine. D ) I need to work from the center of my breast outward toward my shoulder. 1 6. A nurse is working with a woman who has been diagnosed with severe fibrocystic breast disease. When describing the medications that can be used as treatment, which of the following would the nurse be least likely to include? A ) Tamoxifen w w w.m yn ur si n gt es t pr ep.c om A ) B ) Bromocriptine C ) Danazol D ) Penicillin A group of students are reviewing information about benign and malignant breast masses. The students demonstrate understanding when they identify which of the following as indicating a benign breast mass. (Select all the apply.) A ) Painless B ) Unilateral location C ) Firm consistency D ) Absence of dimpling E ) Fixed to chest wall 1 8. The nurse is developing a plan of care for a woman with breast cancer who is scheduled to undergo breast-conserving surgery. The nurse interprets this as which of the following? A ) Removal of nipple and areolar area B ) Lump removal followed by radiation D ).m w w w C ) yn ur si n gt es t pr ep.c om 1 7. Entire breast removal without lymph nodes Axillary lymph node removal A woman comes to the clinic and asks the nurse about when she should have her first mammogram. Using the recommendations of the American Cancer Society, which would the nurse suggest? A ) 30 years B ) 35 years C ) 40 years D ) 45 years 2 0. After teaching a group of nursing students about the different types of chemotherapeutic agents used to treat breast cancer, the instructor determines that the teaching was successful when the students identify which of the following as an example of a selective estrogen receptor modulator (SERM)? (Select all that apply.) A ) Tamoxifen B ) Letozole ep.c pr es t gt yn ur si n.m w w w C ) om 1 9. Raloxifene D ) Exemestane E ) Anastrozole A woman diagnosed with breast cancer is to receive trastuzumab. Which of the following would the nurse incorporate into the explanation about how this drug works? A ) It blocks the effect of the HER-2/neu protein inhibiting the growth of cancer cells. B ) The drug blocks the conversion of androgens to estrogens C ) It interferes with hormone receptors that allow estrogen to enter a cell D ) The drug ultimately attacks areas where micrometastasis has occurred. 2 2. A nurse is conducting a class on breast cancer prevention. Which statement would the nurse most likely include in the discussion? A ) Most often a lump is felt before it is seen. B ) Early breast cancer usually has some symptoms. C ) If the mass is not painful, it is usually benign. D ) If lump is palpable, it has been there for some time. w w w.m yn ur si n gt es t pr ep.c om 2 1. 2 3. When describing programs for breast cancer screening, the nurse include breast self-examination (BSE). Which of the following most accurately reflects the current thinking about breast self-examination? A ) BSE is essential for early breast cancer detection. B ) A woman performing BSE has breast awareness. C BSE plays a minimal role in detecting breast cancer When describing programs for breast cancer screening, the nurse include breast self-examination (BSE). Which of the following most accurately reflects the current thinking about breast self-examination? A ) BSE is essential for early breast cancer detection. B ) A woman performing BSE has breast awareness. C ) BSE plays a minimal role in detecting breast cancer D ) A clinical breast exam has replaced BSE. 2 4. During a wellness visit to the clinic, a woman asks the nurse if there is anything she can do to reduce her risk for developing breast cancer. Which of the following would the nurse most likely include? (Select all that apply.) A ) Eating three servings of fruit daily B ) Keeping weight gain under 11 pounds after age 18 C ) Eating at least seven portions of complex carbohydrates daily D ) Limiting the intake of refined sugar products E ) Using salt liberally when cooking w w w.m yn ur si n gt es t pr ep.c om 2 3. 2 5. A woman comes to the clinic and tells the nurse that she has read an article about certain foods that have anticancer properties and help boost the immune system. The nurse identifies A ) Garlic B ) Soybeans C Milk identifies A ) Garlic B ) Soybeans C ) Milk D ) Leeks C 2. B 3. A 4. D 5. C 6. C 7. B 9. w 10. w w.m 8. A B A 11. D 12. C 13. D 14. C 15. B 16. D 17. C, D 18. B gt es t pr 1. yn ur si n ep.c om E Flax seeds ) Answer Key D 14. C 15. B 16. D 17. C, D 18. B 19. C 20. A, C 21. A 22. D 23. B 24. B, C, D 25. A, B, D, E es t pr ep.c om 13. gt Chapter 7 Benign Disorders of the Female Reproductive Tract A woman is admitted for repair of cystocele and rectocele. She has nine living children. In taking her health history, which of the following would the nurse expect to find? A ) Sporadic vaginal bleeding accompanied by chronic pelvic pain B ) Heavy leukorrhea with vulvar pruritus C ) Menstrual irregularities and hirsutism on the chin w w w.m yn ur si n 1. D ) Stress incontinence with feeling of low abdominal pressure 2. To assist the woman in regaining control of the urinary sphincter for urinary incontinence, the nurse should teach the client to do which of the following? A ) Perform Kegel exercises daily. B Void every hour while awake. To assist the woman in regaining control of the urinary sphincter for urinary incontinence, the nurse should teach the client to do which of the following? A ) Perform Kegel exercises daily. B ) Void every hour while awake. C ) Limit her intake of fluid. D ) Take a laxative every night. 3. When developing the plan of care for a woman who has had an abdominal hysterectomy, which of the following would be contraindicated? A ) Ambulating the client B ) Massaging the clients legs C ) Applying elasticized stockings D ) Encouraging range-of-motion exercises 4. Which of the following would the nurse include when teaching women about preventing pelvic support disorders? w w w.m yn ur si n gt es t pr ep.c om 2. A ) Performing Kegel isometric exercises B ) Consuming low-fiber diets C ) Using hormone replacement D ) Voiding every 2 hours Consuming low-fiber diets C ) Using hormone replacement D ) Voiding every 2 hours 5. A client is diagnosed with an enterocele. The nurse interprets this condition as: A ) Protrusion of the posterior bladder wall downward through the anterior vaginal wall B ) Sagging of the rectum with pressure exerted against the posterior vaginal wall C ) Bulging of the small intestine through the posterior vaginal wall D ) Descent of the uterus through the pelvic floor into the vagina 6. A woman is scheduled for an anterior and posterior colporrhaphy as treatment for a cystocele. When the nurse is explaining this treatment to the client, which of the following descriptions would be most appropriate to include? A ) This procedure helps to tighten the vaginal wall in the front and back so that your bladder and urethra are in the proper position. B ) Your uterus will be removed through your vagina, helping to relieve the organ that is putting the pressure on your bladder. C ) This is a series of exercises that you will learn to do so that you can strengthen your bladder muscles. D ) w w w.m yn ur si n gt es t pr ep.c om B ) These are plastic devices that your physician will insert into your vagina to provide support to the uterus and keep it in the proper position. The nurse would be least likely to find which of the following in a client with uterine fibroids? A ) Regularly shaped, shrunken uterus B ) Acute pelvic pain C ) Menorrhagia D ) Complaints of bloating 8. A client with polycystic ovarian syndrome (PCOS. is receiving oral contraceptives as part of her treatment plan. The nurse understands that the rationale for this therapy is to: A ) Restore menstrual regularity B ) Induce ovulation C ) Improve insulin uptake D ) Alleviate hirsutism w w w.m yn ur si n gt es t pr ep.c om 7. 9. When teaching a woman how to perform Kegel exercises, the nurse explains that these exercises are designed to strengthen which muscles? A ) Gluteus B ) Lower abdominal C ) Pelvic floor D Diaphragmatic nurse explains that these exercises are designed to strengthen which muscles? A ) Gluteus B ) Lower abdominal C ) Pelvic floor D ) Diaphragmatic 1 0. A postmenopausal woman with uterine prolapse is being fitted with a pessary. The nurse would be most alert for which side effect? A ) Increased vaginal discharge B ) Urinary tract infection C ) Vaginitis D ) Vaginal ulceration 1 1. When preparing the discharge teaching plan for the woman who had surgery to correct pelvic organ prolapse, which of the following would the nurse include? A ) Care of the indwelling catheter at home w w w.m yn ur si n gt es t pr ep.c om. B ) Emphasis on coughing to prevent complications C ) Return to usual activity level in a few days D ) Daily douching with dilute vinegar solution Emphasis on coughing to prevent complications C ) Return to usual activity level in a few days D ) Daily douching with dilute vinegar solution 1 2. A woman with polycystic ovary syndrome tells the nurse, I hate this disease. Just look at me! I have no hair on the front of my head but Ive got hair on my chin and upper lip. I dont feel like a woman anymore. Further assessment reveals breast atrophy and increased muscle mass. Which nursing diagnosis would most likely be a priority? A ) Situational low self-esteem related to masculinization effects of the disease B ) Social isolation related to feelings about appearance C ) Risk for suicide related to effects of condition and fluctuating hormone levels D ) Ineffective peripheral tissue perfusion related to effects of disease on vasculature 1 3. After teaching a local womans group about incontinence, the nurse determines that the teaching was successful when the group identifies which of the following as characteristic of stress incontinence? A ) Feeling a strong need to void w w w.m yn ur si n gt es t pr ep.c om B ) B ) Passing a large amount of urine C ) Most common in women after childbirth D ) Sneezing may be an initiating stimulus A woman is being evaluated for pelvic organ prolapse. A postvoid residual urine specimen is obtained via a catheter. Which residual volume finding would lead the nurse to suspect the need for further testing? A ) 50 mL B ) 75 mL C ) 100 mL D ) 120 mL 1 5. After teaching a woman with pelvic organ prolapse about dietary and lifestyle measures, which of the following statements would indicate the need for additional teaching? A ) If I wear a girdle, it will help support the muscles in the area. B ) I should take up jogging to make sure I exercise enough. C ) I will try to drink at least 64 oz of fluid each day. ep.c pr es t gt yn ur si n.m w w w D ) om 1 4. I need to increase the amount of fiber I eat every day. 1 6. After teaching a group of students about genital fistulas, the instructor determines that the teaching was successful when the students identify which of the following as a major cause? A ) Radiation therapy B ) Congenital anomaly After teaching a group of students about genital fistulas, the instructor determines that the teaching was successful when the students identify which of the following as a major cause? A ) Radiation therapy B ) Congenital anomaly C ) Female genital cutting D ) Bartholins gland abscess 1 7. A nurse is providing care to a female client receiving treatment for a Bartholins cyst. The client has had a small loop of plastic tubing secured in place to allow for drainage. The nurse instructs the client that she will have a follow-up appointment for removal of the plastic tubing at which time? A ) 1 week B ) 2 weeks C ) 3 weeks D ) 4 weeks ep.c pr es t gt yn ur si n.m w w w 1 8. om 1 6. After undergoing diagnostic testing, a woman is diagnosed with a corpus luteum cyst. The nurse anticipates that the woman will require: A ) Biopsy B ) No treatment C ) Oral contraceptives D Glucophage ) No treatment C ) Oral contraceptives D ) Glucophage 1 9. A nurse is teaching a client how to perform Kegel exercises. Which of the following would the nurse include? (Select all that apply.) A ) Squeeze your rectal muscles as if you are trying to avoid passing flatus. B ) Tighten your pubococcygeal muscles for a count of 10. C ) Contract and relax your pubococcygeal muscles rapidly 10 times. D ) Try bearing down for about 10 seconds for no more than 5 times. E ) Do these exercises at least 5 times every hour. 2 0. After teaching a group of students about pelvic organ prolapse, the instructor determines that the teaching was successful when the group identifies leiomyomas as which of the following? A ) Cysts w w w.m yn ur si n gt es t pr ep.c om B ) B ) Pelvic organ prolapse C ) Fistula D ) Fibroid Pelvic organ prolapse C ) Fistula D ) Fibroid 2 1. A nurse is assessing a female client and suspects that the client may have endometrial polyps based on which of the following? A ) Bleeding after intercourse B ) Vaginal discharge C ) Bleeding between menses D ) Metrorrhagia 2 2. After teaching a group of students about ovarian cysts, the instructor determines that the teaching was successful when the students identify which type of cyst as being associated with hydatiform mole? A ) Theca-lutein cyst B ) Corpus luteum cyst D ) ep.c pr es t gt yn ur si n.m w w w C ) om B ) Follicular cyst Polycystic ovarian syndrome A nurse is reading a journal article about care of the woman with pelvic organ prolapse. The nurse would expect to find information related to which of the following? (Select all that apply.) A ) Rectocele B ) Fecal incontinence C ) Cystocele D ) Urinary incontinence E ) Enterocele 2 4. A nurse is reviewing the medical record of a client. Which of the following would lead the nurse to suspect that the client is experiencing polycystic ovarian syndrome? (Select all that apply.. A ) Decreased androgen levels B ) Elevated blood insulin levels ep.c pr es t gt yn ur si n.m w w w C ) om 2 3. Anovulation D ) Waist circumference of 32 inches E ) Triglyceride level of 175 mg/dL F ) High-density lipoprotein level of 40 mg/dL Waist circumference of 32 inches E ) Triglyceride level of 175 mg/dL F ) High-density lipoprotein level of 40 mg/dL 2 5. A group of students are preparing a class presentation about polyps. Which of the following would the students most likely include in the presentation? A ) Polyps are rarely the result of an infection. B ) Endocervical polyps commonly appear after menarche. C ) Cervical polyps are more common than endocervical polyps. pr ep.c om D ) yn ur si n gt es t D Endocervical polyps are most common in women in their 50s. ) Answer Key 1. D 2. A.m 3. w w 4. 6. w 5. B A C A 7. B 8. A 9. C 10. D 11. A 12. A 13. D 14. D C 10. D 11. A 12. A 13. D 14. D 15. B 16. C 17. C 18. B 19. A, C 20. D 21. D 22. A 23. A, C, E 24. B, C, E yn ur si n gt es t pr ep.c om 9. 25. D A ) w w The nurse would refer a client, age 54, for follow-up for suspected endometrial carcinoma if she reports which of the following? w 1..m Chapter 8 Cancers of the Female Reproductive Tract Use of oral contraceptives between ages 18 and 25 B ) Onset of painless, red postmenopausal bleeding C ) Menopause occurring at age 46 D ) Use of intrauterine device for 3 years Onset of painless, red postmenopausal bleeding C ) Menopause occurring at age 46 D ) Use of intrauterine device for 3 years 2. Which of the following instructions would the nurse include when preparing a woman for a Pap smear? A ) Refrain from sexual intercourse for 1 week before the test. B ) Wear cotton panties on the day of the test. C ) Avoid taking any medications for 24 hours. D ) Do not douche for 48 hours before the test. 3. A woman comes to the clinic for a routine checkup. A history of exposure to which of the following would alert the nurse that she is at increased risk for cervical cancer? A ) Hepatitis B ) Human papillomavirus C ) Cytomegalovirus w w w.m yn ur si n gt es t pr ep.c om B ) D ) Epstein-Barr virus 4. A client is scheduled to have a Pap smear. After the nurse teaches the client about the Pap smear, which of the following client statements indicates successful teaching? A ) I need to douche the night before with a mild vinegar solution. B ) I will take a bath first thing that morning to make sure Im clean. A client is scheduled to have a Pap smear. After the nurse teaches the client about the Pap smear, which of the following client statements indicates successful teaching? A ) I need to douche the night before with a mild vinegar solution. B ) I will take a bath first thing that morning to make sure Im clean. C ) I will not engage in sexual intercourse for 48 hours before the test. D ) I will get a clean urine specimen when I first wake up the morning of the test. 5. Which finding obtained during a client history would the nurse identify as increasing a clients risk for ovarian cancer? A ) Multiple sexual partners B ) Consumption of a high-fat diet C ) Underweight D ) Grand multiparity (more than five children) 6. A client is scheduled for cryosurgery to remove some abnormal tissue on the cervix. The nurse teaches the client about this treatment, explaining that the tissue will be removed by which method? w w w.m yn ur si n gt es t pr ep.c om 4. A ) Freezing B ) Cutting C ) Burning D ) Irradiating Freezing B ) Cutting C ) Burning D ) Irradiating 7. Which of the following statements best indicates that a client has taken self-care measures to reduce her risk for cervical cancer? A ) Ive really cut down on the amount of caffeine I drink every day. B ) Ive thrown out all my bubble baths and just use soap and water now. C ) Every time I have sexual intercourse, I douche. D ) My partner always uses a condom when we have sexual intercourse. 8. A client is suspected of having endometrial cancer. The nurse would most likely prepare the client for which procedure to confirm the diagnosis? A ) Transvaginal ultrasound ep.c pr es t gt yn ur si n.m w w w B ) om A ) Colposcopy C ) Pap smear D ) Endometrial biopsy Which of the following descriptions would the nurse include when teaching a client about her scheduled colposcopy? A ) A gel will be applied to your abdomen and a microphone-like device will be moved over the area to identify problem areas. B ) A solution will be wiped on your cervix to identify any abnormal cells, which will be visualized with a magnifying instrument. C ) Scrapings of tissue will be obtained and placed on slides to be examined under the microscope. D ) After you receive anesthesia, a small device will be inserted into your abdomen near your belly button to obtain tissue samples. 1 0. The nurse is preparing a presentation for a local womens group about ways to reduce the risk of reproductive tract cancers. Which of the following would the nurse include? A ) Blood pressure evaluation every 6 months B ) Yearly Pap smears starting at age 40 C ) Yearly cholesterol screening starting at age 45 gt yn ur si n.m w w w D ) es t pr ep.c om 9. Consumption of two to three glasses of red wine per day 1 1. The daughter of a woman who has been diagnosed with ovarian cancer asks the nurse about screening for this cancer. Which response by the nurse would be most appropriate? A ) Currently there is no reliable screening test for ovarian cancer. B ) A Pap smear is almost always helpful in identifying this type of cancer. C Theres a blood test for a marker, CA-125, that if elevated The daughter of a woman who has been diagnosed with ovarian cancer asks the nurse about screening for this cancer. Which response by the nurse would be most appropriate? A ) Currently there is no reliable screening test for ovarian cancer. B ) A Pap smear is almost always helpful in identifying this type of cancer. C ) Theres a blood test for a marker, CA-125, that if elevated indicates cancer. D ) A genetic test for two genes, if positive, will identify the ovarian cancer. 1 2. Which of the following would the nurse be least likely to suggest when teaching a group of young women how to reduce their risk for ovarian cancer? A ) Pregnancy B ) Oral contraceptives C ) Feminine hygiene sprays D ) Breast-feeding 1 3. A woman is diagnosed with adenocarcinoma of the endometrium in situ. The nurse interprets this as indicating which of the following about the cancer? w w w.m yn ur si n gt es t pr ep.c om 1 1. A ) Spread to the uterine muscle wall B ) Found on the endometrial surface C ) Spread to the cervix D ) Invaded the bladder Spread to the uterine muscle wall B ) Found on the endometrial surface C ) Spread to the cervix D ) Invaded the bladder 1 4. When preparing a woman with suspected vulvar cancer for a biopsy, the nurse expects that the lesion would most likely be located at which area? A ) Labia majora B ) Labia minora C ) Clitoris D ) Prepuce 1 5. When describing the various types of reproductive tract cancers to a local womens group, which of the following would the nurse identify as the least common type? A ) Vulvar B ) Vaginal w w w.m yn ur si n gt es t pr ep.c om A ) C ) Endometrial D ) Ovarian When assessing a female client for the possibility of vulvar cancer, which of the following would the nurse most likely expect the client to report? (Select all that apply.) A ) Abnormal vaginal bleeding B ) Persistent vulvar itching C ) History of herpes simplex D ) Lesion on the cervix E ) Abnormal Pap smear 1 7. A nurse is reviewing the medical record of a woman diagnosed with vulvar cancer. Which of the following would the nurse identify as a risk factor for this cancer? (Select all that apply.) A ) Age under 40 years B ) HPV 16 exposure C ) Monogamous sexual partner w w w.m yn ur si n gt es t pr ep.c om 1 6. D ) Hypertension E ) Diabetes A nurse is assisting with the collection of a Pap smear. When collecting the specimen, which of the following is done first? A ) Insertion of the speculum B ) Swabbing of the endocervix C ) Spreading of the labia D ) Insertion of the cytobrush 1 9. The plan of care for a woman diagnosed with a suspected reproductive cancer includes a nursing diagnosis of disturbed body image related to suspected reproductive tract cancer and impact on sexuality as evidenced by the clients statement that she is worried that she wont be the same. Which of the following would be an appropriate outcome for this client? A ) Client will verbalize positive statements about self and sexuality. B ) Client will demonstrate understanding of the condition and associated treatment. C ) Client will exhibit positive coping strategies related to diagnosis. D ) w w w.m yn ur si n gt es t pr ep.c om 1 8. Client will identify misconceptions related to her diagnosis. During a routine health check-up, a young adult woman asks the nurse about ways to prevent endometrial cancer. Which of the following would the nurse most likely include? (Select all that apply.) A ) Eating a high-fat diet B ) Having regular pelvic exams C ) Engaging in daily exercise D ) Becoming pregnant E ) Using estrogen contraceptives 2 1. After teaching a group of students about cervical cancer, the instructor determines that the teaching was successful when the students identify which of the following as the area included with a cone biopsy? A ) Clitoris B ) Uterine fundus D ) ep.c pr es t gt yn ur si n.m w w w C ) om 2 0. Ovarian follicle Transformation zone A woman is scheduled for diagnostic testing to evaluate for endometrial cancer. The nurse would expect to prepare the woman for which of the following? A ) CA-125 testing B ) Transvaginal ultrasound C ) Pap smear D ) Mammography 2 3. A nurse is conducting a class for a local womans group about recommendations for a Pap smear. One of the participants asks, At what age should a woman have her first Pap smear? The nurse responds by stating that a woman should have her first Pap smear at which age? A ) 18 B ) 21 C ) 25 ep.c pr es t gt yn ur si n.m w w w D ) om 2 2. 28 2 4. An instructor is describing the development of cervical cancer to a group of students. The instructor determines that the teaching was successful when the students identify which area as most commonly involved? A ) Internal cervical os B ) Junction of the cervix and fundus An instructor is describing the development of cervical cancer to a group of students. The instructor determines that the teaching was successful when the students identify which area as most commonly involved? A ) Internal cervical os B ) Junction of the cervix and fundus C ) Squamous-columnar junction D ) External cervical os 2 5. A client has an abnormal Pap smear that is classified as ASCUS. Based on the nurses understanding of this classification, the nurse would expect which of the following? A ) Immediate colposcopy B ) Testing for HPV C ) Repeat Pap smear in 4 to 6 months yn ur si n gt es t pr ep.c om 2 4. 1. w w w.m D Cone biopsy ) Answer Key B 2. D 3. B 4. C 5. B 6. A 7. D 8. D 9. B B 4. C 5. B 6. A 7. D 8. D 9. B 10. C 11. A 12. C 13. B 14. A 15. B 16. B, C 17. B, D, E 18. C ep.c pr es t A 20. B, C, D w w w.m 21. 23. gt yn ur si n 19. 22. om 3. D B B 24. C 25. C Chapter 9 Violence and Abuse The nurse is presenting a class at a local community health center on violence during pregnancy. Which of the following would the nurse include as a possible complication? A ) Hypertension of pregnancy B ) Chorioamnionitis C ) Placenta previa D ) Postterm labor 2. Which approach would be most appropriate when counseling a woman who is a suspected victim of violence? A ) Offer her a pamphlet about the local battered womens shelter. B ) Call her at home to ask her some questions about her marriage. C ) Wait until she comes in a few more times to make a better assessment. D ) Ask, Have you ever been physically hurt by your partner? w w w.m yn ur si n gt es t pr ep.c om 1. 3. When describing an episode, the victim reports that she attempted to calm her partner down to keep things from escalating. This behavior reflects which phase of the cycle of violence? A ) Battering B ) Honeymoon C ) Tension-building escalating. This behavior reflects which phase of the cycle of violence? Battering B ) Honeymoon C ) Tension-building D ) Reconciliation 4. A battered pregnant woman reports to the nurse that her husband has stopped hitting her and promises never to hurt her again. Which of the following is an appropriate response? A ) Thats great. I wish you both the best. B ) The cycle of violence often repeats itself. C ) He probably didnt mean to hurt you. D ) You need to consider leaving him. 5. Which of the following nursing actions would be least helpful for a client who is a victim of violence? A ) Assist the client to project her anger. w w w.m yn ur si n gt es t pr ep.c om A ) B ) Provide information about a safe home and crisis line. C ) Teach her about the cycle of violence. D ) Discuss her legal and personal rights. When describing the cycle of violence to a community group, the nurse explains that the first phase usually is: A ) Somehow triggered by the victims behavior B ) Characterized by tension-building and minor battery C ) Associated with loss of physical and emotional control D ) Like a honeymoon that lulls the victim 7. Which of the following statements would be most appropriate to empower victims of violence to take action? A ) Give your partner more time to come around. B ) Rememberchildren do best in two-parent families. C ) Change your behavior so as not to trigger the violence. D ) You are a good person and you deserve better than this. ep.c pr es t gt yn ur si n.m w w w 8. om 6. When a nurse suspects that a client may have been abused, the first action should be to: A ) Ask the client about the injuries and if they are related to abuse. B ) Encourage the client to leave the batterer immediately. C ) Set up an appointment with a domestic violence counselor. D ) Ask the suspected abuser about the victims injuries. Ask the client about the injuries and if they are related to abuse. B ) Encourage the client to leave the batterer immediately. C ) Set up an appointment with a domestic violence counselor. D ) Ask the suspected abuser about the victims injuries. 9. Which of the following would the nurse describe as a characteristic of the second phase of the cycle of violence? A ) The batterer is contrite and attempts to apologize for the behavior. B ) The physical battery is abrupt and unpredictable. C ) Verbal assaults begin to escalate toward the victim. D ) The victim accepts the anger as legitimately directed at her. 1 0. In addition to providing privacy, which of the following would be most appropriate initially in situations involving suspected abuse? A ) Allow the client to have a good cry over the situation. B ) Tell the client, Injuries like these dont usually happen by accident. w w w.m yn ur si n gt es t pr ep.c om A ) C ) Call the police immediately so they can question the victim. D ) Ask the abuser to describe his side of the story first. When the nurse is alone with a client, the client says, It was all my fault. The house was so messy when he got home and I know he hates that. Which response would be most appropriate? A ) It is not your fault. No one deserves to be hurt. B ) What else did you do to make him so angry with you? C ) You need to start to clean the house early in the day. D ) Remember, he works hard and you need to meet his needs. 1 2. When developing a presentation for a local community organization on violence, the nurse is planning to include statistics on intimate partner abuse and its effects on children. In what percentage of the cases in which a parent is abused are the children battered also? A ) 50% to 75% B ) 25% to 50% C ) 10% to 25% D ) w w w.m yn ur si n gt es t pr ep.c om 1 1. Less than 5% 1 3. The primary goal when working with victims of intimate partner violence is to: A ) Convince them to leave the abuser soon B ) Help them cope with their life as it is The primary goal when working with victims of intimate partner violence is to: A ) Convince them to leave the abuser soon B ) Help them cope with their life as it is C ) Empower them to regain control of their life D ) Arrest the abuser so he or she cant abuse again 1 4. Teaching for victims who are recovering from abusive situations must focus on ways to: A ) Enhance their personal appearance and hairstyle B ) Develop their creativity and work ethic C ) Improve their communication skills and assertiveness D ) Plan more nutritious meals to improve their own health 1 5. During a follow-up visit to the clinic, a victim of sexual assault reports that she has changed her job and moved to another town. She tells the nurse, I pretty much stay to myself at work and at home. The nurse interprets these findings to indicate that the client is in which phase of rape recovery? w w w.m yn ur si n gt es t pr ep.c om 1 3. A ) Disorganization B ) Denial C ) Reorganization D Integration ) Denial C ) Reorganization D ) Integration 1 6. A nurse is assessing a rape survivor for post-traumatic stress disorder. The nurse asks the woman, Do you feel as though you are reliving the trauma? The nurse is assessing for which of the following? A ) Physical symptoms B ) Intrusive thoughts C ) Avoidance D ) Hyperarousal 1 7. A group of students are preparing a class discussion about rape and sexual assault. Which of the following would the students include as being most accurate? (Select all that apply.) A ) Most victims of rape tell someone about it. ep.c pr es t gt yn ur si n.m w w w B ) om B ) Few women falsely cry rape. C ) Women have rape fantasies desiring to be raped. D ) A rape victim feels vulnerable and betrayed afterwards. E ) Medication and counseling can help a rape victim cope. Women have rape fantasies desiring to be raped. D ) A rape victim feels vulnerable and betrayed afterwards. E ) Medication and counseling can help a rape victim cope. 1 8. After teaching a class on date rape, the instructor determines that the teaching was successful when the class identifies which of the following as the most common date rape drug? A ) Gamma hydroxybutyrate B ) Liquid ecstasy C ) Ketamine D ) Rohypnol 1 9. A nurse is caring for a woman who was recently raped. The nurse would expect this woman to experience which of the following first? A ) Denial B ) Disorganization C ) Reorganization D ) w w w.m yn ur si n gt es t pr ep.c om C ) Integration A group of nurses are researching information about risk factors for intimate partner violence in men. Which of the following would the nurses expect to find related to the individual person? (Select all that apply.) A ) Dysfunctional family system B ) Low academic achievement C ) Victim of childhood violence D ) Heavy alcohol consumption E ) Economic stress 2 1. A nurse is working with a victim of intimate partner violence and helping her develop a safety plan. Which of the following would the nurse suggest that the woman take with her? (Select all that apply.) A ) Drivers license B ) Social security number ep.c pr es t gt yn ur si n.m w w w C ) om 2 0. Cash D ) Phone cards E ) Health insurance cards A nurse is presenting a discussion on sexual violence at a local community college. When describing the incidence of sexual violence, the nurse would identify that a woman has which chance of experiencing a sexual assault in her lifetime? A ) One in three B ) One in six C ) Two in 15 D ) Three in 20 2 3. After teaching a class on sexual violence, the instructor determines that the teaching was successful when the class identifies which of the following as a type of sexual violence. (Select all that apply.) A ) Female genital cutting B ) Bondage C ) Infanticide E ) ep.c pr es t gt yn ur si n.m w w w D ) om 2 2. Human trafficking Rape A nurse is reading a journal article about sexual abuse. Which age range would the nurse expect to find as the peak age for such abuse? A ) 710 years B ) 812 years C ) 1418 years D ) 1822 years 2 5. After teaching a group of students about sexual abuse and violence, the instructor determines that the teaching was successful when the students describe incest as involving which of the following? A ) Sexual exploitation by blood or surrogate relatives B ) Sexual abuse of individuals over age 18 C ) Violent aggressive assault on a person w w.m yn ur si n gt es t pr ep.c om 2 4. w D Consent between perpetrator and victim. ) Answer Key 1. B 2. D 3. C 4. B 5. A 6. B 4. B 5. A 6. B 7. D 8. A 9. B 10. B 11. A 12. A 13. C 14. C 15. C 16. B 17. B, D, E w w w 20..m 18. 19. om C ep.c 3. pr D es t 2. gt B yn ur si n 1. D B B, C, D 21. A, B, C, E 22. B 23. A, B, C, D, E 24. B 25. A Chapter 10 Fetal Development and Genetics While talking with a pregnant woman who has undergone genetic testing, the woman informs the nurse that her baby will be born with Down syndrome. The nurse understands that Down syndrome is an example of: A ) Multifactorial inheritance B ) X-linked recessive inheritance C ) Trisomy numeric abnormality D ) Chromosomal deletion 2. A nurse is describing advances in genetics to a group of students. Which of the following would the nurse least likely include? A ) Genetic diagnosis is now available as early as the second trimester. B ) Genetic testing can identify presymptomatic conditions in children. C ) Gene therapy can be used to repair missing genes with normal ones. ep.c pr es t gt yn ur si n w w.m Not 2ⁿᵈ Actually First w D ) om 1. Genetic agents may be used in the future to replace drugs. 3. After teaching a group of students about fetal development, the instructor determines that the teaching was successful when the students identify which of the following as providing the barrier to other sperm after fertilization? A ) Zona pellucida B ) Zygote After teaching a group of students about fetal development, the instructor determines that the teaching was successful when the students identify which of the following as providing the barrier to other sperm after fertilization? A ) Zona pellucida B ) Zygote C ) Cleavage D ) Morula 4. A nurse is teaching a class on X-linked recessive disorders. Which of the following statements would the nurse most likely include? A ) Males are typically carriers of the disorders. B ) No male-to-male transmission occurs. ep.c pr es t gt yn ur si n C ) om 3. IMIONOTPassdownx Daughters are more commonly affected with the disorder. i.fi y Both sons and daughters have a 50% risk of the disorder. 5. A pregnant woman undergoes maternal serum alpha-fetoprotein (MSAFP) testing at 16 to 18 weeks gestation. Which of the following would the nurse suspect if the womans level is decreased? w w w.m D ) A ) Down syndrome B ) Sickle-cell anemia C ) Cardiac defects D ) Open neural tube defect Down syndrome B ) Sickle-cell anemia C ) Cardiac defects D ) Open neural tube defect 6. The nurse is developing a presentation for a community group of young adults discussing fetal development and pregnancy. The nurse would identify that the sex of offspring is determined at the time of: A ) Meiosis B ) Fertilization C ) Formation of morula D ) Oogenesis 7. When describing amniotic fluid to a pregnant woman, the nurse would include which of the following? A ) This fluid acts as transport mechanism for oxygen and nutrients. B ) The fluid is mostly protein to provide nourishment to your baby. w w w.m yn ur si n gt es t pr ep.c om A ) C ) This fluid acts as a cushion to help to protect your baby from injury. D ) The amount of fluid remains fairly constant throughout the pregnancy. Assessment of a pregnant woman reveals oligohydramnios. The nurse would be alert for the development of which of the following? A ) Maternal diabetes B ) Placental insufficiency C ) Neural tube defects D ) Fetal gastrointestinal malformations 9. A couple comes to the clinic for preconception counseling and care. As part of the visit, the nurse teaches the couple about fertilization and initial development, stating that the zygote formed by the union of the ovum and sperm consists of how many chromosomes? A ) 22 B ) 23 C ) 44.m w w w D ) yn ur si n gt es t pr ep.c om 8. 46 1 0. A woman just delivered a healthy term newborn. Upon assessing the umbilical cord, the nurse would identify which of the following as normal? (Select all that apply.) A ) One vein B ) Two veins A woman just delivered a healthy term newborn. Upon assessing the umbilical cord, the nurse would identify which of the following as normal? (Select all that apply.) A ) One vein B ) Two veins C ) One artery D ) Two arteries E ) One ligament F ) Two ligaments 1 1. After teaching a pregnant woman about the hormones produced by the placenta, the nurse determines that the teaching was successful when the woman identifies which hormone produced as being the basis for pregnancy tests? A ) Human placental lactogen (hPL) B ) Estrogen (estriol) C ) Progesterone (progestin) D ) w w w.m yn ur si n gt es t pr ep.c om 1 0. Human chorionic gonadotropin (hCG) After the nurse describes fetal circulation to a pregnant woman, the woman asks why her fetus has a different circulation pattern than hers. In planning a response, the nurse integrates understanding of which of the following? A ) Fetal blood is thicker than that of adults and needs different pathways. B ) Fetal circulation carries highly oxygenated blood to vital areas first. C ) Fetal blood has a higher oxygen saturation and circulates more slowly. D ) Fetal heart rates are rapid and circulation time is double that of adults. 1 3. When describing genetic disorders to a group of childbearing couples, the nurse would identify which as an example of an autosomal dominant inheritance disorder? A ) Huntingtons disease B ) Sickle cell disease C ) Phenylketonuria ep.c pr es t gt yn ur si n.m w w w D ) om 1 2. Cystic fibrosis 1 4. Prenatal testing is used to assess for genetic risks and to identify genetic disorders. In explaining to a couple about an elevated alpha-fetoprotein screening test result, the nurse would discuss the need for: A ) Special care needed for a Down syndrome infant B ) A more specific determination of the acidbase status Prenatal testing is used to assess for genetic risks and to identify genetic disorders. In explaining to a couple about an elevated alpha-fetoprotein screening test result, the nurse would discuss the need for: A ) Special care needed for a Down syndrome infant B ) A more specific determination of the acidbase status C ) Further, more definitive evaluations to conclude anything D ) Immediate termination of the pregnancy based on results 1 5. A nursing instructor is preparing a teaching plan for a group of nursing students about the potential for misuse of genetic discoveries and advances. Which the following would the instructor most likely include? A ) Gene replacement therapy for defective genes B ) Individual risk profiling and confidentiality C ) Greater emphasis on the causes of diseases D ) Slower diagnosis of specific diseases 1 6. After teaching a class on the stages of fetal development, the instructor determines that the teaching was successful when the students identify which of the following as a stage? (Select all that apply.) w w w.m yn ur si n gt es t pr ep.c om 1 4. A ) Placental B ) Preembryonic C ) Umbilical D Embryonic 0 2 weeks ) B ) Preembryonic C ) Umbilical D ) Embryonic E ) Fetal 1 7. A nurse is discussing fetal development with a pregnant woman. The woman is 12 weeks pregnant and asks, Whats happening with my baby? Which of the following would the nurse integrate into the response? (Select all that apply.) A ) Continued sexual differentiation B ) Eyebrows forming C ) Startle reflex present D ) Digestive system becoming active E ) Lanugo present on the head 1 8. After teaching a group of students about fetal development,