Olds’ Maternal Newborn Nursing & Women’s Health Across the Lifespan ,10th Edition by Michele C. – Test bank
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Sample
Test
Olds’ Maternal-Newborn Nursing and Women’s Health, 10e (Davidson)
Chapter 3 Health Promotion of Women Across the
Lifespan
1) The clinic nurse is returning phone calls. Which call should
the nurse return first?
1. The
call from a 22-year-old reporting that she has menstrual cramps and vomiting
every month
2. The
call from a 17-year-old asking whether there is a problem with using one tampon
for a whole day
3. The
call from a 46-year-old mother of a teen wondering if her daughter should be on
birth control
4. The
call from a 34-year-old requesting information on douching after intercourse
Answer: 2
Explanation: 2. Using a single tampon for an entire day
can lead to toxic shock syndrome, a potentially life-threatening condition.
This client needs education on the danger of using one tampon longer than 3-6
hours.
Page Ref: 39
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: IX. 7.
Provide appropriate patient teaching that reflects developmental stage, age,
culture, spirituality, patient preferences, and health literacy considerations
to foster patient engagement in their care. | NLN Competencies: Quality and
Safety: Communicate effectively with different individuals (team members, other
care providers, patients, families, etc.) so as to minimize risks associated
with handoffs among providers and across transitions in care. | Nursing/Integrated
Concepts Nursing Process: Implementation
Learning Outcome: 2 Summarize information that women may
need in order to implement appropriate self-care measures for dealing with
menstruation.
2) The nurse who is taking a sexual history from a client should
do which of the following?
1. Ask
questions that the client can answer with “yes” or “no.”
2. Ask
mostly open-ended questions.
3. Have
the client fill out a comprehensive questionnaire and review it after the
client leaves.
4. Try
not to make much direct eye contact.
Answer: 2
Explanation: 2. Open-ended questions are often useful in
eliciting information.
Page Ref: 37
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 1. Elicit patient
values, preferences, and expressed needs as part of clinical interview,
implementation of care plan and evaluation of care. | AACN Essentials
Competencies: VII. 3. Assess health/illness beliefs, values, attitudes, and
practices of individuals, families, groups, communities, and populations. | NLN
Competencies: Relationship-Centered Care: Communicate information effectively;
listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing
Process: Assessment
Learning Outcome: 1 Discuss the key points a nurse should
consider when taking a sexual history.
3) The nurse is taking a history on a new client in the clinic.
She determines from talking with the client that she is recently divorced, is
dating, and has had sex with various men. The nurse would be concerned about
and would provide some education on what issues?
1. The
ethics of dating and having sex with more than one man
2. The
client having some kind of permanent birth control done, so she does not become
pregnant
3. Education
about sexual activity and sexually transmitted infections
4. Referral
to a psychologist or counselor for follow-up on the multiple dating
Answer: 3
Explanation: 3. Education about sexual activity and
sexually transmitted infections is correct, since it has been determined that
the client is having sex with multiple partners.
Page Ref: 37
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment:
Safety and Infection Control
Standards: QSEN Competencies: I. C. 4. Seek learning
opportunities with patients who represent all aspects of human diversity. |
AACN Essentials Competencies: VII. 6. Use information and communication
technologies in preventive care. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 1 Discuss the key points a nurse should
consider when taking a sexual history.
MNL LO: 6.2.1 Recognize client behaviors associated with
the acquisition of sexually transmitted infections.
4) The nurse is taking a history of a new client in the clinic.
Histories tend to be lengthy, and the sexual part can be difficult for the
client. The nurse should use what technique to make it easier for the client?
1. Let
the client fill out a paper copy, so she does not have to talk about intimate
matters.
2. Skip
the sexual part until the next time the client comes into the clinic.
3. Start
with the easier medical and surgical questions, and develop a feeling of trust
with the client.
4. Leave
the sexual part of the history for the doctor to ask about.
Answer: 3
Explanation: 3. Starting with easy-to-answer questions and
then going to the sexual ones helps, as client might be at ease by then.
Page Ref: 37
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 3. Provide
patient-centered care with sensitivity and respect for the diversity of human experience.
| AACN Essentials Competencies: VII. 3. Assess health/illness beliefs, values,
attitudes, and practices of individuals, families, groups, communities, and
populations. | NLN Competencies: Context and Environment: Read and interpret
data; apply health promotion/disease prevention strategies; apply health
policy; conduct population-based transcultural health assessments and
interventions. | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 1 Discuss the key points a nurse should
consider when taking a sexual history.
5) The nurse working in a women’s clinic is training a recent
graduate of nursing school who has been hired. The experienced nurse explains
that nurses caring for women of all ages must be which of the following?
Note: Credit will be given only if all correct and no incorrect
choices are selected.
Select all that apply.
1. Aware
of their own feelings
2. Judgmental
when discussing sexuality
3. Aware
of personal values and attitudes
4. Minimally
knowledgeable about reproduction
5. Willing
to discuss sexuality only one-on-one
Answer: 1, 3
Explanation: 1. Nurses must be aware of their own
feelings.
3. Nurses
must develop an awareness of their own values and attitudes about sexuality so
that they can be more sensitive and objective when they encounter the values
and beliefs of others.
Page Ref: 37
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: II. B. 5. Assume role of
team member or leader based on the situation. | AACN Essentials Competencies:
VI. 2. Use inter-and intraprofessional communication and collaborative skills
to deliver evidence-based, patient-centered care. | NLN Competencies: Teamwork:
Function competently within one’s own scope of practice as leader or member of
the health care team and manage delegation effectively. | Nursing/Integrated
Concepts: Nursing Process: Implementation
Learning Outcome: 1 Discuss the key points a nurse should
consider when taking a sexual history.
6) A client asks her nurse, “Is it okay for me to take a tub
bath during the heavy part of my menstruation?” What is the nurse’s correct
response?
1. “Tub
baths are contraindicated during menstruation.”
2. “You
should shower and douche daily instead.”
3. “Either
a bath or a shower is fine at that time.”
4. “You
should bathe and use a feminine deodorant spray during menstruation.”
Answer: 3
Explanation: 3. Bathing, whether it is a tub bath or a
shower, is as important (if not more so) during menses as at any other time.
Page Ref: 39
Cognitive Level: Understanding
Client Need/Sub: Physiological Integrity: Basic Care and
Comfort
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 6.
Use information and communication technologies in preventive care. | NLN
Competencies: Relationship-Centered Care: Communicate information effectively;
listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing
Process: Implementation
Learning Outcome: 2 Summarize information that women may
need in order to implement appropriate self-care measures for dealing with
menstruation.
7) Which client would the nurse document as exhibiting signs and
symptoms of primary dysmenorrhea?
1. 17-year-old,
has never had a menstrual cycle
2. 16-year-old,
had regular menses for 4 years, but has had no menses in 4 months
3. 19-year-old,
regular menses for 5 years that have suddenly become painful
4. 14-year-old,
irregular menses for 1 year, experiences cramping every cycle
Answer: 4
Explanation: 4. Dysmenorrhea, or painful menstruation,
occurs at, or a day before, the onset of menstruation and disappears by the end
of menses. Primary dysmenorrhea is defined as cramps without underlying
disease.
Page Ref: 40
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Diagnosis
Learning Outcome: 4 Contrast dysmenorrhea and premenstrual
syndrome.
8) The nurse is conducting health screening at a community
clinic. The client has asked whether there are any risks with body piercing and
tattooing, or whether these activities would impact sexual activity. How should
the nurse respond?
1. “You
should avoid piercing your genitalia and your nipples.”
2. “There
are no problems that occur with either body piercing or tattooing.”
3. “Both
piercing and tattooing carry risks of infection, including hepatitis.”
4. “The
benefit of body art outweighs any risk of infection of a tattoo or piercing.”
Answer: 3
Explanation: 3. For tattooing and body piercing, risks
include infections such as HIV and hepatitis B and C because of the use of
inadequately sterilized equipment, as well as allergic reactions, local
swelling and burns, granulomas, and keloid formation.
Page Ref: 44
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment:
Safety and Infection Control
Standards: QSEN Competencies: I. C. 4. Seek learning
opportunities with patients who represent all aspects of human diversity. |
AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide
health teaching, health counseling, screening, outreach, disease and outbreak
investigation, referral, and follow-up throughout the lifespan. | NLN
Competencies: Relationship-Centered Care: Appreciate the patient as a whole
person, with his or her own life story and ideas about the meaning of health or
illness. | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 1 Discuss the key points a nurse should
consider when taking a sexual history.
MNL LO: 6.2.1 Recognize client behaviors associated with
the acquisition of sexually transmitted infections.
9) The nurse is teaching a class on menstruation to young girls.
What information would be important for 10-12-year-olds to know?
1. The
age they will start having their periods
2. Variations
in the age menstruation begins, length of the cycle, and duration of the menses
3. The
number of days they will be ill when they have their menses
4. The
number of days they will not be able to take part in physical education at
school during their menses
Answer: 2
Explanation: 2. These are the issues young girls like to
know, as they always question whether they are different from their peers.
Page Ref: 44
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance:
Developmental Stages and Transitions
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2 Summarize information that women may
need in order to implement appropriate self-care measures for dealing with
menstruation.
10) The nurse is interviewing a 16-year-old client who has been
using deodorant tampons during her menses. She comes into the gynecology office
complaining of a rash and open sores on her labia and tenderness in the vagina.
After obtaining her history, what will the nurse determine is the most likely
cause of this client’s problem?
1. She
had forceful intercourse, which caused the trauma.
2. She
is reacting to the deodorant in the tampon.
3. She
might be allergic to the underwear she is wearing.
4. She
is having a normal reaction to her menses.
Answer: 2
Explanation: 2. This is the correct answer, as women often
will react to the deodorant used on pads and tampons.
Page Ref: 38
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment:
Safety and Infection Control
Standards: QSEN Competencies: I. B. 3. Provide
patient-centered care with sensitivity and respect for the diversity of human
experience. | AACN Essentials Competencies: VII. 5. Use evidence-based
practices to guide health teaching, health counseling, screening, outreach,
disease and outbreak investigation, referral, and follow-up throughout the
lifespan. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated
Concepts: Nursing Process: Implementation
Learning Outcome: 2 Summarize information that women may
need in order to implement appropriate self-care measures for dealing with
menstruation.
11) The nurse educator is teaching a group of teens and
20-year-olds reproductive health care. When several of the women bring up douching,
what is the best response the nurse could make?
1. “One
should always douche after having intercourse.”
2. “When
douching, use force putting them in and get the solution up high.”
3. “It
is a good idea to douche before intercourse so the area is clean for the
sperm.”
4. “Douching
is unnecessary because the lining of the vagina has numerous glands that
provide natural cleansing.”
Answer: 4
Explanation: 4. This is a true statement. The vagina has a
natural cleansing system.
Page Ref: 39
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 2 Summarize information that women may
need in order to implement appropriate self-care measures for dealing with
menstruation.
12) The nurse is instructing a young client on avoiding toxic
shock syndrome. Education was successful when the client makes which
statements?
Note: Credit will be given only if all correct and no incorrect
choices are selected.
Select all that apply.
1. “I
will wash my hands before inserting a tampon.”
2. “I
will change my tampon every 3-6 hours.”
3. “I
will not touch the part of the tampon I insert.”
4. “I
will just put the used tampon in the trash.”
5. “I
will take prophylactic antibiotics if needed.”
Answer: 1, 2, 3
Explanation: 1. Washing hands before inserting or removing
a tampon is correct.
2. Changing
the tampon every 3-6 hours will help prevent toxic shock syndrome from
developing.
3. After
the tampon is unwrapped, the client should avoid touching the portion of the
tampon to be inserted into the vagina.
Page Ref: 39
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment:
Safety and Infection Control
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling, screening,
outreach, disease and outbreak investigation, referral, and follow-up
throughout the lifespan. | NLN Competencies: Relationship-Centered Care:
Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 2 Summarize information that women may
need in order to implement appropriate self-care measures for dealing with
menstruation.
13) The nurse is interviewing an adolescent client. The client
reports a weight loss of 50 pounds over the last 4 months, and reports running
at least 5 miles per day. The client asserts that her menarche was 5 years ago.
Her menses are usually every 28 days, but her last menstrual period was 4
months ago. The client denies any sexual activity. Which is the best statement
for the nurse to make?
1. “Your
lack of menses might be related to your rapid weight loss.”
2. “It
is common and normal for runners to stop having any menses.”
3. “Increase
your intake of iron-rich foods to reestablish menses.”
4. “Adolescents
rarely have regular menses, even if they used to be regular.”
Answer: 1
Explanation: 1. Secondary amenorrhea can be caused by
rapid weight loss, including the development of the eating disorders anorexia
and bulimia. Runners with low body fat might have irregular menses, but
amenorrhea is not a normal condition.
Page Ref: 39
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3 Identify causes of amenorrhea.
14) A 19-year-old woman comes to the gynecologist’s office. When
the nurse asks the reason for this visit, the client explains that she has
never had a menstrual period, and that she is concerned there might be
something wrong. What is the diagnosis that the physician is most likely to
make based on this information?
1. Primary
dysmenorrhea
2. Secondary
infertility
3. Primary
amenorrhea
4. Secondary
amenorrhea
Answer: 3
Explanation: 3. Primary amenorrhea is the term for the
condition when menses have never occurred.
Page Ref: 39
Cognitive Level: Remembering
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Diagnosis
Learning Outcome: 3 Identify causes of amenorrhea.
15) The nurse educator is talking with the students in the
clinical area about amenorrhea. She has discussed both primary and secondary
amenorrhea and their possible causes and knows that her teaching has been
successful when, upon being questioned, a student explains that amenorrhea can
be caused by which of the following?
1. Malfunctioning
of the pancreas and insulin usage
2. Lack
of testosterone after the time for menses to start
3. Lack
of vitamin D and calcium in the system
4. Dysfunction
of the hypothalamus
Answer: 4
Explanation: 4. Causes for amenorrhea include dysfunction
of the hypothalamus, pituitary, and/or anovulation.
Page Ref: 39, 40
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I.B.10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Diagnosis
Learning Outcome: 3 Identify causes of amenorrhea.
16) 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 2 years. What is the most likely cause
for the client’s complaint?
1. Primary
dysmenorrhea
2. Secondary
dysmenorrhea
3. Menorrhagia
4. Hypermenorrhea
Answer: 2
Explanation: 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.
Page Ref: 40
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Diagnosis
Learning Outcome: 4 Contrast dysmenorrhea and premenstrual
syndrome.
MNL LO: 6.1.2 Compare advantages, disadvantages, risk
factors, and contraindications of contraception methods.
17) The nurse teaches a group of young women that self-care
measures for dysmenorrhea include which of the following actions?
Note: Credit will be given only if all correct and no incorrect
choices are selected.
Select all that apply.
1. Taking
vitamins B and E
2. Decreasing
salt intake
3. Using
cold packs as needed
4. Using
intermittent exercise
5. Taking
FSH replacement
Answer: 1, 2
Explanation: 1. Some nutritionists suggest that vitamins B
and E help relieve the discomforts associated with menstruation.
2. Self-care
measures such as regular exercise, rest, application of heat, and good
nutrition—including reducing salt—will help dysmenorrhea symptoms.
Page Ref: 40
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4 Contrast dysmenorrhea and premenstrual
syndrome.
18) The nurse at a women’s clinic is planning a class on
premenstrual dysphoric disorder (PMDD). The nurse includes in the education
information about what medications that are shown to be effective for PMDD?
Note: Credit will be given only if all correct and no incorrect
choices are selected.
Select all that apply.
1. Fluoxetine
hydrochloride (Prozac)
2. Sertraline
hydrochloride (Zoloft)
3. Paroxeline
CR (Paxil CR)
4. Hyoscyamine
(Anaspaz)
5. Promethazine
(Phenergan)
Answer: 1, 2, 3
Explanation: 1. Selective serotonin inhibitors such as
fluoxetine hydrocholoride (Prozac) have been found to be effective in
controlling PMDD.
2. Setraline
hydrochloride (Zoloft) is a selective serotonin inhibitor and has been found to
be effective in controlling PMDD.
3. Paroxeline
CR (Paxil CR) is a selective serotonin inhibitor and has been found to be
effective in controlling PMDD.
Page Ref: 41
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2 Summarize information that women may
need in order to implement appropriate self-care measures for dealing with
menstruation.
19) The nurse is teaching a group of women about menopause at a
community clinic. The nurse tells them that the best indicator of menopause is
which of the following symptoms?
1. No
menses for 8 consecutive months
2. Hot
flashes and night sweats
3. FSH
levels rise and ovarian follicles cease to produce estrogen
4. Diagnosed
with osteoporosis 4 months ago
Answer: 3
Explanation: 3. Examining FSH and estrogen levels is a
very accurate indication of menopause.
Page Ref: 45
Cognitive Level: Remembering
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5 Delineate the physical and psychologic
aspects of menopause.
MNL LO: 6.1.1 Explain hormonal changes that occur in menopause
and methods to manage the associated symptoms.
20) A client who is in perimenopause is having a number of
severe symptoms. The nurse assesses this client and knows the doctor will
likely prescribe what to assist in relieving the distress?
1. Calcium
and vitamin D
2. A
form of hormonal contraception
3. Prescriptive
pain medication
4. Antibiotics
Answer: 2
Explanation: 2. Hormonal contraception is the correct
answer, as pregnancy can still be a concern, plus the estrogen will relieve
other symptoms, such as hot flashes and vaginal dryness.
Page Ref: 45
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients
and designated surrogates in active partnerships that promote health, safety
and well-being, and self-care management. | AACN Essentials Competencies: VII.
5. Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5 Delineate the physical and psychologic
aspects of menopause.
MNL LO: 6.1.1 Explain hormonal changes that occur in
menopause and methods to manage the associated symptoms.
21) The nurse is teaching a group of menopausal women about the
signs and symptoms of menopause and how they can get relief. One of the main
concerns of the group is vaginal dryness and difficult intercourse. What is the
reason the nurse will give for this?
1. The
loss of cervical gland function leads to dryness of the mucous membranes of the
vagina.
2. The
vaginal pH increases, and the number of Doderlein’s bacilli decreases.
3. The
uterine lining thins and the muscle layer atrophies.
4. The
labia shrink and lose their pigmentation.
Answer: 1
Explanation: 1. The loss of cervical gland function leads
to dryness of the mucous membranes of the vagina.
Page Ref: 45
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment:
Management of Care
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships in health and safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5 Delineate the physical and psychologic
aspects of menopause.
MNL LO: 6.1.1 Explain hormonal changes that occur in
menopause and methods to manage the associated symptoms.
22) A client is asking the nurse what she can do about the
“falling down of her reproductive organs and urinary tract wall.” The nurse
will tell the client to try what exercise?
1. Lifting
weights to strengthen those muscles
2. Running
two miles a day
3. Running
up and down stairs a few times every day
4. Performing
Kegel exercises and having regular sexual activity
Answer: 4
Explanation: 4. This is the correct answer. Kegel
exercises are done by tightening and relaxing the perineal muscles, and this
activity as well as sexual activity will help the client’s problem.
Page Ref: 45
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5 Delineate the physical and psychologic
aspects of menopause.
MNL LO: 6.1.1 Explain hormonal changes that occur in
menopause and methods to manage the associated symptoms.
23) The nurse educator is talking with a group of students doing
their gynecological rotation. The nurse describes a number of symptoms that
include anovulation, reduced fertility, either decreased or increased menstrual
flow, and menstrual cycle irregularities. The nurse is describing what
condition?
1. Intermenstrual
bleeding
2. Hypermenorrhea
3. Menopause
4. Primary
amenorrhea
Answer: 3
Explanation: 3. This is the correct answer. Anovulation,
reduced fertility, either decreased or increased menstrual flow, and menstrual
cycle irregularities are some of the symptoms of menopause.
Page Ref: 45
Cognitive Level: Remembering
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5 Delineate the physical and psychologic
aspects of menopause.
MNL LO: 6.1.1 Explain hormonal changes that occur in
menopause and methods to manage the associated symptoms.
24) When caring for the menopausal woman, nurses need to be
empathetic in approaching which of the following areas?
Note: Credit will be given only if all correct and no incorrect
choices are selected.
Select all that apply.
1. Administering
medications
2. Health
teaching
3. Providing
physical care
4. Counseling
5. Encouraging
hormone therapy
Answer: 2, 3, 4
Explanation: 2. The nurse needs to use an empathetic
approach in counseling, health teaching, and providing physical care.
3. The
nurse needs to use an empathetic approach in counseling, health teaching, and
providing physical care.
4. The
nurse needs to use an empathetic approach in counseling, health teaching, and
providing physical care.
Page Ref: 50
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5 Delineate the physical and psychologic
aspects of menopause.
MNL LO: 6.1.1 Explain hormonal changes that occur in
menopause and methods to manage the associated symptoms.
25) The nurse assessing a 47-year-old client who is
perimenopausal includes which important topics?
Note: credit will be given only if all correct and no incorrect
choices are selected.
Select all that apply.
1. Vasomotor
symptoms
2. A
decrease in vaginal lubrication
3. Pregnancy
not being an option
4. Mood
changes that occur
5. An
increase in the libido
Answer: 1, 2, 4
Explanation: 1. Women need to know that vasomotor symptoms
occur. It might be important to investigate other possible causes of the
vasomotor symptoms.
2. Women
need to know that a decrease in vaginal lubrication occurs, and that
water-soluble lubricants should be used.
3. Mood
changes and irritability occur, and the woman might experience more
forgetfulness.
Page Ref: 44
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients
and designated surrogates in active partnerships that promote health, safety
and well-being, and self-care management. | AACN Essentials Competencies: VII.
5. Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5 Delineate the physical and psychologic
aspects of menopause.
MNL LO: 6.1.1 Explain hormonal changes that occur in
menopause and methods to manage the associated symptoms.
26) In teaching a group of adolescents, the nurse discusses
which risk factors for cardiovascular disease (CVD) in women?
Note: Credit will be given only if all correct and no incorrect
choices are selected.
Select all that apply.
1. Being
over 55 and postmenopausal
2. Using
cigarettes and tobacco
3. Being
overweight
4. Having
a low cholesterol level
5. Having
an active lifestyle
Answer: 1, 2, 3
Explanation: 1. Being over the age of 55 and
postmenopausal increases the risk of CVD.
2. The
use of cigarettes and tobacco increases the risk of CVD.
3. Being
overweight or obese increases the risk of CVD.
Page Ref: 46
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5 Delineate the physical and psychologic
aspects of menopause.
MNL LO: 6.1.1 Explain hormonal changes that occur in
menopause and methods to manage the associated symptoms.
27) The nurse in the OB-GYN clinic has been seeing a client
through her menopausal stage of life. The nurse assesses psychological concerns
if the client makes which statement?
Note: Credit will be given only if all correct and no incorrect
choices are selected.
Select all that apply.
1. “I
feel so lost with all of the kids away from home.”
2. “I wish
I were younger, and could have a baby.”
3. “Although
my parents are aging, they travel a lot.”
4. “I
don’t think I am a good wife anymore.”
5. “I
really enjoy being able to go out when I want.”
Answer: 1, 2, 4
Explanation: 1. Adjustment to an “empty nest” is a
psychological concern during menopause.
2. Some
women express disappointment in approaching this time of their lives, whereas
others might see it as a positive transition that offers freedom from menses or
concern about contraception.
3. Numerous
personal factors influence a woman’s ability to transition and cope with these
changes, such as self-concept.
Page Ref: 45
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5 Delineate the physical and psychologic
aspects of menopause.
MNL LO: 6.1.1 Explain hormonal changes that occur in
menopause and methods to manage the associated symptoms.
28) The nurse is answering the perimenopausal client’s questions
about hormone replacement therapy. Which client statement indicates a need for
further teaching?
1. “Estrogen
therapy will decrease my chances of developing osteoporosis.”
2. “If I
am taking estrogen therapy, I will not have to worry about my cholesterol being
checked.”
3. “Osteoporosis
is a decrease in bone strength due to bone density and quality.”
4. “Bone
mass tends to decrease after menopause.”
Answer: 2
Explanation: 2. Cholesterol levels should be checked
regularly even when normal, so this statement indicates the need for more
teaching.
Page Ref: 43
Cognitive Level: Understanding
Client Need/Sub: Physiological Integrity: Physiological
Adaptation
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 5 Delineate the physical and psychologic
aspects of menopause.
MNL LO: 6.1.1 Explain hormonal changes that occur in
menopause and methods to manage the associated symptoms.
29) The charge nurse is giving an in-service to the orthopedic
and gynecology nurses concerning the relationship between estrogen and
osteoporosis. Which is a statement the nurse would make concerning this
relationship?
1. “Males
have a higher incidence of osteoporosis than do females.”
2. “Women
who experience menopause at a younger age and have less bone mass could have
more bone loss.”
3. “Estrogen
levels affect only bone mass, but they have nothing to with bone strength and
bone density.”
4. “Osteoporosis
puts the client at a decreased risk for fractures of the forearm and
vertebrae.”
Answer: 2
Explanation: 2. This is a true statement, as women who
experience menopause at a younger age and have less bone mass lose the benefit
of estrogen for more years.
Page Ref: 39
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 6 Explain the relationship between
menopause and osteoporosis.
MNL LO: 6.1.1 Explain hormonal changes that occur in
menopause and methods to manage the associated symptoms.
30) The nurse is interviewing a new client in the clinic. The
client is premenopausal, but is concerned about the bone changes and
osteoporosis that can occur, since she is getting close to menopause. The nurse
tells the client that prevention is the primary goal. Which of the following
would be a primary goal for prevention?
1. Eliminating
all alcohol intake
2. Taking
500 mg of calcium each day
3. Use
of sunscreen to assist with absorption of vitamin D
4. Regular
weight-bearing and muscle-strengthening exercises
Answer: 4
Explanation: 4. This is correct. Regular weight bearing of
the long bones is a primary goal for the prevention of osteoporosis.
Page Ref: 48
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 6 Explain the relationship between
menopause and osteoporosis.
MNL LO: 6.1.1 Explain hormonal changes that occur in
menopause and methods to manage the associated symptoms.
31) The nurse is teaching a group of clients about risk factors
for osteoporosis. The nurse will include which of the following risk factors in
the teaching?
Note: Credit will be given only if all correct and no incorrect
choices are selected.
Select all that apply.
1. Menopause
at an early age increases bone loss
2. A
family history of osteoporosis
3. A
lifetime of high calcium intake
4. Having
an active lifestyle
5. A
vitamin D deficiency
Answer: 1, 2, 5
Explanation: 1. Abnormal absence of menses and early onset
of menopause increase the risk of osteoporosis.
2. Family
history of osteoporosis, especially a maternal hip fracture, increases the risk
of osteoporosis.
3. Vitamin
D deficiency increases the risk of osteoporosis.
Page Ref: 46
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Health
Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships in health, safety and well-being,
and self-care management. | AACN Essentials Competencies: VII. 5. Use
evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 6 Explain the relationship between
menopause and osteoporosis.
MNL LO: 6.1.1 Explain hormonal changes that occur in
menopause and methods to manage the associated symptoms.
32) A menopausal woman tells her nurse that she experiences
discomfort from vaginal dryness during sexual intercourse, and asks, “What
should I use as a lubricant?” The nurse should recommend which of the
following?
1. Petroleum
jelly
2. A
water-soluble lubricant
3. Body
cream or body lotion
4. Less-frequent
intercourse
Answer: 2
Explanation: 2. A water-soluble jelly should be used.
Page Ref: 50
Cognitive Level: Understanding
Client Need/Sub: Physiological Integrity: Basic Care and
Comfort
Standards: QSEN Competencies: I. B. 10. Engage patients or
designated surrogates in active partnerships that promote health, safety and
well-being, and self-care management. | AACN Essentials Competencies: VII. 5.
Use evidence-based practices to guide health teaching, health counseling,
screening, outreach, disease and outbreak investigation, referral, and
follow-up throughout the lifespan. | NLN Competencies: Relationship-Centered
Care: Communicate information effectively; listen openly and cooperatively. |
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5 Delineate the physical and psychologic
aspects of menopause.
MNL LO: 6.1.1 Explain hormonal changes that occur in
menopause and methods to manage the associated symptoms.
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