Chapter 3 Health Promotion of Women Across the Lifespan(FREE) My Nursing Test Banks

Olds Maternal-Newborn Nursing and Womens Health, 10e (Davidson)

Chapter 3 Health Promotion of Women Across the Lifespan

1) The clinic nurse is returning phone calls. Which call should the nurse return first?

1. The call from a 22-year-old reporting that she has menstrual cramps and vomiting every month

2. The call from a 17-year-old asking whether there is a problem with using one tampon for a whole day

3. The call from a 46-year-old mother of a teen wondering if her daughter should be on birth control

4. The call from a 34-year-old requesting information on douching after intercourse

Answer: 2

Explanation: 2. Using a single tampon for an entire day can lead to toxic shock syndrome, a potentially life-threatening condition. This client needs education on the danger of using one tampon longer than 3-6 hours.

Page Ref: 39

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Quality and Safety: Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care. | Nursing/Integrated Concepts Nursing Process: Implementation

Learning Outcome: 2 Summarize information that women may need in order to implement appropriate self-care measures for dealing with menstruation.

2) The nurse who is taking a sexual history from a client should do which of the following?

1. Ask questions that the client can answer with yes or no.

2. Ask mostly open-ended questions.

3. Have the client fill out a comprehensive questionnaire and review it after the client leaves.

4. Try not to make much direct eye contact.

Answer: 2

Explanation: 2. Open-ended questions are often useful in eliciting information.

Page Ref: 37

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment

1

Copyright 2016 Pearson Education, Inc.

Learning Outcome: 1 Discuss the key points a nurse should consider when taking a sexual history.

3) The nurse is taking a history on a new client in the clinic. She determines from talking with the client that she is recently divorced, is dating, and has had sex with various men. The nurse would be concerned about and would provide some education on what issues?

1. The ethics of dating and having sex with more than one man

2. The client having some kind of permanent birth control done, so she does not become pregnant

3. Education about sexual activity and sexually transmitted infections

4. Referral to a psychologist or counselor for follow-up on the multiple dating

Answer: 3

Explanation: 3. Education about sexual activity and sexually transmitted infections is correct, since it has been determined that the client is having sex with multiple partners.

Page Ref: 37

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control

Standards: QSEN Competencies: I. C. 4. Seek learning opportunities with patients who represent all aspects of human diversity. | AACN Essentials Competencies: VII. 6. Use information and communication technologies in preventive care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 1 Discuss the key points a nurse should consider when taking a sexual history.

MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually transmitted infections.

4) The nurse is taking a history of a new client in the clinic. Histories tend to be lengthy, and the sexual part can be difficult for the client. The nurse should use what technique to make it easier for the client?

1. Let the client fill out a paper copy, so she does not have to talk about intimate matters.

2. Skip the sexual part until the next time the client comes into the clinic.

3. Start with the easier medical and surgical questions, and develop a feeling of trust with the client.

4. Leave the sexual part of the history for the doctor to ask about.

Answer: 3

Explanation: 3. Starting with easy-to-answer questions and then going to the sexual ones helps, as client might be at ease by then.

Page Ref: 37

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | NLN Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 1 Discuss the key points a nurse should consider when taking a sexual history.

2

Copyright 2016 Pearson Education, Inc.

5) The nurse working in a womens clinic is training a recent graduate of nursing school who has been hired. The experienced nurse explains that nurses caring for women of all ages must be which of the following?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Aware of their own feelings

2. Judgmental when discussing sexuality

3. Aware of personal values and attitudes

4. Minimally knowledgeable about reproduction

5. Willing to discuss sexuality only one-on-one

Answer: 1, 3

Explanation: 1. Nurses must be aware of their own feelings.

3. Nurses must develop an awareness of their own values and attitudes about sexuality so that they can be more sensitive and objective when they encounter the values and beliefs of others.

Page Ref: 37

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: II. B. 5. Assume role of team member or leader based on the situation. | AACN Essentials Competencies: VI. 2. Use inter-and intraprofessional communication and collaborative skills to deliver evidence-based, patient-centered care. | NLN Competencies: Teamwork: Function competently within ones own scope of practice as leader or member of the health care team and manage delegation effectively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 1 Discuss the key points a nurse should consider when taking a sexual history.

6) A client asks her nurse, Is it okay for me to take a tub bath during the heavy part of my menstruation? What is the nurses correct response?

1. Tub baths are contraindicated during menstruation.

2. You should shower and douche daily instead.

3. Either a bath or a shower is fine at that time.

4. You should bathe and use a feminine deodorant spray during menstruation.

Answer: 3

Explanation: 3. Bathing, whether it is a tub bath or a shower, is as important (if not more so) during menses as at any other time.

Page Ref: 39

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 6. Use information and communication technologies in preventive care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2 Summarize information that women may need in order to implement appropriate self-care measures for dealing with menstruation.

3

Copyright 2016 Pearson Education, Inc.

4

Copyright 2016 Pearson Education, Inc.

7) Which client would the nurse document as exhibiting signs and symptoms of primary dysmenorrhea?

1. 17-year-old, has never had a menstrual cycle

2. 16-year-old, had regular menses for 4 years, but has had no menses in 4 months

3. 19-year-old, regular menses for 5 years that have suddenly become painful

4. 14-year-old, irregular menses for 1 year, experiences cramping every cycle

Answer: 4

Explanation: 4. Dysmenorrhea, or painful menstruation, occurs at, or a day before, the onset of menstruation and disappears by the end of menses. Primary dysmenorrhea is defined as cramps without underlying disease.

Page Ref: 40

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 4 Contrast dysmenorrhea and premenstrual syndrome.

8) The nurse is conducting health screening at a community clinic. The client has asked whether there are any risks with body piercing and tattooing, or whether these activities would impact sexual activity. How should the nurse respond?

1. You should avoid piercing your genitalia and your nipples.

2. There are no problems that occur with either body piercing or tattooing.

3. Both piercing and tattooing carry risks of infection, including hepatitis.

4. The benefit of body art outweighs any risk of infection of a tattoo or piercing.

Answer: 3

Explanation: 3. For tattooing and body piercing, risks include infections such as HIV and hepatitis B and C because of the use of inadequately sterilized equipment, as well as allergic reactions, local swelling and burns, granulomas, and keloid formation.

Page Ref: 44

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control

Standards: QSEN Competencies: I. C. 4. Seek learning opportunities with patients who represent all aspects of human diversity. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 1 Discuss the key points a nurse should consider when taking a sexual history.

MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually transmitted infections.

5

Copyright 2016 Pearson Education, Inc.

9) The nurse is teaching a class on menstruation to young girls. What information would be important for 10-12-year-olds to know?

1. The age they will start having their periods

2. Variations in the age menstruation begins, length of the cycle, and duration of the menses

3. The number of days they will be ill when they have their menses

4. The number of days they will not be able to take part in physical education at school during their menses

Answer: 2

Explanation: 2. These are the issues young girls like to know, as they always question whether they are different from their peers.

Page Ref: 44

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2 Summarize information that women may need in order to implement appropriate self-care measures for dealing with menstruation.

10) The nurse is interviewing a 16-year-old client who has been using deodorant tampons during her menses. She comes into the gynecology office complaining of a rash and open sores on her labia and tenderness in the vagina. After obtaining her history, what will the nurse determine is the most likely cause of this clients problem?

1. She had forceful intercourse, which caused the trauma.

2. She is reacting to the deodorant in the tampon.

3. She might be allergic to the underwear she is wearing.

4. She is having a normal reaction to her menses.

Answer: 2

Explanation: 2. This is the correct answer, as women often will react to the deodorant used on pads and tampons.

Page Ref: 38

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2 Summarize information that women may need in order to implement appropriate

6

Copyright 2016 Pearson Education, Inc.

self-care measures for dealing with menstruation.

7

Copyright 2016 Pearson Education, Inc.

11) The nurse educator is teaching a group of teens and 20-year-olds reproductive health care. When several of the women bring up douching, what is the best response the nurse could make?

1. One should always douche after having intercourse.

2. When douching, use force putting them in and get the solution up high.

3. It is a good idea to douche before intercourse so the area is clean for the sperm.

4. Douching is unnecessary because the lining of the vagina has numerous glands that provide natural cleansing.

Answer: 4

Explanation: 4. This is a true statement. The vagina has a natural cleansing system.

Page Ref: 39

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 2 Summarize information that women may need in order to implement appropriate self-care measures for dealing with menstruation.

8

Copyright 2016 Pearson Education, Inc.

12) The nurse is instructing a young client on avoiding toxic shock syndrome. Education was successful when the client makes which statements?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. I will wash my hands before inserting a tampon.

2. I will change my tampon every 3-6 hours.

3. I will not touch the part of the tampon I insert.

4. I will just put the used tampon in the trash.

5. I will take prophylactic antibiotics if needed.

Answer: 1, 2, 3

Explanation: 1. Washing hands before inserting or removing a tampon is correct.

2. Changing the tampon every 3-6 hours will help prevent toxic shock syndrome from developing.

3. After the tampon is unwrapped, the client should avoid touching the portion of the tampon to be inserted into the vagina.

Page Ref: 39

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 2 Summarize information that women may need in order to implement appropriate self-care measures for dealing with menstruation.

9

Copyright 2016 Pearson Education, Inc.

13) The nurse is interviewing an adolescent client. The client reports a weight loss of 50 pounds over the last 4 months, and reports running at least 5 miles per day. The client asserts that her menarche was 5 years ago. Her menses are usually every 28 days, but her last menstrual period was 4 months ago. The client denies any sexual activity. Which is the best statement for the nurse to make?

1. Your lack of menses might be related to your rapid weight loss.

2. It is common and normal for runners to stop having any menses.

3. Increase your intake of iron-rich foods to reestablish menses.

4. Adolescents rarely have regular menses, even if they used to be regular.

Answer: 1

Explanation: 1. Secondary amenorrhea can be caused by rapid weight loss, including the development of the eating disorders anorexia and bulimia. Runners with low body fat might have irregular menses, but amenorrhea is not a normal condition.

Page Ref: 39

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3 Identify causes of amenorrhea.

14) A 19-year-old woman comes to the gynecologists office. When the nurse asks the reason for this visit, the client explains that she has never had a menstrual period, and that she is concerned there might be something wrong. What is the diagnosis that the physician is most likely to make based on this information?

1. Primary dysmenorrhea

2. Secondary infertility

3. Primary amenorrhea

4. Secondary amenorrhea

Answer: 3

Explanation: 3. Primary amenorrhea is the term for the condition when menses have never occurred.

Page Ref: 39

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 3 Identify causes of amenorrhea.

10

Copyright 2016 Pearson Education, Inc.

15) The nurse educator is talking with the students in the clinical area about amenorrhea. She has discussed both primary and secondary amenorrhea and their possible causes and knows that her teaching has been successful when, upon being questioned, a student explains that amenorrhea can be caused by which of the following?

1. Malfunctioning of the pancreas and insulin usage

2. Lack of testosterone after the time for menses to start

3. Lack of vitamin D and calcium in the system

4. Dysfunction of the hypothalamus

Answer: 4

Explanation: 4. Causes for amenorrhea include dysfunction of the hypothalamus, pituitary, and/or anovulation.

Page Ref: 39, 40

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 3 Identify causes of amenorrhea.

16) A client comes to the clinic complaining of severe menstrual cramps. She has never been pregnant, has been diagnosed with ovarian cysts, and has had an intrauterine device (IUD) for 2 years. What is the most likely cause for the clients complaint?

1. Primary dysmenorrhea

2. Secondary dysmenorrhea

3. Menorrhagia

4. Hypermenorrhea

Answer: 2

Explanation: 2. Secondary dysmenorrhea is associated with pathology of the reproductive tract, and usually appears after menstruation has been established. Conditions that most frequently cause secondary dysmenorrhea include ovarian cysts and the presence of an intrauterine device.

Page Ref: 40

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 4 Contrast dysmenorrhea and premenstrual syndrome.

11

Copyright 2016 Pearson Education, Inc.

MNL LO: 6.1.2 Compare advantages, disadvantages, risk factors, and contraindications of contraception methods.

17) The nurse teaches a group of young women that self-care measures for dysmenorrhea include which of the following actions?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Taking vitamins B and E

2. Decreasing salt intake

3. Using cold packs as needed

4. Using intermittent exercise

5. Taking FSH replacement

Answer: 1, 2

Explanation: 1. Some nutritionists suggest that vitamins B and E help relieve the discomforts associated with menstruation.

2. Self-care measures such as regular exercise, rest, application of heat, and good nutritionincluding reducing saltwill help dysmenorrhea symptoms.

Page Ref: 40

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4 Contrast dysmenorrhea and premenstrual syndrome.

12

Copyright 2016 Pearson Education, Inc.

18) The nurse at a womens clinic is planning a class on premenstrual dysphoric disorder (PMDD). The nurse includes in the education information about what medications that are shown to be effective for PMDD?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Fluoxetine hydrochloride (Prozac)

2. Sertraline hydrochloride (Zoloft)

3. Paroxeline CR (Paxil CR)

4. Hyoscyamine (Anaspaz)

5. Promethazine (Phenergan)

Answer: 1, 2, 3

Explanation: 1. Selective serotonin inhibitors such as fluoxetine hydrocholoride (Prozac) have been found to be effective in controlling PMDD.

2. Setraline hydrochloride (Zoloft) is a selective serotonin inhibitor and has been found to be effective in controlling PMDD.

3. Paroxeline CR (Paxil CR) is a selective serotonin inhibitor and has been found to be effective in controlling PMDD.

Page Ref: 41

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2 Summarize information that women may need in order to implement appropriate self-care measures for dealing with menstruation.

13

Copyright 2016 Pearson Education, Inc.

19) The nurse is teaching a group of women about menopause at a community clinic. The nurse tells them that the best indicator of menopause is which of the following symptoms?

1. No menses for 8 consecutive months

2. Hot flashes and night sweats

3. FSH levels rise and ovarian follicles cease to produce estrogen

4. Diagnosed with osteoporosis 4 months ago

Answer: 3

Explanation: 3. Examining FSH and estrogen levels is a very accurate indication of menopause.

Page Ref: 45

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5 Delineate the physical and psychologic aspects of menopause.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associated symptoms.

20) A client who is in perimenopause is having a number of severe symptoms. The nurse assesses this client and knows the doctor will likely prescribe what to assist in relieving the distress?

1. Calcium and vitamin D

2. A form of hormonal contraception

3. Prescriptive pain medication

4. Antibiotics

Answer: 2

Explanation: 2. Hormonal contraception is the correct answer, as pregnancy can still be a concern, plus the estrogen will relieve other symptoms, such as hot flashes and vaginal dryness.

Page Ref: 45

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients and designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5 Delineate the physical and psychologic aspects of menopause.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associated symptoms.

14

Copyright 2016 Pearson Education, Inc.

21) The nurse is teaching a group of menopausal women about the signs and symptoms of menopause and how they can get relief. One of the main concerns of the group is vaginal dryness and difficult intercourse. What is the reason the nurse will give for this?

1. The loss of cervical gland function leads to dryness of the mucous membranes of the vagina.

2. The vaginal pH increases, and the number of Doderleins bacilli decreases.

3. The uterine lining thins and the muscle layer atrophies.

4. The labia shrink and lose their pigmentation.

Answer: 1

Explanation: 1. The loss of cervical gland function leads to dryness of the mucous membranes of the vagina.

Page Ref: 45

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships in health and safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5 Delineate the physical and psychologic aspects of menopause.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associated symptoms.

22) A client is asking the nurse what she can do about the falling down of her reproductive organs and urinary tract wall. The nurse will tell the client to try what exercise?

1. Lifting weights to strengthen those muscles

2. Running two miles a day

3. Running up and down stairs a few times every day

4. Performing Kegel exercises and having regular sexual activity

Answer: 4

Explanation: 4. This is the correct answer. Kegel exercises are done by tightening and relaxing the perineal muscles, and this activity as well as sexual activity will help the clients problem.

Page Ref: 45

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5 Delineate the physical and psychologic aspects of menopause.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associ

15

Copyright 2016 Pearson Education, Inc.

ated symptoms.

23) The nurse educator is talking with a group of students doing their gynecological rotation. The nurse describes a number of symptoms that include anovulation, reduced fertility, either decreased or increased menstrual flow, and menstrual cycle irregularities. The nurse is describing what condition?

1. Intermenstrual bleeding

2. Hypermenorrhea

3. Menopause

4. Primary amenorrhea

Answer: 3

Explanation: 3. This is the correct answer. Anovulation, reduced fertility, either decreased or increased menstrual flow, and menstrual cycle irregularities are some of the symptoms of menopause.

Page Ref: 45

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5 Delineate the physical and psychologic aspects of menopause.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associated symptoms.

16

Copyright 2016 Pearson Education, Inc.

24) When caring for the menopausal woman, nurses need to be empathetic in approaching which of the following areas?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Administering medications

2. Health teaching

3. Providing physical care

4. Counseling

5. Encouraging hormone therapy

Answer: 2, 3, 4

Explanation: 2. The nurse needs to use an empathetic approach in counseling, health teaching, and providing physical care.

3. The nurse needs to use an empathetic approach in counseling, health teaching, and providing physical care.

4. The nurse needs to use an empathetic approach in counseling, health teaching, and providing physical care.

Page Ref: 50

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5 Delineate the physical and psychologic aspects of menopause.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associated symptoms.

17

Copyright 2016 Pearson Education, Inc.

25) The nurse assessing a 47-year-old client who is perimenopausal includes which important topics?

Note: credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Vasomotor symptoms

2. A decrease in vaginal lubrication

3. Pregnancy not being an option

4. Mood changes that occur

5. An increase in the libido

Answer: 1, 2, 4

Explanation: 1. Women need to know that vasomotor symptoms occur. It might be important to investigate other possible causes of the vasomotor symptoms.

2. Women need to know that a decrease in vaginal lubrication occurs, and that water-soluble lubricants should be used.

4. Mood changes and irritability occur, and the woman might experience more forgetfulness.

Page Ref: 44

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients and designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5 Delineate the physical and psychologic aspects of menopause.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associated symptoms.

18

Copyright 2016 Pearson Education, Inc.

26) In teaching a group of adolescents, the nurse discusses which risk factors for cardiovascular disease (CVD) in women?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Being over 55 and postmenopausal

2. Using cigarettes and tobacco

3. Being overweight

4. Having a low cholesterol level

5. Having an active lifestyle

Answer: 1, 2, 3

Explanation: 1. Being over the age of 55 and postmenopausal increases the risk of CVD.

2. The use of cigarettes and tobacco increases the risk of CVD.

3. Being overweight or obese increases the risk of CVD.

Page Ref: 46

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5 Delineate the physical and psychologic aspects of menopause.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associated symptoms.

19

Copyright 2016 Pearson Education, Inc.

27) The nurse in the OB-GYN clinic has been seeing a client through her menopausal stage of life. The nurse assesses psychological concerns if the client makes which statement?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. I feel so lost with all of the kids away from home.

2. I wish I were younger, and could have a baby.

3. Although my parents are aging, they travel a lot.

4. I dont think I am a good wife anymore.

5. I really enjoy being able to go out when I want.

Answer: 1, 2, 4

Explanation: 1. Adjustment to an empty nest is a psychological concern during menopause.

2. Some women express disappointment in approaching this time of their lives, whereas others might see it as a positive transition that offers freedom from menses or concern about contraception.

4. Numerous personal factors influence a womans ability to transition and cope with these changes, such as self-concept.

Page Ref: 45

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5 Delineate the physical and psychologic aspects of menopause.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associated symptoms.

20

Copyright 2016 Pearson Education, Inc.

28) The nurse is answering the perimenopausal clients questions about hormone replacement therapy. Which client statement indicates a need for further teaching?

1. Estrogen therapy will decrease my chances of developing osteoporosis.

2. If I am taking estrogen therapy, I will not have to worry about my cholesterol being checked.

3. Osteoporosis is a decrease in bone strength due to bone density and quality.

4. Bone mass tends to decrease after menopause.

Answer: 2

Explanation: 2. Cholesterol levels should be checked regularly even when normal, so this statement indicates the need for more teaching.

Page Ref: 43

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5 Delineate the physical and psychologic aspects of menopause.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associated symptoms.

21

Copyright 2016 Pearson Education, Inc.

29) The charge nurse is giving an in-service to the orthopedic and gynecology nurses concerning the relationship between estrogen and osteoporosis. Which is a statement the nurse would make concerning this relationship?

1. Males have a higher incidence of osteoporosis than do females.

2. Women who experience menopause at a younger age and have less bone mass could have more bone loss.

3. Estrogen levels affect only bone mass, but they have nothing to with bone strength and bone density.

4. Osteoporosis puts the client at a decreased risk for fractures of the forearm and vertebrae.

Answer: 2

Explanation: 2. This is a true statement, as women who experience menopause at a younger age and have less bone mass lose the benefit of estrogen for more years.

Page Ref: 39

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6 Explain the relationship between menopause and osteoporosis.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associated symptoms.

22

Copyright 2016 Pearson Education, Inc.

30) The nurse is interviewing a new client in the clinic. The client is premenopausal, but is concerned about the bone changes and osteoporosis that can occur, since she is getting close to menopause. The nurse tells the client that prevention is the primary goal. Which of the following would be a primary goal for prevention?

1. Eliminating all alcohol intake

2. Taking 500 mg of calcium each day

3. Use of sunscreen to assist with absorption of vitamin D

4. Regular weight-bearing and muscle-strengthening exercises

Answer: 4

Explanation: 4. This is correct. Regular weight bearing of the long bones is a primary goal for the prevention of osteoporosis.

Page Ref: 48

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6 Explain the relationship between menopause and osteoporosis.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associated symptoms.

23

Copyright 2016 Pearson Education, Inc.

31) The nurse is teaching a group of clients about risk factors for osteoporosis. The nurse will include which of the following risk factors in the teaching?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Menopause at an early age increases bone loss

2. A family history of osteoporosis

3. A lifetime of high calcium intake

4. Having an active lifestyle

5. A vitamin D deficiency

Answer: 1, 2, 5

Explanation: 1. Abnormal absence of menses and early onset of menopause increase the risk of osteoporosis.

2. Family history of osteoporosis, especially a maternal hip fracture, increases the risk of osteoporosis.

5. Vitamin D deficiency increases the risk of osteoporosis.

Page Ref: 46

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships in health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6 Explain the relationship between menopause and osteoporosis.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associated symptoms.

24

Copyright 2016 Pearson Education, Inc.

32) A menopausal woman tells her nurse that she experiences discomfort from vaginal dryness during sexual intercourse, and asks, What should I use as a lubricant? The nurse should recommend which of the following?

1. Petroleum jelly

2. A water-soluble lubricant

3. Body cream or body lotion

4. Less-frequent intercourse

Answer: 2

Explanation: 2. A water-soluble jelly should be used.

Page Ref: 50

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5 Delineate the physical and psychologic aspects of menopause.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associated symptoms.

25

Copyright 2016 Pearson Education, Inc.

33) A 49-year-old client comes to the clinic with complaints of severe perimenopausal symptoms including hot flashes, night sweats, urinary urgency, and vaginal dryness. The physician has prescribed a combination hormone replacement therapy of estrogen and progestin. When the client asks the nurse why she must take both hormones, what is the nurses best reply?

1. Hot flashes respond better when replacement includes both hormones.

2. You are having very severe symptoms, so you need more hormones replaced.

3. There is an increased risk of tissue abnormality inside the uterus if only one is given.

4. Your blood pressure can become elevated if only one hormone is used.

Answer: 3

Explanation: 3. Estrogen alone, in a woman with a uterus (unopposed estrogen), increases the risk of endometrial (the lining of the uterus) cancer by eightfold and, therefore, is never given without progesterone in these women.

Page Ref: 47

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4 Contrast dysmenorrhea and premenstrual syndrome.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associated symptoms.

26

Copyright 2016 Pearson Education, Inc.

34) The nurse assessing a 50-year-old female client at an orthopedic center asks about the use of complementary and alternative therapies. Which of the following are among those women often try during menopause?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Vitamin and mineral supplements

2. Increasing caffeine intake

3. Soy and red clover

4. Selective estrogen receptor modulators

5. Salmon calcitonin

Answer: 1, 3

Explanation: 1. Vitamin and mineral supplements, especially calcium and vitamins D, E, and B complex, are used to control the symptoms of menopause.

3. Soy and red clover have shown to be effective for some women in controlling their menopausal symptoms.

Page Ref: 49

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 7 Identify medical and complementary therapies to alleviate the discomforts of menopause.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associated symptoms.

27

Copyright 2016 Pearson Education, Inc.

35) The nurse is teaching a group of perimenopausal women about treatment choices for their symptoms. The nurse will include which information?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Importance of continuing contraception

2. Benefits of menstrual regulation with hormones

3. Increase in vaginal dryness with hormones

4. Decrease in acne and hirsutism

5. Increase in endometrial cancer risk

Answer: 1, 2, 4

Explanation: 1. Thirty-eight percent of pregnancies for women ages 40 and older are unplanned; some form of contraception is needed.

2. Regulation of menses with effective contraception is a benefit to the perimenopausal woman.

4. Women on hormones might experience less acne and hirsutism.

Page Ref: 45

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing Process: Implementation

Learning Outcome: 5 Delineate the physical and psychologic aspects of menopause.

MNL LO: 6.1.1 Explain hormonal changes that occur in menopause and methods to manage the associated symptoms.

Leave a Reply