Contemporary Maternal Newborn Nursing Care Maternal Newborn Nursing Care Nurse, Family, 8t, Exams of Health sciences

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Nurse, Family, 8th Edition 2022

A nurse is teaching a classroom of teenage girls about the female reproductive system. After teaching, the nurse asks the students to describe the release of an ovum during ovulation. Which student’s response suggests she correctly understood the nurse’s teaching?

1. “During ovulation, an egg is released from the ovary and enters the fallopian tube.”
2. “Around the middle of the menstrual cycle, one of the fallopian tubes releases an egg.”
3. “Ovulation is when the uterus releases an unfertilized egg or ovum.”
4. “The endometrium is where the eggs are formed and released into the fallopian tube.” Correct Answer: 1 Rationale 1 : The egg is formed in the ovary and once released, it enters the fallopian tube. Rationale 2 : The egg is formed in the ovary and then released near the fimbria of the fallopian tube. Rationale 3 : The egg is formed in the ovary and travels by way of the fallopian tube to the uterus. Rationale 4 : The uterine endometrium is the site of implantation of a fertilized egg. Global Rationale: Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: LO01 – Identify the structures and functions of the female reproductive system. Question 2 Type: MCSA The clinic nurse is caring for a young woman seeking contraception because she has recently married and become sexually active. The teen states, “The opening of my husband’s penis isn’t at the tip; it’s around the corner below the tip. He tells me that he was born that way. Will that cause problems if we want to have children?” What is the best response for the nurse to give? “This variation is called:
5. “Epispadias. It is not likely to impact his fertility.”
6. “Epispadias. It will likely cause him to be infertile.”
7. “Hypospadias. It is not likely to impact his fertility.”
8. “Hypospadias. It will likely cause him to be infertile.” Correct Answer: 3 Rationale 1 : Epispadias is the condition where the urethral opening is on the upper aspect of the penis. The patient is describing hypospadias, when the urethral opening is on the lower side of the penis. Mild hypospadias, when the urethral opening is on the glans of the penis, does not impact fertility. Rationale 2 : Epispadias is the condition where the urethral opening is on the upper aspect of the penis. The patient is describing hypospadias, when the urethral opening is on the lower side of the penis. Mild hypospadias, when the urethral opening is on the glans of the penis, does not impact fertility. Rationale 3 : The patient is describing hypospadias, which is the urethral opening on the lower aspect of the penis. Mild hypospadias, when the urethral opening is on the glans of the penis, does not impact fertility. Rationale 4 : The patient is describing hypospadias, where the urethral opening is on the lower side of the penis. Mild hypospadias, where the urethral opening is on the glans of the penis, does not impact fertility.

Nurse, Family, 8th Edition 2022

Global Rationale: Cognitive Level: Evaluating Client Need: Health Promotion and Maintenance Client Need Sub:

Nurse, Family, 8th Edition 2022

Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO02 – Identify the structures and functions of the male reproductive system. Question 3 Type: MCSA A prenatal patient states, “The doctor said he might have to cut my cervix so the baby can get out during delivery.” Based upon this statement, the nurse should provide teaching related to episiotomy, which includes defining:

1. The perineal body.
2. The labia majora.
3. The mons pubis.
4. The vaginal vestibule. Correct Answer: 1 Rationale 1 : The perineal body, which is located between the lower part of the vagina and the anus, is often the site of an episiotomy or lacerations during childbirth. Rationale 2 : The labia majora are longitudinal, raised folds of pigmented skin located on either side of the vulvar cleft. Rationale 3 : The mons pubis is a softly rounded mound of subcutaneous fatty tissue that covers the front portion of the symphysis pubis. Rationale 4 : The vaginal vestibule contains the vaginal opening, which is the border between the external and internal genitals. Global Rationale: Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO03 – Explain the significance of specific female reproductive structures during childbirth. Question 4 Type: MCSA A pregnant patient asks, “What’s the difference between the true pelvis and the false pelvis?” The nurse’s best response is:
5. “The true pelvis doesn’t affect fetal passage during labor and childbirth.”
6. “The false pelvis consists of the inlet, the pelvic cavity, and the outlet.”
7. “The true pelvis helps direct the presenting fetal part into the false pelvis.”
8. “The false pelvis helps support the weight of the pregnant uterus.” Correct Answer: 4 Rationale 1 : The size and shape of the true pelvis must be adequate for normal fetal passage during labor and childbirth. Rationale 2 : The true pelvis consists of the inlet, the pelvic cavity, and the outlet. Rationale 3 : The false pelvis helps direct the presenting fetal part into the true pelvis. Rationale 4 : The false pelvis helps support the weight of the pregnant uterus. Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO03 – Explain the significance of specific female reproductive

Nurse, Family, 8th Edition 2022

structures during childbirth.

Nurse, Family, 8th Edition 2022

Question 5 Type: MCSA A pregnant adolescent asks the nurse, “Why does the physician call measuring my uterus a ‘fundal height’?” The nurse’s answer is based on the fact that the fundus of the uterus is located:

1. In the elongated portion where the fallopian tubes enter.
2. In the lower third area.
3. At the uppermost (dome-shaped top) portion.
4. Between the internal cervical os and the endometrial cavity. Correct Answer: 3 Rationale 1 : The elongated portion where the fallopian tubes enter the uterus is called the cornua. Rationale 2 : The lower third of the uterus is called the cervix or neck. Rationale 3 : The rounded, uppermost (dome-shaped top) portion of the uterus that extends above the points of attachment of the fallopian tubes is called the fundus. Rationale 4 : The isthmus is the portion of the uterus between the internal cervical os and the endometrial cavity. Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO03 – Explain the significance of specific female reproductive structures during childbirth. Question 6 Type: MCSA A nurse teaches newly pregnant patients that if an ovum is fertilized and implants in the endometrium, the hormone the fertilized egg begins to secrete is:
5. Estrogen.
6. Human chorionic gonadotropin (hCG).
7. Progesterone.
8. Luteinizing hormone. Correct Answer: 2 Rationale 1 : Estrogen is an ovarian hormone. Rationale 2 : When the ovum is fertilized and implants in the endometrium, the fertilized egg begins to secrete human chorionic gonadotropin (hCG) hormone to maintain the corpus luteum. Rationale 3 : Progesterone is an ovarian hormone. Rationale 4 : Luteinizing hormone is excreted by the anterior pituitary. Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO04 – Summarize the actions of the hormones that affect reproductive functioning. Question 7 Type: MCSA A school nurse is teaching a health class to middle school children. The nurse explains that follicle-stimulating hormone (FSH) and luteinizing hormone (LH)

Nurse, Family, 8th Edition 2022

are secreted by the:

1. Hypothalamus.
2. Ovaries and testes.

Nurse, Family, 8th Edition 2022

3. Posterior pituitary.
4. Anterior pituitary. Correct Answer: 4 Rationale 1 : The hypothalamus secretes gonadotropin-releasing hormone to the pituitary gland in response to signals from the central nervous system. Rationale 2 : The ovaries secrete the female hormones estrogen and progesterone, and the testes secrete testosterone. Rationale 3 : The posterior pituitary gland secretes oxytocin and anti-diuretic hormone. Rationale 4 : The anterior pituitary secretes FSH and LH, which are primarily responsible for maturation of the ovarian follicle. Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO04 – Summarize the actions of the hormones that affect reproductive functioning. Question 8 Type: MCSA The nurse is presenting a community education session on female hormones. Which statement from a participant indicates the need for further information?
5. “Estrogen is what causes females to look female.”
6. “The presence of some hormones causes other to be secreted.”
7. “Progesterone is present at the end of the menstrual cycle.”
8. “Prostaglandin is responsible for achieving conception.” Correct Answer: 4 Rationale 1 : This is a true statement. The question is asking for an incorrect statement. Estrogen causes secondary sex characteristics, such as enlarged breasts and widened hips. Rationale 2 : This is a true statement. The question is asking for an incorrect statement. One example is that the production of gonadotropin-releasing hormone (GnRH) causes the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Rationale 3 : This is a true statement. The question is asking for an incorrect statement. Progesterone is present in large quantities during the secretory phase of the menstrual cycle. Rationale 4 : Prostaglandin is not related to conception. Prostaglandin is called the hormone of pregnancy because it maintains pregnancy. Global Rationale: Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: LO04 – Summarize the actions of the hormones that affect reproductive functioning. Question 9 Type: MCSA A woman has been unable to complete a full-term pregnancy because the fertilized ovum failed to implant in the uterus. This is most likely due to a lack of which hormone?
9. Estrogen
10. Progesterone

Nurse, Family, 8th Edition 2022

3. FSH (follicle-stimulating hormone)

Nurse, Family, 8th Edition 2022

4. LH (luteinizing hormone) Correct Answer: 2 Rationale 1 : Estrogen primarily assists in maturation of the ovarian follicles and causes endometrial mucosa to proliferate. Rationale 2 : Progesterone is the likely cause because it decreases uterine motility and contractibility caused by estrogens, thereby preparing the uterus for implantation. Rationale 3 : FSH is a hormone secreted by the pituitary gland. Rationale 4 : LH is a hormone secreted by the pituitary gland. Global Rationale: Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO04 – Summarize the actions of the hormones that affect reproductive functioning. Question 10 Type: MCSA The nurse is explaining the menstrual cycle to a group of women. The teaching on phases of the menstrual cycle should include the fact that the corpus luteum begins to degenerate, estrogen and progesterone levels fall, and the blood supply to the endometrium is reduced in which phase?
5. Menstrual phase
6. Proliferative phase
7. Secretory phase
8. Ischemic phase Correct Answer: 4 Rationale 1 : The menstrual phase is the menses. Rationale 2 : The proliferative phase is characterized by proliferation of the endometrium. Rationale 3 : The secretory phase involves glycogen secretion by the endometrium after ovulation. Rationale 4 : The ischemic phase is characterized by ischemia of the endometrium. Global Rationale: Cognitive Level: Understanding Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO05 – Identify the two phases of the ovarian cycle and the changes that occur in each phase. Question 11 Type: MCSA Which statement best indicates that the patient understands the differences in the follicular and luteal phases of the ovarian cycle?
9. “My period will be every 28 days.”
10. “The first part of my period might vary in length, but not the second.”
11. “The follicular phase is the second half of my cycle.”
12. “The follicular phase is when the egg is fertilized.” Correct Answer: 2 Rationale 1 : The follicular phase can vary, resulting in cycle length other than 28

Nurse, Family, 8th Edition 2022

days. Rationale 2 : For a female with a 28-day cycle, the follicular phase comprises days 1–14 of the menstrual cycle, and the luteal phase comprises days 15–28. The luteal phase does not vary. Rationale 3 : The luteal phase is the second half of the cycle.

Nurse, Family, 8th Edition 2022

Rationale 4 : The follicular phase comprises days 1–14 of the menstrual cycle, not when the egg is fertilized. Global Rationale: Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: LO05 – Identify the two phases of the ovarian cycle and the changes that occur in each phase. Question 12 Type: MCSA The nurse is preparing a handout on the ovarian cycle to a group of middle school girls. Which information should the nurse include?

1. There are two phases of the ovarian cycle: luteal and follicular.
2. Irregular menstrual cycles have varying lengths of the follicular phase.
3. The ovum travels from the ovary to the tube during the luteal phase.
4. The hormone human chorionic gonadotropin stimulates ovulation. Correct Answer: 1 Rationale 1 : The two phases of the ovarian cycle are follicular (days 1–14 of the menstrual cycle) and luteal (days 15–28 of the menstrual cycle). Rationale 2 : Menstrual cycles that are irregular in length have a consistent follicular phase but a varying luteal phase. Rationale 3 : The ovum is released from the graafian follicle of the ovary and travels to the fallopian tube during the follicular phase of the ovarian cycle. Rationale 4 : Human chorionic gonadotropin (hCG) is secreted by a fertilized ovum and does not stimulate ovulation. Global Rationale: Cognitive Level: Applying Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO05 – Identify the two phases of the ovarian cycle and the changes that occur in each phase. Question 13 Type: MCSA The nurse is preparing a presentation on the menstrual cycle for a group of high school students. Which statement should the nurse include in this presentation?
5. “The menstrual cycle has five distinct phases that occur during the month.”
6. “One hormone controls the phases of the menstrual cycle.”
7. “The secretory phase occurs when a woman is most fertile.”
8. “Menstrual cycle phases vary in order from one woman to another.” Correct Answer: 3 Rationale 1 : There are four phases of the menstrual cycle: menstrual, proliferative, secretory, and ischemic phases. Rationale 2 : Four hormones control ovulation and therefore the menstrual cycle: progesterone, estrogen, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). Rationale 3 : During the secretory phase, the endometrium is thickest, and glycogen is produced to nourish a fertilized ovum.

Nurse, Family, 8th Edition 2022

Rationale 4 : Although the length of the menstrual cycle might vary, the phases of the menstrual cycle always occur in the same order. Global Rationale: Cognitive Level: Applying Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO06 – Describe the phases of the menstrual cycle, their dominant hormones, and the changes that occur in each phase. Question 14 Type: MCSA In preparation for teaching a women’s community center class about physiologic changes during menopause, the nurse is preparing a handout for students. Which information should the nurse include in her teaching?

1. The ovaries remain small after puberty, but they increase in size following menopause.
2. Ovarian secretion of estrogen decreases between the ages of 45 to 55, after which point ovulatory activity ceases.
3. Due to changes in estrogen levels, the labia minora increase in size after menopause.
4. After menopause, the endometrium continues to undergo monthly degeneration and renewal. Correct Answer: 2 Rationale 1 : The ovaries of girls are small, but they become larger after puberty and then decrease in size following menopause. Rationale 2 : Between the ages of 45 and 55, a woman’s ovaries secrete decreasing amounts of estrogen. Eventually, ovulatory activity ceases and menopause occurs. Rationale 3 : The labia minora decrease in size after menopause because of changes in estrogen levels. Rationale 4 : From menarche to menopause, the endometrium undergoes monthly degeneration and renewal in the absence of pregnancy. Global Rationale: Cognitive Level: Applying Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO04 – Summarize the actions of the hormones that affect reproductive functioning. Question 15 Type: MCSA A woman is experiencing mittelschmerz and increased vaginal discharge. Her temperature has increased by 0.6°C (1.0° F) for the past 36 hours. This most likely indicates that:
5. Menstruation is about to begin.
6. Ovulation will occur soon.
7. Ovulation has occurred.
8. She is pregnant and will not menstruate. Correct Answer: 3 Rationale 1 : A temperature increase does not occur when menstruation is about to

Nurse, Family, 8th Edition 2022

begin. Rationale 2 : A temperature increase does not occur before ovulation has occurred.

Nurse, Family, 8th Edition 2022

Rationale 3 : Signs that ovulation has occurred include: pain associated with rupture of the ovum (mittelschmerz), increased vaginal discharge, and a temperature increase of 0.6°C over the past 36 hours. Rationale 4 : Pregnancy can be detected only through testing the urine or serum for the presence of human chorionic gonadotropin hormone. Global Rationale: Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO06 – Describe the phases of the menstrual cycle, their dominant hormones, and the changes that occur in each phase.

Ladewig, Contemporary

Maternal- Newborn Nursing , 8/E

Chapter 05

Question 1 Type: MCSA The clinic nurse is returning phone calls. Which call should the nurse return first?

1. 22-year-old reporting that she has menstrual cramps and vomiting every month
2. 17-year-old asking if there is a problem with using one tampon for a whole day
3. 46-year-old mother of a teen wondering if her daughter should be on birth control
4. 34-year-old requesting information on douching after intercourse Correct Answer: 2 Rationale 1 : Because vomiting can lead to dehydration, this patient will require further assessment. Because her symptoms are not life-threatening, this patient’s assessment is not the first priority. Rationale 2 : Using a single tampon for an entire day can lead to toxic shock syndrome, a potentially life-threatening condition. This patient needs education on the danger of using one tampon more than 3–6 hours. Rationale 3 : A sexually active teen could be at risk for unintended pregnancy, as well as sexually transmitted infections. However, it is unclear whether the daughter is sexually active. This call is a low priority. Rationale 4 : Douching is not recommended, because the practice causes a change in the pH of the vagina and impacts the normal flora, predisposing patients to candidiasis and bacterial vaginosis. This patient requires education but is not the first priority. Global Rationale: Cognitive Level: Analyzing Client Need: Physiological Integrity Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO01 – Identify appropriate nursing care based on the results of the patient’s sexual history.

• Nurse, Family, 8th Edition
• Question

Nurse, Family, 8th Edition 2022

Type: MCSA When taking a sexual history from a patient, the nurse should:

1. Ask questions that the patient can answer with a “yes” or “no.”
2. Ask mostly open-ended questions.
3. Have the patient fill out a comprehensive questionnaire and review it after the patient leaves.
4. Try not to make much direct eye contact. Correct Answer: 2 Rationale 1 : “Yes-or-no” answers indicate closed-ended questions that will not encourage the patient to share the necessary information. Rationale 2 : Open-ended questions are often useful in eliciting information because they encourage more than a one-word answer. Rationale 3 : Filling out a questionnaire and reviewing it after the patient leaves is not appropriate. It should be reviewed in the presence of the patient, encouraging conversation regarding the results. Rationale 4 : It is helpful to use direct eye contact as much as possible, unless culturally unacceptable. Eye contact encourages a connection between the involved parties and shows care and concern. Global Rationale: Cognitive Level: Analyzing Client Need: Psychosocial Integrity Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO01 – Identify appropriate nursing care based on the results of the patient’s sexual history. Question 3 Type: MCSA Which patient would the nurse document as exhibiting signs and symptoms of primary dysmenorrhea?
5. 17-year-old, has never had a menstrual cycle
6. 16-year-old, had regular menses for 4 years, but has had no menses in four months
7. 19-year-old, regular menses for 5 years that have suddenly become painful
8. 14-year-old, irregular menses for one year, experiences cramping every cycle Correct Answer: 4 Rationale 1 : This is primary amenorrhea, or the lack of menses. Rationale 2 : Secondary amenorrhea is the term used when a patient has had regular cycles that cease. Rationale 3 : Secondary dysmenorrheal is the sudden onset of pain and discomfort with menses. Rationale 4 : Primary dysmenorrhea is when menstruation has been painful from the first menstrual cycle and consistently continues to be painful each month. Global Rationale: Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Diagnosis Learning Outcome: LO02 – Describe accurate information to be provided to girls and women so that they can implement effective self-care measures for dealing with menstruation.

Nurse, Family, 8th Edition 2022

Question 4 Type: MCSA

Nurse, Family, 8th Edition 2022

A patient asks her nurse, “Is it okay for me to use a vaginal douche each day when I’m on my period?” The nurse’s correct response is:

1. “Douching should be avoided when you’re on your period.”
2. “Using a douche each day will help prevent vaginal infections from occurring.”
3. “During your period, douching will help promote the flow of menstrual secretions.”
4. “Regular douching is necessary in order to promote good hygiene.” Correct Answer: 1 Rationale 1 : Women should avoid douching during menstruation because the cervix is dilated to permit the downward flow of menstrual fluids from the uterine lining. Rationale 2 : Douching washes away the natural mucus and upsets the vaginal flora, which can make the vagina more susceptible to infection. Rationale 3 : During menstruation, douching may interfere with downward flow of menstrual fluids from the uterine lining. Rationale 4 : Douching as a hygiene practice is unnecessary because the vagina cleanses itself. Global Rationale: Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO02 – Describe accurate information to be provided to girls and women so that they can implement effective self-care measures for dealing with menstruation. Question 5 Type: MCSA What should the gynecology clinic nurse recommend for the patient experiencing premenstrual syndrome?
5. “Eat more chocolate and drink more caffeine beginning a week prior to when your menstrual cycle bleeding should begin.”
6. “Engage in aerobic activity often throughout the month, and continue exercising when your symptoms begin.”
7. “Decrease your dietary intake of dairy and soy slightly during the month, and especially during your days of bleeding.”
8. “Increase your consumption of red meat when you feel symptoms, and eat three large meals per day.” Correct Answer: 2 Rationale 1 : Chocolate and caffeine contain methylxanthines; therefore, intake of chocolate, coffee, and colas should be limited throughout the month. Rationale 2 : Regular aerobic activity helps to decrease PMS symptoms. Rationale 3 : 1,200 mg of calcium per day can help decrease PMS symptoms. The calcium can either come from supplements or be obtained through dietary intake of dairy and soy products. Rationale 4 : Decreased red meat consumption can be beneficial to reduce PMS symptoms, as will eating several small meals per day rather than three large meals. Global Rationale: Cognitive Level: Applying Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation

Nurse, Family, 8th Edition 2022

Learning Outcome: LO03 – Discriminate between the signs, symptoms, and nursing management of women with dysmenorrhea and premenstrual syndrome. Question 6

Nurse, Family, 8th Edition 2022

Type: MCSA A patient comes to the clinic complaining of severe menstrual cramps. She has never been pregnant, has been diagnosed with ovarian cysts, and has had an intrauterine device (IUD) for two years. The most likely cause for the patient’s complaint is:

1. Primary dysmenorrhea.
2. Secondary dysmenorrhea.
3. Menorrhagia.
4. Hypermenorrhea. Correct Answer: 2 Rationale 1 : Primary dysmenorrhea is defined as cramps without underlying disease. Rationale 2 : Secondary dysmenorrhea is associated with pathology of the reproductive tract and usually appears after menstruation has been established. Conditions that most frequently cause secondary dysmenorrhea include ovarian cysts and the presence of an intrauterine device. Rationale 3 : Menorrhagia is excessive, profuse flow. Rationale 4 : Hypermenorrhea is an abnormally long menstrual flow. Global Rationale: Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO03 – Discriminate between the signs, symptoms, and nursing management of women with dysmenorrhea and premenstrual syndrome. Question 7 Type: MCMA Which issues should the nurse consider when counseling a patient on contraceptive methods? Standard Text: Select all that apply.
5. Cultural perspectives on menstruation and pregnancy
6. Efficacy of the method
7. Future childbearing plans
8. Whether the patient is a vegetarian
9. Age at menarche Correct Answer: 1,2, Rationale 1 : Cultural and religious beliefs, practices, and sanctions must be considered when discussing contraception with patients in order to avoid insulting a patient for whom a particular type of contraceptive method is prohibited by her background. Rationale 2 : Efficacy of contraceptive methods varies and must be considered when discussing contraception with patients. When pregnancy is medically contraindicated, high-efficacy methods (such as an IUD, hormonal methods, or sterilization) should be discussed with the patient. When the patient would like to avoid pregnancy at this time, but pregnancy is not medically contraindicated, lower-efficacy methods (such as diaphragm, cervical cap, or Today sponge) could be discussed. Rationale 3 : If a patient desires children in the future, sterilization methods would be inappropriate to discuss. Rationale 4 : Vegetarianism has no impact on contraceptive method use. Rationale 5 : Age at menarche has no impact on contraceptive method use. Global Rationale:

Nurse, Family, 8th Edition 2022

Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Planning

Nurse, Family, 8th Edition 2022

Learning Outcome: LO04 – Compare the advantages, disadvantages, and effectiveness of the various methods of contraception available today. Question 8 Type: MCSA A patient has decided to use the NuvaRing vaginal contraceptive ring as her method of contraception. Which statement suggests the patient needs further instruction?

1. “I do not need to be examined in order to determine the contraceptive ring size that is correct for me.”
2. “Every three months, I will need to remove the contraceptive ring and replace it with a new one.”
3. “When I store my replacement rings, I should keep them in my refrigerator.”
4. “The contraceptive ring provides a sustained release of low-dose contraceptive.” Correct Answer: 2 Rationale 1 : One size of the NuvaRing fits virtually all women. Rationale 2 : The ring is left in place for 3 weeks and then removed for 1 week to allow for withdrawal bleeding. Rationale 3 : Replacement rings should be kept in the refrigerator to maintain integrity. Rationale 4 : The contraceptive ring provides a low-dose, sustained- release hormonal contraceptive. Global Rationale: Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: LO04 – Compare the advantages, disadvantages, and effectiveness of the various methods of contraception available today. Question 9 Type: MCSA Which patient is not a good candidate for Depo-Provera (DMPA)?
5. One who wishes to get pregnant within three months
6. One who wishes to breastfeed
7. One with a vaginal prolapse
8. One who weighs 200 pounds Correct Answer: 1 Rationale 1 : Return of fertility after the use of Depo-Provera takes an average of nine months. Rationale 2 : Studies have proven there is no harm to a breastfed baby when a woman uses Depo-Provera. Rationale 3 : There is no correlation between a vaginal prolapse and use of Depo- Provera. Rationale 4 : There is no correlation between one’s weight and use of Depo-Provera. Global Rationale: Cognitive Level: Understanding Client Need: Physiological Integrity Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO04 – Compare the advantages, disadvantages, and effectiveness of the various methods of contraception available today. Question 10

Nurse, Family, 8th Edition 2022

Type: MCSA

Nurse, Family, 8th Edition 2022

The Public Health Nurse receives a phone call from a 16-year-old girl who asks, “Do I need to have a Pap smear just because I’m sexually active?” What is the nurse’s correct response?

1. “Yes, all sexually active females should be screened for both cervical cancer and HPV.”
2. “No, you do not need to be screened for cervical cancer until you are 21 years old.”
3. “Yes, all women under the age of 29 should be screened for both cervical cancer and HPV.”
4. “No, but you will need to begin your screenings for both cervical cancer and HPV when you are 18 years old.” Correct Answer: 2 Rationale 1 : Engaging in sexual activity is not an indication for routine cervical cancer or for HPV screening. Rationale 2 : 2012 guidelines issued by the U.S. Preventive Services Task Force (USPSTF) recommend initiating cervical cancer screening at age 21. Rationale 3 : 2012 guidelines issued by the U.S. Preventive Services Task Force (USPSTF) recommend cervical cancer screening without HPV co-testing in women ages 21 to 29. Rationale 4 : 2012 guidelines issued by the U.S. Preventive Services Task Force (USPSTF) recommend initiating cervical cancer screening at age 21. Global Rationale: Cognitive Level: Applying Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO05 – Delineate basic gynecologic screening procedures indicated for well women. Question 11 Type: MCMA A nurse is providing a patient with instructions regarding breast self-examination (BSE). Which of the following statements by the patient would indicate the likelihood that she understands how to detect changes such as lumps in her breast? Standard Text: Select all that apply.
5. “I should perform BSE one week prior to the start of my period.”
6. “When I reach menopause, I will perform BSE every two months.”
7. “Knowing the texture and feel of my breasts is important.”
8. “I should inspect my breasts in a circular manner.”
9. “I should inspect my breasts while in a supine position, with my arms at my sides.” Correct Answer: 3,4 Rationale 1 : BSE should be performed one week after the start of each menstrual period because hormonal levels are lowest and allow closer exam of softer breast tissue. Rationale 2 : BSE should be performed monthly, on the same day each month, during menopause. Rationale 3 : A woman who knows the texture and feel of her own breasts is far more likely to detect changes that develop. Rationale 4 : Checking breasts in a circular manner, feeling all parts of the breast, provides adequate palpation and possible detection of lumps. Rationale 5 : The breasts should be inspected while standing with arms at sides. Global Rationale:

Nurse, Family, 8th Edition 2022

Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Evaluation