Question 1

A preschool-age child recovering from a surgery to correct undescended testes expresses fear about having a "body part cut off." Which nursing diagnosis should the nurse use to guide care while addressing this child's concern?

A) Risk for insufficient fluid balance
B) Ineffective coping related to altered physical appearance
C) Disturbed body image related to change in physical appearance
D) Deficient knowledge related to child's inexperience with surgical procedure

Disturbed body image related to change in physical appearance

Accepted Answer

The postoperative evaluation after surgery to correct undescended testes should address the boy's feelings about the surgery and the changes in his body. He may need an opportunity to express his fears about mutilation or castration by playing with puppets or dolls after surgery. This surgery is not associated with fluid balance. The child will not have an altered physical appearance after the surgery. The child's fear is more than a knowledge deficit about the surgical procedure.

Question 2

The nurse reviews the 2020 National Health Goals for sexual health prior to preparing a presentation for high school students. On what should the nurse focus when preparing this teaching for the students?

A) Prevention of sexually transmitted infections
B) Communicating health needs to the primary care physician
C) Importance of staying current with recommended immunizations
D) Creating a work-life balance between school and extracurricular activities

Prevention of sexually transmitted infections

Accepted Answer

The 2020 National Health Goals for sexual health focus on the prevention and early treatment of sexually transmitted infections. This is the topic in which the nurse should focus during the presentation with adolescent students. The 2020 National Health Goals for sexual health do not address communication with primary care physicians, immunizations, or creating a work-life balance.

Question 3

A baby is born with ambiguous genitalia. What should the nurse emphasize when discussing this with the parents?&#10;A) Ambiguous genitalia result from hypothalamus stimulation.&#10;B) The child's true sex can be determined by a genetic karyotype.&#10;C) Ambiguous genitalia will develop fully with estrogen therapy.&#10;D) All children with ambiguous genitalia are chromosomally female.

Accepted Answer

If there is any question about a child's gender, karyotyping or DNA analysis establishes whether the child is genetically male or female. Ambiguous genitalia do not result from hypothalamus stimulation. Ambiguous genitalia do not develop fully with estrogen therapy. Ambiguous genitalia can occur in either gender.

Question 4

An adolescent female is experiencing dysmenorrhea. What should the nurse teach the patient to help with this disorder?&#10;A) Take acetaminophen (Tylenol).&#10;B) Restrict fluid when having pain.&#10;C) Take over-the-counter ibuprofen.&#10;D) Use ice to help in reducing inflammation and pain.

Accepted Answer

Dysmenorrhea can usually be controlled by a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen. Tylenol is not identified as a medication to help with the pain of dysmenorrhea. Fluids do not need to be restricted with dysmenorrhea. Applying heat to the abdomen with a heating pad, hot shower, or tub bath may relax muscle tension and relieve pain.

Question 5

A sexually active adolescent female is concerned that she has contracted gonorrhea. Which finding should the nurse expect to assess if gonorrhea is present in this patient?&#10;A) A low-grade fever for 3 days&#10;B) Painful ulcers on the perineum&#10;C) Slight yellow vaginal discharge&#10;D) A white, frothy vaginal discharge

Accepted Answer

Although symptoms of gonorrhea in females are not as visible, there may be a slight yellowish vaginal discharge. The manifestations of a low-grade fever, ulcers on the perineum, and a frothy white vaginal discharge are not associated with gonorrhea.

Question 6

A sexually active adolescent is scheduled for a pelvic examination. What should the nurse do to help the patient relax during the examination?&#10;A) Show her a speculum prior to the exam.&#10;B) Assure her that no part of the exam will hurt.&#10;C) Coach her to hold her breath during the exam.&#10;D) Advise her to keep one hand on her abdomen.

Accepted Answer

Because the first pelvic examination can be stressful, the nurse should spend time with the girl before the procedure to teach her about what is being assessed. Providing representative instruments is helpful when describing the examination. There is no guarantee that no part of the pelvic examination will hurt. The patient should breathe normally during the examination. Keeping one hand on the abdomen has no significance during a pelvic examination.

Question 7

The nurse is instructing a female adolescent about the medication leuprolide acetate (Lupron Depot-Ped), which has been prescribed to reduce the level of testosterone. What should the nurse include when teaching the patient about this medication? (Select all that apply.)

A) Inject in the same region every month.
B) Ensure effective birth control if sexually active.
C) Transfer the medication into another syringe before injecting.
D) Mark on a calendar when the injections are needed every 3 months.
E) Notify the health care provider if nausea and vomiting occurs after taking the medication.

Accepted Answer

The medication leuprolide acetate (Lupron Depot-Ped) is a pregnancy risk category X so pregnant should be avoided when taking this medication. Because injections are given only every 3 months, the patient should prepare a calendar to identify when the next injection is due. The injections should be varied to decrease local irritation. The medication should be administered in the syringe supplied. Nausea and vomiting are possible adverse effects of the medication and do not need to be reported to the health care provider.

Question 8

What should the nurse instruct an adolescent who asks about the best way to prevent vulvovaginitis?&#10;A) Wipe from front to back after urinating or defecating.&#10;B) Apply personal hygiene sprays if vaginal odor develops.&#10;C) Soak in a strong bubble bath solution to maintain hygiene.&#10;D) Use nylon rather than cotton underpants to decrease moisture.

Accepted Answer

To prevent vulvovaginitis, the patient should be instructed to cleanse the perineum from front to back to prevent spreading rectal contamination forward. Personal hygiene sprays should be avoided because the ingredients could cause additional irritation.
Bubble baths should be avoided because the ingredients could cause additional irritation. Cotton underwear should be worn because it allows air to circulate.

Question 9

A female adolescent is diagnosed with polycystic ovary syndrome. Which information should the nurse prepare to instruct the patient about the treatment for this disorder? (Select all that apply.)&#10;A) Importance of exercise&#10;B) Use of antiandrogen medication&#10;C) Eating plan to reach appropriate weight&#10;D) Use of fertility medications to regulate menstrual cycles&#10;E) Use of oral combined estrogen/progesterone contraceptive

Accepted Answer

Treatment is aimed at relieving symptoms so teaching should be about symptom management. Antiandrogen medication may be used to reduce hair growth and acne. An eating plan may be used to reduce obesity. Oral combined estrogen/progesterone contraception is used to better regulate menstrual cycles. Exercise is not identified as a specific treatment. Fertility medication is used if the patient desires to become pregnant and not to regulate menstrual cycles.

Question 10

An 8-year-old child is diagnosed with balanoposthitis. What will the nurse most likely assess in this disorder?&#10;A) Reduced production of sperm&#10;B) Pallor of the prepuce of the penis&#10;C) Bloody urethral discharge and pain on urination&#10;D) Denuded, reddened surface of the glans of the penis

Accepted Answer

Balanoposthitis is inflammation of the glans and prepuce of the penis. The prepuce and glans appear red and swollen; there may be a purulent discharge. The nurse is unable to determine sperm production without a sperm count. The child may have difficulty voiding because of crusting at the meatal opening and because acidic urine touching the denuded surface of the glans causes pain. A bloody urethral discharge is not associated with this disorder.

Question 11

The male partner of a married couple has genital herpes. What should the nurse advise the couple to prevent the spread of infection to the female partner?&#10;A) Use a condom during intercourse.&#10;B) Avoid intercourse until a Pap test is negative.&#10;C) Delay coitus until 10 days after penicillin is started.&#10;D) Apply acyclovir topically to lesions prior to intercourse.

Accepted Answer

The answer of The male partner of a married couple...

Question 12

An adolescent female is concerned about developing toxic shock syndrome. What teaching can the nurse provide to allay this patient's fears about the disorder? (Select all that apply.)&#10;A) Avoid feminine hygiene sprays.&#10;B) Change tampons at least every 4 hours.&#10;C) Take acetaminophen (Tylenol) should a fever occur during menstruation.&#10;D) Use the largest absorbency tampon possible adequate for the menstrual flow.&#10;E) Tampons are to be avoided for 1 month after treatment for toxic shock syndrome.

Accepted Answer

The answer of An adolescent female is concerned about developing...

Question 13

The nurse instructs an adolescent on preventing the sexually transmitted infection syphilis. Which statement indicates that teaching about the spread of the infection has been effective?&#10;A) &#34;In the future, I'll void immediately after sex to prevent this.&#34;&#10;B) &#34;Next time, I'll be smart enough to look at my partner to see if he has any sores.&#34;&#10;C) &#34;I'm lucky I got this early in life. Now, I don't have to worry about getting it again.&#34;&#10;D) &#34;Can't I be prescribed birth control pills so I'll have some protection from getting this again?&#34;

Accepted Answer

The answer of The nurse instructs an adolescent on preventing...

Question 14

An 8-year-old female child has been diagnosed with precocious puberty. When teaching the parents about this diagnosis, what should the nurse include as a priority?&#10;A) &#34;The child will be unable to have children.&#34;&#10;B) &#34;The child will need psychological counseling.&#34;&#10;C) &#34;The child is physically able to become pregnant.&#34;&#10;D) &#34;The child will not need medication to suppress further development.&#34;

Accepted Answer

The answer of An 8-year-old female child has been diagnosed...

Question 15

An adolescent female is diagnosed with fibrocystic breast disease. What advice can the nurse provide the adolescent about this diagnosis?&#10;A) Caffeine may increase the size of lesions.&#10;B) Fibrocystic lesions are precancerous lesions.&#10;C) Lesions will fade with the full growth of breasts.&#10;D) The lesions make breast self-examination ineffective.

Accepted Answer

The answer of An adolescent female is diagnosed with fibrocystic...

Question 16

The nurse is discussing recommended immunizations with the mother of an adolescent female. Which immunization would be important for the nurse to include during this discussion?&#10;A) Gardasil&#10;B) Influenza&#10;C) Pneumonia&#10;D) Hepatitis B

Accepted Answer

The answer of The nurse is discussing recommended immunizations with...

Deck 47: Nursing Care of a Family When a Child Has a Reproductive Disorder