Maternity Nursing Revised Reprint 8th Edition by Deitra Leonard -Test Bank
To Purchase
this Complete Test Bank with Answers Click the link Below
If face any problem or
Further information contact us At tbzuiqe@gmail.com
Sample Test
Lowdermilk: Maternity Nursing, 8th Edition
Chapter 03: Common Concerns
Test Bank
MULTIPLE CHOICE
1. When
assessing the patient for amenorrhea, the nurse should be aware that this may
be caused by all conditions except:
|
a. |
Anatomic abnormalities. |
|
b. |
Type 1 diabetes mellitus. |
|
c. |
Lack of exercise. |
|
d. |
Hysterectomy. |
ANS: C
|
|
Feedback |
|
A |
Anatomic abnormalities are
a possible cause of amenorrhea. |
|
B |
Type 1 diabetes is a
possible cause of amenorrhea. |
|
C |
Lack of exercise is not a
cause of amenorrhea. Strenuous exercise may cause amenorrhea. |
|
D |
Hysterectomy is a possible
cause of amenorrhea. |
DIF: Cognitive Level: Comprehension REF:
61
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Assessment
2. The
nurse who is teaching a group of women about breast cancer would tell the women
that:
|
a. |
Risk factors identify more
than 50% of women who will develop breast cancer. |
|
b. |
Nearly 90% of lumps found
by women are malignant. |
|
c. |
One in ten women in the
United States will develop breast cancer in her lifetime. |
|
d. |
The exact cause of breast
cancer is unknown. |
ANS: D
|
|
Feedback |
|
A |
Risk factors help to
identify fewer than 30% of women in whom breast cancer eventually will
develop. |
|
B |
Women detect about 90% of
all breast lumps. Of this 90%, only 20% to 25% are malignant. |
|
C |
One in eight women in the
United States will develop breast cancer in her lifetime. |
|
D |
The exact cause of breast
cancer in unknown. |
DIF: Cognitive Level: Comprehension REF:
87
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Assessment
3. When
a nurse is counseling a woman for primary dysmenorrhea, which nonpharmacologic
intervention would most likely be recommended?
|
a. |
Increasing the intake of
red meat and simple carbohydrates |
|
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 |
ANS: D
|
|
Feedback |
|
A |
Dietary changes such
as eating less red meat may be recommended for women experiencing
dysmenorrhea. |
|
B |
Increasing the intake of
diuretics, including natural diuretics such as asparagus, cranberry juice,
peaches, parsley, and watermelon, may help ease the symptoms associated with
dysmenorrhea. |
|
C |
Exercise has been found to
help relieve menstrual discomfort through increased vasodilation and
subsequent decreased ischemia. |
|
D |
Heat minimizes cramping by
increasing vasodilation and muscle relaxation and minimizing uterine
ischemia. |
DIF: Cognitive Level:
Analysis
REF: 63
OBJ: Client Needs: Physiologic
Integrity
TOP: Nursing Process: Planning
4. An
essential component of counseling women regarding safe sex practices includes
discussion regarding avoiding the exchange of body fluids. The physical barrier
promoted for the prevention of sexually transmitted infections (STIs) and human
immunodeficiency virus (HIV) is the condom. Nurses can help motivate patients
to use condoms by initiating a discussion related to a number of aspects of
condom use. The most important of these is:
|
a. |
Strategies to enhance
condom use. |
|
b. |
Choice of colors and
special features. |
|
c. |
Leaving the decision up to
the male partner. |
|
d. |
Places to safely carry
condoms. |
ANS: A
|
|
Feedback |
|
A |
When the nurse opens
discussion on safe sex practices, it gives the woman permission to clear up
any concerns or misapprehensions that she may have regarding condom use. The
nurse can also suggest ways that the woman can enhance her condom negotiation
and communications skills. These include role-playing, rehearsal, cultural
barriers, and situations that put the woman at risk. |
|
B |
Although women can be
taught the differences among condoms such as size ranges, where to purchase,
and price, this is not as important as negotiating the use of safe sex
practices. |
|
C |
Women must address the
issue of condom use with every sexual contact. Some men need time to think
about this. If they appear reluctant, the woman may want to reconsider the
relationship. |
|
D |
Although not ideal, women
may safely choose to carry condoms in shoes, wallets, or inside their bra.
They should be taught to keep the condom away from heat. This information is
important; however, it is not germane if the woman cannot even discuss
strategies on how to enhance condom use. |
DIF: Cognitive Level:
Analysis
REF: 72
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Planning
5. A
woman complains of severe abdominal and pelvic pain around the time of
menstruation that has gotten worse over the last 5 years. She also complains of
pain during intercourse and has tried unsuccessfully to get pregnant for the
past 18 months. These symptoms are most likely related to:
|
a. |
Endometriosis. |
|
b. |
PMS. |
|
c. |
Primary dysmenorrhea. |
|
d. |
Secondary dysmenorrhea. |
ANS: A
|
|
Feedback |
|
A |
Symptoms of endometriosis
can change over time and may not reflect the extent of the disease. Major
symptoms include dysmenorrhea and deep pelvic dyspareunia (painful
intercourse). Impaired fertility may result from adhesions caused by
endometriosis. |
|
B |
Endometriosis is not a
cause of PMS. |
|
C |
Although endometriosis may
be associated with secondary dysmenorrhea, it is not a cause of primary
dysmenorrhea. |
|
D |
Although endometriosis may
be associated with secondary dysmenorrhea, this woman is complaining of
dyspareunia and infertility. |
DIF: Cognitive Level: Comprehension REF:
66, 67
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Assessment
6. While
interviewing a 31-year-old woman before her routine gynecologic examination,
the nurse collects data about the woman’s recent menstrual cycles. The nurse
should collect additional information in regard to which statement?
|
a. |
The woman says her
menstrual flow lasts 5 to 6 days. |
|
b. |
She describes her flow as
very heavy. |
|
c. |
She reports that she has
had a small amount of spotting midway between her periods for the past 2
months. |
|
d. |
She says the length of her
menstrual cycle varies from 26 to 29 days. |
ANS: B
|
|
Feedback |
|
A |
This is a normal finding. |
|
B |
Menorrhagia is defined as
excessive menstrual bleeding, in either duration or amount. Heavy bleeding
can have many causes. The amount of bleeding and its effect on daily
activities should be evaluated. |
|
C |
Mittlestaining, a small
amount of bleeding or spotting that occurs at the time of ovulation (14 days
before onset of the next menses), is considered normal. |
|
D |
During her reproductive
years, a woman may have physiologic variations in her menstrual cycle.
Variations in the length of a menstrual cycle are considered normal. |
DIF: Cognitive Level: Comprehension REF:
70
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Assessment
7. A
nurse practitioner performs a clinical breast examination on a woman diagnosed
with fibroadenoma. The nurse knows that fibroadenoma is characterized by:
|
a. |
Inflammation of the milk
ducts and glands behind the nipples. |
|
b. |
Thick, sticky discharge
from the nipple of the affected breast. |
|
c. |
Lumpiness in both breasts
that develops 1 week before menstruation. |
|
d. |
A single lump in one breast
that can be expected to shrink as the woman ages. |
ANS: D
|
|
Feedback |
|
A |
This symptom is associated
with mammary duct ectasia, not fibroadenoma. |
|
B |
This symptom is associated
with galactorrhea, not fibroadenoma. |
|
C |
This symptom is associated
with fibrocystic changes of the breast. |
|
D |
Fibroadenomas are
characterized by discrete, usually solitary lumps smaller than 3 cm in
diameter. Fibroadenomas increase in size during pregnancy and shrink as the
woman ages. |
DIF: Cognitive Level:
Knowledge REF: 86
OBJ: Client Needs: Physiologic
Integrity
TOP: Nursing Process: Assessment
8. A
36-year-old woman has been diagnosed as having uterine fibroids. When planning
care for this patient, the nurse should know that:
|
a. |
Fibroids are malignant
tumors of the uterus that require radiation or chemotherapy. |
|
b. |
Fibroids will increase in
size during the perimenopausal period. |
|
c. |
Menorrhagia is a common
finding. |
|
d. |
The woman is unlikely to
become pregnant as long as the fibroids are in her uterus. |
ANS: C
|
|
Feedback |
|
A |
Fibroids are benign tumors
of the smooth muscle of the uterus, and their etiology is unknown. |
|
B |
Fibroids are
estrogen-sensitive and shrink as levels of estrogen decline. |
|
C |
The major symptoms
associated with fibroids are menorrhagia and the physical effects produced by
large myomas. |
|
D |
Fibroids occur in 25% of
women of reproductive age and are seen more often in African-American women. |
DIF: Cognitive Level: Comprehension REF:
68
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Planning
9. With
regard to endometriosis, nurses should be aware that:
|
a. |
It is characterized by the
presence and growth of endometrial tissue inside the uterus. |
|
b. |
It is found more often in
African-American women than in Caucasian or Asian women. |
|
c. |
It may worsen with repeated
cycles or remain asymptomatic and disappear after menopause. |
|
d. |
It is unlikely to affect
sexual intercourse or fertility. |
ANS: C
|
|
Feedback |
|
A |
With endometriosis, the
endometrial tissue is outside the uterus. Symptoms vary among women, ranging
from nonexistent to incapacitating. |
|
B |
Endometriosis is found
equally in Caucasian and African-American women and is slightly more
prevalent in Asian women. |
|
C |
Symptoms vary among women,
ranging from nonexistent to incapacitating. |
|
D |
Women can experience
painful intercourse and impaired fertility. |
DIF: Cognitive Level:
Knowledge REF: 66, 67
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Assessment
10. With
regard to dysfunctional uterine bleeding (DUB), the nurse should be aware that:
|
a. |
It is most commonly caused
by anovulation. |
|
b. |
It most often occurs in
middle age. |
|
c. |
The diagnosis of DUB should
be the first considered for abnormal menstrual bleeding. |
|
d. |
The most effective medical
treatment involves steroids. |
ANS: A
|
|
Feedback |
|
A |
Anovulation may occur
because of hypothalamic dysfunction or polycystic ovary syndrome. |
|
B |
DUB most often occurs when
the menstrual cycle is being established or when it draws to a close at
menopause. |
|
C |
A diagnosis of DUB is made
only after all other causes of abnormal menstrual bleeding have been ruled
out. |
|
D |
The most effective medical
treatment is oral or intravenous estrogen. |
DIF: Cognitive Level:
Knowledge REF: 69
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Diagnosis
11. The
two primary areas of risk for sexually transmitted infections (STIs) are:
|
a. |
Sexual orientation and
socioeconomic status. |
|
b. |
Age and educational level. |
|
c. |
Large number of sexual
partners and race. |
|
d. |
Risky sexual behaviors and
inadequate preventive health behaviors. |
ANS: D
|
|
Feedback |
|
A |
Although low socioeconomic
status may be a factor in avoiding purchasing barrier protection, sexual
orientation does not put one at higher risk. |
|
B |
Younger individuals with
less education may not be aware of proper prevention techniques: however,
these are not the primary areas of risk for STIs. |
|
C |
Having a large number of
sexual partners is certainly a risk-taking behavior, but race does not
increase the risk for STIs. |
|
D |
Risky sexual behaviors and
inadequate preventive health behaviors put a person at risk for acquiring or
transmitting an STI. |
DIF: Cognitive Level:
Knowledge REF: 71, 72
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Assessment
12. When
evaluating a woman for sexually transmitted infections (STIs), the nurse should
be aware that the most common bacterial sexually transmitted infection is:
|
a. |
Gonorrhea. |
|
b. |
Syphilis. |
|
c. |
Chlamydia. |
|
d. |
Candidiasis. |
ANS: C
|
|
Feedback |
|
A |
Gonorrhea and syphilis are
bacterial STIs, but they are not the most common ones among American women.
Candidiasis is caused by a fungus, not by bacteria. |
|
B |
Gonorrhea and syphilis are
bacterial STIs, but they are not the most common ones among American women.
Candidiasis is caused by a fungus, not by bacteria. |
|
C |
Chlamydia is the most
common and fastest spreading STI among American women, with an estimated
three million new cases each year. |
|
D |
Gonorrhea and syphilis are
bacterial STIs, but they are not the most common ones among American women.
Candidiasis is caused by a fungus, not by bacteria. |
DIF: Cognitive Level:
Knowledge REF: 73
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Assessment
13. One
of the alterations in cyclic bleeding that occurs between periods is called:
|
a. |
Oligomenorrhea. |
|
b. |
Menorrhagia. |
|
c. |
Leiomyoma. |
|
d. |
Metrorrhagia. |
ANS: D
|
|
Feedback |
|
A |
Oligomenorrhea is
infrequent or scanty menstruation. |
|
B |
Menorrhagia is excessive menstruation. |
|
C |
Leiomyoma is a common cause
of excessive bleeding. |
|
D |
Metrorrhagia is bleeding
between periods. It can be caused by progestin injections and implants. |
DIF: Cognitive Level:
Knowledge REF: 68
OBJ: Client Needs: Physiologic
Integrity
TOP: Nursing Process: Diagnosis
14. The
Centers for Disease Control and Prevention (CDC) recommends that HPV be treated
with patient-applied:
|
a. |
Miconazole ointment. |
|
b. |
Topical Podofilox 0.5%
solution or gel. |
|
c. |
Penicillin given
intramuscularly for two doses. |
|
d. |
Metronidazole by mouth. |
ANS: B
|
|
Feedback |
|
A |
Miconazole ointment is used
to treat athlete’s foot. |
|
B |
Available treatments are
Imiquimod, Podophyllin, and Podofilox. |
|
C |
Penicillin IM is used to
treat syphilis. |
|
D |
Metronidazole is used to
treat bacterial vaginosis. |
DIF: Cognitive Level:
Knowledge REF: 76
OBJ: Client Needs: Physiologic Integrity
TOP: Nursing Process: Implementation
15. A woman
has a thick, white, lumpy, cottage cheese–like discharge, with patches on her
labia and in her vagina. She complains of intense pruritus. The nurse
practitioner would order which preparation for treatment?
|
a. |
Fluconazole |
|
b. |
Tetracycline |
|
c. |
Clindamycin |
|
d. |
Acyclovir |
ANS: A
|
|
Feedback |
|
A |
Fluconazole, metronidazole,
and clotrimazole are the drugs of choice to treat candidiasis. |
|
B |
Tetracycline is used to
treat syphilis. |
|
C |
Clindamycin is used to
treat bacterial vaginosis. |
|
D |
Acyclovir is used to treat
genital herpes. |
DIF: Cognitive Level: Comprehension REF:
83
OBJ: Client Needs: Physiologic Integrity
TOP: Nursing Process: Implementation
16. To
detect the human immunodeficiency virus (HIV), most laboratory tests focus on:
|
a. |
HIV virus. |
|
b. |
HIV antibodies. |
|
c. |
CD4 counts. |
|
d. |
CD8 counts. |
ANS: B
|
|
Feedback |
|
A |
The screening tool used to
detect HIV is the enzyme immunoassay, which tests for the presence of
antibodies to the HIV virus. CD4 counts are associated with the incidence of acquired
immunodeficiency syndrome (AIDS) in HIV-infected individuals. |
|
B |
The screening tool used to
detect HIV is the enzyme immunoassay, which tests for the presence of
antibodies to the HIV virus. |
|
C |
The screening tool used to
detect HIV is the enzyme immunoassay, which tests for the presence of
antibodies to the HIV virus. CD4 counts are associated with the incidence of AIDS in
HIV-infected individuals. |
|
D |
The screening tool used to
detect HIV is the enzyme immunoassay, which tests for the presence of
antibodies to the HIV virus. CD4 counts are associated with the incidence of AIDS in
HIV-infected individuals. |
DIF: Cognitive Level:
Knowledge REF: 80
OBJ: Client Needs: Physiologic
Integrity
TOP: Nursing Process: Planning
17. On
vaginal examination of a 30-year-old woman, the nurse documents the following
findings: profuse, thin, grayish white vaginal discharge with a “fishy” odor;
complaint of pruritus. On the basis of these findings, the nurse suspects that
this woman has:
|
a. |
Bacterial vaginosis (BV). |
|
b. |
Candidiasis. |
|
c. |
Trichomoniasis. |
|
d. |
Gonorrhea. |
ANS: A
|
|
Feedback |
|
A |
Most women with BV complain
of a characteristic “fishy odor.” The discharge usually is profuse, thin, and
has a white, gray, or milky color. Some women also may have mild irritation
or pruritus. |
|
B |
The discharge associated
with candidiasis is thick, white, and lumpy and resembles cottage cheese. |
|
C |
Trichomoniasis may be
asymptomatic, but women commonly have a characteristic yellowish to greenish,
frothy, mucopurulent, copious, and malodorous discharge. |
|
D |
Women with gonorrhea are
often asymptomatic. They may have a purulent endocervical discharge, but
discharge usually is minimal or absent. |
DIF: Cognitive Level: Comprehension REF:
82
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Assessment
18. Which
viral sexually transmitted infection is characterized by a primary infection
followed by recurrent episodes?
|
a. |
Herpes simplex virus
(HSV)-2 |
|
b. |
Human papillomavirus (HPV) |
|
c. |
Human immunodeficiency
virus (HIV) |
|
d. |
Cytomegalovirus (CMV) |
ANS: A
|
|
Feedback |
|
A |
The initial HSV genital
infection is characterized by multiple painful lesions, fever, chills,
malaise, and severe dysuria; it may last 2 to 3 weeks. Recurrent episodes of
HSV infection commonly have only local symptoms that usually are less severe
than those of the initial infection. |
|
B |
With HPV infection, lesions
are a chronic problem. |
|
C |
HIV is a retrovirus. Seroconversion
to HIV positivity usually occurs within 6 to 12 weeks after the virus has
entered the body. Severe depression of the cellular immune system associated
with HIV infection characterizes acquired immunodeficiency syndrome (AIDS).
AIDS has no cure. |
|
D |
In most adults the onset of
CMV infection is uncertain and asymptomatic. However, the disease may become
a chronic, persistent infection. |
DIF: Cognitive Level: Comprehension REF:
77
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Assessment
19. During
her annual gynecologic checkup, a 17-year-old woman states that recently she
has been experiencing cramping and pain during her menstrual periods. The nurse
would document this complaint as:
|
a. |
Amenorrhea. |
|
b. |
Dysmenorrhea. |
|
c. |
Dyspareunia. |
|
d. |
Premenstrual syndrome
(PMS). |
ANS: B
|
|
Feedback |
|
A |
Amenorrhea is the absence
of menstrual flow. |
|
B |
Dysmenorrhea is pain during
or shortly before menstruation. |
|
C |
Dyspareunia is pain during intercourse. |
|
D |
PMS is a cluster of
physical, psychologic, and behavioral symptoms that begin in the luteal phase
of the menstrual cycle and resolve within a couple of days of the onset of
menses. |
DIF: Cognitive Level:
Knowledge REF: 62
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Diagnosis
20. The
nurse should know that once human immunodeficiency virus (HIV) enters the body,
seroconversion to HIV positivity usually occurs within:
|
a. |
6 to 10 days. |
|
b. |
2 to 4 weeks. |
|
c. |
6 to 12 weeks. |
|
d. |
6 months. |
ANS: C
|
|
Feedback |
|
A |
Seroconversion to HIV
positivity does not occur this quickly. |
|
B |
Seroconversion to HIV
positivity usually occurs within 6 to 12 weeks after the virus has entered
the body, not within 2 to 4 weeks. |
|
C |
Seroconversion to HIV
positivity usually occurs within 6 to 12 weeks after the virus has entered
the body. |
|
D |
Seroconversion to HIV
positivity usually occurs much sooner than this. The correct timeframe is
within 6 to 12 weeks after the virus has entered the body. |
DIF: Cognitive Level:
Knowledge REF: 80
OBJ: Client Needs: Physiologic
Integrity
TOP: Nursing Process: Assessment
21. Nafarelin
(200 mcg bid per nasal spray) currently is used as a treatment for
mild-to-severe endometriosis. The nurse should tell the woman taking this
medication that the drug:
|
a. |
Stimulates the secretion of
gonadotropin-releasing hormone (GnRH), thereby stimulating ovarian activity. |
|
b. |
Should be sprayed into one
nostril every other day. |
|
c. |
Should be injected into
subcutaneous tissue BID. |
|
d. |
Can cause her to experience
some hot flashes and vaginal dryness. |
ANS: D
|
|
Feedback |
|
A |
Nafarelin is a GnRH agonist
that suppresses the secretion of GnRH. |
|
B |
Nafarelin is administered
twice daily by nasal spray. |
|
C |
Nafarelin is administered
intranasally. |
|
D |
Nafarelin is a GnRH
agonist, and its side effects are similar to those of menopause. The
hypoestrogenism effect results in hot flashes and vaginal dryness. |
DIF: Cognitive Level: Comprehension REF:
67
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Planning
22. A
25-year-old single female comes to the gynecologist’s office for a follow-up
visit related to her abnormal Papanicolaou (Pap) test. The test revealed that
the woman has human papillomavirus (HPV). The woman asks, “What is that? Can
you get rid of it?” Your best response is:
|
a. |
“It’s just a little lump on
your cervix. We can freeze it off.” |
|
b. |
“HPV stands for ‘human
papillomavirus.’ It is a sexually transmitted infection (STI) that may lead
to cervical cancer.” |
|
c. |
“HPV is a type of early
human immunodeficiency virus (HIV). You will die from this.” |
|
d. |
“You probably caught this
from your current boyfriend. He should get tested for this.” |
ANS: B
|
|
Feedback |
|
A |
The health care team has a
duty to provide proper information to the patient, including information
related to STIs. |
|
B |
It is important to inform
the woman about STIs and the risks involved with HPV. |
|
C |
HPV and HIV are both
viruses that can be transmitted sexually, but they are not the same virus. |
|
D |
The onset of HPV can be
insidious. Often STIs go unnoticed. Abnormal bleeding frequently is the
initial symptom. The patient may have had HPV before her current boyfriend.
You cannot make any deductions from this limited information. |
DIF: Cognitive Level:
Analysis
REF: 77
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Planning
23. Which
statement about the various forms of hepatitis is accurate?
|
a. |
A vaccine exists for
hepatitis C but not for hepatitis B. |
|
b. |
Hepatitis A is acquired by
eating contaminated food or drinking polluted water. |
|
c. |
Hepatitis B is less
contagious than human immunodeficiency virus (HIV). |
|
d. |
The incidence of hepatitis
C is decreasing. |
ANS: B
|
|
Feedback |
|
A |
A vaccine exists for
hepatitis B but not for hepatitis C. |
|
B |
Contaminated milk and
shellfish are common sources of infection with hepatitis A. |
|
C |
Hepatitis B is more
contagious than HIV. |
|
D |
The incidence of hepatitis
C is increasing. |
DIF: Cognitive Level:
Knowledge REF: 78
OBJ: Client Needs: Physiologic
Integrity
TOP: Nursing Process: Assessment
24. The
nurse providing education regarding breast care should explain to the woman
that fibrocystic changes in breasts are:
|
a. |
A disease of the milk ducts
and glands in the breasts. |
|
b. |
A premalignant disorder
characterized by lumps found in the breast tissue. |
|
c. |
Lumpiness with pain and
tenderness found in varying degrees in the breast tissue of healthy women
during menstrual cycles. |
|
d. |
Lumpiness accompanied by
tenderness after menses. |
ANS: C
|
|
Feedback |
|
A |
Fibrocystic changes are palpable
thickenings in the breast. |
|
B |
Approximately 70% of
fibrocystic changes are nonproliferative lesions, 26% are proliferative
lesions without atypia, and the rest are proliferative lesions with atypical
hyperplasia. |
|
C |
Fibrocystic changes are
palpable thickenings in the breast usually associated with pain and
tenderness. The pain and tenderness fluctuate with the menstrual cycle. |
|
D |
Fibrocystic changes are
palpable thickenings in the breast usually associated with pain and
tenderness. The pain and tenderness fluctuate with the menstrual cycle. |
DIF: Cognitive Level:
Knowledge REF: 84
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Assessment
25. Which
diagnostic test is used to confirm a suspected diagnosis of breast cancer?
|
a. |
Mammogram |
|
b. |
Ultrasound |
|
c. |
Fine-needle aspiration
(FNA) |
|
d. |
CA 15-3 |
ANS: C
|
|
Feedback |
|
A |
Mammography is a clinical
screening tool that may aid in early detection of breast cancers. |
|
B |
Transillumination,
thermography, and ultrasound breast imaging are being explored as methods of
detecting early breast carcinoma. |
|
C |
When a suspicious mammogram
is noted or a lump is detected, diagnosis is confirmed by FNA, core needle
biopsy, or needle localization biopsy. |
|
D |
CA-15 is a serum tumor marker that is used to test for
residual disease. |
DIF: Cognitive Level:
Knowledge REF: 89
OBJ: Client Needs: Physiologic
Integrity
TOP: Nursing Process: Diagnosis
26. What
important, immediate postoperative care practice should the nurse remember when
caring for a woman who has had a mastectomy?
|
a. |
The blood pressure (BP)
cuff should not be applied to the affected arm. |
|
b. |
Venipuncture for blood work
should be performed on the affected arm. |
|
c. |
The affected arm should be
used for intravenous (IV) therapy. |
|
d. |
The affected arm should be
held down close to the woman’s side. |
ANS: A
|
|
Feedback |
|
A |
The affected arm should not
be used for BP readings, IV therapy, or venipuncture. |
|
B |
The affected arm should not
be used for BP readings, IV therapy, or venipuncture. |
|
C |
The affected arm should not
be used for BP readings, IV therapy, or venipuncture. |
|
D |
The affected arm should be
elevated with pillows above the level of the right atrium. |
DIF: Cognitive Level:
Application REF: 91
OBJ: Client Needs: Physiologic Integrity
TOP: Nursing Process: Implementation
27. Management
of primary dysmenorrhea often requires a multifaceted approach. The nurse who
provides care for a patient with this condition should be aware that the
optimal pharmacologic therapy for pain relief is:
|
a. |
Acetaminophen. |
|
b. |
Oral contraceptives (OCPs). |
|
c. |
Nonsteroidal
antiinflammatory drugs (NSAIDs). |
|
d. |
Aspirin. |
ANS: C
|
|
Feedback |
|
A |
Preparations containing
acetaminophen are less effective for dysmenorrhea because they lack the
antiprostaglandin properties of NSAIDs. |
|
B |
OCPs are a reasonable
choice for women who also want birth control. The benefit of OCPs is the
reduction of menstrual flow and irregularities. OCPs may be contraindicated
for some women and have a number of potential side effects. |
|
C |
This pharmacologic agent
has the strongest research results for pain relief. Often if one NSAID is not
effective, another one will provide relief. Approximately 80% of women gain
relief from these prostaglandin inhibitors. |
|
D |
NSAIDs are the drug of
choice. If a woman is taking an NSAID, she should avoid taking aspirin. |
DIF: Cognitive Level: Application
REF: 63
OBJ: Client Needs: Physiologic
Integrity
TOP: Nursing Process: Planning
28. A
woman has a breast mass that is not well-delineated and is nonpalpable,
immobile, and nontender. This is most likely:
|
a. |
Fibroadenoma. |
|
b. |
Lipoma. |
|
c. |
Intraductal papilloma. |
|
d. |
Mammary duct ectasia. |
ANS: C
|
|
Feedback |
|
A |
Fibroadenoma is
well-delineated, palpable, and movable. |
|
B |
Lipoma is palpable and
movable. |
|
C |
Intraductal papilloma is
the only benign breast mass that is nonpalpable. |
|
D |
Mammary duct ectasia is not
well-delineated and is immobile, but it is palpable and painful. |
DIF: Cognitive Level:
Application REF: 86
OBJ: Client Needs: Physiologic Integrity
TOP: Nursing Process: Diagnosis
MULTIPLE RESPONSE
1. There
is little consensus on the management of premenstrual dysphoric disorder
(PMDD). However, nurses can advise women on several self-help modalities that
often result in symptom improvement. The nurse knows that health teaching has
been effective when the woman reports that she has adopted a number of
lifestyle changes, including (choose all that apply):
|
a. |
Regular exercise. |
|
b. |
Improved nutrition. |
|
c. |
A daily glass of wine. |
|
d. |
Smoking cessation. |
|
e. |
Oil of evening primrose. |
ANS: A, B, D, E
|
|
Feedback |
|
Correct |
These are accurate
modalities that may provide significant symptom relief in 1 to 2 months. If
there is no improvement after these changes have been made, the woman may
need to begin pharmacologic therapy. |
|
Incorrect |
Women should decrease both
their alcohol and caffeinated beverage consumption if they suffer from PMDD. |
DIF: Cognitive Level:
Analysis
REF: 65, 66
OBJ: Client Needs: Physiologic
Integrity
TOP: Nursing Process: Evaluation
COMPLETION
1. Any
episode of vaginal bleeding that occurs at a time other than during menses is
referred to as _______________.
ANS:
Metrorrhagia
Defined as intermenstrual bleeding, metrorrhagia is also
commonly referred to as breakthrough
bleeding or mittlestaining. It
can be a normal part of a woman’s menstrual cycle if it occurs regularly, or it
may be an indication of an underlying disease process that requires further
investigation.
DIF: Cognitive Level:
Knowledge REF: 68
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Assessment
Lowdermilk: Maternity Nursing, 8th Edition
Chapter 04: Contraception, Abortion, and Infertility
Test Bank
MULTIPLE CHOICE
1. A
married couple is discussing alternatives for pregnancy prevention and has
asked about fertility awareness methods (FAMs). The nurse’s most appropriate
reply is:
|
a. |
“They’re not very
effective, and it’s very likely you’ll get pregnant.” |
|
b. |
“They can be effective for
many couples, but they require motivation.” |
|
c. |
“These methods have a few
advantages and several health risks.” |
|
d. |
“You would be much safer
going on the pill and not having to worry.” |
ANS: B
|
|
Feedback |
|
A |
FAMs are effective if used
correctly by a woman with a regular menstrual cycle. The typical failure rate
for all FAMs is 25% during the first year of use. |
|
B |
FAMs are effective with
proper vigilance of ovulatory changes in the body and adherence to coitus
intervals. |
|
C |
FAMs have no associated
health risks. |
|
D |
The use of birth control
has associated health risks. In addition, taking a pill daily requires
compliance on the patient’s part. |
DIF: Cognitive Level:
Application REF: 98, 99
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Planning
2. Which
test used to diagnose the basis of infertility is done during the luteal or
secretory phase of the menstrual cycle?
|
a. |
Hysterosalpingogram |
|
b. |
Endometrial biopsy |
|
c. |
Laparoscopy |
|
d. |
Follicle-stimulating
hormone (FSH) level |
ANS: B
|
|
Feedback |
|
A |
A hysterosalpingogram is
scheduled 2 to 5 days after menstruation to avoid flushing potentially
fertilized ovum out through a uterine tube into the peritoneal cavity. |
|
B |
Endometrial biopsy is
scheduled after ovulation, during the luteal phase of the menstrual cycle. |
|
C |
Laparoscopy usually is
scheduled early in the menstrual cycle. |
|
D |
Hormone analysis is
performed to assess endocrine function of the hypothalamic-pituitary-ovarian
axis when menstrual cycles are absent or irregular. |
DIF: Cognitive Level:
Knowledge REF: 125
OBJ: Client Needs: Physiologic
Integrity
TOP: Nursing Process: Planning
3. A man
smokes two packs of cigarettes a day. He wants to know if smoking is
contributing to the difficulty he and his wife are having getting pregnant. The
nurse’s most appropriate response is:
|
a. |
“Your sperm count seems to
be okay based on the first semen analysis.” |
|
b. |
“Only marijuana cigarettes
affect sperm count.” |
|
c. |
“Smoking can give you lung
cancer, even though it has no effect on sperm.” |
|
d. |
“Smoking can reduce the
quality of your sperm.” |
ANS: D
|
|
Feedback |
|
A |
This statement is
inaccurate. Sperm counts vary from day to day and depend on emotional and
physical status and sexual activity. Therefore a single analysis may be
inconclusive. A minimum of two analyses must be performed several weeks apart
to assess male fertility. |
|
B |
The use of alcohol and
marijuana may affect sperm counts. |
|
C |
The use of tobacco may
affect sperm counts. |
|
D |
The use of tobacco may
reduce the quality of the sperm. |
DIF: Cognitive Level:
Application REF: 123
OBJ: Client Needs: Health Promotion and
Maintenance TOP: Nursing
Process: Diagnosis
4. A
couple is trying to cope with an infertility problem. They want to know what
they can do to preserve their emotional equilibrium. The nurse’s most
appropriate response is:
|
a. |
“Tell your friends and
family so they can help you.” |
|
b. |
“Talk only to other friends
who are infertile because only they can help.” |
|
c. |
“Get involved with a
support group. I’ll give you some names.” |
|
d. |
“Start adoption proceedings
immediately because it is very difficult to obtain an infant.” |
ANS: C
|
|
Feedback |
|
A |
Although talking about
their feelings may unburden them of negative feelings, infertility can be a
major stressor that affects the couple’s relationships with family and
friends. |
|
B |
Limiting their interactions
to other infertile couples may be a beginning point for addressing
psychosocial needs, but depending on where the other couple is in their own
recovery process, this may or may not help them. |
|
C |
Venting negative feelings
may unburden the couple. A support group may provide a safe haven for the
couple to share their experiences and gain insight from others’ experiences. |
|
D |
This statement is not supportive
of the psychosocial needs of this couple and may be detrimental to their
well-being. |
DIF: Cognitive Level:
Application REF: 124
OBJ: Client Needs: Psychosocial
Integrity
TOP: Nursing Process: Assessment
Comments
Post a Comment