Test Bank for Maternal and Child Health Nursing 9th Edition by Silbert

7. The nurse is instructing a female adolescent about the medication leuprolide acetate (Lupron Depot-Ped), which has been prescribed to reduce the level of testosterone. What should the nurse include when teaching the patient about this medication? (Select all that apply.) A) Inject in the same region every month. B) Ensure effective birth control if sexually active. C) Transfer the medication into another syringe before injecting. D) Mark on a calendar when the injections are needed every 3 months. E) Notify the health care provider if nausea and vomiting occurs after taking the medication. Ans: B, D Feedback: The medication leuprolide acetate (Lupron Depot-Ped) is a pregnancy risk category X so pregnant should be avoided when taking this medication. Because injections are given only every 3 months, the patient should prepare a calendar to identify when the next injection is due. The injections should be varied to decrease local irritation. The medication should be administered in the syringe supplied. Nausea and vomiting are possible adverse effects of the medication and do not need to be reported to the health care provider. 8. What should the nurse instruct an adolescent who asks about the best way to prevent vulvovaginitis? A) Wipe from front to back after urinating or defecating. B) Apply personal hygiene sprays if vaginal odor develops. C) Soak in a strong bubble bath solution to maintain hygiene. D) Use nylon rather than cotton underpants to decrease moisture. Ans: A Feedback: To prevent vulvovaginitis, the patient should be instructed to cleanse the perineum from front to back to prevent spreading rectal contamination forward. Personal hygiene sprays should be avoided because the ingredients could cause additional irritation. Bubble baths should be avoided because the ingredients could cause additional irritation. Cotton underwear should be worn because it allows air to circulate. 9. A female adolescent is diagnosed with polycystic ovary syndrome. Which information should the nurse prepare to instruct the patient about the treatment for this disorder? (Select all that apply.) A) Importance of exercise B) Use of antiandrogen medication C) Eating plan to reach appropriate weight D) Use of fertility medications to regulate menstrual cycles E) Use of oral combined estrogen/progesterone contraceptive Ans: B, C, E Feedback: Treatment is aimed at relieving symptoms so teaching should be about symptom management. Antiandrogen medication may be used to reduce hair growth and acne. An eating plan may be used to reduce obesity. Oral combined estrogen/progesterone contraception is used to better regulate menstrual cycles. Exercise is not identified as a specific treatment. Fertility medication is used if the patient desires to become pregnant and not to regulate menstrual cycles. 10. An 8-year-old child is diagnosed with balanoposthitis. What will the nurse most likely assess in this disorder? A) Reduced production of sperm B) Pallor of the prepuce of the penis C) Bloody urethral discharge and pain on urination D) Denuded, reddened surface of the glans of the penis Ans: D Feedback: Balanoposthitis is inflammation of the glans and prepuce of the penis. The prepuce and glans appear red and swollen; there may be a purulent discharge. The nurse is unable to determine sperm production without a sperm count. The child may have difficulty voiding because of crusting at the meatal opening and because acidic urine touching the denuded surface of the glans causes pain. A bloody urethral discharge is not associated with this disorder. 5. The nurse is preparing teaching materials for the parents of a child with encopresis. What information should the nurse emphasize during this teaching? A) Not punishing the child for the condition B) Necessity for giving 4 to 6 tablespoons of Kaopectate per day C) Need for keeping the child close to bathroom facilities at all times D) Importance of cleaning the child immediately after an accident occurs Ans: A Feedback: Encopresis is the inappropriate passage of stool in places not culturally appropriate for that purpose. Parents should not punish the child for encopresis but rather to pay as little attention as possible to bowel accidents and to give praise for days when encopresis does not occur. The child does not need Kaopectate every day. The child does not need to be close to bathroom facilities at all times. The child does not experience diarrhea soiling after accidents would not be of a high priority for teaching. 6. The mother of an 11-month-old infant is concerned that the child is developing autism because the child likes to rock on the hands and knees in the crib before going to sleep. What should the nurse respond to this mother's concern? A) “Rocking means the child is hungry.” B) “Rocking is abnormal behavior associated with autism.” C) “Rocking can be seen as a form of self-stimulation.” D) “Be sure to pad the crib so the child does not hurt the head while rocking.” Ans: B Feedback: Rocking is hypothesized as being a form of self-stimulation. The child with autism will engage in constant body rocking. Because the child likes to perform body rocking before going to sleep and not constantly, it is more likely being used by the child as a form of self-stimulation. Rocking does not mean that the child is hungry. Rocking is not only seen in autism. The mother did not express concern that the child is banging the head on the crib while rocking so padding the crib might not be appropriate at this time.