Exam IV Maternity and Pediatrics

A 6-year-old child with cystic fibrosis is admitted for a pulmonary exacerbation. Which nursing diagnosis takes priority?

A. Imbalanced Nutrition: Less than Body Requirements
B. Ineffective Airway Clearance
C. Risk for Impaired Skin Integrity
D. Delayed Growth and Development

B. Ineffective Airway Clearance

Airway clearance is always a top priority in CF due to the thick mucus secretions that impair gas exchange.

The nurse is teaching parents of a child with CF about pancreatic enzyme replacement. Which statement indicates correct understanding?

A. "We will give the enzymes once daily in the morning."
B. "Enzymes should be taken 30 minutes after meals."
C. "We will crush the enzyme capsules and mix them with milk."
D. "We will give enzymes before every meal and snack."

D. "We will give enzymes before every meal and snack."

Pancreatic enzymes must be taken before all meals and snacks to aid digestion and nutrient absorption.

Cystic fibrosis is inherited in which of the following patterns?

A. Autosomal dominant
B. Autosomal recessive
C. X-linked dominant
D. Mitochondrial inheritance

B. Autosomal recessive

CF is caused by a mutation in the CFTR gene; results in dehydration of epithelial cells in airways and pancreas

A pediatric patient with CF is at risk for which nutritional imbalance?

A. Hyperglycemia
B. Fat-soluble vitamin deficiency
C. Protein overload
D. Hypokalemia

B. Fat-soluble vitamin deficiency

Due to pancreatic insufficiency, children with CF have difficulty absorbing vitamins A, D, E, and K.

Which test is considered the gold standard for diagnosing cystic fibrosis?

A. Chest X-ray
B. Sweat chloride test
C. Pulmonary function test
D. Sputum culture

B. Sweat chloride test

*Lots of moms notice their babies are salty when kissed

Which of the following would you expect to find in an infant with undiagnosed CF? (Select all that apply)

A. Bulky, foul-smelling stools
B. Meconium ileus at birth
C. Frequent respiratory infections
D. Excessive weight gain
E. Clubbing of the fingers

A. Bulky, foul-smelling stools
B. Meconium ileus at birth
C. Frequent respiratory infections

E.Clubbing of the fingers

A 13-year-old with CF is being screened for CF-related diabetes. Which of the following is the most appropriate test?

A. Random glucose
B. Hemoglobin A1C
C. Oral glucose tolerance test (OGTT)
D. Fasting insulin level

C. OGTT

Which instruction is most important to teach a child with CF about infection control at school?

A. Wear a surgical mask at all times
B. Avoid classmates with colds or flu
C. Do not participate in physical education
D. Use hand sanitizer only at home

B. Avoid classmates with colds or flus

Children with CF are especially vulnerable to respiratory infections, which can worsen lung damage.

Which signs and symptoms should the nurse teach parents to recognize as early indicators of hypoglycemia in their child? (Select all that apply)

A. Tremors
B. Irritability
C. Fruity breath odor
D. Diaphoresis
E. Tachycardia

A. Tremors
B. Irritability

D. Diaphoresis
E. Tachycardia

Fruity breath indicates hyperglycemia and possible DKA

The nurse is teaching a 10-year-old how to self-administer insulin. Which teaching method is most appropriate?

A. Provide a written handout about insulin
B. Demonstrate on a model and have the child return-demonstrate
C. Administer the insulin while the child watches
D. Ask the parents to teach the child at home

B. Demonstrate on a model and have the child return-demonstrate

Hands-on, age-appropriate teaching ensures skill acquisition and builds independence.

Which statement indicates a need for further teaching about "sick day" rules for a child with Type 1 Diabetes?

A. "I will monitor blood glucose levels every 3 hours."
B. "I will skip insulin if my child isn’t eating."
C. "I will encourage fluids to prevent dehydration."
D. "I will call the provider if ketones are present in the urine."

B. "I will skip insulin if my child isn’t eating."

Insulin should never be skipped during illness, as it can lead to DKA.

Which of the following is the most concerning sign in a child with suspected diabetic ketoacidosis (DKA)?

A. Frequent urination
B. Kussmaul respirations
C. Thirst
D. Irritability

B. Kussmaul respirations

Which child is at highest risk for developing Type 2 Diabetes Mellitus?

A. A 4-year-old with a family history of asthma
B. An 8-year-old who is active and of normal weight
C. A 13-year-old with obesity and acanthosis nigricans
D. A 10-year-old with cystic fibrosis

C. A 13-year-old with obesity and acanthosis nigricans

Somogyi Effect

Nightitme hypoglycemia followed by early morning hyperglycemia; r/t insulin overuse and persistent hypoglycemia

Honeymoon period

Minimal amount of inulin needed to manage diabetes; exogenous insulin stimulates islet cells to produce natural insulin then falls within a year

Which diagnostic test is most useful in confirming a diagnosis of central precocious puberty?

A. Pelvic ultrasound
B. Growth hormone stimulation test
C. Bone age X-ray
D. Blood culture

C. Bone age X-ray

Which clinical findings would support a diagnosis of precocious puberty in a 6-year-old girl? (Select all that apply)
A. Breast development
B. Appearance of pubic hair
C. Rapid height growth
D. Acne and voice deepening
E. Menarche

A. Breast development
B. Appearance of pubic hair
C. Rapid height growth

E. Menarche

Which clinical finding is most suggestive of growth hormone deficiency in a 5-year-old child?

A. Rapid weight gain with proportional height
B. Short stature with normal body proportions
C. Early onset of secondary sexual characteristics
D. Large head circumference

B. Short stature with normal body proportions

Children with GHD typically present with short stature, but normal body proportions.

Which diagnostic test is most commonly used to confirm growth hormone deficiency?

A. Thyroid function test
B. Growth hormone stimulation test
C. Bone density scan
D. Serum cortisol level

B. Growth hormone stimulation test

GHD is diagnosed by failure to raise GH levels after pharmacologic stimulation

Why is a bone age X-ray ordered for a child suspected of having growth hormone deficiency?

A. To evaluate bone fragility
B. To assess for scoliosis
C. To estimate skeletal maturation
D. To confirm a bone tumor

C. To estimate skeletal maturation

Bone age helps determine if growth is delayed relative to chronological age, which is common in GHD.

Which side effect should the nurse monitor for in a child receiving growth hormone therapy?

A. Increased appetite and weight gain
B. Increased intracranial pressure
C. Hypoglycemia
D. Hypotension

B. Increased intracranial pressure

A 5-year-old has a seizure that begins with a blank stare, followed by lip-smacking and hand rubbing, lasting about 20 seconds. What type of seizure does this most likely represent?

A. Tonic-clonic seizure
B. Absence seizure
C. Myoclonic seizure
D. Atonic seizure

B. Absence seizure

During a generalized tonic-clonic seizure in a 6-year-old, what is the nurse’s priority action?

A. Insert an oral airway
B. Administer prescribed antiseizure medication
C. Turn the child to the side and monitor for safety
D. Restrain the child’s movements

C. Turn the child to the side and monitor for safety

Turning the child prevents aspiration. Never insert objects or restrain during a seizure

A 7-year-old is in the postictal phase after a tonic-clonic seizure. What is the most appropriate nursing intervention?

A. Offer food and fluids immediately
B. Place the child in a supine position
C. Monitor airway and allow the child to rest
D. Administer rectal diazepam

C. Monitor airway and allow the child to rest

The child will likely be drowsy and confused; maintain safety and airway patency

The parent of a 3.5-year-old asks about febrile seizures. Which teaching point is most important?

A. “Your child will need daily seizure medication.”
B. “These seizures are usually harmless and self-limiting.”
C. “A febrile seizure means your child has epilepsy.”
D. “Avoid all immunizations going forward.”

B. “These seizures are usually harmless and self-limiting.”

Which statement by a parent indicates a need for further teaching about antiseizure medications?

A. "We give the medicine at the same time each day."
B. "If she’s seizure-free for a week, we can stop the medication."
C. "We will call if she has side effects like drowsiness or rash."
D. "We will not skip doses even when traveling."

B. If she’s seizure-free for a week, we can stop the medication

Seizure medications must not be stopped abruptly, even if the child is seizure-free

What is the most appropriate position for a child immediately after tonsillectomy?

A. Supine with head elevated
B. Prone or side-lying
C. Sitting upright in a chair
D. Trendelenburg position

B. Prone or side-lying

These positions promote drainage of secretions and reduce the risk of aspiration or airway obstruction.

A 6-year-old is recovering from a tonsillectomy. Which assessment finding requires immediate intervention?
A. Frequent swallowing
B. Sore throat
C. Low-grade fever
D. Halitosis (bad breath)

A. Frequent swallowing

Frequent swallowing can indicate active bleeding from the surgical site, which is a medical emergency.

Which food should be avoided in the first 24 hours after tonsillectomy?

A. Apple juice
B. Popsicles
C. Ice cream
D. Orange juice

D. Orange juice

Acidic and citrus drinks can irritate the throat and cause pain.

Which statement by a parent indicates a need for further discharge teaching after a tonsillectomy?

A. "I will watch for bleeding, especially around day 7."
B. "We’ll encourage soft, cool foods at first."
C. "Coughing and clearing the throat will help healing."
D. "My child should avoid strenuous activity for 1–2 weeks."

C. Coughing and clearing the throat will help healing

Coughing or throat clearing can dislodge clots and cause bleeding; it should be discouraged.

Which is an expected postoperative finding in a child after a tonsillectomy?

A. Bright red bleeding
B. Ear pain
C. Severe neck stiffness
D. Projectile vomiting

B. Ear pain

Which of the following symptoms suggests a possible post-tonsillectomy hemorrhage? (Select all that apply)

A. Vomiting bright red blood
B. Continuous sleepiness
C. Pallor and increased heart rate
D. Refusing to eat
E. Dark brown emesis

A. Vomiting bright red blood

C. Pallor and increased heart rate

Volkmann Ischemic Contracture

• Arm is flexed in cast and the radial nerve/artery can be compressed at the elbow resulting in nerve injury.

• If sx not detected within 6hr = possible permanent damage

  • Permanently flexed at elbow

  • Wrist hyperextended

  • Fingers flexed “clawlike”

• Look for coldness, blanching, and color of fingers during first 8hrs

Which behavior observed by the nurse is most consistent with hyperactive-impulsive type ADHD in a school-aged child?

A. Difficulty making friends
B. Failure to complete homework assignments
C. Talking excessively and blurting out answers
D. Preferring solitary play

C. Talking excessively and blurting out answers

Which behavioral intervention is most appropriate for managing a 6-year-old with ADHD in the classroom?

A. Placing the child near a window for stimulation
B. Providing long homework assignments
C. Giving frequent breaks and positive reinforcement
D. Using punishment to reduce disruptive behavior

C. Giving frequent breaks and positive reinforcement

Which factor is most commonly associated with the development of acne in adolescents?

A. Vitamin deficiency
B. Increased androgen production
C. Excessive hygiene
D. Allergic reaction

B. Increased androgen production

What teachings should be provided on tretinonin?

• Avoid the sun

• Use SPF 15+

What should adolescent patients know about benzoyl peroxide/azeliac acid?

Complexion may look worse for the first two weeks

Tetracycline should not be prescribed for patients <12 years old d/t….

• Permanent staining of teeth

• Long bone growth interference

• DO NOT USE WITH ISOTRETINOIN RF BRAIN EDEMA

Which teaching point is most important when starting an adolescent on antihypertensive medication?

A. “Stop medication when blood pressure normalizes.”
B. “Take the medication at the same time daily and do not skip doses.”
C. “Only take medication when you feel symptoms.”
D. “You can double the dose if you miss one.”

B. “Take the medication at the same time daily and do not skip doses.”

Hypertension Criteria in Adolescents

• Normal

  • <13yrs = <90th percentile

  • >13yrs = 120/80

• Prehypertension

  • <13yrs = greater or equal to 90th percentile but less than the 95th percentile

  • >13yrs = 120/80 - 129/80

• Hypertension

  • Stage I

    • <13yrs = >95th percentile and <95th percentile+12

    • >13yrs = 130-139/80-89

  • Stage II

    • <13yrs = >95 percentile+12

    • >13yrs = >140/90

• Diagnosis cannot be given until BP elevated on 3 separate readings at 3 visits

Which triad of symptoms is classically associated with meningitis?

A. Fever, cough, and rash
B. Fever, headache, and neck stiffness
C. Vomiting, diarrhea, and rash
D. Fever, abdominal pain, and sore throat

B. Fever, headache, and neck stiffness

Which test is definitive for diagnosing bacterial meningitis?

A. Complete blood count (CBC)
B. Lumbar puncture with cerebrospinal fluid (CSF) analysis
C. Chest X-ray
D. Blood cultures only

B. Lumbar puncture with cerebrospinal fluid (CSF) analysis

CSF will be cloudy!

What is the nurse’s highest priority when caring for an adolescent suspected of having meningitis?

A. Administer antipyretics as ordered
B. Maintain isolation precautions
C. Monitor neurological status closely
D. Encourage oral fluids

C. Monitor neurological status closely

Early recognition of neurological changes is critical due to risk of complications like increased intracranial pressure.

Which of the following signs indicates increased intracranial pressure in an adolescent with meningitis?

A. Bradycardia and irregular respirations
B. Tachycardia and hypotension
C. Hyperactive reflexes
D. Dilated pupils unresponsive to light

A. Bradycardia and irregular respirations

Which of the following is a common complication of bacterial meningitis in adolescents?

A. Hearing loss
B. Diabetes mellitus
C. Renal failure
D. Heart failure

A. Hearing Loss

+Brudzinski Sign

r/t meningitis; involuntary flex of knee and hips when neck is flexed

+Kernig Sign

r/t meningitis; pain/resistance when extending leg at knee while hip flexed 90*

Opisthotonos

r/t meningitis; back arched, neck hyperextended

Comfort for meningitis patients

• HOB 45*

• No pillow

Which behavior is a common manifestation of generalized anxiety disorder in adolescents?

A. Avoiding social situations and school
B. Persistent worry about future events
C. Engaging in risk-taking behaviors
D. Talking excessively

B. Persistent worry about future events

Which statement by an adolescent starting selective serotonin reuptake inhibitors (SSRIs) indicates understanding?

A. "I should stop the medication if I feel worse in the first weeks."
B. "It may take several weeks before I notice an improvement."
C. "I can double the dose if symptoms persist."
D. "This medication cures depression overnight."

B. "It may take several weeks before I notice an improvement."

SSRIs typically take 4-6 weeks to show full effect.

Which therapy is most effective in treating adolescent anxiety and depression?

A. Cognitive-behavioral therapy (CBT)
B. Electroconvulsive therapy (ECT)
C. Psychoanalysis only
D. Hypnotherapy

A. Cognitive-behavioral therapy (CBT)

CBT helps adolescents identify and change negative thought patterns.

Why are growth plate fractures in children particularly concerning?

A. They heal faster than other fractures
B. They may affect future bone growth and cause deformities
C. They do not require treatment
D. They only occur in the elderly

B. They may affect future bone growth and cause deformities

What is the priority nursing intervention immediately after a pediatric fracture?

A. Apply heat to the injured area
B. Immobilize the affected limb and assess neurovascular status
C. Encourage movement to prevent stiffness
D. Administer oral pain medication only

B. Immobilize the affected limb and assess neurovascular status

Splint extremity; extends from joint above to joint below

Which instruction should the nurse provide to parents about cast care?

A. Insert objects inside the cast to scratch itchy skin
B. Keep the cast dry and report any foul odor or increased pain
C. Remove the cast daily for cleaning
D. Expose the cast to direct sunlight to dry it faster

B. Keep the cast dry and report any foul odor or increased pain

Which symptom requires immediate reporting to the healthcare provider in a child with a cast?

A. Slight itching under the cast
B. Persistent pain unrelieved by medication and swelling
C. Mild redness around the cast edges
D. Occasional numbness when moving the fingers

B. Persistent pain unrelieved by medication and swelling

Compartment syndrome = cast/constrictive dressing puts pressure enclosed space = decreased perfusion

Which hormone is primarily responsible for triggering ovulation?

A. Follicle-stimulating hormone (FSH)
B. Luteinizing hormone (LH)
C. Estrogen
D. Progesterone

B. Luteinizing hormone (LH)

A surge in LH triggers ovulation, releasing the mature egg.

Which effect does estrogen have on the endometrium during the menstrual cycle?

A. Causes endometrial shedding
B. Thickens and rebuilds the endometrium
C. Inhibits follicle development
D. Promotes progesterone secretion

B. Thickens and rebuilds the endometrium

Estrogen stimulates proliferation and thickening of the endometrial lining.

What is the primary function of the corpus luteum during the menstrual cycle?

A. To produce estrogen and progesterone to maintain the endometrium
B. To release the egg during ovulation
C. To initiate menstruation
D. To stimulate FSH production

A. To produce estrogen and progesterone to maintain the endometrium

The corpus luteum secretes hormones to prepare the uterus for possible implantation.

Which hormone decreases if pregnancy does not occur, leading to menstruation?

A. FSH
B. LH
C. Estrogen and progesterone
D. Human chorionic gonadotropin (hCG)

C. Estrogen and progesterone

Decrease in estrogen and progesterone causes the endometrium to break down and menstruation to begin.

On which day of a typical 28-day menstrual cycle does ovulation usually occur?

A. Day 1
B. Day 7
C. Day 14
D. Day 28

C. Day 14

What is the role of progesterone in the menstrual cycle?

A. Stimulates follicle development
B. Maintains the uterine lining for implantation
C. Causes menstrual bleeding
D. Triggers LH surge

B. Maintains the uterine lining for implantation

Progesterone stabilizes the endometrium to support potential pregnancy.

What is the primary symptom of menorrhagia?

A. Painful urination during menstruation
B. Excessive or prolonged menstrual bleeding
C. Absence of menstrual periods
D. Irregular spotting between cycles

B. Excessive or prolonged menstrual bleeding

Which treatment is commonly recommended for primary dysmenorrhea?

A. NSAIDs to reduce prostaglandin production and relieve pain
B. Antibiotics
C. Hormonal replacement therapy only
D. Bed rest without medication

A. NSAIDs to reduce prostaglandin production and relieve pain

NSAIDs reduce uterine contractions and inflammation causing pain.

A 17-year-old patient reports experiencing severe, throbbing headaches that begin 1–2 days before her menstrual period and last for several days. Which statement by the nurse best explains the likely cause of these symptoms?

A. "These headaches are most likely due to dehydration during menstruation."
B. "You may be experiencing menstrual migraines, which are triggered by a drop in estrogen levels."
C. "This is a normal part of adolescence and requires no treatment."
D. "You are likely experiencing tension headaches due to school-related stress."

B. "You may be experiencing menstrual migraines, which are triggered by a drop in estrogen levels."

Menstrual migraines are commonly triggered by the that occurs in the late luteal phase of the menstrual cycle.

What best describes the pathophysiology of endometriosis?

A. Infection of the uterus spreading to the fallopian tubes
B. Endometrial tissue growing outside the uterus, often on pelvic organs
C. Fibroid tumors forming within the uterus
D. Proliferation of cervical epithelial cells

B. Endometrial tissue growing outside the uterus, often on pelvic organs

Which symptom is most commonly associated with endometriosis?

A. Amenorrhea
B. Severe pelvic pain, especially during menstruation
C. Heavy vaginal discharge with itching
D. Intermittent hypertension

B. Severe pelvic pain, especially during menstruation

Which concern is most important to address in a patient with endometriosis who is trying to conceive?

A. Increased risk of gestational diabetes
B. Decreased fertility due to adhesions and scarring
C. Increased chance of delivering prematurely
D. Higher chance of developing cervical cancer

B. Decreased fertility due to adhesions and scarring

Which type of medication is commonly used to manage symptoms of endometriosis?

A. Estrogen supplements
B. Antibiotics
C. GnRH agonists to suppress ovulation
D. Anticoagulants

C. GnRH agonists to suppress ovulation

(GnRH) agonists reduce estrogen production and suppress the menstrual cycle, helping to shrink endometrial implants and reduce pain.

Which of the following symptoms is most characteristic of Premenstrual Dysphoric Disorder (PMDD)?

Which medication class is considered first-line pharmacologic treatment for PMDD?

Which clinical finding is most commonly associated with chlamydia infection in adolescent females?
A. Severe lower back pain only
B. Painful breast swelling
C. Often asymptomatic or mild vaginal discharge with dysuria
D. Heavy menstrual bleeding

C. Often asymptomatic or mild vaginal discharge with dysuria

What is a potential long-term complication of untreated chlamydia in females?

A. Ovarian cancer
B. Pelvic inflammatory disease (PID) and infertility
C. Polycystic ovarian syndrome (PCOS)
D. Breast fibroids

B. Pelvic inflammatory disease (PID) and infertility

A patient is prescribed azithromycin for chlamydia. Which teaching is most important?

A. "You may stop the antibiotic once symptoms improve."
B. "You only need to take this medication if you have symptoms."
C. "Take the full dose as prescribed, and abstain from sexual activity for 7 days."
D. "Avoid calcium-rich foods while taking this antibiotic."

C. "Take the full dose as prescribed, and abstain from sexual activity for 7 days."

Which clinical symptom is most indicative of a primary herpes simplex virus type 2 (HSV-2) infection?

A. Painless cervical swelling
B. Fever with widespread rash
C. Painful genital ulcers with flu-like symptoms
D. Vaginal itching without discharge

C. Painful genital ulcers with flu-like symptoms

Which medication is commonly prescribed to manage recurrent HSV-2 outbreaks?

A. Azithromycin
B. Metronidazole
C. Acyclovir
D. Penicillin

C. Acyclovir

Which sign is most characteristic of primary syphilis?

A. Painless genital chancre
B. Diffuse maculopapular rash on palms and soles
C. Generalized lymphadenopathy without lesions
D. Severe headache and fever

A. Painless genital chancre

What symptom is commonly seen during secondary syphilis?

A. Neurosyphilis with seizures
B. Generalized rash including palms and soles
C. Cardiac involvement
D. Gumma formation

B. Generalized rash including palms and soles

What is the recommended treatment for early syphilis?

A. Oral doxycycline for 7 days
B. Intramuscular penicillin G benzathine single dose
C. Oral azithromycin once
D. Intravenous acyclovir

B. Intramuscular penicillin G benzathine single dose (PO erythromycin or tetracycline if KA penicillin)

Dose depends on stage

A nurse is caring for a client diagnosed with genital warts. The client asks what caused them. Which is the best response?

A. "They are caused by a bacterial infection."
B. "They result from stress and poor hygiene."
C. "They are caused by certain types of human papillomavirus."
D. "They are a sign of advanced cervical cancer."

C. "They are caused by certain types of human papillomavirus."

Which of the following individuals is most at risk for persistent HPV infection?

A. A 17-year-old who received all HPV vaccine doses
B. A 30-year-old smoker with multiple sexual partners
C. A 10-year-old child with no sexual history
D. A 50-year-old male in a monogamous relationship

B. A 30-year-old smoker with multiple sexual partners

The nurse is educating a male client about HPV. Which statement should the nurse include?

A. "HPV only affects females."
B. "HPV infection in men never causes complications."
C. "HPV can lead to penile, anal, and throat cancers in men."
D. "Men cannot transmit HPV if they are asymptomatic."

C. "HPV can lead to penile, anal, and throat cancers in men."

Which of the following symptoms is most commonly reported by males with gonorrhea?

A. Testicular torsion
B. Painless ulcer
C. Purulent urethral discharge
D. Rash on palms and soles

C. Purulent urethral discharge

What is the recommended first-line treatment for uncomplicated gonorrhea infection?

A. Azithromycin 1g orally once
B. Metronidazole 500 mg orally for 7 days
C. Ceftriaxone 500 mg IM once
D. Doxycycline 100 mg IV

C. Ceftriaxone 500 mg IM once

A newborn is delivered to a mother with untreated gonorrhea. What is the nurse’s priority action?

A. Administer vitamin K injection
B. Apply erythromycin ophthalmic ointment
C. Obtain a rectal culture
D. Delay breastfeeding for 48 hours

B. Apply erythromycin ophthalmic ointment

A male patient treated for gonorrhea asks when he can resume sexual activity. What is the appropriate response?

A. "You may resume sexual activity after 3 days of antibiotics."
B. "You should avoid sex for at least 1 month."
C. "You can resume sex once your symptoms disappear."
D. "Avoid sexual activity for 7 days after completing treatment and ensure your partner is treated."

D. "Avoid sexual activity for 7 days after completing treatment and ensure your partner is treated."

A nurse suspects that a client with gonorrhea might also be co-infected with which other STI?

A. Herpes simplex virus
B. Syphilis
C. Chlamydia
D. Trichomoniasis

C. Chlamydia

A 26-year-old woman presents with frothy, greenish-yellow vaginal discharge and itching. Which STI does the nurse suspect?

A. Bacterial vaginosis
B. Candidiasis
C. Trichomoniasis
D. Gonorrhea

C. Trichomoniasis

What is the first-line treatment for trichomoniasis?

A. Metronidazole 2g orally in a single dose
B. Doxycycline 100 mg twice daily for 7 days
C. Ceftriaxone 500 mg IM
D. Acyclovir 400 mg three times daily

A. Metronidazole (Flagyl) 2g orally in a single dose

What should the nurse include in discharge instructions for a patient taking metronidazole?

A. “You may drink alcohol 12 hours after your last dose.”
B. “Avoid alcohol during treatment and for 24–48 hours afterward.”
C. “You can resume sexual activity immediately after starting the medication.”
D. “Take this medication only with dairy products.”

B. “Avoid alcohol during treatment and for 24–48 hours afterward.”

Strawberry cervix is most commonly associated with….

Trichomoniasis

Which of the following signs is commonly used to identify ovulation in the symptothermal method of NFP?

A. Breast tenderness and mood swings
B. Sharp pelvic pain and nausea
C. Changes in cervical mucus and basal body temperature
D. Frequent urination and fatigue

C. Changes in cervical mucus and basal body temperature

*Abstains until 3days after rise in temp or 4th day after peal mucus change

A postpartum woman is breastfeeding and interested in NFP. Which method is most appropriate initially?

A. Calendar rhythm method
B. Withdrawal method
C. Lactational Amenorrhea Method (LAM)
D. Symptothermal method

C. Lactational Amenorrhea Method (LAM)

*Infant must be <6mo

*Totally BF at least q4h/day and q6h/night

*Menses has not returned

A nurse is teaching a patient about the male condom. Which of the following statements by the patient indicates a need for further teaching?

A. "I should put the condom on before any genital contact occurs."
B. "If the condom breaks, I should consider emergency contraception."
C. "I can use petroleum jelly as a lubricant."
D. "Condoms help protect against STIs."

C. "I can use petroleum jelly as a lubricant."

A woman using a diaphragm asks how long she must leave it in after intercourse. Which is the correct response?

A. “You can remove it immediately after sex.”
B. “It must remain in place for at least 6 hours after intercourse.”
C. “It should stay in for 24 hours for full protection.”
D. “Remove it as soon as possible to prevent irritation.”

B. “It must remain in place for at least 6 hours after intercourse.”

The diaphragm should stay in place for at least 6 hours after sex to allow spermicide to be effective; reapply spermicide if intercourse repeated; DO NOT USE >24hr.

Symptoms of TSS (complication of diaphragm)

*Fever

*Diarrhea

*Vomiting

*Muscle aches

*Sunburn rash

When should you get a second fitting for a diaphragm?

*q2yrs

*Wt gain/loss >10lb

*Pregnancy

*Cervical surgery

Contraindications of cervical caps and diaphragms

*Prolapsed/retroflexed uterus

*Intrusion on vagina by cystocele/retrocele

*HPV/herpes/acute cervicitis

Which client would be most appropriate for progestin-only pills (POPs)?

A. A 34-year-old smoker with no children
B. A 40-year-old with a history of migraines with aura
C. A 28-year-old breastfeeding mother
D. A 30-year-old with controlled hypertension

C. A 28-year-old breastfeeding mother

Progestin-only pills are safe for breastfeeding women and are often recommended postpartum.