Question 1

Which nursing diagnosis would be most appropriate for a client who is experiencing vaginal atrophy as a result of menopause?&#10;A)Injury,Risk for&#10;B)Skin Integrity,Impaired&#10;C)Body Image,Disturbed&#10;D)Knowledge,Deficient&#10;

Accepted Answer

Injury,Risk for

Question 2

A client with infertility who was treated with clomiphene (Clomid)for 6 months without success will now be treated with a follitropin.Which statement by this client would require immediate intervention by the health care provider?

A)"I have had three diarrhea stools each day since I started these medications."
B)"I have had a headache since I began using these medications."
C)"I began wheezing last night."
D)"My husband is going to give me these injections."

"I began wheezing last night."

Accepted Answer

Wheezing is a potential side effect of follitropin and could signify a serious allergic reaction, which requires immediate intervention by the health care provider. The other options could be side effects of the medication, but they are not as concerning as wheezing. The provider should still monitor these symptoms and address them as necessary.

Question 3

A client at 35 weeks' gestation is having contractions caused by preterm labor.Which statement by the nurse best describes the rationale for giving this client magnesium sulfate?&#10;A)&#34;Magnesium sulfate will cause your baby to gain weight quickly so he will be more developed when he is born.&#34;&#10;B)&#34;Magnesium sulfate is used to decrease your stress level.This will cause your contractions to stop.&#34;&#10;C)&#34;Magnesium sulfate relaxes the uterus and slows contractions.This gives the baby's lungs a few more days to develop.&#34;&#10;D)&#34;Magnesium sulfate will allow you to be monitored from home.&#34;&#10;

Accepted Answer

Magnesium sulfate is used to relax the uterus and slow contractions, which gives the baby's lungs a few more days to develop. It does not cause the baby to gain weight quickly or decrease the client's stress level, and it does not allow for monitoring from home.

Question 4

The school nurse is teaching a group of middle-school students about the female reproductive system.Which statement by a student most accurately describes the reason menstruation begins?&#10;A)&#34;Your uterus starts to contract,and this causes the lining to come out,which is your period.&#34;&#10;B)&#34;Your brain sends a signal that there is enough estrogen and progesterone.Then these hormone levels drop,and you get your period.&#34;&#10;C)&#34;You have to have your period every 28 days to be normal.&#34;&#10;D)&#34;You get your period when you ovulate.&#34;&#10;

Accepted Answer

Menstruation occurs when the levels of hormones estrogen and progesterone drop, causing the lining of the uterus to shed. Option A is incorrect because uterus contractions are part of the menstrual cycle, but they do not cause menstruation. Option C is incorrect because menstrual cycles can vary in length and still be considered normal. Option D is incorrect because ovulation is when an egg is released from the ovary, and menstruation occurs if that egg is not fertilized.

Question 5

Which client should not receive progestin therapy for the treatment of dysfunctional uterine bleeding?&#10;A)The client with a history of asthma&#10;B)The client with a history of a blood clot&#10;C)The client with a history of glaucoma&#10;D)The client with a history of hepatitis&#10;

Accepted Answer

Clients with a history of blood clots should not receive progestin therapy because it can increase the risk of clot formation.

Question 6

A postmenopausal client learns that her level of &#34;good&#34; cholesterol is decreasing and the level of &#34;bad&#34; cholesterol is rising.How should the nurse explain this physiologic mechanism to the client?&#10;A)&#34;At menopause,your body quits producing progesterone,which keeps your cholesterol level low.&#34;&#10;B)&#34;Menopause weakens the blood vessels and allows the bad cholesterol to become more prominent.&#34;&#10;C)&#34;During menopause,the estrogen level decreases dramatically.Estrogen helps to keep the 'good' cholesterol high and the 'bad' cholesterol low,and also helps to protect the heart.&#34;&#10;D)&#34;Because cholesterol problems are all hereditary,your 'bad' cholesterol levels are probably rising in the same manner as your family members' did.&#34;&#10;

Accepted Answer

During menopause, the level of estrogen decreases dramatically. Estrogen helps to keep the "good" cholesterol high and the "bad" cholesterol low and also helps to protect the heart. Therefore, the decrease in estrogen during menopause is associated with a decrease in "good" cholesterol and an increase in "bad" cholesterol.

Question 7

Which client would not be a good candidate for induction of labor using parenteral oxytocin (Pitocin)?&#10;A)The client who is at 38 weeks' gestation and has gestational diabetes&#10;B)The client at 37 weeks' gestation whose fetus has developed an abnormal heart rate&#10;C)The client who is at 38 weeks' gestation and has developed signs of preeclampsia&#10;D)The client at 39 weeks' gestation who wants the baby to have the same birthday as another family member&#10;

Accepted Answer

Inducing labor for non-medical reasons such as having the baby on a specific date is generally not recommended. Medical indications for labor induction include gestational diabetes, abnormal fetal heart rate, and preeclampsia, making options A, B, and C appropriate candidates under certain conditions.

Question 8

The nurse is reviewing the menstrual cycle with a client who is experiencing menstrual irregularities.The nurse teaches that during the menstrual cycle,the majority of progesterone is secreted by the:&#10;A)hypothalamus.&#10;B)corpus luteum.&#10;C)ovarian follicle.&#10;D)anterior pituitary gland.&#10;

Accepted Answer

The corpus luteum is the structure that forms from the follicle after ovulation and is responsible for the majority of progesterone secretion in the menstrual cycle. The hypothalamus and pituitary gland are involved in regulating hormone production, but do not directly secrete progesterone. The ovarian follicle secretes estrogen, not progesterone.

Question 9

A client reports infertility in spite of trying to get pregnant for the last 18 months.A priority assessment in this client would be:&#10;A)height and weight.&#10;B)understanding of ovulation and timing of intercourse.&#10;C)job status.&#10;D)preferred position during sexual intercourse.&#10;

Accepted Answer

Understanding of ovulation and timing of intercourse is a priority assessment in a client reporting infertility as it helps to identify any knowledge gaps or misconceptions the client may have about the reproductive process and to provide education on effective methods for conception. Height and weight, job status, and preferred position during sexual intercourse may also be assessed, but they are not the priority in this situation.

Question 10

Which outcome statement indicates that a client has effectively been treated with conjugated estrogen (Premarin)for severe and frequent hot flashes?&#10;A)The client is able to sleep 4-5 hours every night.&#10;B)The client reports one to two hot flashes per day.&#10;C)The client reports experiencing headaches while taking this drug.&#10;D)The client reports an improvement in mood.&#10;

Accepted Answer

Severe and frequent hot flashes are being treated with conjugated estrogen (Premarin). The best outcome statement is the client reporting one to two hot flashes per day, indicating significant improvement in symptoms. The other choices do not specifically address the effectiveness of the drug in treating hot flashes. The ability to sleep, improvement in mood, and experiencing headaches may be important outcomes but are not specific to the treatment of hot flashes with conjugated estrogen.

Question 11

An adolescent client is experiencing oligomenorrhea with infrequent periods over the last year.What is the most likely cause of this client's problem?&#10;A)Anovulatory cycles&#10;B)Abnormal uterine lining&#10;C)Polycystic ovarian syndrome&#10;D)Pregnancy&#10;

Accepted Answer

The answer of An adolescent client is experiencing oligomenorrhea with...

Question 12

Which statement by a menopausal client reflects an advantage of using estrogen/progesterone combination hormone replacement therapy (HRT)?&#10;A)&#34;I have a lower chance of developing breast cancer while I am taking this medication.&#34;&#10;B)&#34;This medication protects me from uterine cancer.&#34;&#10;C)&#34;I am protected from developing Alzheimer disease because I am taking this medication.&#34;&#10;D)&#34;I have a lower chance of having a heart attack until I turn 60.&#34;&#10;

Accepted Answer

The answer of Which statement by a menopausal client reflects...

Question 13

A postmenopausal client asks why she has been scheduled for a bone density test even though she has no history of fractures.What is the nurse's best response?&#10;A)&#34;This is a very quick test,and it won't cause you any pain.&#34;&#10;B)&#34;It is important to find out if you are losing bone density because you do not produce as much estrogen as you did previously.This test will see if you are developing osteoporosis.&#34;&#10;C)&#34;Because you are not ovulating,your bones will start breaking.&#34;&#10;D)&#34;Everyone should have a bone density test.&#34;&#10;

Accepted Answer

The answer of A postmenopausal client asks why she has...

Question 14

Which statement by a client taking estrogen/progesterone combination hormone replacement therapy (HRT)requires immediate intervention by the nurse?&#10;A)&#34;I have gained 6 pounds since I began taking this medication 3 months ago.&#34;&#10;B)&#34;Sexual intercourse is still slightly uncomfortable,even though I have been on the medication for 2 months.&#34;&#10;C)&#34;I got nauseated and had right shoulder pain after I ate fried fish last night.&#34;&#10;D)&#34;My ankles are swollen when I go to bed at night.&#34;&#10;

Accepted Answer

The answer of Which statement by a client taking estrogen/progesterone...

Question 15

Which client would benefit most from using hormone replacement therapy (HRT)?&#10;A)The client who is unable to sleep because of continual hot flashes and night sweats&#10;B)The client who finds sexual intercourse painful&#10;C)The client who wants to prevent osteoporosis&#10;D)The client who has a family history of colorectal cancer&#10;

Accepted Answer

The answer of Which client would benefit most from using...

Question 16

A client had an anterior pituitary tumor removed a few years ago and is curious if this will affect her future ability to become pregnant.What is the best response by the nurse to this client?&#10;A)&#34;You shouldn't have any problems at all because you still have your ovaries and uterus.&#34;&#10;B)&#34;You might have trouble getting pregnant.The hormones necessary for stimulating the ovaries are contained in the anterior pituitary.&#34;&#10;C)&#34;You will have trouble getting pregnant because the anterior pituitary secretes gonadotropin-releasing hormone (GnHR),which is necessary for conception.&#34;&#10;D)&#34;You shouldn't have any problems at all.The important hormones for conception are contained in the posterior pituitary.&#34;&#10;

Accepted Answer

The answer of A client had an anterior pituitary tumor...

Question 17

A client is being treated pharmacologically for endometriosis.Which statement by the client indicates a need for further instruction?&#10;A)&#34;I will be able to get pregnant as soon as I finish taking this medication.&#34;&#10;B)&#34;I will probably have to take this medication for 3-6 months.&#34;&#10;C)&#34;This medication could cause my voice to get deeper.&#34;&#10;D)&#34;I should dress in layers,because I might get hot flashes while I take this medication.&#34;&#10;

Accepted Answer

The answer of A client is being treated pharmacologically for...

Question 18

The nurse is taking a medication history from a client who is seeking information about infertility treatments.Which drug taken by this client could potentially contraindicate the use of clomiphene (Clomid)?

A)Cimetidine (Tagamet)
B)St.John's wort
C)Levothyroxine sodium (Synthroid)
D)Amoxicillin (Amoxil)

Accepted Answer

The answer of The nurse is taking a medication history...

Question 19

An older male client has been prescribed estrogen therapy for prostate cancer and is confused because &#34;it is a medication for women.&#34; How can the nurse best explain this use of estrogen to the client?&#10;A)&#34;Estrogen blocks the hormones that allow the prostate cancer to grow.&#34;&#10;B)&#34;Estrogen helps to restore sexual drive in men with prostate cancer.&#34;&#10;C)&#34;Estrogen helps with the hot flashes that clients with prostate cancer usually have.&#34;&#10;D)&#34;Estrogen helps to lift the mood of clients who have cancer.&#34;&#10;

Accepted Answer

The answer of An older male client has been prescribed...

Question 20

A client at 25 weeks' gestation has experienced a fetal demise.What medication is most likely to be used first to induce labor in this client?&#10;A)Dinoprostone (Cervidil)&#10;B)Methylergonovine (Ergotrate)&#10;C)Parenteral oxytocin (Pitocin)&#10;D)Carboprost (Hemabate)&#10;

Accepted Answer

The answer of A client at 25 weeks' gestation has...

Question 21

The nurse is reviewing the indications for the use of clomiphene (Clomid)with couples seeking infertility treatment.Which statement concerning clomiphene (Clomid)does not accurately represent this medication?

A)Women who take clomiphene often experience a small weight gain.
B)Clomiphene may be given to males to increase the motility of the sperm.
C)A woman who takes clomiphene has a small chance (5% or less)of having a pregnancy with multiple gestations.
D)Clomiphene is used to induce ovulation in a woman who does not ovulate on a regular basis.

Accepted Answer

The answer of The nurse is reviewing the indications for...

Question 22

During a health history,a client who is taking Premarin tells the nurse about using a variety of herbal supplements.For which supplements should the nurse assess the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)St.John's wort
B)Red clover
C)Black cohosh
D)Ginseng
E)Garlic

Accepted Answer

The answer of During a health history,a client who is...

Question 23

A client is being considered for progestin therapy.However,the nurse is concerned because of which risk factors? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Current age 39
B)Being treated for atrial fibrillation
C)Smoking
D)Sedentary lifestyle
E)Vegetarian diet

Accepted Answer

The answer of A client is being considered for progestin...

Question 24

The nurse is reviewing the labor and delivery plan for a pregnant client who is scheduled to receive oxytocin (Pitocin)for induction of labor contractions.Which client statement indicates the need for additional instruction from the nurse?

A)"I want to walk around as much as possible to help stimulate my labor."
B)"I will receive gradually increasing doses of the medication until I'm in active labor."
C)"I realize my blood pressure will need to be taken frequently as long as I am on this medication."
D)"I will tell you if I develop a headache."

Accepted Answer

The answer of The nurse is reviewing the labor and...

Question 25

The cervix of a laboring client is not adequately ripening to support the pending delivery of the fetus.Which medications should the nurse prepare to administer to this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Dinoprostone (Cervidil)
B)Misoprostol (Cytotec)
C)Methylergonovine (Methergine)
D)Oxytocin (Pitocin)
E)Medroxyprogesterone (Provera)

Accepted Answer

The answer of The cervix of a laboring client is...

Question 26

The nurse should use of medroxyprogesterone acetate (Provera)in a client who:&#10;A)was hospitalized for depression 3 months ago.&#10;B)has just been diagnosed with anemia.&#10;C)was treated for acute bronchitis 2 weeks ago.&#10;D)had a cyst removed from her kidney 6 months ago.&#10;

Accepted Answer

The answer of The nurse should use of medroxyprogesterone acetate...

Question 27

The nurse should stop the infusion of terbutaline (Brethine)in a client being treated for premature uterine contractions based on which assessment findings? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Heart rate 110
B)Premature ventricular contractions on electrocardiogram tracing
C)Serum potassium level 3.0 mg/dL
D)Cough and shortness of breath
E)Reduction in uterine contractions

Accepted Answer

The answer of The nurse should stop the infusion of...

Question 28

A client who is prescribed progestin is experiencing hip joint pain.What does this new finding suggest to the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)The client could be experiencing bone demineralization.
B)The route of medication administration might need to be changed.
C)The dose needs to be increased.
D)The client needs to be prescribed penicillin.
E)The client needs an antidepressant medication.

Accepted Answer

The answer of A client who is prescribed progestin is...

Question 29

The nurse is caring for a client who is taking medroxyprogesterone (Provera).For which health problems should the nurse contact the health care provider? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Inability to conceive
B)Confusion
C)Lower extremity pain and swelling
D)Right-sided weakness
E)Changes in cardiac enzymes

Accepted Answer

The answer of The nurse is caring for a client...

Question 30

A client is receiving medroxyprogesterone (Provera)for secondary amenorrhea.Which medications would be contraindicated for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Barbiturates
B)Rifampin
C)Topiramate
D)Acetaminophen
E)Furosemide

Accepted Answer

The answer of A client is receiving medroxyprogesterone (Provera)for secondary...

Question 31

The nurse is monitoring a client who is receiving nifedipine (Adalat)for premature labor.For which side effects of this medication should the nurse contact the health care provider? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Productive cough
B)Premature ventricular contractions on electrocardiogram rhythm
C)Blood pressure 70/48 mmHg
D)No uterine contractions for 20 minutes
E)Respiratory rate 18

Accepted Answer

The answer of The nurse is monitoring a client who...

Question 32

A client receiving an infusion of oxytocin (Pitocin)begins to experience sustained uterine contractions.What should the nurse do to help this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Stop the infusion.
B)Provide intravenous fluids as prescribed.
C)Position the client on her side.
D)Provide oxygen.
E)Place the client in the lithotomy position.

Accepted Answer

The answer of A client receiving an infusion of oxytocin...

Deck 69: Estrogens,progestins,and Drugs Modifying Uterine Function