3280 NC of Women & Families - Final Exam Review (Qns & Ans) - OSU 2025, Exams of Nursing

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32 80 Nursing Care of Women &

Families During Reproductive

Transitions

Final Exam Review

(Questions & Solutions)

1. Multiple Choice Question: A 28‑year‑old primigravida at 32 weeks of gestation presents with new- onset hypertension and proteinuria. Which condition is most likely, and what is the priority intervention?

• A. Gestational hypertension; reassurance and routine monitoring
• B. Preeclampsia; prompt evaluation for seizure prophylaxis and maternal-fetal monitoring
• C. Chronic hypertension; adjustment of her existing antihypertensive regimen
• D. HELLP syndrome; immediate delivery regardless of gestational age Correct ANS : B. Preeclampsia; prompt evaluation for seizure prophylaxis and maternal- fetal monitoring Rationale: Preeclampsia is characterized by new-onset hypertension and proteinuria after 20 weeks’ gestation. Early intervention with magnesium sulfate for seizure prophylaxis and continuous maternal-fetal monitoring is critical to prevent progression to eclampsia.

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2. Fill-in-the-Blank Question: The theory that views reproductive transitions as a series of developmental milestones influenced by biological, psychological, and social factors is known as __________ theory. Correct ANS : lifespan

A, B, C, E

Rationale: A comprehensive postpartum assessment should review uterine involution, emotional well-being, breastfeeding issues, and perineal healing. Although the Apgar score is important, it pertains to the newborn rather than the mother.

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5. Multiple Choice Question: A nurse is providing education on contraception for a 35‑year‑old woman with a history of deep venous thrombosis. Which method is most appropriate given her elevated thrombotic risk?

• A. Combined estrogen‑progestin oral contraceptives
• B. Progestin‑only pills
• C. Intrauterine device (IUD)
• D. Barrier methods exclusively Correct ANS : C. Intrauterine device (IUD) Rationale: Women with a history of DVT are at increased risk for thromboembolic events, making estrogen-containing methods (A) potentially hazardous. An IUD is both safe and highly effective in this risk population.

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6. Fill-in-the-Blank Question: Screening for postpartum depression in new mothers is typically performed using the __________, a tool that assesses depressive symptoms within the prior two weeks.

Correct ANS : Edinburgh Postnatal Depression Scale (EPDS) Rationale: The EPDS is a validated, widely used screening tool that enables early detection of postpartum depression, allowing timely referral and intervention.

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7. True/False Question: True or False: Patient-centered care during reproductive transitions requires that nurse educators provide information in a standardized format without adapting materials to the family's cultural background. Correct ANS : False Rationale: Patient-centered care mandates that teaching and interventions be culturally sensitive and tailored to the unique needs, backgrounds, and literacy levels of each patient and family.

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8. Multiple Response Question: Which strategies can help improve breastfeeding outcomes postpartum? (Select all that apply)

• A. Partnering with lactation consultants
• B. Providing hands-on guidance with proper latch techniques
• C. Waiting several days before initiating breastfeeding
• D. Educating on recognizing adequate weight gain in the infant

In reproductive transitions, the process of ovarian follicular decline leading to cessation of menstruation is referred to as __________. Correct ANS : menopause Rationale: Menopause marks the definitive end of a woman’s reproductive years, characterized by decreased estrogen and cessation of menstruation. Understanding this process is essential for managing associated symptoms and the increased risk of osteoporosis.

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11. True/False Question: True or False: In the care of women during reproductive transitions, shared decision-making regarding hormone replacement therapy (HRT) should consider both the benefits (such as relief of vasomotor symptoms) and the potential risks (including cardiovascular events and breast cancer). Correct ANS : True Rationale: HRT involves weighing the benefits and risks, and shared decision-making includes a detailed discussion on individual risk factors, preferences, and patient history to ensure safe, informed choices.

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12. Multiple Response Question: When caring for a woman undergoing a reproductive transition, which

indicators should the nurse assess to evaluate the impact of hormonal changes? (Select all that apply)

• A. Sleep disturbances
• B. Mood fluctuations and emotional well-being
• C. Bone density measurements
• D. Changes in lipid profiles
• E. Increase in hair growth on the face Correct ANS s: A, B, C, D Rationale: Hormonal changes during reproductive transitions commonly affect sleep, mood, bone density (risk for osteoporosis), and lipid metabolism. Facial hair increase is less characteristic of menopausal changes.

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13. Multiple Choice Question: 

A nurse is counseling a woman experiencing severe vasomotor symptoms during early menopause. Which non-pharmacologic intervention is recommended as part of the management plan?

• A. Weight gain strategies
• B. Cognitive behavioral therapy
• C. Cold-water immersion
• D. Mindfulness meditation and lifestyle modifications Correct ANS : D. Mindfulness meditation and lifestyle modifications Rationale: Lifestyle modifications—including stress reduction techniques such as mindfulness meditation, exercise, and dietary adjustments—are effective in reducing vasomotor symptoms and improving quality of life during

16. Multiple Response Question: Which of the following maternal conditions increase the risk of complications during pregnancy? (Select all that apply)

• A. Chronic hypertension
• B. Diabetes mellitus
• C. Obesity
• D. Hypothyroidism
• E. Seasonal allergies Correct ANS s: A, B, C, D Rationale: Chronic hypertension, diabetes, obesity, and thyroid dysfunction are significant risk factors for pregnancy complications. Seasonal allergies (E) are generally less impactful on pregnancy outcomes.

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17. Multiple Choice Question: A 32‑year‑old woman presents with irregular menstrual cycles, hirsutism, and obesity. Her laboratory results reveal elevated androgen levels and insulin resistance. Which condition is most indicative of her clinical picture?

• A. Hypothyroidism
• B. Polycystic ovary syndrome (PCOS)
• C. Premature ovarian failure
• D. Cushing’s syndrome Correct ANS : B. Polycystic ovary syndrome (PCOS)

Rationale: PCOS is characterized by irregular menses, hyperandrogenism (leading to hirsutism), and metabolic disturbances such as insulin resistance. This diagnosis guides appropriate treatment and lifestyle interventions.

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18. Fill-in-the-Blank Question: The process by which a woman’s body adapts to the hormonal changes associated with pregnancy, labor, and postpartum recovery is referred to as __________. Correct ANS : physiologic adaptation Rationale: Physiologic adaptation encompasses the extensive cardiovascular, respiratory, metabolic, and endocrine changes that occur during and after pregnancy. Understanding these adaptations is essential for safe perinatal nursing care.

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19. True/False Question: True or False: In women with recurrent pregnancy loss, assessments should include evaluation of both uterine anatomy and endocrine function to determine potential causes. Correct ANS : True Rationale: Recurrent pregnancy loss is multifactorial. Uterine anomalies,

• D. Delaying any psychosocial interventions until after ART is completed Correct ANS : B. Addressing emotional stress and potential relationship challenges Rationale: ART can be emotionally and psychologically taxing. Holistic care includes addressing both the technical aspects of ART and the emotional, relational, and social stresses that may accompany the process.

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22. Fill-in-the-Blank Question: 

The process of evaluating the effectiveness of educational and clinical interventions during reproductive transitions is known as __________ evaluation. Correct ANS : formative Rationale: Formative evaluation is conducted to assess the impact of interventions as they are implemented, allowing for timely adjustments in care and education to ensure optimal outcomes during dynamic reproductive transitions.

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23. True/False Question: 

True or False: Cultural competence in reproductive health care requires the nurse to consider patients’ cultural beliefs about fertility, pregnancy, and menopause when planning interventions.

Correct ANS : True Rationale: Cultural beliefs significantly influence health behaviors and acceptance of medical interventions. Culturally competent care tailors education and treatment plans to align with patients’ values and traditions, improving trust and adherence.

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24. Multiple Response Question: Which non-pharmacologic interventions play an important role in managing menopausal symptoms? (Select all that apply)

• A. Lifestyle modifications such as regular exercise and dietary adjustments
• B. Cognitive behavioral therapy for mood stabilization
• C. Use of complementary therapies (e.g., acupuncture)
• D. Immediate initiation of high-dose hormone replacement therapy for all patients
• E. Support groups and patient education Correct ANS s: A, B, C, E Rationale: Non-pharmacologic interventions including lifestyle changes, behavioral therapies, complementary approaches, and support groups can effectively reduce menopausal symptoms. Universal high-dose HRT (D) is inappropriate without individual risk assessment.

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25. Multiple Choice

27. True/False Question: True or False: In managing gestational diabetes, frequent blood glucose monitoring and patient education regarding diet and exercise are critical for preventing adverse perinatal outcomes. Correct ANS : True Rationale: Gestational diabetes demands strict glycemic control. Frequent monitoring and lifestyle education reduce risks such as macrosomia, neonatal hypoglycemia, and other adverse outcomes.

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28. Multiple Response Question: Which aspects of a woman’s psychosocial history are important to assess during reproductive transitions? (Select all that apply)

• A. Marital or partner support
• B. Socioeconomic status and access to healthcare
• C. Stressors such as recent losses or chronic stress
• D. Religious and cultural beliefs regarding reproduction
• E. Favorite television shows Correct ANS s: A, B, C, D Rationale: A thorough psychosocial assessment should cover relational support, socioeconomic context, stressors, and cultural/religious beliefs, all of which affect coping and adaptation during reproductive transitions. Personal entertainment preferences (E) are not typically clinically

relevant.

29. Multiple Choice Question: A nurse is caring for a postmenopausal woman who is experiencing vaginal dryness and discomfort during intercourse. Which nursing intervention is most appropriate?

• A. Instruct on the use of over-the-counter water‑based lubricants
• B. Recommend total abstinence from sexual activity
• C. Advise immediate cessation of any current hormone replacement therapy
• D. Downplay the symptoms as a normal part of aging Correct ANS : A. Instruct on the use of over-the-counter water‑based lubricants Rationale: Water‑based lubricants can effectively alleviate discomfort from vaginal dryness, thereby improving quality of life and sexual health. Dismissing or ignoring the symptoms (B, D) fails to address the patient’s needs.

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30. Fill-in-the-Blank Question: Before implementing any advanced clinical interventions during reproductive transitions, it is essential to conduct a __________ assessment to establish a comprehensive baseline from which to measure outcomes. Correct ANS : comprehensive

Postpartum hemorrhage is defined as a blood loss of greater than 500 mL after a vaginal delivery. ANS : True Rationale: This is the standard definition of postpartum hemorrhage following a vaginal delivery. Multiple Response: A nurse is caring for a patient diagnosed with placenta previa. Which of the following interventions are appropriate? (Select all that apply.) a) Continuous fetal heart rate monitoring. b) Vaginal examination to assess cervical dilation. c) Monitoring for signs of vaginal bleeding. d) Preparing for potential cesarean delivery. ANS : a, c, d Rationale: Placenta previa requires careful monitoring of fetal well- being, assessment for bleeding, and preparation for cesarean delivery, as vaginal exams are contraindicated. Multiple Choice: A patient at 20 weeks gestation reports feeling no fetal movement. What is the most appropriate initial action by the nurse? a) Perform an ultrasound to assess fetal viability. b) Auscultate for fetal heart tones using a Doppler. c) Instruct the patient to lie on her left side. d) Administer oxygen to the patient. ANS : b) Auscultate for fetal heart tones using a Doppler.

Rationale: The initial step is to attempt to locate fetal heart tones using a Doppler. Fill-in-the-Blank: The hormone primarily responsible for stimulating uterine contractions during labor is __. ANS : oxytocin Rationale: Oxytocin is a key hormone in labor, triggering and strengthening uterine contractions. True/False: The use of epidural analgesia during labor is associated with an increased risk of cesarean delivery. ANS : True Rationale: Studies have shown a correlation, although not a direct cause-and-effect relationship, between epidural use and increased cesarean rates. Multiple Response: A patient is diagnosed with gestational diabetes. Which of the following are essential components of her care plan? (Select all that apply.) a) Dietary modification. b) Regular exercise. c) Fetal kick counts. d) Oral hypoglycemic medications.