Client Need&Sub: Psychosocial Integrity Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN
Trang 1Test bank for Contemporary Maternal Newborn Nursing 9th edition
by Ladewig London and Davidson
Link full download:
https://getbooksolutions.com/download/test-bank-for-contemporary-maternal-newborn-nursing-9th-edition-by-ladewig-london-and-davidson/
Chapter 5 Health Promotion for Women
1) The clinic nurse is returning phone calls Which call should the nurse return first?
A, A 22-year-old client reporting that she has menstrual cramps and vomiting every month
B, 17-year-old client asking if there is a problem with using one tampon for a whole day
C, 46-year-old mother of a teen wondering if her daughter should be on birth control
D, 34-year-old client requesting information on douching after intercourse
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 Douching is not recommended, because the practice causes a change in the pH of the vagina and impacts the normal flora, predisposing clients to candidiasis and bacterial vaginosis This client requires education but is not the first priority
Page Ref: 64, 65
Cognitive Level: Analyzing
Client Need&Sub: Physiological Integrity
Trang 2Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care
Learning Outcome: LO 5.1-Describe accurate information to be provided to girls and women so that they can implement effective self-care measures for dealing with menstruation
MNL LO: Explore the role of the nurse in maternity care delivery
2) When taking a sexual history from a client, the nurse should:
A, Ask questions that the client can answer with a “yes” or “no.”
B, Ask mostly open-ended questions
C, Have the client fill out a comprehensive questionnaire and review it after the client leaves
D, Try not to make much direct eye contact
Answer: B
Explanation: 1 “Yes-or-no” answers indicate closed-ended questions that will not encourage the client
to share the necessary information
Open-ended questions are often useful in eliciting information because they encourage more than a one-word answer
Filling out a questionnaire and reviewing it after the client leaves is not appropriate It should be
reviewed in the presence of the client, encouraging conversation regarding the results
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
Page Ref: 64
Cognitive Level: Analyzing
Trang 3Client Need&Sub: Psychosocial Integrity
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care
Learning Outcome: LO 5.1-Describe accurate information to be provided to girls and women so that they can implement effective self-care measures for dealing with menstruation
MNL LO: Relate sexual maturation and its impact on the reproductive system
3) Which client would the nurse document as exhibiting signs and symptoms of primary dysmenorrhea?
A, A 17-year-old female who has never had a menstrual cycle
B, A 16-year-old female who had regular menses for 4 years, but has had no menses in four months
C, A 19-year-old female who had regular menses for 5 years that have suddenly become painful
D, A 14-year-old female who had irregular menses for one year, experiences cramping every cycle Answer: D
Explanation: 1 This is primary amenorrhea, or the lack of menses
Secondary amenorrhea is the term used when a client has had regular cycles that cease
Secondary dysmenorrhea is the sudden onset of pain and discomfort with menses
Primary dysmenorrhea is when menstruation has been painful from the first menstrual cycle and
consistently continues to be painful each month
Page Ref: 67
Trang 4Cognitive Level: Analyzing
Client Need&Sub: Health Promotion and Maintenance
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Diagnosis/Coordination of care
Learning Outcome: LO 5.2-Contrast the signs, symptoms, and nursing management of women with dysmenorrhea and those with premenstrual syndrome
MNL LO: Explore the role of the nurse in maternity care delivery
4) A client 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:
A, “Douching should be avoided when you’re on your period.”
B, “Using a douche each day will help prevent vaginal infections from occurring.”
C, “During your period, douching will help promote the flow of menstrual secretions.”
D, “Regular douching is necessary in order to promote good hygiene.”
Trang 5Cognitive Level: Application
Client Need&Sub: Physiological Integrity
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion
Learning Outcome: LO 5.2-Contrast the signs, symptoms, and nursing management of women with dysmenorrhea and those with premenstrual syndrome
MNL LO: Explain the female reproductive cycle
Trang 6An intake of 1200 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
Decreased red meat consumption can be beneficial to reduce PMS symptoms, as will eating several small meals per day rather than three large meals
Page Ref: 67, 68
Cognitive Level: Application
Client Need&Sub: Health Promotion and Maintenance
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion
Learning Outcome: LO 5.2-Contrast the signs, symptoms, and nursing management of women with dysmenorrhea and those with premenstrual syndrome
MNL LO: Explain the female reproductive cycle
6) A client 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 client’s complaint is:
Trang 7Explanation: 1 Primary dysmenorrhea is defined as cramps without underlying disease
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
Menorrhagia is excessive, profuse flow
Hypermenorrhea is an abnormally long menstrual flow
Page Ref: 67, 68
Cognitive Level: Analyzing
Client Need&Sub: Health Promotion and Maintenance
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care
Learning Outcome: LO 5.2-Contrast the signs, symptoms, and nursing management of women with dysmenorrhea and those with premenstrual syndrome
MNL LO: Compare advantages, disadvantages, risk factors, and contraindications of contraception methods
7) Which issues should the nurse consider when counseling a client on contraceptive methods? Select all that apply
A, Cultural perspectives on menstruation and pregnancy
B, Efficacy of the method
C, Future childbearing plans
Trang 8D, Whether the patient is a vegetarian
Age at menarche
Answer: A,B,C
Explanation: 1 Cultural and religious beliefs, practices, and sanctions must be considered when
discussing contraception with clients in order to avoid insulting a client for whom a particular type of contraceptive method is prohibited by her background
Efficacy of contraceptive methods varies and must be considered when discussing contraception with clients When pregnancy is medically contraindicated, high-efficacy methods (such as an IUD, hormonal methods, or sterilization) should be discussed with the client When the client would like to avoid pregnancy at this time, but pregnancy is not medically contraindicated, lower-efficacy methods (e.g., diaphragm, cervical cap, or sponge) could be discussed
If a client desires children in the future, sterilization methods would be inappropriate to discuss
Vegetarianism has no impact on contraceptive method use
Age at menarche has no impact on contraceptive method use
Page Ref: 68—76
Cognitive Level: Analyzing
Client Need&Sub: Health Promotion and Maintenance
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Planning/Coordination of care
Learning Outcome: LO 5.3-Compare the advantages, disadvantages, and effectiveness of the various methods of contraception available today
MNL LO: Compare advantages, disadvantages, risk factors, and contraindications of contraception methods
Trang 9B, “Every three months, I will need to remove the contraceptive ring and replace it with a new one.”
C, “When I store my replacement rings, I should keep them in my refrigerator.”
D, “The contraceptive ring provides a sustained release of low-dose contraceptive.”
Answer: B
Explanation: 1 One size of the NuvaRing fits virtually all women
The ring is left in place for 3 weeks and then removed for 1 week to allow for withdrawal bleeding Replacement rings should be kept in the refrigerator to maintain integrity
The contraceptive ring provides a low-dose, sustained-release hormonal contraceptive
Page Ref: 75
Cognitive Level: Analyzing
Client Need&Sub: Health Promotion and Maintenance
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion
Learning Outcome: LO 5.3-Compare the advantages, disadvantages, and effectiveness of the various methods of contraception available today
Trang 10MNL LO: Compare advantages, disadvantages, risk factors, and contraindications of contraception methods
9) Which client is not a good candidate for Depo-Provera (DMPA)?
A, One who wishes to get pregnant within three months
B, One who wishes to breastfeed
C, One with a vaginal prolapse
D, One who weighs 200 pounds
Answer: A
Explanation: 1 Return of fertility after the use of Depo-Provera takes an average of nine months
Studies have proven there is no harm to a breastfed baby when a woman uses Depo-Provera
There is no correlation between a vaginal prolapse and use of Depo-Provera
There is no correlation between ones weight and use of Depo-Provera
Page Ref: 76
Cognitive Level: Understanding
Client Need&Sub: Physiological Integrity
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care
Learning Outcome: LO 5.3-Compare the advantages, disadvantages, and effectiveness of the various methods of contraception available today
Trang 11MNL LO: Compare advantages, disadvantages, risk factors, and contraindications of contraception methods
10) The public health nurse receives a phone call from a 16-year-old female who asks, “Do I need to have a Pap smear just because I’m sexually active?” What is the nurse’s correct response?
A, “Yes, all sexually active females should be screened for both cervical cancer and HPV.”
B, “No, you do not need to be screened for cervical cancer until you are 21 years old.”
C, “Yes, all women under the age of 29 should be screened for both cervical cancer and HPV.”
D, “No, but you will need to begin your screenings for both cervical cancer and HPV when you are 18 years old.”
Cognitive Level: Application
Client Need&Sub: Health Promotion and Maintenance
Standards: QSEN Competencies: Evidence based practice | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care
Trang 12Learning Outcome: LO 5.5-Identify basic gynecologic screening procedures indicated for well women
MNL LO: Explore the role of the nurse in maternity care delivery
11) A nurse is providing a client with instructions regarding breast self-examination (BSE) Which of the following statements by the client would indicate the likelihood that she understands how to detect changes such as lumps in her breast? Select all that apply
A, “I should perform BSE one week prior to the start of my period.”
B, “When I reach menopause, I will perform BSE every two months.”
C, “Knowing the texture and feel of my breasts is important.”
D, “I should inspect my breasts in a circular manner.”
E, “I should inspect my breasts while in a supine position, with my arms at my sides.”
Answer: C,D
Explanation: 1 A 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
A BSE should be performed monthly, on the same day each month, during menopause
A woman who knows the texture and feel of her own breasts is far more likely to detect changes that develop
Checking breasts in a circular manner, feeling all parts of the breast, provides adequate palpation and possible detection of lumps
The breasts should be inspected while standing with arms at sides
Page Ref: 79
Cognitive Level: Analyzing
Trang 13Client Need&Sub: Health Promotion and Maintenance
Standards: QSEN Competencies: Evidence based practice | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion
Learning Outcome: LO 5.5-Identify basic gynecologic screening procedures indicated for well women
MNL LO: Describe the structures and functions of the female reproductive system
12) What is the best indicator that the client is experiencing menopause?
A, No menses for 8 consecutive months
B, Hot flashes and night sweats
C, High serum FSH with low serum estrogen
D, Diagnosed with osteoporosis 4 months ago
Answer: C
Explanation: 1 Menopause is defined as 12 months of amenorrhea
Although hot flashes and night sweats are common in menopause, lab values or 12 months of
amenorrhea are better indicators
Examining serum levels of the hormones FSH and estrogen is a very accurate indication of menopause Menopause is not the only cause of osteoporosis; therefore, the diagnosis of osteoporosis 4 months ago
is not an indicator of menopause