Chapter 11: The Nurses Role in Womens Health Care My Nursing Test Banks

Chapter 11: The Nurses Role in Womens Health Care

Elsevier items and derived items 2007 by Saunders, an imprint of Elsevier Inc.

MULTIPLE CHOICE

1. The nurse is preparing a community education program on preventive health care for women. The nurse plans to tell the women attending the program that a screening test common in womens health care is:

a.

Breast examination by a health professional

b.

Breast self-examination

c.

Breast biopsy

d.

Mammography

ANS: D

Mammography is a screening test used to detect breast cancer.

DIF: Cognitive Level: Application REF: Text Reference: 249

OBJ: Objective: 2

TOP: Topic: Preventive Health Care for Women

KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

2. A 25-year-old woman has a family history of breast cancer. The nurse reviews the procedure for breast self-examination and tells her that the best time for a woman to perform a breast self-examination is:

a.

A few days before her period

b.

During her menstrual period

c.

On the last day of menstrual flow

d.

One week after the beginning of her period

ANS: D

The best time for BSE is 1 week after the beginning of the menstrual period.

DIF: Cognitive Level: Application REF: Text Reference: 250

OBJ: Objective: 2

TOP: Topic: Preventive Health Care for Women

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

3. A woman asks the nurse, How do oral contraceptives prevent pregnancy? The nurse explains the action of combination estrogen and progesterone in oral contraceptives is:

a.

Making cervical mucus hostile to sperm

b.

Preventing ovulation

c.

Prohibiting implantation of the egg

d.

Acting as a barrier by destroying sperm

ANS: B

Oral contraceptives contain a combination of estrogen and progesterone that suppress ovulation.

DIF: Cognitive Level: Application REF: Text Reference: 261

OBJ: Objective: 5 TOP: Topic: Family Planning

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

4. The nurse would tell the patient to expect which of the following after she had an intrauterine device (IUD) inserted?

a.

Menstrual flow will be lighter.

b.

Menstrual cramps are eliminated.

c.

A string should be felt in the vagina.

d.

The device should be changed every 2 years.

ANS: C

A woman should feel for the string periodically, especially after her period, to confirm the presence of the intrauterine device.

DIF: Cognitive Level: Analysis REF: Text Reference: 262

OBJ: Objective: 5 TOP: Topic: Family Planning

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

5. The woman who is using a diaphragm correctly would tell the nurse that the diaphragm:

a.

Does not require the use of a spermicidal cream or jelly with it

b.

Should be left in place for at least 6 hours after intercourse

c.

Is removed immediately after intercourse for douching

d.

Is effective for up to 48 hours if positioned properly

ANS: B

To act as a barrier, the diaphragm must be left in place for at least 6 hours after intercourse and can be left in place up to 24 hours.

DIF: Cognitive Level: Analysis REF: Text Reference: 264

OBJ: Objective: 5 TOP: Topic: Family Planning

KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

6. The nurse reminds a group of high school students that the most effective choice of birth control for preventing pregnancy and sexually transmitted diseases is to:

a.

Abstain from sex

b.

Use the male condom

c.

Use the female condom

d.

Use the barrier method

ANS: A

Abstinence is 100% effective in preventing pregnancy and sexually transmitted diseases.

DIF: Cognitive Level: Comprehension REF: Text Reference: 260

OBJ: Objective: 5 TOP: Topic: Family Planning

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Maintenance and Promotion: Prevention and Early Detection of Disease

7. On day 13 of a 28-day cycle, a womans basal body temperature is 97.7F. If she ovulates on day 14, her temperature measurement on day 14 would most likely be:

a.

96.7 F

b.

98.1 F

c.

98.9 F

d.

97.3 F

ANS: B

At the time of ovulation, body temperature will increase slightly, about 0.4F.

DIF: Cognitive Level: Application REF: Text Reference: 259

OBJ: Objective: 6 TOP: Topic: Family Planning

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

8. The nurse tells a woman who is trying to conceive to check her cervical mucus for changes. A few days before ovulation, the cervical mucus is:

a.

Cloudy and tacky

b.

Scant and thick

c.

Thin and white

d.

Clear and slippery

ANS: D

Within a few days of ovulation, cervical mucus will become slippery and clear to aid the passage of sperm into the cervix.

DIF: Cognitive Level: Analysis REF: Text Reference: 260

OBJ: Objective: 6 TOP: Topic: Family Planning

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

9. The nurse is discussing cervical mucus changes with a woman who wishes to use natural family planning methods. The nurse determines the woman understands the information presented when she says the changes in cervical mucus at ovulation:

a.

Enhance the motility of the sperm

b.

Indicate endometrial readiness for implantation

c.

Facilitate movement of the ovum through the fallopian tube

d.

Provide vaginal lubrication during intercourse

ANS: A

Around the time of ovulation, the slippery, clear cervical mucus enhances the motility of the sperm.

DIF: Cognitive Level: Comprehension REF: Text Reference: 260

OBJ: Objective: 6 TOP: Topic: Family Planning

KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

10. In the week before her menstrual period, a woman experiences irritability, anxiety, and difficulty concentrating. The nurse suggests a remedy to relieve these symptoms, which is:

a.

Drink tea or hot chocolate before going to bed.

b.

Take a daily folic acid and vitamin C supplement.

c.

Include complex carbohydrates and fiber in the diet.

d.

Avoid exercise when symptoms occur.

ANS: C

A diet rich in complex carbohydrates and fiber is recommended for premenstrual dysmorphic disorder.

DIF: Cognitive Level: Analysis REF: Text Reference: 253

OBJ: Objective: 3 TOP: Topic: Menstrual Disorders

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

11. The nurse explains that the drug clomiphene (Clomid) is used in infertility treatment because it:

a.

Induces ovulation

b.

Reduces endometriosis

c.

Promotes implantation of a fertilized ovum

d.

Inhibits excess prolactin secretion

ANS: A

Clomiphene (Clomid) induces ovulation. It may also increase sperm production, although this is an unlabeled use.

DIF: Cognitive Level: Knowledge REF: Text Reference: 272

OBJ: Objective: 7 TOP: Topic: Infertility Care

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

12. At her regular gynecological examination, a woman tells the nurse that she is concerned about osteoporosis. The nurse could suggest to the patient to:

a.

Take a vitamin E supplement daily

b.

Do isometric exercises that can be practiced every day

c.

Include more dairy products and green, leafy vegetables in her diet

d.

Try to limit her intake of caffeine

ANS: C

Foods rich in calcium include milk, dairy products, and green, leafy vegetables.

DIF: Cognitive Level: Application REF: Text Reference: 273

OBJ: Objective: 8 TOP: Topic: Menopause

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

13. A 48-year-old woman tells the nurse, I missed my period last month. Am I in menopause? The nurse would respond that a woman is considered to be menopausal when:

a.

Her periods have stopped for 1 year

b.

Her periods have been irregular and light for 12 months

c.

She has symptoms of vasomotor instability

d.

She experiences symptoms of decreased estrogen, such as dyspareunia

ANS: A

When a womans menstrual periods have stopped for 1 year, she is considered menopausal.

DIF: Cognitive Level: Analysis REF: Text Reference: 272

OBJ: Objective: 8 TOP: Topic: Menopause

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

14. The nurse planning to teach a woman about perimenopause would include the information that estrogen:

a.

Prevents osteoporosis

b.

Decreases vaginal lubrication

c.

Lowers the level of low-density lipoproteins

d.

Raises the level of high-density lipoproteins

ANS: D

Estrogen increases the amount of high-density lipoproteins that carry cholesterol from body cells to the liver for excretion.

DIF: Cognitive Level: Knowledge REF: Text Reference: 272

OBJ: Objective: 8 TOP: Topic: Menopause

KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

15. When a woman starts hormone replacement therapy, the nurse would instruct her to look for the side effect of:

a.

Fatigue

b.

Headache

c.

Weight loss

d.

Amenorrhea

ANS: B

Clients initiating HRT are reminded to have regular follow-up care and report headaches, vision changes, and symptoms of thrombophlebitis or cardiac symptoms.

DIF: Cognitive Level: Comprehension REF: Text Reference: 273

OBJ: Objective: 8 TOP: Topic: Menopause

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. When a woman asks what she can do to reduce the discomfort of hot flashes, the nurse advises:

a.

Aerobic exercise helps control hot flashes.

b.

Increase the amount of calcium and vitamin D in your diet.

c.

Dress in layers of cotton clothing.

d.

Drink plenty of fluids, particularly caffeinated beverages.

ANS: C

Cotton allows easier passage of air than synthetic fabrics. Layering allows the woman to take off or put on clothes when symptoms occur.

DIF: Cognitive Level: Application REF: Text Reference: 274, NCP 11-1

OBJ: Objective: 8 TOP: Topic: Menopause

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

17. Which statement made by the nurse would teach an adolescent using tampons how to prevent toxic shock syndrome (TSS)?

a.

Super-absorbency tampons offer the best protection against TSS.

b.

Tampons should be changed at least every 4 hours.

c.

Gloves should be worn when changing tampons.

d.

TSS can be prevented by using a pad for the first 2 days of menstrual flow.

ANS: B

Tampons should be changed every 4 hours because a blood-soaked tampon is an excellent environment for bacteria.

DIF: Cognitive Level: Comprehension REF: Text Reference: 254

OBJ: Objective: 4 TOP: Topic: Gynecological Infections

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

18. The statement from the man considering a vasectomy, which indicates the need for further information about a vasectomy, is:

a.

Sterility does not occur immediately after the procedure.

b.

We will need to use some form of birth control for about a month afterward.

c.

The procedure involves the use of local anesthesia.

d.

Ill need to remain in the hospital for a few days.

ANS: D

A vasectomy takes about 20 minutes and is performed on an outpatient basis under local anesthesia.

DIF: Cognitive Level: Analysis REF: Text Reference: 266

OBJ: Objective: 5

TOP: Topic: Family Planning-Permanent Contraception

KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

19. At her 6-week postpartum check-up, a woman states, I am wondering about birth control. I used oral contraceptives before. Im breastfeeding now. Can I use the pill again? The nurses best response is:

a.

You should know that oral contraceptives increase your milk production.

b.

Oral contraceptives can be taken once lactation is well established.

c.

You dont need to use any form of birth control as long as you are breastfeeding.

d.

Oral contraceptives are contraindicated for the lactating woman.

ANS: B

Oral contraceptives decrease breast milk production and are contraindicated until lactation is well established. Women who breastfeed usually will not ovulate for 10 weeks and do not need contraception until that time.

DIF: Cognitive Level: Analysis REF: Text Reference: 261

OBJ: Objective: 5 TOP: Topic: Family Planning

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

20. A 17-year-old girl comes to the emergency department complaining of severe pain in her left lower quadrant. When an ovarian cyst is suspected, the nurse explains that the diagnosis is confirmed by:

a.

Laparotomy

b.

Oophorectomy

c.

Transvaginal ultrasound

d.

Hysteroscopy

ANS: C

Diagnosis of an ovarian cyst is made by transvaginal ultrasound.

DIF: Cognitive Level: Analysis REF: Text Reference: 277

OBJ: Objective: 9

TOP: Topic: Other Female Reproductive Tract Disorders

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Reduction of Risk

21. A 21-year-old college student has come to see the nurse practitioner for treatment of a vaginal infection. Physical assessment reveals inflammation of the vagina and vulva. Vaginal discharge has a cottage-cheese appearance. These findings are consistent with:

a.

Candidiasis

b.

Trichomoniasis

c.

Bacterial vaginosis

d.

Chlamydia

ANS: A

The signs and symptoms of candidiasis include inflammation of the vagina and vulva and a cottage-cheese appearance to vaginal discharge.

DIF: Cognitive Level: Analysis REF: Text Reference: 255, Table 11-1

OBJ: Objective: 4 TOP: Topic: Gynecological Infections

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

MULTIPLE RESPONSE

1. The nurse points out that anonymous sperm donors are screened for:

Select all that apply.

a.

Particular physical features

b.

Genetic defects

c.

Infections

d.

High-risk behaviors

e.

Nationality

ANS: B, C, D

Sperm donors are screened for genetic defects, infections, and high-risk behaviors. As an added precaution, the sperm are kept frozen for 6 months before the sample is used.

DIF: Cognitive Level: Comprehension REF: Text Reference: 270

OBJ: Objective: 6 TOP: Topic: Sperm Donors

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

2. The nurse cautions that not all women are candidates for hormone replacement therapy (HRT) because of:

Select all that apply.

a.

History of melanoma

b.

Estrogen-dependent breast cancer

c.

Hepatitis C

d.

Thromboembolic disease

e.

Epilepsy

ANS: A, B, C, D, E

Persons who are absolutely restricted from HRT are those with estrogen- dependent breast cancers, melanoma, chronic liver disorders, thromboembolic disease, and seizure disorders.

DIF: Cognitive Level: Analysis REF: Text Reference: 273

OBJ: Objective: 9 TOP: Topic: HRT KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

3. The patient who has been dealing with urge incontinence tells the nurse that the symptoms have gotten worse lately. The nurse reminds the patient that many foods and drugs increase incontinence, among which are:

Select all that apply.

a.

Antidepressants

b.

Coffee

c.

Alcohol

d.

Diuretics

e.

Anticholinergics

ANS: A, B, C, D, E

Foods and drugs that increase the symptoms of urge incontinence are antidepressants, caffeine, alcohol, diuretics, ACE inhibitors, and anticholinergics.

DIF: Cognitive Level: Application REF: Text Reference: 276

OBJ: Objective: 10 TOP: Topic: Urge Incontinence

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

4. The nurse advises the woman with pelvic floor dysfunction that for relief of the associated discomfort she could:

Select all that apply.

a.

Lie down with feet elevated.

b.

Practice Kegel exercises.

c.

Assume knee-chest position periodically.

d.

Do leg lift exercises.

e.

Prevent constipation.

ANS: A, B, C, E

Performing Kegel exercises, elevating the feet, assuming the knee-chest position, and preventing constipation will reduce the pelvic discomfort of pelvic floor dysfunction.

DIF: Cognitive Level: Application REF: Text Reference: 276

OBJ: Objective: 8 TOP: Topic: Pelvic Floor Dysfunction

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

COMPLETION

1. The nurse outlines the process of ova being mixed with sperm and then the resulting embryos being returned to the mothers uterus. This process of infertility treatment is _____ ______ ___________________.

ANS: in vitro fertilization

DIF: Cognitive Level: Comprehension REF: Text Reference: 270

OBJ: Objective: 6 TOP: Topic: In Vitro Fertilization

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

NOT: Rationale: The in vitro fertilization technique mixes ova with sperm and deposits several of the resulting embryos in the mothers uterus.

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