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WOMEN’S HEALTH NR 602 FINAL EXAM
A 25-year-old woman comes to the clinic complaining of increased vaginal
discharge, milky gray in color with a "fishy" odor that both she and her husband
have noticed. A wet smear is performed and the presence of "clue cells"
confirmed. Which type of infection does the nurse suspect?
1
Candidiasi
s2
Trichomoniasi
s3
Bacterial
vaginosis 4
Group B Streptococcus
-Bacterial vaginosis
Signs of bacterial vaginosis include a milky gray vaginal discharge that has a
characteristic fishy odor. "Clue cells" noted on wet smear are indicative of BV.
Candidiasis is a yeast infection caused by the organism Candida albicans. The
most common symptom of a yeast infection is vulvar and vaginal pruritus. Vaginal
discharge in a candidal infection is thick, white, and lumpy. A woman with a
trichomoniasis infection may present with a frothy yellowish-green vaginal
discharge. Vulvar irritation, pruritus, and dyspareunia are usually present. Group B
Streptococcus may be considered part of the normal vaginal flora in a woman who
is not pregnant, and no treatment is necessary.
A 20-year-old woman visiting the clinic says that she wishes to begin using depot
medroxyprogesterone acetate (Depo-Provera) as a form of birth control. What
important information should the nurse include when teaching the client about
Depo-Provera?
1
Depo-Provera offers protection against the herpes simplex virus.
2
To continue the contraceptive effects the client will need to return for another
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injection in 6 months.
3
Women using Depo-Provera may lose more blood each month with their periods,
so it is important to add iron-rich foods to the diet to help prevent anemia.
4
Calcium intake and exercise should be increased because of possible loss of bone
mineral density with increasing duration of use
-Calcium intake and exercise should be increased because of possible loss of bone
mineral density with increasing duration of use
Loss of bone mineral density is a significant side effect of Depo-Provera, and
increased calcium intake and exercise should be encouraged. Depo-Provera should
be administered every 11 to 13 weeks; 6 months is too long before thenext dose.
Menstrual periods usually lighten or disappear over time. Depo- Provera confers
no protection against herpes simplex virus.
A 24-year-old woman wants to use her basal body temperature (BBT) in natural
family planning but is unsure when to take her temperature. The nurse informs
her that an accurate BBT is best taken:
1
Each night right before bed
2
On the first day of her next menstrual cycle
3
Each morning prior to getting out of bed or increasing her activity
4
At bedtime beginning on day 14 of her menstrual cycle and continuing until her
next period
-Each morning prior to getting out of bed or increasing her activity
The most accurate BBT is taken before a woman gets out of bed and begins any
type of activity that could increase the body's temperature even slightly. BBT
should be charted daily on a calendar to permit interpretation of temperature
fluctuations. A BBT taken in the evening may be increased after a day of activity.
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Daily assessment and recording of BBT during the first half of the menstrual cycle
is also crucial, because a woman's BBT is lower then than during the second half
of her cycle. The BBT temperature may rise slightly with ovulation.
A 37-year-old woman is admitted to the unit with severe menorrhagia. During
assessment the nurse learns that she has a history of fibroids, menorrhagia, pelvic
pain, and depression. The client has been undergoing hormone therapy in hopes of
easing the symptoms and reducing the size of the fibroids, without success. Thelab
reports hemoglobin and hematocrit readings of 6.8 and 20.2, respectively. The
client begins to sob and cries, "I don't know what to do—the doctor is
recommending a hysterectomy, but I haven't had children yet!" What is the best
response by the nurse?
1
"There are so many orphans looking for a mother."
2
"This must be so difficult for you. Children are really important to you?"
3
"You really have no choice but to follow the recommendation; the doctor is right." 4
"Believe me when I tell you that kids are so difficult to raise—you're better off
without them."
-"This must be so difficult for you. Children are really important to you?"
Validating the client's feelings and including an open-ended question will
encourage further expression. Previous problems and health conditions could later
be included in the conversation to help the client make the best decision. Adoption
is certainly an option for this person, but this is not what she needs to hear at this
time. This statement also closes down communication. The client does have a
choice, and telling her that she does not could close down communication and
cause anger and defensiveness. Telling the client that she's better off without
children is not what the client needs to hear, especially when she is facing an
operation that could end her chance of giving birth to children.
A 23-year-old woman comes to the clinic for a Pap smear. After the examination, the
client confides that her mother died of endometrial cancer 1 year ago and
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
says that she is afraid that she will die of the same cancer. Which risk factor
stated by the client after an education session on risk factors indicates that
further teaching is needed?
1
Obesity
2
High-fat diet
3
Hypertension
4
Late-onset menarche
-Late-onset menarche
Early-onset, not late-onset, menarche is a risk factor for endometrial cancer. A
high-fat diet, hypertension, and obesity are all risk factors
A 32-year-old woman is admitted to the unit with a history of fibroids and
menorrhagia. Which findings does the nurse expect to encounter during assessment
of the client? Select all that apply.
1
Fluid
overload 2
Intermittent diarrhea
3
Pale mucous membranes
4
Difficulty emptying the bladder
5
High hemoglobin and hematocrit
-Pale mucous membranes, Difficulty emptying the bladder
Menorrhagia (heavy menstrual bleeding) can cause anemia (acute or chronic).
Because this client has a history of menorrhagia, the nurse can anticipate chronic
anemia. Urinary frequency, urgency, and incontinence are symptoms of fibroids,
WOMEN’S HEALTH NR 602 FINAL EXAM
A 25-year-old woman comes to the clinic complaining of increased vaginal
discharge, milky gray in color with a "fishy" odor that both she and her husband
have noticed. A wet smear is performed and the presence of "clue cells"
confirmed. Which type of infection does the nurse suspect?
1
Candidiasi
s2
Trichomoniasi
s3
Bacterial
vaginosis 4
Group B Streptococcus
-Bacterial vaginosis
Signs of bacterial vaginosis include a milky gray vaginal discharge that has a
characteristic fishy odor. "Clue cells" noted on wet smear are indicative of BV.
Candidiasis is a yeast infection caused by the organism Candida albicans. The
most common symptom of a yeast infection is vulvar and vaginal pruritus. Vaginal
discharge in a candidal infection is thick, white, and lumpy. A woman with a
trichomoniasis infection may present with a frothy yellowish-green vaginal
discharge. Vulvar irritation, pruritus, and dyspareunia are usually present. Group B
Streptococcus may be considered part of the normal vaginal flora in a woman who
is not pregnant, and no treatment is necessary.
A 20-year-old woman visiting the clinic says that she wishes to begin using depot
medroxyprogesterone acetate (Depo-Provera) as a form of birth control. What
important information should the nurse include when teaching the client about
Depo-Provera?
1
Depo-Provera offers protection against the herpes simplex virus.
2
To continue the contraceptive effects the client will need to return for another
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
injection in 6 months.
3
Women using Depo-Provera may lose more blood each month with their periods,
so it is important to add iron-rich foods to the diet to help prevent anemia.
4
Calcium intake and exercise should be increased because of possible loss of bone
mineral density with increasing duration of use
-Calcium intake and exercise should be increased because of possible loss of bone
mineral density with increasing duration of use
Loss of bone mineral density is a significant side effect of Depo-Provera, and
increased calcium intake and exercise should be encouraged. Depo-Provera should
be administered every 11 to 13 weeks; 6 months is too long before thenext dose.
Menstrual periods usually lighten or disappear over time. Depo- Provera confers
no protection against herpes simplex virus.
A 24-year-old woman wants to use her basal body temperature (BBT) in natural
family planning but is unsure when to take her temperature. The nurse informs
her that an accurate BBT is best taken:
1
Each night right before bed
2
On the first day of her next menstrual cycle
3
Each morning prior to getting out of bed or increasing her activity
4
At bedtime beginning on day 14 of her menstrual cycle and continuing until her
next period
-Each morning prior to getting out of bed or increasing her activity
The most accurate BBT is taken before a woman gets out of bed and begins any
type of activity that could increase the body's temperature even slightly. BBT
should be charted daily on a calendar to permit interpretation of temperature
fluctuations. A BBT taken in the evening may be increased after a day of activity.
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
Daily assessment and recording of BBT during the first half of the menstrual cycle
is also crucial, because a woman's BBT is lower then than during the second half
of her cycle. The BBT temperature may rise slightly with ovulation.
A 37-year-old woman is admitted to the unit with severe menorrhagia. During
assessment the nurse learns that she has a history of fibroids, menorrhagia, pelvic
pain, and depression. The client has been undergoing hormone therapy in hopes of
easing the symptoms and reducing the size of the fibroids, without success. Thelab
reports hemoglobin and hematocrit readings of 6.8 and 20.2, respectively. The
client begins to sob and cries, "I don't know what to do—the doctor is
recommending a hysterectomy, but I haven't had children yet!" What is the best
response by the nurse?
1
"There are so many orphans looking for a mother."
2
"This must be so difficult for you. Children are really important to you?"
3
"You really have no choice but to follow the recommendation; the doctor is right." 4
"Believe me when I tell you that kids are so difficult to raise—you're better off
without them."
-"This must be so difficult for you. Children are really important to you?"
Validating the client's feelings and including an open-ended question will
encourage further expression. Previous problems and health conditions could later
be included in the conversation to help the client make the best decision. Adoption
is certainly an option for this person, but this is not what she needs to hear at this
time. This statement also closes down communication. The client does have a
choice, and telling her that she does not could close down communication and
cause anger and defensiveness. Telling the client that she's better off without
children is not what the client needs to hear, especially when she is facing an
operation that could end her chance of giving birth to children.
A 23-year-old woman comes to the clinic for a Pap smear. After the examination, the
client confides that her mother died of endometrial cancer 1 year ago and
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
says that she is afraid that she will die of the same cancer. Which risk factor
stated by the client after an education session on risk factors indicates that
further teaching is needed?
1
Obesity
2
High-fat diet
3
Hypertension
4
Late-onset menarche
-Late-onset menarche
Early-onset, not late-onset, menarche is a risk factor for endometrial cancer. A
high-fat diet, hypertension, and obesity are all risk factors
A 32-year-old woman is admitted to the unit with a history of fibroids and
menorrhagia. Which findings does the nurse expect to encounter during assessment
of the client? Select all that apply.
1
Fluid
overload 2
Intermittent diarrhea
3
Pale mucous membranes
4
Difficulty emptying the bladder
5
High hemoglobin and hematocrit
-Pale mucous membranes, Difficulty emptying the bladder
Menorrhagia (heavy menstrual bleeding) can cause anemia (acute or chronic).
Because this client has a history of menorrhagia, the nurse can anticipate chronic
anemia. Urinary frequency, urgency, and incontinence are symptoms of fibroids,
