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1. A married couple lives in a single-family house with their newborn son and the husband’s daughter from a previous marriage. On the basis of the information given, what family form best describes this family? a. Married-blended family b. Extended family c. Nuclear family d. Same-sex family 2. In what form do families tend to be most socially vulnerable? a. Married-blended family b. Extended family c. Nuclear family d. Single-parent family 3. The nurse should be aware that the criteria used to make decisions and solve problems within families are based primarily on family: a. rituals and customs. b. values and beliefs. c. boundaries and channels. d. socialization processes. 4. Using the family stress theory as an intervention approach for working with families experiencing parenting, the nurse can help the family change internal context factors. These include: a. Biologic and genetic makeup. b. Maturation of family members. c. The family’s perception of the event. d. The prevailing cultural beliefs of society. 5. While working in the prenatal clinic, you care for a very diverse group of patients. When planning interventions for these families, you realize that acceptance of the interventions will be most influenced by: a. educational achievement. b. income level. c. subcultural group. d. individual beliefs. 6. The nurse’s care of a Hispanic family includes teaching about infant care. When developing a plan of care, the nurse bases interventions on the knowledge that in traditional Hispanic families: a. breastfeeding is encouraged immediately after birth. b. male infants typically are circumcised. c. the maternal grandmother participates in the care of the mother and her infant. d. special herbs mixed in water are used to stimulate the passage of meconium.
7. The woman’s family members are present when the home care maternal-child nurse arrives for a after birth and newborn visit. What should the nurse do? a. Observe the family members’ interactions with the newborn and one another. b. Ask the woman to meet with her and the baby alone. c. Do a brief assessment on all family members present. d. Reschedule the visit for another time so that the mother and infant can be assessed privately. 8. The nurse should be aware that during the childbearing experience an African- American woman is most likely to: a. Seek prenatal care early in her pregnancy. b. Avoid self-treatment of pregnancy-related discomfort. c. Request liver in the after-birth period to prevent anemia. d. Arrive at the hospital in advanced labor. 9. To provide competent care to an Asian-American family, the nurse should include which of the following questions during the assessment interview? a. “Do you prefer hot or cold beverages?” b. “Do you want milk to drink?” c. “Do you want music playing while you are in labor?” d. “Do you have a name selected for the baby?” 10. The patient’s family is important to the maternity nurse because: a. they pay the bills. b. the nurse will know which family member to avoid. c. the nurse will know which mothers will really care for their children. d. the family culture and structure will influence nursing care decisions. 11. A mother’s household consists of her husband, his mother, and another child. She is living in a(n): a. extended family. b. single-parent family. c. married-blended family. d. nuclear family. 12. A traditional family structure in which male and female partners and their children live as an independent unit is known as a(n): a. extended family. b. binuclear family. c. nuclear family. d. blended family. 13. Which statement about family systems theory is inaccurate? a. A family system is part of a larger suprasystem. b. A family as a whole is equal to the sum of the individual members. c. A change in one family member affects all family members. d. The family is able to create a balance between change and stability.
Due to the effects of cyclic ovarian changes in the breast, when is the best time for breast self-examination (BSE)? a. Between 5 and 7 days after menses ceases b. Day 1 of the endometrial cycle c. Midmenstrual cycle d. Any time during a shower or bath Individual irregularities in the ovarian (menstrual) cycle are most often caused by what? a. Variations in the follicular (preovulatory) phase b. Intact hypothalamic-pituitary feedback mechanism c. Functioning corpus luteum d. Prolonged ischemic phase How would the physiologic process of the sexual response best be characterized? a. Coitus, masturbation, and fantasy b. Myotonia and vasocongestion c. Erection and orgasm d. Excitement, plateau, and orgasm Which action would be inappropriate for the nurse to perform before beginning the health history interview? a. Smile and ask the client whether she has any special concerns. b. Speak in a relaxed manner with an even, nonjudgmental tone. c. Make the client comfortable. d. Tell the client her questions are irrelevant. The nurse guides a woman to the examination room and asks her to remove her clothes and put on an examination gown with the front open. The woman replies, "I have special undergarments that I do not remove for religious reasons." Which is the most appropriate response from the nurse? a. "You can't have an examination without removing all your clothes." b. "I'll ask the physician to modify the examination." c. "Tell me about your undergarments. I'll explain the examination procedure, and then we can discuss how you can comfortably have your examination." d. "I have no idea how we can accommodate your beliefs." A woman arrives at the clinic for her annual examination. She tells the nurse that she thinks she has a vaginal infection, and she has been using an over-the-counter cream for the past 2 days to treat it. How should the nurse initially respond? a. Inform the woman that vaginal creams may interfere with the Papanicolaou (Pap) test for which she is scheduled. b. Reassure the woman that using vaginal cream is not a problem for the examination. c. Ask the woman to describe the symptoms that indicate to her that she has a vaginal infection. d. Ask the woman to reschedule the appointment for the examination.
Preconception and prenatal care have become important components of women's health. What is the guiding principal of preconception care? a. Ensure that pregnancy complications do not occur. b. Identify the woman who should not become pregnant. c. Encourage healthy lifestyles for families desiring pregnancy. d. Ensure that women know about prenatal care. Ovarian function and hormone production decline during which transitional phase? a. Climacteric b. Menarche c. Menopause d. Puberty Which statement indicates that a client requires additional instruction regarding BSE? a. "Yellow discharge from my nipple is normal if I'm having my period." b. "I should check my breasts at the same time each month, after my period." c. "I should also feel in my armpit area while performing my breast examination." d. "I should check each breast in a set way, such as in a circular motion." A blind woman has arrived for an examination. Her guide dog assists her to the examination room. She appears nervous and says, "I've never had a pelvic examination." What response from the nurse would be most appropriate? a. "Don't worry. It will be over before you know it." b. "Try to relax. I'll be very gentle, and I won't hurt you." c. "Your anxiety is common. I was anxious when I first had a pelvic examination." d. "I'll let you touch each instrument that I'll use during the examination as I tell you how it will be used." Which female reproductive organ(s) is(are) responsible for cyclic menstruation? a. Uterus b. Ovaries c. Vaginal vestibule d. Urethra Which body part both protects the pelvic structures and accommodates the growing fetus during pregnancy? a. Perineum b. Bony pelvis c. Vaginal vestibule d. Fourchette Which phase of the endometrial cycle best describes a heavy, velvety soft, fully matured endometrium? a. Menstrual b. Proliferative c. Secretory d. Ischemic
d. Four As procedure
Which questionnaire would be best for the nurse to use when screening an adolescent client for an eating disorder? a. Four Cs b. Dietary Guidelines for Americans c. SCOFF screening tool d. Dual-energy x-ray absorptiometry (DEXA) scan The unique muscle fibers that constitute the uterine myometrium make it ideally suited for what? a. Menstruation b. Birth process c. Ovulation d. Fertilization Which hormone is responsible for the maturation of mammary gland tissue? a. Estrogen b. Testosterone c. Prolactin d. Progesterone What is the goal of a long-term treatment plan for an adolescent with an eating disorder? a. Managing the effects of malnutrition b. Establishing sufficient caloric intake c. Improving family dynamics d. Restructuring client perception of body image A 62-year-old woman has not been to the clinic for an annual examination for 5 years. The recent death of her husband reminded her that she should come for a visit. Her family physician has retired, and she is going to see the women's health nurse practitioner for her visit. What should the nurse do to facilitate a positive health care experience for this client? a. Remind the woman that she is long overdue for her examination and that she should come in annually. b. Carefully listen and allow extra time for this woman's health history interview. c. Reassure the woman that a nurse practitioner is just as good as her old physician. d. Encourage the woman to talk about the death of her husband and her fears about her own death. During a health history interview, a woman states that she thinks that she has "bumps" on her labia. She also states that she is not sure how to check herself. The correct response by the nurse would be what? a. Reassure the woman that the examination will reveal any problems. b. Explain the process of vulvar self-examination and reassure the woman that she should become familiar with normal and abnormal findings during the examination. c. Reassure the woman that "bumps" can be treated. d. Reassure her that most women have "bumps" on their labia.
Women of all ages will receive substantial and immediate benefits from smoking cessation. The process is not easy, and most people have attempted to quit numerous times before achieving success. Which organizations provide self-help and smoking cessation materials? (Select all that apply.) a. Leukemia and Lymphoma Society b. March of Dimes c. American Cancer Society d. American Lung Association e. Easter Seals Many pregnant teenagers wait until the second or third trimester to seek prenatal care. What should the nurse recognize as reasons for this delay? (Select all that apply.) a. Lack of realization that they are pregnant b. Uncertainty as to where to go for care c. Continuing to deny the pregnancy d. Desire to gain control over their situation e. Wanting to hide the pregnancy as long as possible
1. Historically, what was the justification for the victimization of women? a. Women were regarded as possessions. b. Women were the weaker sex. c. Control of women was necessary to protect them. d. Women were created subordinate to men. 2. What is the primary theme of the feminist perspective regarding violence against women? a. Role of testosterone as the underlying cause of men’s violent behavior b. Basic human instinctual drive toward aggression c. Male dominance and coercive control over women d. Cultural norm of violence in Western society 3. Which trait is least likely to be displayed by a woman experiencing intimate partner violence (IPV)? a. Socially isolated b. Assertive personality c. Struggling with depression d. Dependent partner in a relationship 4. A woman who is 6 months pregnant has sought medical attention, saying she fell down the stairs. What scenario would cause an emergency department nurse to suspect that the woman has been a victim of IPV? a. The woman and her partner are having an argument that is loud and hostile. b. The woman has injuries on various parts of her body that are in different stages of healing. c. Examination reveals a fractured arm and fresh bruises. d. She avoids making eye contact and is hesitant to answer questions.
5. Which statement is most accurate regarding the reporting of IPV in the United States? a. Asian women report more IPV than do other minority groups. b. Caucasian women report less IPV than do non-Caucasians. c. Native-American women report IPV at a rate similar to other groups. d. African-American women are less likely to report IPV than Caucasian women. 6. Intervention for the sexual abuse survivor is often not attempted by maternity and women’s health nurses because of the concern about increasing the distress of the woman and the lack of expertise in counseling. What initial intervention is appropriate and most important in facilitating the woman’s care? a. Initiating a referral to an expert counselor b. Setting limits on what the client discloses c. Listening and encouraging therapeutic communication skills d. Acknowledging the nurse’s discomfort to the client as an expression of empathy 7. A young woman arrives at the emergency department and states that she thinks she has been raped. She is sobbing and expresses disbelief that this could happen because the perpetrator was a very close friend. Which statement is most appropriate at this time? a. Rape is not limited to strangers and frequently occurs by someone who is known to the victim. b. I would be very upset if my best friend did that to me; that is very unusual. c. You must feel very betrayed. In what way do you think you might have led him on? d. This does not sound like rape. Didn’t you just change your mind about having sex after the fact? 8. Nurses are often the first health care professional with whom a woman comes into contact after being sexually assaulted. Which statement best describes the initial care of a rape victim? a. All legal evidence is preserved during the physical examination. b. The victim appreciates the legal information; however, decides not to pursue legal proceedings. c. The victim states that she is going to advocate against sexual violence. d. The victim leaves the health care facility without feeling re-victimized. 9. When the nurse is alone with a battered client, the client seems extremely anxious and says, it was all my fault. The house was so messy when he got home, and I know he hates that. What is the most suitable response by the nurse? a. No one deserves to be hurt. It’s not your fault. How can I help you? b. What else do you do that makes him angry enough to hurt you? c. He will never find out what we talk about. Don’t worry. Were here to help you. d. You have to remember that he is frustrated and angry, so he takes it out on you.
d. Human trafficking primarily refers to commercial sex work.
16. Which statement is the most comprehensive description of sexual violence? a. Sexual violence is limited to rape. b. Sexual violence is an act of force during which an unwanted and uncomfortable sexual act occurs. c. Sexual violence encompasses a number of sexual acts. d. Sexual violence includes degrading sexual comments and behaviors. 17. Women with severe and persistent mental illness are likely to be more vulnerable to being involved in controlling and/or violent relationships; however, many women develop mental health problems as a result of long-term abuse. Which condition is unlikely to be a psychologic consequence of continued abuse? a. Substance abuse b. Posttraumatic stress disorder (PTSD) c. Eating disorders d. Bipolar disorder 1. The nurse who is evaluating the client for potential abuse should be aware that IPV includes a number of different forms of abuse, including which of the following? (Select all that apply.) a. Physical b. Sexual c. Emotional d. Psychologic e. Financial 2. What are some common characteristics of a potential male batterer? (Select all that apply.) a. High level of self-esteem b. High frustration tolerance c. Substance abuse problems d. Excellent verbal skills e. Personality disorders 3. Which nursing diagnoses would be most applicable for battered women? (Select all that apply.) a. Loss of trust b. Ineffective family coping c. Situational low self-esteem d. Risk for self-directed violence e. Enhanced communication 4. A thorough abuse assessment screen should be completed on all female clients. This screen should include which components? (Select all that apply.) a. Asking the client if she has ever been slapped, kicked, punched, or physically hurt by her partner b. Asking the client if she is afraid of her partner c. Asking the client if she has been forced to perform sexual acts d. Diagramming the client’s current injuries on a body map
Chapter 06: Reproductive System Concerns MULTIPLE CHOICE
1. Which condition is the least likely cause of amenorrhea in a 17-year-old client? a. Anatomic abnormalities b. Type 1 diabetes mellitus c. Obesity d. Pregnancy 2. When a nurse is counseling a woman for primary dysmenorrhea, which nonpharmacologic intervention might be recommended? a. Increasing the intake of red meat to replace blood loss b. Reducing the intake of diuretic foods, such as peaches and asparagus c. Temporarily substituting physical activity for a sedentary lifestyle d. Using a heating pad on the abdomen to relieve cramping 3. Nafarelin (Synarel) is used to treat mild-to-severe endometriosis. What instruction or information should the nurse provide to a client regarding nafarelin administration? a. Nafarelin stimulates the secretion of gonadotropin-releasing hormone (GnRH), thereby stimulating ovarian activity. b. It should be administered by intramuscular (IM) injection. c. Nafarelin should be administered by a subcutaneous implant. d. It can cause the client to experience some hot flashes and vaginal dryness. 4. While interviewing a 31-year-old woman before her routine gynecologic examination, the nurse collects data about the client’s recent menstrual cycles. Which statement by the client should prompt the nurse to collect further information? a. “My menstrual flow lasts 5 to 6 days.” b. “ My flow is very heavy.” c. “I have had a small amount of spotting midway between my periods for the past 2 months.” d. “The length of my menstrual cycles varies from 26 to 29 days.” 5. A 21-year-old client complains of severe pain immediately after the commencement of her menses. Which gynecologic condition is the most likely cause of this client’s presenting complaint? a. Primary dysmenorrhea b. Secondary dysmenorrhea c. Dyspareunia d. Endometriosis
6. Which symptom described by a client is characteristic of premenstrual syndrome (PMS)? a. “I feel irritable and moody a week before my period is supposed to start.” b. “I have lower abdominal pain beginning on the third day of my menstrual period.” c. “I have nausea and headaches after my period starts, and they last 2 to 3 days.” d. “I have abdominal bloating and breast pain after a couple days of my period.” 7. A client complains of severe abdominal and pelvic pain around the time of menstruation. This pain has become progressively worse over the last 5 years. She also complains of pain during intercourse and has tried unsuccessfully to become pregnant for the past 18 months. To which condition are these symptoms most likely related? a. Endometriosis b. PMS c. Primary dysmenorrhea d. Secondary dysmenorrhea 8. Which menopausal discomfort would the nurse anticipate when evaluating a woman for signs and symptoms of the climacteric? a. Headaches b. Hot flashes c. Mood swings d. Vaginal dryness with dyspareunia 9. Which risk factor would the nurse recognize as being frequently associated with osteoporosis? a. African-American race b. Low-protein intake c. Obesity d. Cigarette smoking 10. A perimenopausal client has arrived for her annual gynecologic examination. Which preexisting condition would be extremely important for the nurse to identify during a discussion regarding the risks and benefits of hormone therapy? a. Breast cancer b. Vaginal and urinary tract atrophy c. Osteoporosis d. Arteriosclerosis
17. Which alteration in cyclic bleeding best describes bleeding that occurs at any time other than menses? a. Oligomenorrhea b. Menorrhagia c. Leiomyoma d. Metrorrhagia 18. Management of primary dysmenorrhea often requires a multifaceted approach. Which pharmacologic therapy provides optimal pain relief for this condition? a. Acetaminophen b. Oral contraceptive pills (OCPs) c. Nonsteroidal antiinflammatory drugs (NSAIDs) d. Aspirin MULTIPLE RESPONSE 1. A client has requested information regarding alternatives to hormonal therapy for menopausal symptoms. Which current information should the nurse provide to the client? (Select all that apply.) a. Soy b. Vitamin C c. Vitamin K d. Vitamin E e. Vitamin A 2. Which suggestions are appropriate for a client who complains of hot flashes? (Select all that apply.) a. Avoid caffeine. b. Drink a glass of wine to relax. c. Wear layered clothing. d. Drink ice water. e. Drink warm beverages for their calming effect. 3. Which medications can be taken by postmenopausal women to treat and/or prevent osteoporosis? (Select all that apply.) a. Calcium b. NSAIDs c. Fosamax d. Actonel e. Calcitonin
4. Which statement(s) might the nurse appropriately include when teaching a client about calcium intake for osteoporosis? (Select all that apply.) a. “You should try to increase your protein intake when you are taking calcium.” b. “It is best to take calcium in one large dose.” c. “Tums are the most soluble form of calcium.” d. “You should take calcium with vitamin D because the vitamin D helps your body better absorb calcium.” e. “It’s okay to take calcium if you have had a history of kidney stones.” 5. Nurses are in an ideal position to educate clients who experience PMDD. What self-help activities have been documented as helpful in alleviating the symptoms of PMDD? (Select all that apply.) a. Regular exercise b. Improved nutrition c. Daily glass of wine d. Smoking cessation e. Oil of evening primrose MATCHING Herbal preparations have long been used for the management of menstrual problems, including dysmenorrhea, cramping and discomfort, and breast pain. For the nurse to counsel adequately the client who elects to use this alternative modality, understanding the action of these herbal preparations is important. Match the herbal medicine with the appropriate action. a. Uterine antispasmodic: Valerian, wild yam b. Uterotonic: Fennel, dong quai c. Antiinflammatory: Ginger d. Estrogen-like luteinizing hormone suppressant: Black cohosh root e. Decreases prolactin levels: Chaste tree fruit
