Review Questions 579
Childbearing and Women’s Health Nursing
Review Questions with Answers 28
CHAPTER
and Rationales
QUESTIONS
Note: Thousands of additional practice questions are available
on the enclosed companion CD.
Nursing Care to Promote Childbearing 4. An effective mother does not experience ambivalence and
g
and Women’s Health anxiety about mothering.
5. Why is it important for a nurse to support the parents’ deci-
in
1. A woman arrives at the prenatal clinic stating that her preg- sion to abort a fetus with a birth defect even if the nurse is
nancy test is positive. She asks the nurse for information morally against abortion?
about an abortion. After verifying that the woman is at 8 1. Supporting them will eliminate feelings of guilt.
rs
weeks’ gestation, the nurse counsels her that having an abor- 2. The parents are legally responsible for the decision.
tion is controversial and that many women have long-term 3. It is essential for maintenance of the family equilibrium.
guilt feelings after an abortion. Legally, the: 4. The nurse’s support will relieve the pressure caused by
1. nurse’s statements need not be based on current clinical this decision.
research.
information. nu
2. client has a right to receive correct, unbiased
3. nurse has a right to state feelings as long as they are
6. During the postpartum period a client with heart disease
and type 2 diabetes asks a nurse, “Which contraceptives will
I be able to use to prevent pregnancy in the near future?”
How should the nurse respond?
l_
identified as the nurse’s own. 1. “You may use oral contraceptives because they are almost
4. health care provider should be notified because this is completely effective in preventing a pregnancy.”
beyond the scope of nursing practice. 2. “You should use foam with a condom to prevent preg-
2. One day the family planning clinic is very busy, and the nancy because this is the safest method for women with
ca
supervisor asks a nurse from the pediatric clinic who is your illnesses.”
strongly opposed to any chemical or mechanical method of 3. “You will find that the intrauterine device is best for
birth control to work in the family planning clinic. What is you because it prevents a fertilized ovum from implant-
the most professional response that this nurse could give to ing in the uterus.”
i
the supervisor? 4. “You do not need to worry about becoming pregnant
in
1. “I will go, but it is against my beliefs.” in the near future because women with your illnesses
2. “I won’t do it because I do not believe in birth control.” usually become infertile.”
3. “I would prefer another assignment that is not contrary 7. A nurse is teaching a group of women about the side effects
to my beliefs.” of different types of contraceptives .What is the most fre-
cl
4. “I will have to reinforce that the rhythm method is the quent side effect associated with the use of an intrauterine
method of choice.” device (IUD)?
3. The result of an amniocentesis performed at 16 weeks’ gesta- 1. A tubal pregnancy
@
tion reveals a fetus with Down syndrome. The client elects 2. A rupture of the uterus
to have the pregnancy terminated. What should the nurse 3. An expulsion of the device
conclude about an abortion at this stage of the pregnancy? 4. An excessive menstrual flow
1. The client is exhibiting emotional instability. 8. A client asks a nurse about the most common problem
2. There is a high risk for a postoperative infection. associated with the use of an intrauterine device (IUD).
3. Contraceptive counseling should be deferred to a later What should the nurse respond?
time. 1. Perforation of the uterus
4. An opportunity to express feelings about her decision 2. Spontaneous device expulsion
should be provided. 3. Discomfort associated with coitus
4. Which research-based knowledge guides a nurse regarding 4. Development of vaginal infections
the emotional factors of pregnancy? 9. A client seeking advice about contraception asks a nurse
1. A rejected pregnancy will result in a rejected infant. about how an intrauterine device (IUD) prevents pregnancy.
2. Ambivalence and anxiety about mothering are common. How should the nurse respond?
3. A mother’s love usually develops within the first week 1. “It covers the entrance to the cervical os.”
after birth. 2. “The openings to the fallopian tubes are blocked.”
u Denotes alternate format question. 579
,580 CHAPTER 28 Childbearing and Women’s Health Nursing
3. “The sperm are prevented from reaching the vagina.” 17. A biphasic antiovulatory medication of combined progestin
4. “It produces a spermicidal intrauterine environment.” and estrogen is prescribed for a female client. What should
10. A nurse teaches women in the fertility clinic that after ovula- a nurse include when teaching about this oral
tion has occurred, the ovum is thought to remain viable for: contraceptive?
1. 1 to 6 hours. 1. Report irregular vaginal bleeding.
2. 12 to 18 hours. 2. Restrict sexual activity temporarily.
3. 24 to 36 hours. 3. Have regular bimonthly Pap smears.
4. 48 to 72 hours. 4. Increase the dietary intake of calcium.
11. A nurse is teaching clients to determine the time of 18. A nurse is giving discharge instructions to a client who had
ovulation by taking the basal temperature. What change an aspiration abortion by suction curettage. What should
is expected to occur in the basal temperature during the client be told?
ovulation? 1. Avoid showering for 2 days.
1. Slight drop and then rises 2. Tampons may be used after 1 day.
2. Sudden rise and then drops 3. Sexual intercourse should be delayed for 3 weeks.
g
3. Marked rise and remains high 4. Report bleeding that requires a pad change every 2 hours.
4. Marked drop and remains lower 19. A client at 10 weeks’ gestation elects to have an induced
in
12. Oral contraceptives are prescribed for a client. What side abortion. After receiving oral mifepristone (Mifeprex), she
effect should the nurse inform the client might occur? returns to the clinic 2 days later to have misoprostol (Cytotec)
1. Cervicitis inserted vaginally. For when should the nurse schedule a
rs
2. Ovarian cysts follow-up visit?
3. Breakthrough bleeding 1. 4 hours after the procedure
4. Fibrocystic breast disease 2. 2 weeks after the procedure
13. What is important for a nurse to discuss with a client who 3. 4 to 8 days after the procedure
just had a vasectomy?
1. Recanalization of the vas deferens is impossible.
2. Unprotected coitus is safe within 1 week to 10 days.
3. Some impotency is to be expected for several weeks.
nu 4. 8 to 24 hours after the procedure
20. A couple indicate that they do not want any more children.
The woman is scheduled for a laparoscopic bilateral tubal
ligation. What should the nurse include in preoperative
l_
4. There must be 15 ejaculations to clear the tract of sperm. teaching?
14. The school nurse is discussing issues concerning premarital 1. “Menstruation will stop after the surgery.”
sex with a group of adolescents taking a health education 2. “Birth control will be needed until your follow-up visit.”
course. The students are asked to write an essay on what they 3. “You will be admitted as an outpatient for same-day
ca
have learned about preventing pregnancy. Which comment surgery.”
alerts the nurse to have a private discussion with the student? 4. “You can have the operation reversed if you decide to
1. “I can’t get pregnant if I have sex during my period.” have more children.”
2. “The pill may prevent me from getting pregnant, but I 21. One of the responsibilities of a nurse in a fertility specialist’s
i
can still get an STI.” office is to provide health teaching to the client in relation
in
3. “I won’t get pregnant if I swim in a pool where a boy to timing of intercourse. Which instruction addresses the
has just masturbated.” best time to achieve a pregnancy?
4. “A condom will not always protect me from getting 1. Midway between periods
pregnant, but it can protect me from getting an STI.” 2. Immediately after menses end
cl
15. Contraceptives that have estrogen-like and/or progesterone- 3. 14 days before the next period is expected
u like compounds are prepared in a variety of forms. Which 4. 14 days after the beginning of the last period
contraceptives should a nurse identify as having a hormonal 22. A nurse teaches a client that a postcoital test to evaluate
@
component? Select all that apply. fertility should be performed:
1. Oral agents 1. 1 week after ovulation.
2. Diaphragms 2. immediately after menses.
3. Cervical caps 3. just before the next menstrual period.
4. Female condoms 4. within 1 to 2 days of presumed ovulation.
5. Foam spermicides 23. A histogram (hysterosalpingography [HSG]) is performed
6. Transdermal agents to determine whether there is a tubal obstruction. The nurse
16. A nurse explains that the efficiency of the basal body concludes that infertility caused by a defect in the tube is
temperature method of contraception depends on fluctua- most often related to a:
tion of the basal body temperature. What factor will alter 1. tubal injury.
its effectiveness? 2. past infection.
1. Presence of stress 3. fibroid tumor.
2. Length of abstinence 4. congenital anomaly.
3. Age of those involved 24. A nurse is counseling a couple in the fertility clinic. Which
4. Frequency of intercourse aspect of the protocol is the most stressful for the couple?
, Review Questions 581
1. Planning when to have intercourse 1. Estrogen (Premarin)
2. Obtaining the necessary specimens 2. Leuprolide (Lupron)
3. Visiting the fertility clinic frequently 3. Diclofenac (Voltaren)
4. Taking daily basal body temperatures 4. Ergonovine (Ergotrate)
25. Genetic testing is being discussed with a couple at the fer 31. At 6 weeks’ gestation a client is diagnosed with gonorrhea.
tility clinic. What is the nurse’s best response when they What medication does a nurse expect the health care pro-
express concerns? vider to prescribe?
1. “You should be tested because it will be to your benefit.” 1. Ceftriaxone (Rocephin)
2. “Environmental factors can have an impact on genetic 2. Levofloxacin (Levaquin)
factors.” 3. Sulfasalazine (Azulfidine)
3. “This type of testing will determine if you’ll need in vitro 4. Trimethoprim/sulfamethoxazole (Bactrim)
fertilization.” 32. A 15-year-old adolescent tells a school nurse, “I have persis-
4. “If you have a gene for a disease there is a probability tent pain during my periods.” What should the nurse
that your children will inherit it.” encourage her to do?
g
26. A client is admitted with a diagnosis of torsion of the testes. 1. Continue daily activities.
How should the nurse respond when the client asks, “Why 2. Have a gynecologic examination.
in
must I have surgery immediately?”? 3. Eat a nutritious diet containing iron.
1. “There is no other way to control the pain.” 4. Practice relaxation of abdominal muscles.
2. “Irreversible damage occurs after a few hours.” 33. A client at the women’s health clinic tells the nurse she has
rs
3. “Swelling is excessive, which may cause the testicle to u endometriosis. What factors associated with endometriosis
rupture.” does the nurse anticipate the client will report? Select all
4. “There is a reduction in testicular blood flow, which leads that apply.
to rapid death of sperm.” 1. Insomnia
27.
nu
A nurse at the fertility clinic is counseling a couple about
the tests that will be needed to determine the cause of their
infertility. Which test should the nurse describe that will
evaluate the woman’s organs of reproduction?
2. Ecchymoses
3. Rectal pressure
4. Abdominal pain
5. Skipped periods
l_
1. Biopsy 6. Pelvic infections
2. Cystogram 34. What does a nurse expect to be the priority concern of a
3. Culdoscopy 28-year-old woman who is to undergo a laparoscopic bilat-
4. Hysterosalpingogram eral salpingo-oophorectomy?
ca
28. While preparing a client for her first routine Papanicolaou 1. Acute pain
(Pap) smear, a nurse determines that she appears anxious. 2. Risk for hemorrhage
What should the nurse include as part of the teaching plan? 3. Fear of chronic illness
1. Current statistics on the incidence of cervical cancer 4. Loss of childbearing potential
i
2. Description of the early symptoms of cervical cancer 35. A nurse is assessing a client who is being admitted for surgi-
in
3. Explanation of why there is a small risk for cervical u cal repair of a rectocele. What signs or symptoms does the
cancer nurse expect the client to report? Select all that apply.
4. Written instructions about the purpose of the Papanico- 1. Painful intercourse
laou smear 2. Crampy abdominal pain
cl
29. A client who menstruates regularly every 30 days asks a 3. Bearing-down sensations
nurse on what day she is most likely to ovulate. Her last 4. Urinary stress incontinence
menses started on January 1st. On what day in January 5. Recurrent urinary tract infections
@
should the nurse respond? 36. When taking the health history of a client who is admitted
1. 7th for repair of a cystocele and rectocele, the nurse should
2. 16th expect the client to report the occurrence of:
3. 24th 1. white vaginal discharge and itching.
4. 29th 2. sporadic bleeding and abdominal pain.
3. elevated temperature and intractable diarrhea.
4. stress incontinence and low abdominal pressure.
Nursing Care Related to Major Disorders 37. A client has an anterior and posterior surgical repair of a
Affecting Women’s Health u cystocele and rectocele and returns from the postanesthesia
care unit (PACU) with an indwelling catheter in place.
30. A client who has a diagnosis of endometriosis is concerned What should the nurse tell the client about the primary
about the side effect of hot flashes from her prescribed reasons for the catheter? Select all that apply.
medication. She tells the nurse that her mother found them 1. Discomfort is minimized.
very uncomfortable during her menopause. Which medica- 2. Bladder tone is maintained.
tion causes this side effect? 3. Urinary retention is prevented.
, 582 CHAPTER 28 Childbearing and Women’s Health Nursing
4. Pressure on the suture line is relieved. 46. A nurse in the women’s health clinic is obtaining a client’s
5. Hourly urine outputs can be easily measured health history. What question will elicit information about
38. A client past menopause undergoes an anterior-posterior the client’s risk for exposure to diethylstilbestrol (DES)?
colporrhaphy. What should the discharge teaching include? 1. “Were you born before 1971?”
1. Eating a high-fiber diet 2. “Have you ever taken oral contraceptives?”
2. Limiting daily activities 3. “Have you noticed any lesions in your perineal area?”
3. Reporting signs of urinary retention 4. “Did your mother take hormones during her
4. Observing for signs of a rectovaginal fistula pregnancy?”
39. What potential complication does a nurse anticipate when 47. A 35-year-old client is scheduled for a conization of the
admitting a client with the diagnosis of severe procidentia cervix to remove dysplastic cervical cells and to determine
(prolapse of the uterus)? the extent of involvement. What behavior indicates to a
1. Edema nurse that the client understands the postoperative
2. Fistulas instructions?
3. Exudate 1. States she will not resume sexual intercourse for 48 hours
g
4. Ulcerations 2. Verbalizes expectations of a vaginal discharge for 3 to 5
40. A client with a third-degree uterine prolapse is scheduled for days
in
a vaginoplasty. What should the nurse anticipate the surgeon 3. Demonstrates the ability to change sterile surgical
will order? dressings
1. Encourage ambulation. 4. Affirms that because she has children she does not mind
rs
2. Elevate the foot of the bed. being sterile
3. Apply moist compresses to the uterus. 48. A client with cancer of the cervix has an intracavity radio
4. Support the prolapsed uterus with a sanitary pad. active sealed implant in place. What precaution should
41. What resting position should a nurse encourage for a client the nurse take to protect against excessive exposure to
with pelvic inflammatory disease (PID)?
1. Sims
2. Fowler
3. Supine with knees flexed
nu radiation?
1. Dispose of body fluids in special marked containers.
2. Cohort two clients who have implanted radiation therapy.
3. Exit the room walking backward while wearing a lead
l_
4. Lithotomy with head elevated apron.
42. A nurse explains to a client with cervical erosion that early 4. Limit visitors to individuals who are 13 years of age
treatment of the erosion can help prevent: and older.
1. cancer of the cervix. 49. A client who is scheduled to have an abdominal panhyster-
ca
2. pelvic inflammatory disease. ectomy asks how the surgery will affect her periods. How
3. unexpected vaginal bleeding. should the nurse respond?
4. more erosions from occurring. 1. “You will not have any more periods.”
43. A client asks a nurse why she developed cervical polyps. 2. “Your periods will become more regular.”
i
How should the nurse respond? 3. “Your periods will become lighter until they disappear.”
in
1. “They are often malignant and must be removed.” 4. “You will notice that the time between periods will be
2. “Cervical polyps usually are precursors of uterine longer.”
cancer.” 50. A client is diagnosed with uterine fibroids, and the health
3. “They are usually benign and a biopsy rules out a care provider advises a hysterectomy. The client expresses
cl
malignancy.” concern about having a hysterectomy at age 45 because she
4. “Cervical polyps do not cause bleeding unless they has heard from friends that she will undergo severe symp-
are malignant.” toms of menopause after surgery. What is the nurse’s most
@
44. A nurse in the women’s health clinic is counseling clients appropriate response?
about the signs of gynecological problems. What early mani- 1. “You are correct, but there are medicines you can take
festation of cervical cancer should prompt a client to seek that will ease the symptoms.”
professional care? 2. “This sometimes occurs in women of your age, but you
1. Abdominal heaviness needn’t worry about it at this time.”
2. Pressure on the bladder 3. “Perhaps you should talk to your surgeon because I am
3. Foul-smelling discharge not allowed to discuss this with you.”
4. Bloody spotting after intercourse 4. “Some women may experience symptoms of menopause
45. After a client has a biopsy for suspected cervical cancer, the if their ovaries are removed with their uterus.”
laboratory report reveals a stage 0 lesion. What does a nurse 51. After a hysterosalpingo-oophorectomy, a client wants to
conclude about this client’s stage of cancer? know whether it would be wise for her to take hormones
1. The lesion is carcinoma in situ. right away to prevent symptoms of menopause. What is the
2. There is early stromal invasion. nurse’s most appropriate response?
3. There is parametrial involvement. 1. “It is best to wait because you may not have any
4. The cancer is confined to the cervix. symptoms.”
Childbearing and Women’s Health Nursing
Review Questions with Answers 28
CHAPTER
and Rationales
QUESTIONS
Note: Thousands of additional practice questions are available
on the enclosed companion CD.
Nursing Care to Promote Childbearing 4. An effective mother does not experience ambivalence and
g
and Women’s Health anxiety about mothering.
5. Why is it important for a nurse to support the parents’ deci-
in
1. A woman arrives at the prenatal clinic stating that her preg- sion to abort a fetus with a birth defect even if the nurse is
nancy test is positive. She asks the nurse for information morally against abortion?
about an abortion. After verifying that the woman is at 8 1. Supporting them will eliminate feelings of guilt.
rs
weeks’ gestation, the nurse counsels her that having an abor- 2. The parents are legally responsible for the decision.
tion is controversial and that many women have long-term 3. It is essential for maintenance of the family equilibrium.
guilt feelings after an abortion. Legally, the: 4. The nurse’s support will relieve the pressure caused by
1. nurse’s statements need not be based on current clinical this decision.
research.
information. nu
2. client has a right to receive correct, unbiased
3. nurse has a right to state feelings as long as they are
6. During the postpartum period a client with heart disease
and type 2 diabetes asks a nurse, “Which contraceptives will
I be able to use to prevent pregnancy in the near future?”
How should the nurse respond?
l_
identified as the nurse’s own. 1. “You may use oral contraceptives because they are almost
4. health care provider should be notified because this is completely effective in preventing a pregnancy.”
beyond the scope of nursing practice. 2. “You should use foam with a condom to prevent preg-
2. One day the family planning clinic is very busy, and the nancy because this is the safest method for women with
ca
supervisor asks a nurse from the pediatric clinic who is your illnesses.”
strongly opposed to any chemical or mechanical method of 3. “You will find that the intrauterine device is best for
birth control to work in the family planning clinic. What is you because it prevents a fertilized ovum from implant-
the most professional response that this nurse could give to ing in the uterus.”
i
the supervisor? 4. “You do not need to worry about becoming pregnant
in
1. “I will go, but it is against my beliefs.” in the near future because women with your illnesses
2. “I won’t do it because I do not believe in birth control.” usually become infertile.”
3. “I would prefer another assignment that is not contrary 7. A nurse is teaching a group of women about the side effects
to my beliefs.” of different types of contraceptives .What is the most fre-
cl
4. “I will have to reinforce that the rhythm method is the quent side effect associated with the use of an intrauterine
method of choice.” device (IUD)?
3. The result of an amniocentesis performed at 16 weeks’ gesta- 1. A tubal pregnancy
@
tion reveals a fetus with Down syndrome. The client elects 2. A rupture of the uterus
to have the pregnancy terminated. What should the nurse 3. An expulsion of the device
conclude about an abortion at this stage of the pregnancy? 4. An excessive menstrual flow
1. The client is exhibiting emotional instability. 8. A client asks a nurse about the most common problem
2. There is a high risk for a postoperative infection. associated with the use of an intrauterine device (IUD).
3. Contraceptive counseling should be deferred to a later What should the nurse respond?
time. 1. Perforation of the uterus
4. An opportunity to express feelings about her decision 2. Spontaneous device expulsion
should be provided. 3. Discomfort associated with coitus
4. Which research-based knowledge guides a nurse regarding 4. Development of vaginal infections
the emotional factors of pregnancy? 9. A client seeking advice about contraception asks a nurse
1. A rejected pregnancy will result in a rejected infant. about how an intrauterine device (IUD) prevents pregnancy.
2. Ambivalence and anxiety about mothering are common. How should the nurse respond?
3. A mother’s love usually develops within the first week 1. “It covers the entrance to the cervical os.”
after birth. 2. “The openings to the fallopian tubes are blocked.”
u Denotes alternate format question. 579
,580 CHAPTER 28 Childbearing and Women’s Health Nursing
3. “The sperm are prevented from reaching the vagina.” 17. A biphasic antiovulatory medication of combined progestin
4. “It produces a spermicidal intrauterine environment.” and estrogen is prescribed for a female client. What should
10. A nurse teaches women in the fertility clinic that after ovula- a nurse include when teaching about this oral
tion has occurred, the ovum is thought to remain viable for: contraceptive?
1. 1 to 6 hours. 1. Report irregular vaginal bleeding.
2. 12 to 18 hours. 2. Restrict sexual activity temporarily.
3. 24 to 36 hours. 3. Have regular bimonthly Pap smears.
4. 48 to 72 hours. 4. Increase the dietary intake of calcium.
11. A nurse is teaching clients to determine the time of 18. A nurse is giving discharge instructions to a client who had
ovulation by taking the basal temperature. What change an aspiration abortion by suction curettage. What should
is expected to occur in the basal temperature during the client be told?
ovulation? 1. Avoid showering for 2 days.
1. Slight drop and then rises 2. Tampons may be used after 1 day.
2. Sudden rise and then drops 3. Sexual intercourse should be delayed for 3 weeks.
g
3. Marked rise and remains high 4. Report bleeding that requires a pad change every 2 hours.
4. Marked drop and remains lower 19. A client at 10 weeks’ gestation elects to have an induced
in
12. Oral contraceptives are prescribed for a client. What side abortion. After receiving oral mifepristone (Mifeprex), she
effect should the nurse inform the client might occur? returns to the clinic 2 days later to have misoprostol (Cytotec)
1. Cervicitis inserted vaginally. For when should the nurse schedule a
rs
2. Ovarian cysts follow-up visit?
3. Breakthrough bleeding 1. 4 hours after the procedure
4. Fibrocystic breast disease 2. 2 weeks after the procedure
13. What is important for a nurse to discuss with a client who 3. 4 to 8 days after the procedure
just had a vasectomy?
1. Recanalization of the vas deferens is impossible.
2. Unprotected coitus is safe within 1 week to 10 days.
3. Some impotency is to be expected for several weeks.
nu 4. 8 to 24 hours after the procedure
20. A couple indicate that they do not want any more children.
The woman is scheduled for a laparoscopic bilateral tubal
ligation. What should the nurse include in preoperative
l_
4. There must be 15 ejaculations to clear the tract of sperm. teaching?
14. The school nurse is discussing issues concerning premarital 1. “Menstruation will stop after the surgery.”
sex with a group of adolescents taking a health education 2. “Birth control will be needed until your follow-up visit.”
course. The students are asked to write an essay on what they 3. “You will be admitted as an outpatient for same-day
ca
have learned about preventing pregnancy. Which comment surgery.”
alerts the nurse to have a private discussion with the student? 4. “You can have the operation reversed if you decide to
1. “I can’t get pregnant if I have sex during my period.” have more children.”
2. “The pill may prevent me from getting pregnant, but I 21. One of the responsibilities of a nurse in a fertility specialist’s
i
can still get an STI.” office is to provide health teaching to the client in relation
in
3. “I won’t get pregnant if I swim in a pool where a boy to timing of intercourse. Which instruction addresses the
has just masturbated.” best time to achieve a pregnancy?
4. “A condom will not always protect me from getting 1. Midway between periods
pregnant, but it can protect me from getting an STI.” 2. Immediately after menses end
cl
15. Contraceptives that have estrogen-like and/or progesterone- 3. 14 days before the next period is expected
u like compounds are prepared in a variety of forms. Which 4. 14 days after the beginning of the last period
contraceptives should a nurse identify as having a hormonal 22. A nurse teaches a client that a postcoital test to evaluate
@
component? Select all that apply. fertility should be performed:
1. Oral agents 1. 1 week after ovulation.
2. Diaphragms 2. immediately after menses.
3. Cervical caps 3. just before the next menstrual period.
4. Female condoms 4. within 1 to 2 days of presumed ovulation.
5. Foam spermicides 23. A histogram (hysterosalpingography [HSG]) is performed
6. Transdermal agents to determine whether there is a tubal obstruction. The nurse
16. A nurse explains that the efficiency of the basal body concludes that infertility caused by a defect in the tube is
temperature method of contraception depends on fluctua- most often related to a:
tion of the basal body temperature. What factor will alter 1. tubal injury.
its effectiveness? 2. past infection.
1. Presence of stress 3. fibroid tumor.
2. Length of abstinence 4. congenital anomaly.
3. Age of those involved 24. A nurse is counseling a couple in the fertility clinic. Which
4. Frequency of intercourse aspect of the protocol is the most stressful for the couple?
, Review Questions 581
1. Planning when to have intercourse 1. Estrogen (Premarin)
2. Obtaining the necessary specimens 2. Leuprolide (Lupron)
3. Visiting the fertility clinic frequently 3. Diclofenac (Voltaren)
4. Taking daily basal body temperatures 4. Ergonovine (Ergotrate)
25. Genetic testing is being discussed with a couple at the fer 31. At 6 weeks’ gestation a client is diagnosed with gonorrhea.
tility clinic. What is the nurse’s best response when they What medication does a nurse expect the health care pro-
express concerns? vider to prescribe?
1. “You should be tested because it will be to your benefit.” 1. Ceftriaxone (Rocephin)
2. “Environmental factors can have an impact on genetic 2. Levofloxacin (Levaquin)
factors.” 3. Sulfasalazine (Azulfidine)
3. “This type of testing will determine if you’ll need in vitro 4. Trimethoprim/sulfamethoxazole (Bactrim)
fertilization.” 32. A 15-year-old adolescent tells a school nurse, “I have persis-
4. “If you have a gene for a disease there is a probability tent pain during my periods.” What should the nurse
that your children will inherit it.” encourage her to do?
g
26. A client is admitted with a diagnosis of torsion of the testes. 1. Continue daily activities.
How should the nurse respond when the client asks, “Why 2. Have a gynecologic examination.
in
must I have surgery immediately?”? 3. Eat a nutritious diet containing iron.
1. “There is no other way to control the pain.” 4. Practice relaxation of abdominal muscles.
2. “Irreversible damage occurs after a few hours.” 33. A client at the women’s health clinic tells the nurse she has
rs
3. “Swelling is excessive, which may cause the testicle to u endometriosis. What factors associated with endometriosis
rupture.” does the nurse anticipate the client will report? Select all
4. “There is a reduction in testicular blood flow, which leads that apply.
to rapid death of sperm.” 1. Insomnia
27.
nu
A nurse at the fertility clinic is counseling a couple about
the tests that will be needed to determine the cause of their
infertility. Which test should the nurse describe that will
evaluate the woman’s organs of reproduction?
2. Ecchymoses
3. Rectal pressure
4. Abdominal pain
5. Skipped periods
l_
1. Biopsy 6. Pelvic infections
2. Cystogram 34. What does a nurse expect to be the priority concern of a
3. Culdoscopy 28-year-old woman who is to undergo a laparoscopic bilat-
4. Hysterosalpingogram eral salpingo-oophorectomy?
ca
28. While preparing a client for her first routine Papanicolaou 1. Acute pain
(Pap) smear, a nurse determines that she appears anxious. 2. Risk for hemorrhage
What should the nurse include as part of the teaching plan? 3. Fear of chronic illness
1. Current statistics on the incidence of cervical cancer 4. Loss of childbearing potential
i
2. Description of the early symptoms of cervical cancer 35. A nurse is assessing a client who is being admitted for surgi-
in
3. Explanation of why there is a small risk for cervical u cal repair of a rectocele. What signs or symptoms does the
cancer nurse expect the client to report? Select all that apply.
4. Written instructions about the purpose of the Papanico- 1. Painful intercourse
laou smear 2. Crampy abdominal pain
cl
29. A client who menstruates regularly every 30 days asks a 3. Bearing-down sensations
nurse on what day she is most likely to ovulate. Her last 4. Urinary stress incontinence
menses started on January 1st. On what day in January 5. Recurrent urinary tract infections
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should the nurse respond? 36. When taking the health history of a client who is admitted
1. 7th for repair of a cystocele and rectocele, the nurse should
2. 16th expect the client to report the occurrence of:
3. 24th 1. white vaginal discharge and itching.
4. 29th 2. sporadic bleeding and abdominal pain.
3. elevated temperature and intractable diarrhea.
4. stress incontinence and low abdominal pressure.
Nursing Care Related to Major Disorders 37. A client has an anterior and posterior surgical repair of a
Affecting Women’s Health u cystocele and rectocele and returns from the postanesthesia
care unit (PACU) with an indwelling catheter in place.
30. A client who has a diagnosis of endometriosis is concerned What should the nurse tell the client about the primary
about the side effect of hot flashes from her prescribed reasons for the catheter? Select all that apply.
medication. She tells the nurse that her mother found them 1. Discomfort is minimized.
very uncomfortable during her menopause. Which medica- 2. Bladder tone is maintained.
tion causes this side effect? 3. Urinary retention is prevented.
, 582 CHAPTER 28 Childbearing and Women’s Health Nursing
4. Pressure on the suture line is relieved. 46. A nurse in the women’s health clinic is obtaining a client’s
5. Hourly urine outputs can be easily measured health history. What question will elicit information about
38. A client past menopause undergoes an anterior-posterior the client’s risk for exposure to diethylstilbestrol (DES)?
colporrhaphy. What should the discharge teaching include? 1. “Were you born before 1971?”
1. Eating a high-fiber diet 2. “Have you ever taken oral contraceptives?”
2. Limiting daily activities 3. “Have you noticed any lesions in your perineal area?”
3. Reporting signs of urinary retention 4. “Did your mother take hormones during her
4. Observing for signs of a rectovaginal fistula pregnancy?”
39. What potential complication does a nurse anticipate when 47. A 35-year-old client is scheduled for a conization of the
admitting a client with the diagnosis of severe procidentia cervix to remove dysplastic cervical cells and to determine
(prolapse of the uterus)? the extent of involvement. What behavior indicates to a
1. Edema nurse that the client understands the postoperative
2. Fistulas instructions?
3. Exudate 1. States she will not resume sexual intercourse for 48 hours
g
4. Ulcerations 2. Verbalizes expectations of a vaginal discharge for 3 to 5
40. A client with a third-degree uterine prolapse is scheduled for days
in
a vaginoplasty. What should the nurse anticipate the surgeon 3. Demonstrates the ability to change sterile surgical
will order? dressings
1. Encourage ambulation. 4. Affirms that because she has children she does not mind
rs
2. Elevate the foot of the bed. being sterile
3. Apply moist compresses to the uterus. 48. A client with cancer of the cervix has an intracavity radio
4. Support the prolapsed uterus with a sanitary pad. active sealed implant in place. What precaution should
41. What resting position should a nurse encourage for a client the nurse take to protect against excessive exposure to
with pelvic inflammatory disease (PID)?
1. Sims
2. Fowler
3. Supine with knees flexed
nu radiation?
1. Dispose of body fluids in special marked containers.
2. Cohort two clients who have implanted radiation therapy.
3. Exit the room walking backward while wearing a lead
l_
4. Lithotomy with head elevated apron.
42. A nurse explains to a client with cervical erosion that early 4. Limit visitors to individuals who are 13 years of age
treatment of the erosion can help prevent: and older.
1. cancer of the cervix. 49. A client who is scheduled to have an abdominal panhyster-
ca
2. pelvic inflammatory disease. ectomy asks how the surgery will affect her periods. How
3. unexpected vaginal bleeding. should the nurse respond?
4. more erosions from occurring. 1. “You will not have any more periods.”
43. A client asks a nurse why she developed cervical polyps. 2. “Your periods will become more regular.”
i
How should the nurse respond? 3. “Your periods will become lighter until they disappear.”
in
1. “They are often malignant and must be removed.” 4. “You will notice that the time between periods will be
2. “Cervical polyps usually are precursors of uterine longer.”
cancer.” 50. A client is diagnosed with uterine fibroids, and the health
3. “They are usually benign and a biopsy rules out a care provider advises a hysterectomy. The client expresses
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malignancy.” concern about having a hysterectomy at age 45 because she
4. “Cervical polyps do not cause bleeding unless they has heard from friends that she will undergo severe symp-
are malignant.” toms of menopause after surgery. What is the nurse’s most
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44. A nurse in the women’s health clinic is counseling clients appropriate response?
about the signs of gynecological problems. What early mani- 1. “You are correct, but there are medicines you can take
festation of cervical cancer should prompt a client to seek that will ease the symptoms.”
professional care? 2. “This sometimes occurs in women of your age, but you
1. Abdominal heaviness needn’t worry about it at this time.”
2. Pressure on the bladder 3. “Perhaps you should talk to your surgeon because I am
3. Foul-smelling discharge not allowed to discuss this with you.”
4. Bloody spotting after intercourse 4. “Some women may experience symptoms of menopause
45. After a client has a biopsy for suspected cervical cancer, the if their ovaries are removed with their uterus.”
laboratory report reveals a stage 0 lesion. What does a nurse 51. After a hysterosalpingo-oophorectomy, a client wants to
conclude about this client’s stage of cancer? know whether it would be wise for her to take hormones
1. The lesion is carcinoma in situ. right away to prevent symptoms of menopause. What is the
2. There is early stromal invasion. nurse’s most appropriate response?
3. There is parametrial involvement. 1. “It is best to wait because you may not have any
4. The cancer is confined to the cervix. symptoms.”
