N144 EAQ Set - Women's Health/Disorders and Childbearing Health Promotion

Question 1

At her first prenatal visit, the client informs the nurse that her last menstrual period started on June 10. Which is her expected date of birth (EDB), according to Naegele's rule?

0 March 3

0 March 10

0 March 17

0 March 24

March 17

A client informs the nurse that her home pregnancy test was positive and that her last menstrual period began on June 18. According to Naegele's rule, which is the estimated date of birth (EDB)?

0 March 8

0 March 11

Q March 1

0 March 25

March 25

A 16-year-old high school student comes to a community health center because of the fear of having contracted herpes. The teenager is upset and shares this information with the community health center nurse. Which response would the nurse provide?

0 'Let me get a brief health history now.'

0 'Try not to worry until you know whether you have herpes.'

0 'You sound worried. Let me make arrangements to have you examined.'

0 'Herpes has received too much attention in the media; let's be realistic.'

'You sound worried. Let me make arrangements to have you examined.'

The nurse plans to delegate some of the tasks for the discharge of a postpartum client to an unlicensed health care worker. Which activity must be performed by the nurse?

0 Taking the neonate's picture

0 Calling to arrange the client's postpartum appointment

0 Comparing the identification bands of mother and infant

0 Preparing the discharge packets and distributing them to the parents

Comparing the identification bands of mother and infant

Which client care activity may the nurse safely delegate to an unlicensed health care worker?

0 Assessing a client's mastectomy incision for signs of inflammation

0 Assisting a client who is recovering from an abdominal hysterectomy to the bathroom

0 Providing information about side effects to a client receiving chemotherapy for breast cancer

0 Evaluating the effectiveness of an antiemetic that was administered to a client to relieve nausea

Assisting a client who is recovering from an abdominal hysterectomy to the bathroom

A client who recently was told by her primary health care provider that she has extensive terminal metastatic carcinoma of the breast tells the nurse that she believes an error has been made. She states that she does not have breast cancer, and she is not going to die. Which stage of death and dying is the client experiencing?

O Anger

O Denial

O Bargaining

0 Acceptance

Denial

Which statement is an accurate description of dysmenorrhea?

0 Pain with menses

O Endometrial hyperplasia

O Bleeding between menses

0 Heavy bleeding with menses

Pain with menses

A client at the fertility clinic is being treated for hypertension and obesity and has lost 8 lb (3.6 kg) in the past month, and her blood pressure has decreased to 154/98 mmHg. She states she is using self-control strategies to achieve these improvements. Which would be a therapeutic response by the nurse?

0 Explaining to the client that her current program needs revision to improve results

0 Acknowledging the client's achievement while encouraging continuation of her current program

0 Emphasizing to the client the importance of exercise in addition to reduced sodium and caloric intake

0 Recommending that the client ask her health care practitioner about a prescription for an antihypertensive or a diuretic

Acknowledging the client's achievement while encouraging continuation of her current program

Which medication is safe to take during pregnancy? Select all that apply. One, some, or all responses may be correct.

0 Metronidazole

O Aspirin

O Codeine

O Acetaminophen

O Diphenhydramine HCI

Acetaminophen

Which client statement leads the nurse to conclude that the client has been experiencing menorrhagia?

O 'It hurts when l have intercourse.'

0 'I have a foul-smelling vaginal discharge.'

0 'I have bleeding between my menstrual periods.'

0 'I have severe bleeding during my menstrual periods.'

'I have severe bleeding during my menstrual periods.'

Which information about nausea and vomiting in the first trimester would the nurse provide to the pregnant client?

Q It is always present during early pregnancy.

Q It will disappear when lightening occurs.

0 It is a common response to an unwanted pregnancy.

Q It may be related to an increased human chorionic gonadotropin level.

It may be related to an increased human chorionic gonadotropin level.

Which intervention would the nurse recommend to relieve symptoms of a yeast infection?

0 Using a sitz bath

0 Sleeping in tight leggings

O Sitting in a warm bubble bath

0 Using tampons if she is on her period

Using a sitz bath

Which statement accurately describes the current advice regarding breast self-examination (BSE)?

O BSEs clearly decrease mortality.

0 BSEs prevent unnecessary testing.

0 BSEs should be done immediately before menstruation.

O BSE should be taught to all women.

BSE should be taught to all women.

A client is being initiated on bisphosphonates. Which advice will the nurse provide?

O 'Take it on an empty stomach.'

O 'This medication should be taken at night before bed.l

O 'These medications should be taken with food or milk.'

O 'Lie down for a bit after taking the medication.'

'Take it on an empty stomach.'

Offspring of men of advanced paternal age are at an increased risk for which condition?

0 Schizophrenia

O Cystic fibrosis

0 Sickle cell anemia

O Tay-Sachs disease

Schizophrenia

Which sexually transmitted infection is caused by protozoa?

Q Scabies

O Chancroid

O Pediculosis

O Trichomoniasis

Trichomoniasis

Which disease is in the top five leading causes of death in American women?

0 Alzheimer

0 Diabetes mellitus

O Unintentional injury

0 Influenza and pneumonia

Alzheimer

After treatment for a bladder infection, a client asks whether there is anything she can do to prevent cystitis in the future. Which response would the nurse give?

0 'Avoid regular use of tampons.'

O 'Decrease your intake of prune juice.'

O 'Increase your daily fluid consumption.'

O 'Cleanse the perineum from back to front.'

'Increase your daily fluid consumption.'

The nurse is caring for four postpartum clients, each with a different medical condition. Which condition will result in the primary health care provider advising the new mother not to breast-feed?

Q Mastitis

O Inverted nipples

O Herpes genitalis

0 Human immunodeficiency virus (HIV) infection

Human immunodeficiency virus (HIV) infection

A client has just given birth to an infant with Down syndrome. The mother is crying and asks the nurse what she is supposed to do now. Which response would the nurse give?

0 'Tell me what you know about Down syndrome.'

O 'I would just continue to rest and recover from your delivery.'

0 'You really need to pull yourself together for your baby.'

0 'Should I call in a chaplain or social worker for you?'

'Tell me what you know about Down syndrome.'

A pregnant client tells the nurse that she has two toddlers at home and that their father abandoned the family last month and she doesn't know what to do. Which conclusion would the nurse make about the client's emotional state?

0 She is angry that the father has left.

0 She feels overwhelmed by the situation.

0 She is expressing ambivalence about her pregnancy.

0 She is denying the reality of her pregnancy.

She feels overwhelmed by the situation.

Which definition would the nurse use to explain osteoporosis?

Q It is avascular necrosis.

0 It is caused by pathological fractures.

Q It is hyperplasia of osteoblasts.

Q It involves a decrease in bone substance.

It involves a decrease in bone substance.

Which time during the menstrual cycle would the nurse stress as the optimal time to achieve pregnancy?

0 Midway between periods

0 Immediately after a period ends

0 14 days before the next period is expected

0 14 days after the beginning of the last period

14 days before the next period is expected

A primigravida in the first trimester tells the nurse that she has heard that hormones play an important role in pregnancy. Which hormone would the nurse tell the client maintains pregnancy?

O Prolactin

O Estrogen

O Progesterone

O Somatotropin

Progesterone

How many milligrams of calcium would the nurse instruct the 30-year-old client to consume during pregnancy?

0 1500 mg

0 1000 mg

0 2500 mg

0 2000 mg

1000 mg

The nurse is teaching a family planning class about ovulation and conception. For which period of time would the nurse inform the class that the ovum is capable of being fertilized after ovulation?

O l to 6 hours

0 12 to 18 hours

0 24 to 36 hours

0 48 to 72 hours

24 to 36 hours

Which term would the nurse use to describe the first fetal movements that a pregnant client feels?

O Lightening

O Quickening

0 Engagement

0 Ballottement

Quickening

Which symptom indicates pelvic inflammatory disease? Select all that apply. One, some, or all responses may be correct.

|:| Fever

[:l Elevated erythrocyte sedimentation rate (ESR)

[:l Chronic pelvic pain

|:| Irregular vaginal bleeding

|:| Abnormal vaginal discharge

|:| Bilateral adnexal tenderness

Fever

Elevated erythrocyte sedimentation rate (ESR)

Chronic pelvic pain

Irregular vaginal bleeding

Abnormal vaginal discharge

Bilateral adnexal tenderness

Which assessment finding would the nurse question for a client who is considering oral contraceptives? Select all that apply. One, some, or all responses may be correct.

D Blood clots

D Heart disease

D Breast cancer

D Impaired liver function

E Undiagnosed vaginal bleeding

D Smoking more than 15 cigarettes per day

Blood clots

Heart disease

Breast cancer

Impaired liver function

Undiagnosed vaginal bleeding

Smoking more than 15 cigarettes per day

Which information regarding risks that may result from an untreated chlamydia infection would the nurse include when providing education for a female client? Select all that apply. One, some, or all responses may be correct.

|:| Sterility

|:| Ectopic pregnancy

|:| Blocked Fallopian tubes

|:| Pelvic inflammatory disease

|:| Increased likelihood of HIV infection

Sterility

Ectopic pregnancy

Blocked Fallopian tubes

Pelvic inflammatory disease

Increased likelihood of HIV infection

Which cause may produce abnormal uterine bleeding? Select all that apply. One, some, or all responses may be correct.

|:| Hypothyroidism

|:| Failure to ovulate

|:| Bleeding disorders

|:| Unidentified pregnancy

|:| Use of oral contraceptives

|:| Benign lesions of the uterus

Hypothyroidism

Failure to ovulate

Bleeding disorders

Unidentified pregnancy

Use of oral contraceptives

Benign lesions of the uterus

Which action would the nurse include in the plan of care for a client who is being treated for a sexually transmitted infection and reports fever and irregular bleeding? Select all that apply. One, some, or all responses may be correct.

D The use of analgesics

D Abdominal palpation

D Complete blood count

D Culture of the cervical canal

D Administration of antibiotics as prescribed

D Teaching about negative effects of douching

The use of analgesics

Abdominal palpation

Complete blood count

Culture of the cervical canal

Administration of antibiotics as prescribed

Teaching about negative effects of douching

Which statement by the female client with a diagnosis of gonorrhea indicates she has understood the teaching by the nurse on how to avoid future infection?

0 'I'll douche after each time I have sex.'

0 'Having sex is a thing of the past for me.'

Q 'My partner has to use a condom all the time.'

0 'I'll be using a spermicidal cream from now on.'

'My partner has to use a condom all the time.'

Which time period would the nurse teach the health education class that fertilization of the ovum by the sperm occurs?

0 As the ovum leaves the ovary

Q When 1 sperm penetrates the wall of the ovum

Q When the ovum reaches the endometrium of the uterus

Q As 1 sperm prevents the ovum from moving along the tube

When 1 sperm penetrates the wall of the ovum

Which response would the nurse provide to the client admitted with severe preeclampsia who anxiously asks the nurse, 'Will my baby be all right?'

0 'There's no way of telling at this time what the outcome will be.'

0 'If you do what the primary health care provider tells you to do, everything will progress normally.'

O 'The baby will probably be all right. Did you know that the amniotic fluid provides protection?'

O 'We'll be monitoring your baby's condition continuously. Would you like to listen to the baby's heartbeat?'

'We'll be monitoring your baby's condition continuously. Would you like to listen to the baby's heartbeat?'

Which response would the nurse provide to a client in labor at 32 weeks' gestation who tells the nurse that she and her husband are very concerned because the baby will be born 2 months early?

0 'You should be concerned. I feel for you.'

O 'If you're concerned, let's talk about it.'

Q 'Try not to worry about it; just concentrate on your labor.'

0 'Don't worry; the care of preterm babies has greatly improved.'

'If you're concerned, let's talk about it.'

On the first postpartum day, a client whose infant is rooming in asks the nurse to return her baby to the nursery and bring the baby to her only at feeding times. Which response would the nurse provide?

Q 'It seems that you've changed your mind about rooming in.'

Q 'I think you're having difficulty caring for the baby.'

0 'All right. I'll inform the other nurses of your decision.'

0 'You must be tired. I'll bring the baby back at feeding time.'

'It seems that you've changed your mind about rooming in.'

A female client who is undergoing infertility testing is taught how to examine her cervical mucus. After listening to the instructions, the client says, 'That sounds gross. I don't think I can do it.' Which conclusion would the nurse make from this statement?

0 The client is unduly fastidious.

O The client feels that having a baby is not that important.

0 The client may be uncomfortable with performing manual examination of the genitals.

O The client is afraid that she is the cause of the infertility.

The client may be uncomfortable with performing manual examination of the genitals.

After 5 years of unprotected intercourse, a childless couple comes to the fertility clinic. The husband tells the nurse that his parents have promised to make a down payment on a house for them if his wife gets pregnant this year. Which response would the nurse provide?

0 'This must be very difficult for you with this added pressure.'

0 'Having a child is a decision you should make without your parents' input.'

0 'You're lucky. It's nice that your parents are making such a generous offer.'

0 'Five years without a pregnancy is a long time. You were right to come to the fertility clinic.'

'This must be very difficult for you with this added pressure.'

When a client who has had a mastectomy sees her incision for the first time, she exclaims, 'I look horrible! Will it ever look better?' Which response would the nurse provide?

Q 'You seem shocked by the way you look now.'

0 'Now that the tumor is gone, the area will heal quickly.'

O 'After it heals, others won't even know you had surgery.'

Q 'You will feel better about it when the swelling subsides.'

'You seem shocked by the way you look now.'

Which client statement confirms that the client who is being treated for a sexually transmitted infection (STI) has understood the nurse's instruction regarding future sexual contacts?

0 'If I have sex, nothing I do will really prevent me from getting another STI.'

O 'If I get another STI, I can take any antibiotic, because I'm not allergic to any of them.'

0 'I won't have unprotected sex again, and I'll tell my partners to be tested for STIs.'

0 II have to ask my partners if they have an STI, and if they say no I'll know that I can have sex.'

'I won't have unprotected sex again, and I'll tell my partners to be tested for STIs.'

Which instruction would the nurse give to the pregnant client with anemia?

0 Take an iron and calcium supplement together daily.

0 Drink orange juice with an iron supplement.

0 Include fresh fruit at every meal.

0 Include 4 servings of calcium-rich foods daily.

Drink orange juice with an iron supplement.

Before discharge, which suggestion would the nurse give to a nonnursing mother to help limit breast engorgement?

0 Place raw cabbage leaves over the breast.

0 Stop drinking milk for 1 week.

0 Take an analgesic every 4 hours.

0 Apply warm compresses to the breasts.

Place raw cabbage leaves over the breast.

Which exercise would the nurse instruct the women in a childbirth preparation class to use for toning the muscles of the pelvic floor?

0 Pelvic tilt

O Half sit—ups

O Pelvic rocking

O Kegel exercises

Kegel exercises

A client seeking advice regarding contraception asks the nurse to explain how an intrauterine device (IUD) prevents pregnancy. How would the nurse respond?

0 'It covers the entrance to the cervical os.'

O 'The openings to the fallopian tubes are blocked.'

O 'The sperm are kept from reaching the vagina.'

Q 'It produces a spermicidal intrauterine environment.'

'It produces a spermicidal intrauterine environment.'

Which information would the nurse include as part of the teaching plan for the client requesting information on different methods of contraception?

O Sperm cannot reach the ovum if the male uses coitus interruptus or withdrawal.

0 The rim of a condom must be held in place while the penis is withdrawn from the vagina.

O Intrauterine devices (IUDs) must be removed after 1 year.

0 Individuals who use periodic abstinence should have intercourse on days when the woman has an increase in temperature.

The rim of a condom must be held in place while the penis is withdrawn from the vagina.

The primigravida would be taught by the nurse to anticipate quickening in which week of pregnancy?

0 24th week

0 20th week

0 16th week

0 12th week

20th week

While inspecting her healthy newborn just delivered at 37 weeks' gestation, the client asks, 'What's this sticky white stuff all over the baby?' How would the nurse respond?

0 'It's a secretion from the baby's fat cells called milia.'

O 'This is vernix. It helps protect the baby while it's in the uterus.'

O 'Your baby was born several weeks early, so we expect to see this.'

0 1It's nothing to be concerned about. Most newborns are covered with it.'

'This is vernix. It helps protect the baby while it's in the uterus.'

The nurse teaches a postpartum client how to care for her episiotomy at home. Which statement indicates to the nurse that the client understands the priority instruction?

0 'I should discontinue the anti-inflammatories once I'm home.'

0 'I mustn't climb up or down stairs for at least 3 days after discharge.'

0 'I should discontinue the sitz baths after 3 days.'

0 'l need to continue perineal care after! go to the bathroom until everything is healed.'

'l need to continue perineal care after! go to the bathroom until everything is healed.'

Which clinical data indicate that the client at 39 weeks' gestation is in true labor?

0 Contractions occur every 10 minutes with no change in Frequency over 2 hours, and the cervix is closed.

0 Contractions are not evident; the cervix is dilated 3 cm and 50% effaced, and there is no change after 4 hours of staying out of bed.

0 Contractions occur every 5 to 10 minutes, the cervix is dilated 2 cm and 75% effaced, and dilation has increased to 3 cm in 2 hours.

0 Contractions are irregular, occurring every 10 to 15 minutes, the cervix is dilated one fingertip and is 50% effaced, and there is no change with 4 hours of bed rest.

Contractions occur every 5 to 10 minutes, the cervix is dilated 2 cm and 75% effaced, and dilation has increased to 3 cm in 2 hours.

An increase in which factor causes urinary frequency in the first trimester of pregnancy?

0 Estrogen level

0 Extracellular fluid volume

0 Kidney glomerular filtration

O Bladder pressure from the enlarged uterus

Bladder pressure from the enlarged uterus

A 41-year—old woman is being seen for an initial visit in the infertility clinic after 3 years of trying to become pregnant. Which test or treatment would the nurse advise her would be done first?

Q A laparoscopy

O The start of fertility medication

0 A hysteroscopy

O Semen analysis

Semen analysis

Which nursing intervention would be needed before a client undergoes amniocentesis at 16 weeks' gestation?

0 Starting an intravenous infusion of normal saline

0 Performing a vaginal and rectal examination

0 Ensuring that informed consent has been obtained from the client

0 Informing the client that she will need bed rest after amniocentesis

Ensuring that informed consent has been obtained from the client

A female client is scheduled for a hysterectomy. While discussing the preoperative preparations, the nurse determines that the client's understanding of the surgery is inadequate. Which nursing intervention would be performed?

0 Describing the proposed surgery to the client

0 Proceeding with the preoperative plan

0 Notifying the surgeon that the client needs more information

Q Explaining gently to the client that she should have asked more questions

Notifying the surgeon that the client needs more information

The client at 8 weeks' gestation requests information from the nurse regarding abortion. Which action would be the nurse's responsibility?

0 To share her own thoughts on abortion with the client

0 To provide the client with correct, unbiased information

0 To ask why the client wants information about abortion

0 To notify the primary health care provider because this is beyond the scope of nursing practice

To provide the client with correct, unbiased information

On a visit to the fertility clinic a couple requests fertility medications because, despite having a 28—day menstrual cycle and temperature readings that demonstrate an ovulatory pattern, the woman has been unable to conceive. Which guidance would the nurse provide to this couple?

0 A laparoscopy will be scheduled.

0 An endometrial biopsy will be required.

0 A fertility medication will be prescribed.

0 An examination of semen will be needed.

An examination of semen will be needed.

The mammography results for a 37-year-old client with a breast mass are inconclusive. The client is undergoing further diagnostic tests to determine whether the mass is malignant. Which information would the nurse take into consideration before planning health teaching for this client?

0 Squamous cell carcinomas are neoplasms arising from glandular tissues.

0 Results of a biopsy are necessary before a specific form of therapy is selected.

0 Mammograms should be repeated to confirm the presence of malignancies.

0 Waiting for several weeks before receiving confirmation of cancer is helpful to the client.

Results of a biopsy are necessary before a specific form of therapy is selected.

A 37-year-old woman with a history of fibroids and menorrhagia that have not been responsive to hormonal treatments is admitted with severe menorrhagia with resulting anemia. She also has depression and pelvic pain. She is crying and states, 'I don't know what to do—my primary health care provider is recommending a hysterectomy, but I haven't had children yet!' Which response would the nurse provide?

0 'There are so many children up for adoption, looking for a mother.'

O 'This must feel so difficult for you. Children are really important to you?'

Q 'You really have no choice but to follow the recommendation; the primary health care provider is right.'

O 'Believe me when I tell you that kids are so difficult to raise—you're better off without them.'

'This must feel so difficult for you. Children are really important to you?'

After giving birth to her third child, a client tearfully says to the nurse, 'How much more can I give of myself?' Which principle would the nurse consider in the care of any new mother?

0 It is easier to adjust to the first child than to later ones.

0 Feeling anger and resentment toward a child is pathological.

0 Some parents experience feelings of being overwhelmed by multiple children.

0 Parents usually have inborn feelings of love and acceptance of their children.

Some parents experience feelings of being overwhelmed by multiple children.

A 30-year-old woman is scheduled for a total abdominal hysterectomy because of noninvasive endometrial cancer. The nurse anticipates the client may have difficulty adjusting emotionally to this type of surgery. Which concern would be the cause of this anticipated difficulty?

0 Change in femininity

0 Body image changes

0 Diminished sexual desire

0 Slow recovery

Change in femininity

A client is crying after undergoing dilation and curettage after an early miscarriage (spontaneous abortion). Which response would the nurse give?

0 'This must be a very difficult experience for you to deal with.'

O 'You'll have other children to take the place of the child you lost.'

0 'Of course you're sad now, but at least you know you can get pregnant.'

0 'I know how you feel, but when a woman miscarries, it's usually for the best.'

'This must be a very difficult experience for you to deal with.'

A client who is to undergo dilation and curettage and conization of the cervix for cancer appears tense and anxious. Which approach would the nurse use to support the client emotionally?

O Explaining that these procedures are considered minor surgery

0 Asking whether something is troubling the client and whether she'd like to talk about it

Q Stating that the procedures are routine and asking what the client is really worried about

0 Explaining that everyone is fearful before the surgery even though there is little reason to worry

Asking whether something is troubling the client and whether she'd like to talk about it

Which interventions would be expected in the immediate postoperative period after a vaginal hysterectomy and anterior and posterior repair of the vaginal wall?

0 Placement of a pessary

O Insertion of a rectal tube

0 Use of a douche periodically

0 Presence of a urinary catheter

Presence of a urinary catheter

A client who is at 28 weeks' gestation and in active labor is crying. She says, l| just know that this baby is going to die. What's the use of doing all this to save it?' Which explanation would interpret the client's statements?

O She is depressed and needs firm, positive support during labor.

O She is experiencing anticipatory grief and withdrawing from bonding.

O She is in need of sedation to help her cope with the impending birth.

O She is demonstrating difficulty dealing with the birth by using the word 'it.'

She is experiencing anticipatory grief and withdrawing from bonding.

The nurse notes bruises on the pregnant client's face and abdomen. There are no bruises on her legs and arms. Further assessment is required to confirm which condition?

0 Domestic abuse

0 Hydatidiform mole

0 Excessive exercise

0 Thrombocytopenic purpura

Domestic abuse

The mother of an infant in the neonatal intensive care unit expresses concern about her infant. Which nursing intervention best facilitates mother—infant bonding?

O Asking the mother to change her baby's diaper

O Assuring the mother that her baby is receiving excellent care

O Encouraging the mother to touch her baby whenever possible

O Keeping the mother informed about the care the nursing staff is giving her baby

Encouraging the mother to touch her baby whenever possible

How would a client limit breast swelling as a symptom of PMS?

Eliminate food and beverages containing caffeine.

How would a client limit the development of edema premenstrually?

Reduce salt intake before menses.

Why does a full bladder improve visualization of the fetus during a scheduled sonogram and amniocentesis?

A full bladder places the uterus in the optimal position for imaging because it raises the uterus out of the pelvis.

What are the Leopold maneuvers for?

They are used to determine the position, presentation, and engagement of the fetus in utero.