Deck 4: Health Promotion of Women Across the Lifespan

Question 1

The nurse is interviewing an adolescent patient. The patient reports a weight loss of 50 pounds over the last 4 months, and reports running at least 5 miles per day. The patient 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 patient denies any sexual activity. Which statement is best for the nurse to make?

A) "Your lack of menses might be related to your rapid weight loss."
B) "It is common and normal for runners to stop having any menses."
C) "Increase your intake of iron-rich foods to re-establish menses."
D) "Adolescents rarely have regular menses, even if they used to be regular."

Answer 1

"Your lack of menses might be related to your rapid weight loss."

Question 2

The nurse at a women's clinic is planning a class on premenstrual dysphoric disorder (PMDD). Information about medications shown to be effective for PMDD that the nurse includes in the education are:

A) Fluoxetine hydrochloride (Prozac).
B) Sertraline hydrochloride (Zoloft).
C) Paroxeline CR (Paxil CR).
D) Hyoscyamine (Anaspaz).
E) Promethazine (Phenergan).

Answer 2

Fluoxetine hydrochloride (Prozac).
Sertraline hydrochloride (Zoloft).
Paroxeline CR (Paxil CR).

Question 3

A 19-year-old woman comes to the gynecologist's office. When the nurse asks the reason for this visit, the woman explains that she has never had a menstrual period, and that she is concerned there might be something wrong. The diagnosis that the physician is most likely to make based on this information is:

A) Primary dysmennorrhea.
B) Secondary infertility.
C) Primary amenorrhea.
D) Secondary amenorrhea.

Answer 3

Primary amenorrhea.

Question 4

The nurse who is taking a sexual history from a patient should:

A) Ask questions that the patient can answer with "yes" or "no".
B) Ask mostly open-ended questions.
C) Have the patient fill out a comprehensive questionnaire and review it after the patient leaves.
D) Try not to make much direct eye contact.

Question 5

The nurse is teaching a class on menstruation to young girls. What information would be important for 10-12-year-olds to know about?

A) The age they will start having their periods
B) Variations in the age menstruation begins, length of the cycle, and duration of the menses
C) The number of days they will be ill when they have their menses
D) The number of days they will not be able to take part in physical education at school during their menses

Question 6

The nurse is interviewing a 16-year-old patient 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 patient's problem?

A) She had forceful intercourse, which caused the trauma.
B) She is reacting to the deodorant in the tampon.
C) She might be allergic to the underwear she is wearing.
D) She is having a normal reaction to her menses.

Question 7

The nurse is taking a history of a new patient in the clinic. Histories tend to be lengthy, and the sexual part can be difficult for the patient. The nurse should use what technique to make it easier for the patient?

A) Let the patient fill out a paper copy, so she does not have to talk about intimate matters.
B) Skip the sexual part until the next time the patient comes into the clinic.
C) Start with the easier medical and surgical questions, and develop a feeling of trust with the patient.
D) Leave the sexual part of the history for the doctor to ask about.

Question 8

A patient comes to the clinic complaining of severe menstrual cramps. She has never been pregnant, has been diagnosed with ovarian cysts, and has had an intrauterine device (IUD) for 2 years. The most likely cause for the patient's complaint is:

A) Primary dysmenorrhea.
B) Secondary dysmenorrhea.
C) Menorrhagia.
D) Hypermenorrhea.

Question 9

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:

A) Malfunctioning of the pancreas and insulin usage.
B) Lack of testosterone after the beginning of time for menses to start.
C) Lack of vitamin D and calcium in the system.
D) Dysfunction of the hypothalamus.

Question 10

A patient asks her nurse, "Is it okay for me to take a tub bath during the heavy part of my menstruation?" The correct response by the nurse is:

A) "Tub baths are contraindicated during menstruation."
B) "You should shower and douche daily instead."
C) "Either a bath or a shower is fine at that time."
D) "You should bathe and use a feminine deodorant spray during menstruation."

Question 11

The nurse is conducting health screening at a community clinic. The patient 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?

A) "You should avoid piercing your genitalia and your nipples."
B) "There are no problems that occur with either body piercing or tattooing."
C) "Both piercing and tattooing carry risks of infection, including hepatitis."
D) "The benefit of body art outweighs any risk of infection of a tattoo or piercing."

Question 12

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. The nurse will explain the reason for this is:

A) The loss of cervical gland function to the mucous membranes of the vagina.
B) The vaginal pH increases, and the number of Doderlein's bacilli decreases.
C) The uterine lining thins and the muscle layer atrophies.
D) The labia shrink and lose their pigmentation.

Question 13

The nurse teaches a group of young women that self-care measures for dysmenorrhea include:

A) Taking vitamins B and E.
B) Decreasing salt intake.
C) Using cold packs as needed.
D) Using intermittent exercise.
E) Taking FSH replacement.

Question 14

Which patient would the nurse document as exhibiting signs and symptoms of primary dysmenorrhea?

A) 17-year-old, has never had a menstrual cycle
B) 16-year-old, had regular menses for 4 years, but has had no menses in 4 months
C) 19-year-old, regular menses for 5 years that have suddenly become painful
D) 14-year-old, irregular menses for 1 year, experiences cramping every cycle

Question 15

The nurse is instructing a young patient on avoiding toxic shock syndrome. Education was successful when the patient states:

A) "I will wash my hands before inserting a tampon."
B) "I will change my tampon every 3-6 hours."
C) "I will not touch the part of the tampon I insert."
D) "I will just put the used tampon in the trash."
E) "I will take prophylactic antibiotics if needed."

Question 16

The clinic nurse is returning phone calls. Which call should the nurse return first?

A) The call from a 22-year-old reporting that she has menstrual cramps and vomiting every month
B) The call from a 17-year-old asking whether there is a problem with using one tampon for a whole day
C) The call from a 46-year-old mother of a teen wondering if her daughter should be on birth control
D) The call from a 34-year-old requesting information on douching after intercourse

Question 17

The nurse educator is teaching a group of teens and 20-year-olds reproductive health care. When several of the women bring up douching, the best remark the nurse could make is:

A) "One should always douche after having intercourse."
B) "When douching, use the prepared products, as one can use force putting them in and get the solution up high."
C) "It is a good idea to douche before intercourse so the area is clean for the sperm."
D) "Douching is unnecessary because the lining of the vagina has numerous glands that provide natural cleansing."

Question 18

The nurse is taking a history on a new patient in the clinic. She determines from talking with the patient that she is recently divorced, is dating, and has had sex with various men. The nurse would be concerned about and hopefully provide some education on what issues?

A) The ethics of dating and having sex with more than one man
B) The patient having some kind of permanent birth control done, so she does not become pregnant
C) Education about sexual activity and sexually transmitted infections
D) Referral to a psychologist or counselor for follow-up on the multiple dating

Question 19

A patient who is in perimenopause is having a number of severe symptoms. The nurse assesses this patient and knows the doctor will likely prescribe what to assist in relieving the distress?

A) Calcium and vitamin D
B) A form of hormonal contraception
C) Prescriptive pain medication
D) Antibiotics

Question 20

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:

A) No menses for 8 consecutive months.
B) Hot flashes and night sweats
C) High serum FSH with low serum estrogen
D) Diagnosed with osteoporosis 4 months ago

Question 21

In teaching a group of adolescents, the nurse discusses risk factors for cardiovascular disease (CVD) in women, including:

A) Being over 55 and postmenopausal.
B) Using cigarettes and tobacco.
C) Being overweight.
D) Having a low cholesterol level.
E) Having an active lifestyle.

Question 22

The nurse assessing a 47-year-old patient who is perimenopausal includes important topics, such as:

A) Vasomotor symptoms.
B) A decrease in vaginal lubrication.
C) Pregnancy not being an option.
D) Mood changes that occur.
E) An increase in the libido.

Question 23

The nurse is teaching a group of perimenopausal women about treatment choices for their symptoms. The nurse will include information regarding the:

A) Importance of continuing contraception.
B) Benefits of menstrual regulation with hormones.
C) Increase in vaginal dryness with hormones .
D) Decrease in acne and hirsutism.
E) Increase in endometrial cancer risk.

Question 24

When caring for the menopausal woman, nurses need to be empathetic in approaching the areas of:

A) Administering medications.
B) Health teaching.
C) Providing physical care.
D) Counseling.
E) Encouraging hormone therapy.

Question 25

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:

A) Intermenstrual bleeding.
B) Hypermenorrhea.
C) Menopause.
D) Primary amenorrhea.

Question 26

The nurse is interviewing a new patient in the clinic. The patient 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 patient that prevention is the primary goal. A primary goal for prevention would be:

A) Eliminating all alcohol intake.
B) Taking 500 mg of calcium each day.
C) Use of sunscreen to assist with absorption of vitamin D
D) Regular weight-bearing and muscle-strengthening exercises.

Question 27

The nurse in the OB-GYN clinic has been seeing a patient through her menopausal stage of life. The nurse assesses psychological concerns if the patient says:

A) "I feel so lost with all of the kids away from home."
B) "I wish I were younger, and could have a baby."
C) "Although my parents are aging, they travel a lot."
D) "I don't think I am a good wife anymore."
E) "I really enjoy being able to go out when I want."

Question 28

The charge nurse is giving an in-service to the orthopedic and gynecology nurses concerning the relationship between estrogen and osteoporosis. A statement the nurse would make concerning this relationship would be:

A) "Males have a higher incidence of osteoporosis than do females."
B) "Women who experience menopause at a younger age and have less bone mass could have more bone loss."
C) "Estrogen levels affect only bone mass, but have nothing to with bone strength and bone density."
D) "Osteoporosis puts the patient at a decreased risk for fractures of the forearm and vertebrae."

Question 29

The nurse is answering the perimenopausal patient's questions about hormone replacement therapy. Which patient statement indicates a need for further teaching?

A) "Estrogen therapy will decrease my chances of developing osteoporosis."
B) "If I am taking estrogen therapy, I will not have to worry about my cholesterol being checked."
C) "Osteoporosis is a decrease in bone strength due to bone density and quality."
D) "Bone mass tends to decrease after menopause."

Question 30

The nurse assessing a 50-year-old female patient at an orthopedic center asks about the use of complementary and alternative therapies. Among those women often try during menopause include:

A) Vitamin and mineral supplements.
B) Increasing caffeine intake.
C) Soy and red clover.
D) Selective estrogen receptor modulators.
E) Salmon calcitonin.

Question 31

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:

A) Petroleum jelly.
B) A water-soluble lubricant.
C) Body cream or body lotion.
D) Less-frequent intercourse.

Question 32

A patient 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 patient to try what exercise?

A) Lifting weights to strengthen those muscles
B) Running two miles a day
C) Running up and down stairs a few times every day
D) Performing Kegel exercises and having regular sexual activity

Question 33

The nurse is teaching a group of patients about risk factors for osteoporosis. The nurse will include:

A) Menopause at an early age increases bone loss.
B) A family history of osteoporosis.
C) A lifetime of high calcium intake.
D) Having an active lifestyle.
E) A vitamin D deficiency.

Question 34

A 49-year-old patient comes to the clinic with complaints of severe perimenopausal symptoms including hot flashes, night sweats, urinary urgency, and vaginal dryness. The physician has prescribed a combination hormone replacement therapy of estrogen and progestin. When the patient asks the nurse why she must take both hormones, the best reply is:

A) "Hot flashes respond better when replacement includes both hormones."
B) "You are having very severe symptoms, so you need more hormones replaced."
C) "There is an increased risk of tissue abnormality inside the uterus if only one is given."
D) "Your blood pressure can become elevated if only one hormone is used."