TEST BANK WOMENS HEALTH AND PRIMARY CARE CLINICAL GUIDE 5TH EDITION YOUNGKIN SCHADEWALD PRITHAM

TEST BANK WOMENS HEALTH AND PRIMARY CARE CLINICAL GUIDE 5TH EDITION YOUNGKIN SCHADEWALD PRITHAM Table ofContents Chapter 1 Access to Women’s Health Care in the United States: Affordability, Equity, Rights... 2 Chapter 2 Women’s Development into the 21st Century ................................ . 6 Chapter 3 Epidemiology, Diagnostic Methods, and Procedures for Women’s Health .......... 9 Chapter 4 Assessing Adolescent Women’s Health Renee Sieving, Sarah Stoddard, Deborah A. Raines................................ ................................ ........... 13 Chapter 5 Assessing Adult Women’s Health Diane Marie Schadewald, Catherine Juve, Ellis Quinn Youngkin, Marcia Szmania Davis ................................ .................... 18 Chapter 6 Assessing Older Women’s Health Debra Hain................................ . 22 Chapter 7 Women and Sexuality Catherine Ingram Fogel, Diane Marie Schadewald.......... 26 Chapter 8 Health Needs of Lesbian, Bisexual, and Transgender Populations ................ 31 Chapter 9 Health Needs of Women with Disabilities Michele Davidson..................... 34 Chapter 10 Integrating Wellness: Complementary Therapies and Women’s Health J o Lynne W. Robins................................ ................................ ........... 37 Chapter 11 Menstruation and Related Problems and Concerns Kristine Alswager, Christine Durler, Deborah Griswold................................ ........................... 41 Chapter 12 Contraceptive Management and Family Planning Beth Walcker, Coralie Pederson, Kathryn A. Caufield................................ ................................ 47 Chapter 13 Infertility Michelle Valentine, Jennifer R. Gardella ............................ 57 Chapter 14 Vaginitis and Sexually Transmitted Diseases Susan D. Schaffer, Jane Houston ..... 60 Chapter 15 Women and HIV Dina Treloar, Susan D. Schaffer............................. 70 Chapter 16 Common Gynecologic Pelvic Disorders Jennifer M. Laubach, Reena P. Lorntson, Donna E. Forrest................................ ................................ .. 74 Chapter 17 Breast Health Linda Christinsen-Rengel ................................ .... 83 Chapter 18 The Menopausal Transition Catherine Juve, Valerie T. Cotter, Ellis Quinn Youngkin88 Chapter 19 Promotion of Women’s Health Care During Pregnancy ....................... 93 Chapter 20 Maternal Conditions Impacting Risk in Pregnancy Debbie Ringdahl, Melissa Frisvold, Joan Corder-Mabe ................................ ................................ . 96 Chapter 21 Assessing Fetal Well-Being Michele Davidson, Marion Herndon Fuqua ......... 101 Chapter 22 Postpartum and Lactation Diane Schadewald, Cheri Friedrich, Kathleen M. Akridge ................................ ................................ ............... 105 Chapter 23 Common Medical Problems: Cardiovascular through Hematological Disorders Mary Benbenek, Mary Dierich, Elaine Ferrary, Rita A. Seeger Jablonski ......................... 115 Chapter 24 Common Medical Problems: Musculoskeletal Injuries through Urinary Tract Disorders Gwen Short, Rita A. Seeger Jablonski, Elaine Ferrary........................... 120 Chapter 25 Psychosocial Health Concerns Ann Bateman,Eugenia Zelanko ................. 125 Chapter 26 Substance Use Disorders and Women ................................ .... 130 1 | P a g eChapter 1 Access to Women’s Health Care in the United States: Affordability, Equity, Rights 1. Which health occupation has the highest percentage of women? A. Pharmacists B. Physical therapists C. Registered nurses D. Dental hygienists Answer: D 2. Which health occupation has the lowest percentage of women? A. Physicians B. Dentists C. Pharmacists D. Physical therapists Answer: B 3. Which health profession has the largest number of workers? A. Health aides B. Physicians C. Licensed practical nurses D. Registered nurses Answer: D 4. Which of the following are certifications available in advanced practice registered nursing? (Select all that apply.) A. Certified nurse midwife B. Certified registered nurse anesthetist C. Certified nurse pharmacologist 2 | P a g eD. Clinical nurse specialist E. Nurse practitioner Answer: A, B, D, E 5. What level of education is required to become a licensed practical nurse? A. 2-year master’s degree (in addition to a 4-year bachelor’s degree) B. 4-year bachelor’s degree C. 2-year associate’s degree D. 1-year certificate or diploma Answer: D 6. What percentage of physicians and surgeons in the United States in 2014 were women? A. 27% B. 37% C. 47% D. 57% Answer: B 7. What medical specialty has the highest percentage of women? A. General pediatrics B. Obstetrics and gynecology C. Orthopedic surgery D. Urology Answer: A 8. On an average, the income of female physicians is what percentage of that of male physicians? A. 59% B. 79% 3 | P a g eC. 99% D. 109% Answer: A 9. What level of education is required to become a pharmacist? A. 6-year doctorate degree B. 2-year master’s degree (in addition to a 4-year bachelor’s degree) C. 4-year bachelor’s degree D. 2-year associate’s degree Answer: A 10. Which of the following is the median income of dentists in the United States (2012)? A. $89,310 B. $109,310 C. $129,310 D. $149,310 Answer: D 11. Which of the following are the current trends in dentistry? (Select all that apply.) A. More specialists than generalists B. Research linking oral health to overall health C. Focus on treatment of disease rather than prevention D. Expected growth of 18% from 2014 to 2024 E. Increasing demand for dental implants, bridges, and cosmetic services Answer: B, D, E 12. Which allied health occupation is projected to be the fastest growing? A. Health information technicians B. Nursing aides C. Occupational therapists 4 | P a g eD. Paramedics Answer: A 13. One in five workers in which of the following allied health occupation is at or below the federal poverty level? A. Medical assistant B. Home health aide C. Radiology technician D. Speech-language pathologist Answer: B 14. Veronica is a registered nurse who pours herself into her job. She works long hours without complaint andstrives to do her best. Often, she maintains a cheerful, caring, and kind demeanor on the outside whilefeeling exhausted and frustrated on the inside. The effort it takes to maintain this front before her patientsresults in a lot of stress. This phenomenon can best be described as which of the following? A. Identity crisis B. Psychological disparity C. Emotional dissonance D. Gender discrimination Answer: C 15. Tests of implicit racial bias among health professionals have revealed which of the following? A. An unconscious preference for Whites over Blacks B. Use of racially charged, derogatory language C. Sharing of racist jokes D. Lower pay for racial minorities Answer: A 5 | P a g eChapter 2 Women’s Development into the 21st Century 1. To enhance women’s health care in the 21st century, researchers should do which of the following? (Select all that apply.) A. Design studies in collaboration with women B. Analyze changes in women’s health data relative to men’s C. Include homogeneous populations of women in studies D. Translate research findings into clinical and public health practice E. Focus on treatment approaches equally applicable to men and women Answer: A, B, D 2. Historically, gender has been defined by which of the following? (Select all that apply.) A. Self-identification B. Appropriate roles C. Division of labor D. Economic power E. Political influence Answer: B, C, D, E 3. Hammarstrӧm et al. propose a model of sex and gender that includes which of the following concepts? (Select all that apply.) A. Binary sexuality based on one’s chromosomes B. Sex, interacting with gender, as a continuum C. Biologically determined sex based on the effects of sex hormones on reproductive organ development D. Sex and gender as an integration of body, mind, and context E. Intersectionality and embodiment as factors significantly affecting sex andgender Answer: B, D, E 6 | P a g e4. Which of the following is the best example of how gender bias has affected the health and health care of women? A. Similar rates of mental illness being found in men and women B. Treatment outcomes among women varying based on patient compliance C. Association of patient income level with type of diagnosis D. Disproportionately more psychotropic medications being prescribed to women thanmen Answer: D 5. Krieger has proposed which of the following regarding sex, gender, and health? (Select all that apply.) A. Gender and sex played no significant role in determining health outcomes for women B. Gender relations influence the expression and the interpretation of biological traits C. Sex-linked biological characteristics contribute to gender differentials in health D. Traditional perspectives on gender and sex have resulted in better health outcomes for women than for men E. Equitable gender relationships have resulted in similar health outcomes in men and women Answer: B, C 6. When did women’s health scholarship begin to flourish? A. 1960s B. 1970s C. 1980s D. 1990s Answer: B 7. Which of the following were the goals included in the report “Women’s HealthResearch: Progress, Pitfalls, and Promise,” which was published by the Office of Research on Women’s Health in 2010? (Select all that apply.) 7 | P a g eA. Increase sex similarities research in basic sciences studies B. Incorporate findings of sex and gender differences in the design of new technologies C. Create strategic alliances to maximize domestic and global impact of women’s health research D. Develop and implement new social networking technologies to promote men’s health and wellness research E. Employ innovative strategies to build a well-trained, diverse, and vigorous women’s health research workforce Answer: B, C, E 8. The National Institutes of Health (NIH) Revitalization Act of 1993 mandated that the NIH do which of the following? A. Expand health insurance coverage for women B. Include women and minorities in clinical research C. Research and develop new women-specific medications D. Decrease infection rates during obstetric surgeries Answer: B 9. Historical examples ofgender bias in medical textbooks include which of the following? (Select all that apply.) A. Portrayals of women as inherently sick B. A recommendation that women simulate orgasms if not orgasmic with their husbands C. Portrayals of women patients as being intellectually superior to their male physicians D. Omission of the clitoris from anatomical illustrations of women’s genitals E. Portrayal of women as invincible to illness and age, as long as they make the rightchoices Answer: A, B, D, E 10. Which of the following best describes the new model for health care for women? 8 | P a g eA. Physician-centered B. Authoritarian C. Pluralistic D. Disease-oriented Answer: C Chapter 3 Epidemiology, Diagnostic Methods, and Procedures for Women’s Health 1:A 46-year-old patient is referred for the biopsy of a vaginal lesion. Vaginal biopsy typically requires what type of anesthesia? a:General b:Caudal c:None d:Conscious sedation e:Pudendal 2:A 36-year-old patient is to undergo removal of her uterus for benign disease. Which of the following is an advantage of abdominal hysterectomy over vaginal hysterectomy? a: Repair of rectocele more readily accessible b: Fewer incisional complications c: Ability to deal with smaller uterine sizes d: Ability to visualize associated pelvic pathology e: Shorter recovery period 3:She undergoes removal of only her uterus. Which term refers to the surgical removal of only the uterine corpus? a:Complete hysterectomy b:Vaginal hysterectomy cTotal hysterectomy d:Subtotal hysterectomy e:Radical hysterectomy 4:A 53-year-old is referred to you for the evaluation of an adnexal mass found at the time of annual 9 | P a g ephysical examination. In the initial evaluation of a possible adnexal mass, the most appropriate imaging technique is a:computed axial tomography scanning b:ultrasonography c:flat plate of the abdomen d:magnetic resonance imaging e:positron emission tomography (PET) imaging 5:What is the most appropriate biopsy location for a 45-year-old woman with abnormal vaginal bleedingfor 5 days and a normal physical examination? a:Vulva b:No biopsy indicated if less than 7 days c:Endometrium d:Vagina e:Cervix 6: A 25-year-old patient had an IUD inserted last year, but no longer feels the string. Which of the following is the most appropriate next step in management? a: Dilation and curettage b: MRI c: Hysteroscopy d: "Flat-plate" X-ray of the lowerabdomen e: Ultrasonography 7: A 35-year-old patient does not recall why she had a laparoscopy 3 years ago. Which of the following conditions is most likely to be associated with a laparoscopy for evaluation? a: Pelvic pain b: Abnormal Pap smear c: Abnormal bleeding d: Recurrent cystitis 8: A 32-year-old patient recovering from a gynecologic procedure complains of shoulder pain. The procedure she had was most likely a(n) a: LEEP b: cervical biopsy 10 | P a g ec: endometrial ablation d: dilation and curettage e: laparoscopy 9: What is the most appropriate initial imaging study in an asymptomatic patient with 18-week-size fibroids? a: Positron emission tomography (PET) b: computed tomography (CT) c: Transabdominal ultrasonography d: Sonohysterography e: Magnetic resonance imaging (MRI) 10: A 20-year-old patient at 6 weeks of gestation is suspected of having an ovarian neoplasm. The most appropriate initial imaging technique is a: Computed tomography (CT) b: Positron emission tomography (PET) c: transvaginal ultrasonography d: transabdominal ultrasonography e: Magnetic resonance imaging (MRI) 11: A healthy, asymptomatic, nulliparous 36-year-old woman requests your advice because she has been unsuccessful at achieving pregnancy over the last 13 months, despite regular menses. Performing an initial physical examination, you detect a firm, non-tender, multinodular uterus whose size corresponds to that at approximately 8 to 10 weeks of pregnancy, which is consistent with leiomyomata uteri. The remainder of the medical history and physical examination is within normal limits, as is her husband's semen analysis. Normal ovulatory status has been documented by basal body temperature monitoring and luteal-phase progesterone measurement. Your next best step is to recommend a: normal pelvic ultrasonography b: hysterosalpingogram (HSG) c: in vitro fertilization - embryo transfer (IVF-ET) d: 11 | P a g emyomectomy e: arterial embolization of the fibroids 12: A 36-year-old woman with regular, monthly, 5-day menstrual cycles presents with a 2-year history of severe right-sided pelvic pain. Pelvic examination reveals no abnormalities. She reports insomnia, loss of appetite, and decreased libido. The patient once considered evaluation for infertility but now does not desire childbearing. She has had three laparoscopic procedures in the last 18 months that showed minmal peritoneal adhesions, with no change in the pain. Appropriate management of this includes a: repeat diagnostic laparoscopy b: barium enema, intravenous pyelography, and plevic ultrasonography c: presacral neurectomy d: transabdominal hysterectomy and bilateral salpingo-oophorectomy e: psychological counseling with antidepressant therapy 13: A 63-year-old woman with 6 months of early satiety and increased abdominal girth has an abdominal fluid wave and a palpable 12 cm nodular right adnexal mass. The next BEST step would be for her to obtain a: a diagnostic laparoscopy b: a staging laparotomy and debulking for her presumed ovarian cancer c: a CT scan to get the exact dimensions of the mass d: chemotherapy e: an ultrasonography to determine if the mass is cystic or solid 14: A 42-year-old woman, G2P2, who had a laparoscopic tubal fulguration 7 years ago, has abnormal uterine bleeding. Her menstrual cycle has been 28-30 days with a menstrual flow of 5-6 days. During the last 6 months, the interval has varied from 14 to 35 days and the menstrual flow has lasted from 1 to 14 days. The uterus is irregular and firm and consistent in size with an 8-week gestation. Both ovaries are palpably normal in size. Urine pregnancy test is negative. The most appropriate next step in management is a: endometrial sampling b: laparoscopy 12 | P a g ec: transabdominal ultrasonography d: pelvic CT e: hysteroscopy 15: A 19-year-old primigravid woman is seen because of vaginal bleeding. Her LMP was about 11 weeks ago; the vagina contains a small amount of dark blood and the cervix is long and closed. The uterus is enlarged and not tender. A pelvic ultrasonography demonstrates an intrauterine gestational sac but no fetal pole is identified. The patient is distraught but declines surgical management. Of the following, the most appropriate management of this patient's condition is a: combination oral contraceptive pills b: methotrexate intramuscular injection c: depot medroxyprogesterone acetate d: oral broad-spectrum antibiotic thearpy e: mifepristone pills and vaginal misoprostol ANS: [cddbc eaecc beaae] Chapter 4 Assessing Adolescent Women’s Health Renee Sieving, Sarah Stoddard, Deborah A. Raines 1. The teen birthrate is highest among which major racial or ethnic group? A. Latinos B. African Americans C. Whites D. Asians Answer: A 2. What percentage of the U.S. population was 10 to 19 years old in 2014? A. 14% B. 19% C. 24% D. 29% 13 | P a g eAnswer: A 3. Which of the following are examples of protective factors for adolescents? (Select all that apply.) A. Bonds with friends and family B. Physical inactivity C. A school’s high expectations of students D. Risky sexual behaviors E. Opportunities for youth participation in the community Answer: A, C, E 4. Rachel is a talkative, open 13-year-old who is in for a physical exam today by herself. In talking with Rachel, the nurse should recognize which of the following as characteristics typical of this stage of development? (Select all that apply.) A. Criticism of her parents B. Acceptance of the physical changes ofpuberty C. Mood swings D. Sexual feelings emerging E. Transition to adulthood Answer: A, C, D 5. Lydia is a teenager who is in the process of researching college programs. She thinks she would like to be a lawyer. She is also searching for a summer job to save up to buy a car. Which stage of development is Lydia most likely in? A. Preadolescence B. Early adolescence C. Middle adolescence D. Late adolescence 14 | P a g eAnswer: D 6. Yancy is a 14-year-old with Down syndrome. She, like many teens with disabilities, is at an increased risk of having which chronic condition? A. Epilepsy B. Obesity C. Heart disease D. Arthritis Answer: B 7. Brooke is a 17-year-old who is questioning both her sexual orientation and her gender. She says she has begun exploring these but that her parents do not know. Brooke is at an increased risk of experiencing which of the following? (Select all that apply.) A. Obesity B. Family violence C. Homelessness D. Substance abuse E. Suicidality Answer: B, C, D, E 8. Rose is a 14-year-old refugee from Nigeria who recently came to the United States. Being a foreign born, which of the following is Rose more likely to do than her native-born classmates? A. Exercise B. Succeed academically C. Eat meals with her family D. Develop positive peer relationships Answer: C 15 | P a g e9. Destiny is an outgoing, fun-loving 13-year-old who has developed a strong network of friends at school. These positive relationships make it more likely that Destiny will experience which of the following? (Select all that apply.) A. Academic achievement B. A healthy diet C. Reduced substance abuse D. Improved mental health E. Lack of peer conflict Answer: A, C, D 10. During an office visit, Jordan, a 16-year-old patient, asks her nurse if she can share something in confidence. The nurse affirms, but adds that there were a few disclosures that would legally require breaking confidentiality. Which of the following are issues the nurse would be obligated to report? (Select all that apply.) A. Sexual activity B. Intent to self-harm C. Evidence of abuse D. Gender questioning E. Religious doubts Answer: B, C 11. What percentage of adolescents were covered by health insurance in 2013? A. 48% B. 63% C. 78% D. 93% 16 | P a g eAnswer: D 12. A nurse is having trouble communicating with her teenaged client, Enid, who is disengaged and sullen. What approach would most likely be effective in helping the nurse engage with Enid? A. Giving some concrete goals to Enid for her to pursue B. Asking Enid’s mother to join them C. Using motivational interviewing with Enid D. Reminding Enid of the consequences ofnoncompliance Answer: C 13. Nadia is a 13-year-old who is in for her first reproductive health visit. She reports having no special concerns and appears healthy. Which of the following is most important for the nurse to do in this visit? A. A Pap exam B. An internal pelvic exam C. An assessment of menstrual issues D. Amammogram Answer: C 14. In a 2013 survey of the Youth Risk Behavior Surveillance System, what percentage ofhigh school females reported drinking more than five drinks in a row on at least 1 day in the 30 days before the survey? A. 16.1% B. 21.1% C. 26.1% D. 31.1% Answer: B 15. A nurse needs to assess an adolescent client’s level of sexual development. Which diagnostic tool should 17 | P a g ethe nurse use? A. Tanner staging B. CRAFFT screening C. Motivational interviewing D. Mini-Cog assessment Answer: A Chapter 5 Assessing Adult Women’s Health Diane Marie Schadewald, Catherine Juve, Ellis Quinn Youngkin, Marcia Szmania Davis 1. Midlife is commonly defined by which of the following ways? (Select all that apply.) A. Age B. Proximity to menopause C. Degree of children’s independence D. Level of cognitive function E. Women’s self-perception ofage Answer: A, B, C, E 2. Vivian is an 80-year-old patient who is reminiscing about her own midlife with her nurse, who has just entered midlife. Given her age, Vivian is most likely to identify which of the following as having been a primary source of meaning during her midlife? A. Her career B. Her family C. Her friends D. Her artistic accomplishments Answer: B 3. Which of the following is the definition of menopause currently used in the health sciences? 18 | P a g eA. The date of onset of menopause-related symptoms B. The cessation of menses, defined as the end of the final menstrual period C. The cessation ofmenses, defined as 1 year after the final menstrual period D. The date of the last menopause-related symptom Answer: C 4. Women of which U.S. ethnic group are most likely to describe menopause as “something you have to go through” and to view it as a time to reorient and restructure their lives? A. African Americans B. Japanese Americans C. European Americans D. Urban Latinas Answer: D 5. Which of the following endocrine changes are typical during the last 2 years before the final menstrual period? (Select all that apply.) A. Increased testosterone levels B. Decreased antral follicle count C. Increased follicle-stimulating hormone levels D. Decreased progesterone levels E. Increased estradiol levels Answer: B, C, D 6. Sleep disruption, a common symptom during the menopausal transition, is most often associated with which other perimenopausal symptom? A. Hot flashes B. Decline in memory 19 | P a g eC. Back pain D. Depressedmood Answer: A 7. Which of the following are common symptoms during the menopausal transition? (Select all that apply.) A. Difficulty concentrating B. Urinary incontinence C. Vaginal dryness D. Increased sexual desire E. Nausea and vomiting Answer: A, B, C 8. Which of the following statements is most accurate concerning symptoms of the menopausal transition? A. Almost all women experience the same set of symptoms, known as menopausal syndrome. B. Almost all women experience hot flashes, but other symptoms are too variable to predict. C. Symptoms experienced appear to vary from culture to culture, and thus may be culture bound. D. Symptoms are completely random, demonstrating no predictable patterns. Answer: C 9. Which of the following accurately describes metabolic changes in bone, muscle, and fat that typically occur in the menopausal transition? A. Increases in bone, muscle, and fat mass B. Decreases in bone, muscle, and fat mass C. Increases in muscle and fat mass but a decrease in bone mass D. Decreases in bone and muscle mass but an increase in fat mass Answer: D 10. Which of the following are characteristics of metabolic syndrome? (Select all that apply.) A. Increased lipid levels 20 | P a g eB. Insulin resistance C. Decreased inflammatory response D. Increased risk of thrombosis E. Increased blood pressure Answer: A, B, D, E 11. The nurse is reviewing assessment and lab results of a patient at risk for metabolic syndrome. Which of the following findings are consistent with metabolic syndrome? (Select all that apply.) A. Waist circumference of 37 inches B. Body mass index (BMI) of 23 C. Blood pressure of 138/86 mmHg D. Fasting blood glucose level of 99 mg/dL E. Triglycerides level of 161mg/dL Answer: A, C, E 12. Patricia is a 50-year-old woman with a body mass index (BMI) of 31 and elevated lipid levels. Which of the following changes would you recommend to promote Patricia’s health? A. Exercise 60 to 90 minutes per day at moderate intensity, most days B. Limit alcohol intake to no more than two drinks per day C. Take omega-3 fatty acid supplements D. No smoking or use of tobacco E. Reduce waist circumference to less than 40 inches Answer: A, C, D 13. Lorraine is a 46-year-old woman who has a body mass index (BMI) of 21 and who is generally healthy. Based on current recommendations by the National Institutes of Health (NIH), what exercise program would you suggest to Lorraine to maintain her current level of fitness? 21 | P a g eA. None—she is already maintaining her fitness level B. 20 minutes of light-intensity exercise per day, 3 days per week C. 30 minutes of moderate-intensity exercise per day, 5 days per week D. 60 minutes of heavy-intensity exercise per day, 6 days per week Answer: C 14. Isadora is a 49-year-old woman with a body mass index (BMI) of 18 and a family history of osteoporosis. Which of the following health promotion recommendations specifically related to preventing osteoporosis should the nurse give to Isadora? (Select all that apply.) A. Take aspirin daily B. Include plenty of calcium in the diet C. Consume foods fortified with vitamin D D. Limit sodium intake E. Engage in weight-bearing exercise Answer: B, C, E 15. How much more likely are women to be diagnosed with depression in their lifetime than men? A. 60% B. 70% C. 80% D. 90% Answer: B Chapter 6 Assessing Older Women’s Health Debra Hain 1. How many people in the United States were 65 years or older in 2010? A. 3.1 million B. 20.5 million 22 | P a g eC. 40.3 million D. 83.7million Answer: C 2. What percentage of those 85 years and older in the United States in 2010 were women? A. 47% B. 57% C. 67%