Womens Health- Exam 3 – Flashcards

Correct Answer: D Rational: "Women with menorrhagia should be warned not to use aspirin because of its tendency to increase bleeding" (Lowdermilk, Perry, Cashion, & Alden, 2012, p. 129). If patient wishes to maintain childbearing potential, "a myomectomy may be done" Other surgical options increase a woman's loss of fertility.

Answer: D Rationale: "The side effects associated with estrogen use include headaches, nausea and vomiting, bloating, ankle and feet swelling, weight gain, breast soreness, brown spots on the skin, eye irritation with contact lenses, and depression" (Lowdermilk et al., 2012, p. 134). A, B, & C, are not indicated.

ANSWER: C Rationale: Once vaginal intercourse is resumed, water-soluble lubricants, relaxation exercises, and positions that control penile penetration can be used to decrease sexual discomfort. Incorrect: A) Foods high in fiber, iron, vitamin C, and protein are found to aid tissue healing. B) Vigorous exercise and heavy lifting should not be resumed until 6 weeks after the procedure. D) Tub baths and douching should be avoided until after the follow-up examination.

Correct: C INCORRECT: It is important for the nurse to set off the woman's words in quotation marks and use such phrase as "client states" to indicate the information recorded reflects the woman's words. Describe the offender and the event in the words of the woman INCORRECT: The nurse should record the time of day of the examination and indicate whenever possible how much time has passed since the abuse CORRECT: The nurse should describe the demeanor of the patient ALWAYS not only when angry INCORRECT: The nurse should take photographs of the injuries known or believed to have been caused by domestic violence

Answer: C A. INCORRECT. The major symptoms of endometriosis are pelvic pain, dysmenorrhea (pain during menstruation), dyspareunia (painful intercourse), abnormal menstrual bleeding, and infertility. While dysmenorrhea is a symptom of endometriosis, vaginal discharge is not a sign of endometriosis. B. INCORRECT. The major symptoms of endometriosis are pelvic pain, dysmenorrhea (pain during menstruation), dyspareunia (painful intercourse), abnormal menstrual bleeding, and infertility. Ovary pain and dysuria do not indicate endometriosis. C. CORRECT. The major symptoms of endometriosis are pelvic pain, dysmenorrhea (pain during menstruation), dyspareunia (painful intercourse), abnormal menstrual bleeding, and infertility. Some women report bowel symptoms such as diarrhea, pain with defecation, and constipation or pain radiating to the thighs. D. INCORRECT. The major symptoms of endometriosis are pelvic pain, dysmenorrhea (pain during menstruation), dyspareunia (painful intercourse), abnormal menstrual bleeding, and infertility. Back pain and difficulty swallowing do not indicate endometriosis

Answer: A Rationale: A. Correct- Women experiencing PMS symptoms should limit refined sugar (< 5 tablespoons), salt (< 3 grams), red meat (up to 3 ounces), and alcohol (< 1 once) or caffeinated drinks consumption per day B. Correct- Keeping a detailed log of symptoms and mood fluctuations occurring over several cycles may give insight for possible management strategies C. Correct- Medication may be prescribed for treatment of PMS symptoms after 1-2 months if relief is not found using nonpharmacological PMS management strategies D. Incorrect- Regular exercise, up to 3 to 4 times a week, is recommended, especially in the luteal phase because it can help with relief of PMS symptoms

Answer: C A. Incorrect. Pain should be managed with an anti-inflammatory such as ibuprofen (Lowdermilk, Perry, Cashion, & Alden, 2012, p. 212). B. Incorrect. Eliminating caffeine can help reduce symptoms of fibrocystic changes (Lowdermilk, Perry, Cashion, & Alden, 2012, p. 212). C. Correct. Chemotherapy is not needed for fibrocystic changes; treatment is usually conservative (Lowdermilk, Perry, Cashion, & Alden, 2012, p. 212). D. Incorrect. Smoking and alcohol should be avoided to reduce symptoms of fibrocystic changes (Lowdermilk, Perry, Cashion, & Alden, 2012, p. 212).

Answer C Rationale: PCOS occurs when an endocrine imbalance results in high levels of estrogen, testosterone, and luteinizing hormone (LH) and decreased secretions of follicle-stimulating hormone (FSH). Choices A, B, and D are correct characteristics of PCOS.

Correct answer: B Rationale: There are three main groups of women that are more likely to seek assistance in changing their lives in an abusive relationship. These groups include: women who are beaten frequently and severely, women who have NOT experienced or witnessed family violence in their family, and women who see an alternative to life in an abusive relationship . It is also known that women seek help after their children have been hurt or when the children start imitating the abuser's behavior

Answer: C Nicotine replacement products are not appropriate to suggest to a woman who is to become pregnant, as these products are not recommended for use during pregnancy (Lowdermilk, D., Perry, S., Cashion, K., & Alden, K., p. 92). A, B, and D are all appropriate ways to help this woman quit smoking prior to becoming pregnant.

Answer: C A. Incorrect. Emergency contraception should be used within 72 hours of unprotected intercourse, or birth control mishap to prevent unintended pregnancy B. Incorrect. Anyone regardless of gender or age can purchase this pill C. Correct. Contraceptive counseling should be provided to all women requesting emergency contraception D. Incorrect. Emergency contraception does not protect a woman against pregnancy if she engages in unprotected intercourse in the days or weeks following treatment

Answer: C A: Incorrect; this statement is true. "Women with milk pain who may desire a future pregnancy, treatment may be limited to use of NSAIDs during menstruation" B: Incorrect; this statement is true. "The condition is seven times more prevalent in women who have a first-degree relative with endometriosis as compared with the general population" C: Correct; this statement is false. While endometriosis occurs in 30-45% of infertile women, a diagnosis of endometriosis does not mean the patient will never be able to conceive. D: Incorrect; this statement is true. "Severity of symptoms can change over time and may be disproportionate to the extent of the disease

Answer: A A. CORRECT. This is a false statement and shows that more teaching is necessary. An IUD does not protect against HIV or other STIs B. INCORRECT. This is a true statement and shows that teaching was effective. After removal of the IUD, the woman will return to a state of fertility. C. INCORRECT. This is a true statement and shows that teaching was effective. It is important to teach patients to check after each menstrual cycle for the IUD strings. This ensures that unintentional expulsion of the IUD did not take place. D. INCORRECT. This is a true statement and shows that teaching was effective. The hormonal intrauterine system (Mirena) lasts up to 5 years, while the ParaGard Copper T 380A is effective for up to 10 years.

Answer: C Rationale: A, B, and D are expected to occur during the woman's menstrual cycle. C is an incorrect statement. "The physiologic alternations in breast size and activity reach their minimum level about 5 to 7 days after menstruation stops" this is the optimum point in the woman's cycle to perform a breast self-exam. Current American Cancer Society (ACS) guidelines list the monthly breast self-exam as an option, due to unneccessary biopsies that the ACS believes occured due to "recommended" breast self-exams

Correct answer: C Rational: A female's menstrual cycle occurs over 30-40 years of her life, not 10-20 years. Answer choices A, B, and D are correct statements pertaining to the female reproductive cycle.

Answer: C A. Incorrect. This is a correct statement. Hormone replacement therapy entails the woman taking both estrogen and progestins (Lowdermilk, 2012, pp. 134). B. Incorrect. This is a correct statement. Hormone replacement therapy has been "prescribed for discomforts associated with the perimenopausal years, including hot flashes and vaginal and urinary tract atrophy" C. Correct. This is an incorrect statement. "If used, MHT should be taken at the lowest effective dose for the shortest possible duration D. Incorrect. This is a correct statement. "When a woman decides to stop MHT, a recurrence of symptoms will occur whether the medication is tapered or discontinued abruptly"

Answer: C A. Incorrect. A program of regular weight-bearing and muscle strengthening exercises further helps promote bone health. B. Incorrect. To protect bone health, it is important that all individuals have a nutritionally balanced diet that includes calcium rich foods and Vitamin D C. Correct. The U.S. Preventative Services Task Force and the National Osteoporosis Foundation recommend testing for postmenopausal women and all women ages 65 and older. Although, the patient may be younger than 65 she is still postmenopausal. D. Correct. Vitamin D does increase and aid in the absorption of calcium

Answer: D A) Incorrect. Only bacterial STI's can be treated with antibiotics. B)Incorrect. Even though contraception can decrease the risk of getting an STI, no method guarantees complete protection. C)Incorrect. STI's can cause many complications during pregnancy such as infertility, ectopic pregnancies, and neonatal mortality. D)Correct. The risks of acquiring an STI are high in adolescents and young adults who become sexually active at a young age.

1. False. When women are in their 40s, anovulation occurs more often, menstrual cycles increase in length, and ovarian follicles become less sensitive to hormonal stimulation from FSH and LH. 2. False. Osteoporosis is a major health problem associated with menopause. A greater phosphorus than calcium intake, which occurs with soft drink consumption, may be a risk factor. 3. False. Vasomotor instability in the form of hot flashes is common during the perimenopausal years. Nightly sweats, characterized by profuse perspiration and heat radiating from the body during the night, are another form of vasomotor instability experienced by many women. Wearing light clothing may help for hot flashes. 4. Correct. This statement indicates further teaching is needed. The patient is in the beginning stages of the perimenopausal period. Natural menopause is a gradual process with progressive increases in anovulatory cycles and eventual cessation of menses. In the 2 to 8 years preceding menopause, subtle hormonal changes eventually lead to altered menstrual function and later to amenorrhea.

Answer: D A indicates an expected finding that can be related to the decrease in estrogen within the body. B is an indicator that the patient may be undergoing osteoporosis, the first sign of which can be a decrease in the patient's height, often due to vertebral fracture or collapse. It is expected that the menstrual cycle will change as the woman enters perimenopause. D is the answer that is not expected, as women who are progressing through perimenopause and menopause are expected to experience hot flashes and night sweats due to vasomotor changes due to changing estrogen levels (Lowdermilk, Perry, Cashion, Alden, 2012). (PWC: Osteoporosis that results in a shorter stature is severe, and it would not be one of the first signs a woman notices when she is entering menopause. Women begin losing bone at menopause, and it continues at a rapid rate for the first 5 to 6 years after menopause. A shorter stature would not be apparent until well after menopause, not during the perimenopause.)

Answer: B Incorrect. This is a true statement. The patient may feel pain at ovulation Correct. This statement is incorrect. The menstrual period will be about the same as before the sterilization. Incorrect. This statement is true. The patient should expect no change in hormones and their influence. Incorrect. This is a true statement. Sterilization does not offer protection from STIs. Therefore, the patient may need to use condoms

Answer: A- diaphragm Rational: "Toxic shock syndrome (TSS), although reported in very small numbers, can occur in association with the use of the contraceptive diaphragm and cervical caps." (Lowdermilk, D., Perry, S., Cashion, K., & Alden, K., 2012, pp.180) Knowing that using a diaphragm as a form of birth control increases the woman's chances of TSS, it is proper to educate the client so that risk can be properly reduced.

Correct Answer: C Rationale: The IUD is a safe, cost-effective, and highly reliable method of contraception for this woman. She should be taught signs of potential complications of an IUD by the nurse before insertion. The correct answer to this question (C) would not be a sign of a potential complication. The woman would experience abdominal pain or pain with intercourse. All of the other answer choices (A, B, D) would be signs of a potential complication and should be reported to her health care provider. (PWC: While your book lists only abdominal pain, it would not be unusual to experience the pain in the lower back. Just as some women feel menstrual cramps in their low back, or labor contractions in the low back, an intrauterine infection could also cause back pain.)

Rationale Incorrect. Oral contraceptives are contraindicated for patients with a history of thromboembolic disorders. Incorrect. Patients who are less than six weeks postpartum and lactating should not use oral contraceptives. Incorrect. Some over-the-counter medications and herbal supplements, such as St. John's wort, and alter the effectiveness of combined oral contraceptive pills. Correct. A latex allergy is not a contraindication to oral contraceptive use. This would be more of a concern for patients using latex condoms as a method of contraception.

A. This answer is not correct because Plan B must be taken within 120 hours (5 days) after failed contraception. B. This is a true statement. C. This is not an accurate statement because pregnancy is still possible after taking Plan B if not taken as prescribed. D. This is an inaccurate statement because emergency contraception does not disturb an implanted pregnancy. (PWC: It's important to understand that emergency contraception is just that...emergency treatment when a woman's contraceptive has failed (e.g. "condom broke") or after she has had unprotected sex. If this event occurs in her cycle before ovulation, then it works by inhibiting follicular development. If, however, the event occurs after ovulation, then Plan B works by either preventing fertilization, or by preventing a fertilized egg from implanting into the endometrium.)

Answer: C Rationale: Because Marfan's Syndrome is an autosomal dominant trait. The mother, who has at least one dominant gene, will pass the gene onto 50% of her children. (Lowdermilk, Perry, Cashion, & Alden, 2012, p. 712)

Correct Answer: C C) "If the results are not within normal range, the test is repeated. If subsequent results are still within the subfertile range, further evaluation is needed to evaluate the problem" (Lowdermilk, Perry, Cashion, & Alden, 2012, p. 201). According to Lowdermilk et al., (2012) the other statements are correct and do not require any follow-up by the nurse. (p. 201). (PWC: Answer A is not correct--a semen analysis cannot assess the sperm's ability to penetrate an ovum or evaluate the effects of cervical mucus on sperm motility or survival. Only a post-coital test can evaluate the effect of cervical mucus on sperm motility/survival. The semen analysis looks at sperm number, morphology, and motility. Please see box 9-4 on page 201 of the 11th edition of the textbook.)

Answer: B Rationale: The RN should be concerned that the patient lives alone and has several cats. This means that the patient most likely has had contact with cat feces, putting the patient and her fetus at risk for toxoplasmosis infection. Therefore, the priority interventions should involve screening for infection as well as educating the patient about avoidance of toxoplasmosis exposure (B). (A) is not a valid recommendation based on the patient's statements. (C) is an untrue statement and (D) is not indicated.

Rationale: A, B, and C are all correct ways to assess a female for infertility. D is INCORRECT as this is a way to assess a male for infertility

Correct answer: A Rationale: A is correct because the embryo changes from being almost straight to C-shpaed as both ends fold in toward the ventral surface B: is incorrect because the respiratory system beings to develop during embryonic life and continues through fetal life and into childhood. The development begins during week 4 and continues to term with various structures developing at different times C: is incorrect because sex differentiation begins during the 7th week and is distinguishable after the 9th week D: is incorrect because the cardiovascular system is the FIRST system to function in the developing human

ANSWER: D Rationale: Depression often presents with signs of isolation and withdrawal from normal activities of daily living. If the patient stated low motivation to get out of bed and a lack of desire to interact with others, the nurse would need to further assess for other signs and symptoms of depression. Incorrect: A) Refusing to accept the possibility that the couple may not be able to get pregnant is indicative of denial, not depression. B) Feeling frustration and jealousy over other pregnant women is a sign of anger, not depression. C) Associating previous behaviors with infertility is most often associated with guilt, not depression. All of these behaviors may be expressed concurrently in a patient; however, lack of motivation and desire to interact is the sign that most specifically links to depression.

Rationale: A. Correct- The respiratory tract beings developing in week 4 and continues developing into childhood until it reaches maturity (Lowdermilk, Perry, Cashion, & Alden, 2012, p. 281). B. Correct- The larynx, trachea, bronchi, and lung buds are formed by 17 weeks gestation (Lowdermilk, Perry, Cashion, & Alden, 2012, p. 281). C. Correct- Type I and type II specialized alveolar cells are formed and being to increase pulmonary surfactant secretion at 24 weeks gestation until term (Lowdermilk, Perry, Cashion, & Alden, 2012, p. 281). D. Incorrect- The infant's lungs are considered to be mature at approximately 35 weeks gestation because the L/S (Lecithin/Sphingomyelin) ratio is 2:1 Lecithin and sphingomyelin are forms of alveolar surfactant that are essential for proper lung function and expansion (PWC: The current version of the textbook states that the fetal lungs are considered to be mature sometime in the middle of the third trimester (not 35 weeks)

Correct: A A. Correct. If both parents have sickle cell trait, there is a 25% (or 1 in 4) chance that the child will have sickle cell disease (Lowdermilk, Perry, Cashion, & Alden, 2012, p. 51). B. Incorrect. If both parents have sickle cell trait, there is a 50% (or 1 in 2) chance that the child also will have sickle cell trait and a 25% (or 1 in 4) chance that the child will have sickle cell disease (Lowdermilk, Perry, Cashion, & Alden, 2012, p. 51). C. Incorrect. If both parents have sickle cell trait, there is a 25% (or 1 in 4) chance that the child will not have sickle cell disease or sickle cell trait. (Lowdermilk, Perry, Cashion, & Alden, 2012, p. 51). D. Incorrect. Knowing that the parents are carriers of the trait, the risk can be estimated using mendelian principles (Lowdermilk, Perry, Cashion, & Alden, 2012, p. 54).

ANSWER: A A) CORRECT: With fertility treatment, there is a risk of multiple gestations. Therefore, further teaching is needed for this couple B)INCORRECT: Part of fertility treatment teaching includes stress management techniques and recommendations for ongoing psychologic and couples counseling. Therefore, this comment does not indicate further teaching is needed C)INCORRECT: With fertility treatment, there is a possible risk of long-term effects of medications and treatment on women, children, and families. Therefore, this comment does not indicate further teaching is needed D) INCORRECT: With fertility treatment, there is a possible need for donor oocytes, sperm, or embryos, or for gestational carrier (surrogate mother). Therefore, this comment does not indicate further teaching is needed

Correct: B A: Incorrect; this should be discussed prior to starting treatment B: Correct; while adoption may be something for the couple consider, it is not an issue to be discussed prior to starting infertility treatment. C: Incorrect; this should be addressed prior to starting treatment. D: Incorrect; the risks associated with infertility treatment, which include a multiple gestation pregnancy, should be addressed.

A. CORRECT. This process is called capacitation, and it is necessary for the plasma membrane to separate from the sperm in order for the sperm to fertilize the ovum. B. INCORRECT. Transportation of the sperm to the fallopian tube can occur within 5 minutes, but on average, it takes 4-6 hours. C. INCORRECT. Estrogen increases peristalsis in the fallopian tubes during ovulation, which helps move the ovum toward the uterus. D. INCORRECT. Prostaglandins in the semen help transport the sperm by increasing uterine smooth muscle contractions.

Answer: B. Rationale: Braxton Hicks contractions, painless contractions that occur intermittently after the 1st trimester, appear to enhance the movement of blood through the intervillous space, aiding placental circulation.

Rationale: Dizygotic twinning, or fraternal twinning, increases in frequency with maternal age up to 35 years and with parity (p. 286). Monozygotic twinning, or identical twinning, has no association with race, heredity, maternal age, or parity. Fertility drugs increase the incidence of monozygotic twinning and dizygotic twinning. Therefore, answer A would be an inappropriate response by the nurse.