RN- NCLEX exam
A client has obtained Plan B (levonorgestrel 0.75 mg, 2 tablets) as emergency contraception.
After unprotected intercourse , the client calls the clinic to ask questions about taking the
contraceptives. The nurse realizes the client needs further explanation when she makes which
of the following responses? - Ans>>1. I can wait 3 to 4 days after intercourse to start taking
these to prevent pregnancy.
Plan B is a series of contraceptive pills similar in composition to birth control pills that have
been used for the past 30 years. Plan B is the brand name for levonorgestrel 0.75 mg. Pills are
most effective if taken immediately after unprotected intercourse and then again 12 hours
later. Males can purchase this contraceptive as long as they are over 18 years of age. Common
side effects include nausea, breast tenderness, vertigo, and stomach pain.
An antenatal G2, T1, P0, Ab0, L1 client is discussing her postpartum plans for birth control with
her health care provider. In analyzing the available choices, which of the following factors has
the greatest impact on her birth control options? - Ans>>3. Breast - or bottle-feeding plan.
Birth control plans are influenced primarily by whether the mother is breast- or bottle-feeding
her infant. The maternal milk supply must be well established prior to the initiation of most
hormonal birth control methods. Low-dose oral contraceptives would be the exception. Use of
estrogen-/progesterone-based pills and progesterone-only pills are commonly initiated from 4
to 6 weeks postpartum because the milk supply is well established by this time. Prior
experiences with birth control methods have an impact on the method chosen as do to
preferences of the client's partner; however, they are not the most influential factors. Desire to
have another child in two years would make some methods, such as an IUD, less attractive but
would still be secondary to the choice to breast-feed.
After the nurse instructs a 20 year old nulligravid client on how to perform a breast self-
examination, which of the following client statements indicates that the teaching has been
successful? - Ans>>4. If there is discharge from my nipples, I should call my health care
provider.
The nurse determines that the client has understood the instructions when the client says that
she will notify her primary health care provider if she notices discharge or bleeding because this
may be symptomatic of underlying disease. Ideally, breast self-examination should be
performed about 1 week after the onset of menses because hormonal influences on breast
tissue are at a low ebb at this time. The client should perform breast self-examination on the
,same day each month only if she has stopped menstruating (as with menopause). The client's
breasts should mirror each other. If one breast is significantly larger than the other, or if there is
"pitting" of breast tissue, a tumor may be present.
Which of the following would be important to include in the teaching plan for the client who
wants more information on ovulation and fertility management? - Ans>>3. Ovulation usually
occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle.
For a client with a typical menstrual cycle of 28 days, ovulation usually occurs on day 14, plus or
minus 2 days, before the onset of the next menstrual cycle. Stated another way, the menstrual
period begins about 2 weeks after ovulation has occurred. Ovulation does not usually occur
during the menses component of the cycle when the uterine lining is being shed. In most
women, the ovum survives for about 12 to 24 hours after ovulation, during which time
conception is possible. The basal body temperature rises 0.5 F to 1.0 F (0.28 C to 0.56 C) when
ovulation occurs. Although some women experience some pelvic discomfort during ovulation
(mittelschmerz), severe or unusual pain is rare. After ovulation, the cervical mucus is thin and
copious.
Which of the following instructions about activities during menstruation would the nurse
include when counseling an adolescent who has just begun to menstruate? - Ans>>1. Take a
mild analgesic if needed for menstrual pain.
The nurse should instruct the client to take a mild analgesic, such as ibuprofen, if menstrual
pain or "cramps" are present. The client should also eat foods rich in iron and should continue
moderate exercise during menstruation, which increases abdominal tone. Avoiding cold foods
will not decrease dysmenorrhea. Sexual intercourse is not prohibited during menstruation, but
the male partner should wear condom to prevent expose to blood.
After conducting a class for female adolescents about human reproduction, which of the
following statements indicates that the school nurse's teaching has been effective? - Ans>>1.
Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes, resulting in pregnancy.
Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes. This is an important
point to make with adolescents who may be sexually active. Many people believe that the time
interval is much longer and that they can wait until after intercourse to take steps to prevent
conception. Without protection, pregnancy and sexually transmitted diseases can occur. When
using the abstinence or calendar method, the couple should abstain from intercourse on the
days of menstrual cycle when the woman is most likely to conceive. Using a 28-day cycle as an
example, a couple should abstain from coitus 3 to 4 days before ovulation (days 10 through 14)
, and 3 to 4 days after after ovulation (days 15 through 18). Sperm from a healthy male can
remain viable for 24 to 72 hours in the female reproductive tract. If the female client ovulates
after coitus, there is a possibility that fertilization can occur. Before fertilization, the ovum and
sperm each contain 23 chromosomes. After fertilization, the conceptus contains 46
chromosomes unless there is a chromosomal abnormality.
A 20-year-old nulligravid client expresses a desire to learn more about the symptothermal
method of family planning. Which of the following would the nurse include in the teaching
plan? - Ans>>3. Cervical mucus is carefully monitored for changes.
The symptothermal method is a natural method of fertility management that depends on
knowing when ovulation has occurred. Because regular menstrual cycles can vary by 1 or 2 days
in either direction, the symptothermal method requires daily basal body temperature
assessments plus close monitoring of cervical mucus changes. The method relies on abstinence
during the period of ovulation, which occurs approximately 14 days before the beginning of the
next cycle. Abstinence from coitus for 5 days after menses is unnecessary because it is unlikely
that ovulation will occur during this time period (days 1 through 10). Typically, the failure rate
for this method is between 10% and 20 %. Although a condom may increase the effectiveness
of this method, most clients who choose natural methods are not interested in chemical or
barrier types of family planning.
Before advising a 24-year-old client desiring oral contraceptives for family planning, the nurse
would assess the client for signs and symptoms of which of the following? - Ans>>2.
Hypertension.
Before advising a client about oral contraceptives, the nurse needs to assess the client for signs
and symptoms of hypertension. Clients who have hypertension, thrombophlebitis, obesity, or a
family history of cerebral or cardiovascular accident are poor candidates for oral
contraceptives. In addition, women who smoke, are older than 40 years of age, or have a
history of pulmonary disease should be advised to use a different method. Iron-deficiency,
anemia, dysmenorrhea, and acne are not contraindications for the use of oral contraceptives.
Iron-deficiency anemia is a common disorder in young women. Oral contraceptives decrease
the amount of iron lost through menses, thereby providing a beneficial effect when used by
clients with anemia.Low-dose oral contraceptives to prevent ovulation may be effective in
decreasing the severity of dysmenorrhea (painful menstruation). Dysmenorrhea is thought to
be caused by the release of prostaglandins in response to tissue destruction during the ischemic
phase of the menstrual cycle. Use of oral contraceptives commonly improves facial acne.
A client has obtained Plan B (levonorgestrel 0.75 mg, 2 tablets) as emergency contraception.
After unprotected intercourse , the client calls the clinic to ask questions about taking the
contraceptives. The nurse realizes the client needs further explanation when she makes which
of the following responses? - Ans>>1. I can wait 3 to 4 days after intercourse to start taking
these to prevent pregnancy.
Plan B is a series of contraceptive pills similar in composition to birth control pills that have
been used for the past 30 years. Plan B is the brand name for levonorgestrel 0.75 mg. Pills are
most effective if taken immediately after unprotected intercourse and then again 12 hours
later. Males can purchase this contraceptive as long as they are over 18 years of age. Common
side effects include nausea, breast tenderness, vertigo, and stomach pain.
An antenatal G2, T1, P0, Ab0, L1 client is discussing her postpartum plans for birth control with
her health care provider. In analyzing the available choices, which of the following factors has
the greatest impact on her birth control options? - Ans>>3. Breast - or bottle-feeding plan.
Birth control plans are influenced primarily by whether the mother is breast- or bottle-feeding
her infant. The maternal milk supply must be well established prior to the initiation of most
hormonal birth control methods. Low-dose oral contraceptives would be the exception. Use of
estrogen-/progesterone-based pills and progesterone-only pills are commonly initiated from 4
to 6 weeks postpartum because the milk supply is well established by this time. Prior
experiences with birth control methods have an impact on the method chosen as do to
preferences of the client's partner; however, they are not the most influential factors. Desire to
have another child in two years would make some methods, such as an IUD, less attractive but
would still be secondary to the choice to breast-feed.
After the nurse instructs a 20 year old nulligravid client on how to perform a breast self-
examination, which of the following client statements indicates that the teaching has been
successful? - Ans>>4. If there is discharge from my nipples, I should call my health care
provider.
The nurse determines that the client has understood the instructions when the client says that
she will notify her primary health care provider if she notices discharge or bleeding because this
may be symptomatic of underlying disease. Ideally, breast self-examination should be
performed about 1 week after the onset of menses because hormonal influences on breast
tissue are at a low ebb at this time. The client should perform breast self-examination on the
,same day each month only if she has stopped menstruating (as with menopause). The client's
breasts should mirror each other. If one breast is significantly larger than the other, or if there is
"pitting" of breast tissue, a tumor may be present.
Which of the following would be important to include in the teaching plan for the client who
wants more information on ovulation and fertility management? - Ans>>3. Ovulation usually
occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle.
For a client with a typical menstrual cycle of 28 days, ovulation usually occurs on day 14, plus or
minus 2 days, before the onset of the next menstrual cycle. Stated another way, the menstrual
period begins about 2 weeks after ovulation has occurred. Ovulation does not usually occur
during the menses component of the cycle when the uterine lining is being shed. In most
women, the ovum survives for about 12 to 24 hours after ovulation, during which time
conception is possible. The basal body temperature rises 0.5 F to 1.0 F (0.28 C to 0.56 C) when
ovulation occurs. Although some women experience some pelvic discomfort during ovulation
(mittelschmerz), severe or unusual pain is rare. After ovulation, the cervical mucus is thin and
copious.
Which of the following instructions about activities during menstruation would the nurse
include when counseling an adolescent who has just begun to menstruate? - Ans>>1. Take a
mild analgesic if needed for menstrual pain.
The nurse should instruct the client to take a mild analgesic, such as ibuprofen, if menstrual
pain or "cramps" are present. The client should also eat foods rich in iron and should continue
moderate exercise during menstruation, which increases abdominal tone. Avoiding cold foods
will not decrease dysmenorrhea. Sexual intercourse is not prohibited during menstruation, but
the male partner should wear condom to prevent expose to blood.
After conducting a class for female adolescents about human reproduction, which of the
following statements indicates that the school nurse's teaching has been effective? - Ans>>1.
Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes, resulting in pregnancy.
Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes. This is an important
point to make with adolescents who may be sexually active. Many people believe that the time
interval is much longer and that they can wait until after intercourse to take steps to prevent
conception. Without protection, pregnancy and sexually transmitted diseases can occur. When
using the abstinence or calendar method, the couple should abstain from intercourse on the
days of menstrual cycle when the woman is most likely to conceive. Using a 28-day cycle as an
example, a couple should abstain from coitus 3 to 4 days before ovulation (days 10 through 14)
, and 3 to 4 days after after ovulation (days 15 through 18). Sperm from a healthy male can
remain viable for 24 to 72 hours in the female reproductive tract. If the female client ovulates
after coitus, there is a possibility that fertilization can occur. Before fertilization, the ovum and
sperm each contain 23 chromosomes. After fertilization, the conceptus contains 46
chromosomes unless there is a chromosomal abnormality.
A 20-year-old nulligravid client expresses a desire to learn more about the symptothermal
method of family planning. Which of the following would the nurse include in the teaching
plan? - Ans>>3. Cervical mucus is carefully monitored for changes.
The symptothermal method is a natural method of fertility management that depends on
knowing when ovulation has occurred. Because regular menstrual cycles can vary by 1 or 2 days
in either direction, the symptothermal method requires daily basal body temperature
assessments plus close monitoring of cervical mucus changes. The method relies on abstinence
during the period of ovulation, which occurs approximately 14 days before the beginning of the
next cycle. Abstinence from coitus for 5 days after menses is unnecessary because it is unlikely
that ovulation will occur during this time period (days 1 through 10). Typically, the failure rate
for this method is between 10% and 20 %. Although a condom may increase the effectiveness
of this method, most clients who choose natural methods are not interested in chemical or
barrier types of family planning.
Before advising a 24-year-old client desiring oral contraceptives for family planning, the nurse
would assess the client for signs and symptoms of which of the following? - Ans>>2.
Hypertension.
Before advising a client about oral contraceptives, the nurse needs to assess the client for signs
and symptoms of hypertension. Clients who have hypertension, thrombophlebitis, obesity, or a
family history of cerebral or cardiovascular accident are poor candidates for oral
contraceptives. In addition, women who smoke, are older than 40 years of age, or have a
history of pulmonary disease should be advised to use a different method. Iron-deficiency,
anemia, dysmenorrhea, and acne are not contraindications for the use of oral contraceptives.
Iron-deficiency anemia is a common disorder in young women. Oral contraceptives decrease
the amount of iron lost through menses, thereby providing a beneficial effect when used by
clients with anemia.Low-dose oral contraceptives to prevent ovulation may be effective in
decreasing the severity of dysmenorrhea (painful menstruation). Dysmenorrhea is thought to
be caused by the release of prostaglandins in response to tissue destruction during the ischemic
phase of the menstrual cycle. Use of oral contraceptives commonly improves facial acne.
