Chapter 16-32 Flashcards
(251 cards)
1
Q
A national study with 31,581 respondents found that ________ of women reported
having some type of sexual problem, such as orgasm difficulties.
a. 67%
b. 44%
c. 22.3%
d. 10%
A
b. 44%
2
Q
A woman’s sexual complaint may be attributed to
a. physical or mental health factors.
b. sociocultural influences.
c. normal variations of sexuality.
d. any of the above.
A
d. any of the above.
3
Q
Which one of the following statements about androgen supplementation is false?
a. Adverse effects of its use include acne, liver damage, and decreased levels of
HDL cholesterol.
b. There are no androgen therapies approved by the U.S. Food and Drug
Administration (FDA) for use in women.
c. Correlations between testosterone levels and sexual dysfunction have been
found to be consistent across numerous studies.
d. Transdermal preparations are frequently used in women, though dosing is
difficult because they are packaged in doses appropriate for men.
A
c. Correlations between testosterone levels and sexual dysfunction have been
found to be consistent across numerous studies.
4
Q
The absence or markedly diminished feelings of sexual excitement and sexual pleasure
from any type of sexual stimulation is called _______ sexual arousal disorder.
a. genital
b. subjective
c. combined genital and subjective
d. persistent
A
b. subjective
5
Q
All of the following medications may cause sexual arousal problems except
a. SSRIs and MAOIs.
b. tricyclic antidepressants.
c. sildenafil, alprostadil, and tibolone.
d. antihistamines and antihypertensives.
A
c. sildenafil, alprostadil, and tibolone.
6
Q
Management of sexual arousal disorders in women may include any one of the
following except
a. treatments that decrease blood flow to the genital tissues.
b. the use of vaginal lubricants to increase stimulation.
c. use of the Eros-CTD, a clitoral therapy device.
d. localized estrogen therapy.
A
a. treatments that decrease blood flow to the genital tissues.
7
Q
. In a randomized controlled trial, women who used _______ had significantly greater
mean improvement in the desire and arousal domains of the FSFI compared to women
who used a placebo.
a. Yohimbine, an extract from the bark of an African tree
b. L-Arginine, one of the ingredients in a nutritional supplement
c. Zestra, a topical formulation that contains botanical oils and extracts
d. None of the above
A
c. Zestra, a topical formulation that contains botanical oils and extracts
8
Q
For the woman who has never experienced orgasm, the clinician should
a. diagram and describe female genital anatomy to her.
b. recommend Kegel exercises to help inhibit the orgasmic response.
c. suggest psychotherapy before suggesting any self-help measures.
d. explain that most women achieve orgasm only through penetration of the
vagina
A
a. diagram and describe female genital anatomy to her.
9
Q
Which one of the following is the best definition of vaginismus?
a. Persistent difficulty to allow vaginal entry of a penis, finger, or any object
b. Semen hypersensitivity that causes pain, diffuse urticaria, and malaise
c. A form of vaginal spasm that results from fearful anticipation of pain
d. Recurrent pain upon vaginal entry and/or penile vaginal intercourse
A
a. Persistent difficulty to allow vaginal entry of a penis, finger, or any object
10
Q
Management of dyspareunia
a. depends on the etiology of the pain.
b. requires nonpharmacologic treatment modalities.
c. is 100% effective with vestibulectomy and advancement plasty.
d. is only a matter of teaching the patient to change the angle of the uterus during
intercourse.
A
a. depends on the etiology of the pain.
11
Q
About half of all pregnancies in the United States are unintended and occur most frequently in women who a. are married or divorced. b. have finished high school. c. are between the ages of 18 and 24. d. are members of the majority group.
A
c. are between the ages of 18 and 24.
12
Q
Estimates from the 2002 National Survey of Family Growth indicate that _______ of
infants born to never-married women younger than 45 years of age were relinquished for
adoption between 1996 and 2002.
a. 1%
b. 11%
c. 24%
d. 49%
A
a. 1%
13
Q
Unintended pregnancy is associated with
a. tobacco and alcohol use during pregnancy.
b. less risk of physical abuse and depression.
c. higher number of total prenatal care visits.
d. higher infant birth weights.
A
a. tobacco and alcohol use during pregnancy.
14
Q
One study of more than 10,000 women who had abortions found that _______ had
been using a contraceptive method in the month they conceived.
a. 14%
b. 34%
c. 54%
d. 74%
A
c. 54%
15
Q
When a patient’s decision about an unintended pregnancy causes an irreconcilable
conflict between a clinician’s personal beliefs and professional responsibilities, the
clinician should
a. make sure the patient understands what those personal beliefs are.
b. continue to work in settings where such conflicts occur frequently.
c. deny comprehensive pregnancy options counseling to the patient.
d. refer the patient to a colleague or to a different setting entirely.
A
d. refer the patient to a colleague or to a different setting entirely.
16
Q
All of the alternatives that follow are included in pregnancy options counseling except
a. discontinue the pregnancy.
b. carry the pregnancy and parent the child.
c. assess the need for additional attention after abortion.
d. carry the pregnancy and place the infant for adoption
A
c. assess the need for additional attention after abortion.
17
Q
Women who present for pregnancy options counseling
a. understand the time-sensitive nature of the decision-making process.
b. should be made aware of the gestational age of the pregnancy.
c. have made their decision and do not need to discuss it.
d. need no further resources to establish a plan of action.
A
b. should be made aware of the gestational age of the pregnancy.
18
Q
The most recent data on the timing of abortions indicate that \_\_\_\_\_\_\_\_\_\_ are performed prior to 13 weeks gestation. a. 99% b. 88% c. 77% d. 66%
A
b. 88%
19
Q
The methods of abortion used in the United States—in order, with the most common
method listed first—are
a. aspiration, medication, induction, surgical.
b. medication, induction, aspiration, surgical.
c. surgical, induction, medication, aspiration.
d. induction, aspiration, surgical, medication.
A
a. aspiration, medication, induction, surgical.
20
Q
The World Health Organization (2007) estimates that _______ unsafe abortions took
place annually between 1993 and 2003, resulting in enough deaths to render unsafe
abortion one of the leading causes of maternal mortality.
a. 19 to 20 million
b. 19 to 20 thousand
c. 1 to 2 million
d. 1 to 2 thousand
A
a. 19 to 20 million
21
Q
For women younger than 35, infertility is defined as failure to achieve a successful
pregnancy after _______ of regular unprotected intercourse.
a. 6 weeks
b. 6 months
c. 12 weeks
d. 12 months
A
d. 12 months
22
Q
For a woman older than 35, the clinician will consider infertility treatment after six
months of attempting a pregnancy because
a. fecundity begins to increase gradually at age 28.
b. there is a higher risk of pregnancy loss in the older woman.
c. the older woman is not as frivolous as a younger woman might be.
d. conditions that impair fertility decline after age 35.
A
b. there is a higher risk of pregnancy loss in the older woman.
23
Q
Approximately 72 _______ are required for spermatogenesis, after which sperm
mature in the epididymis and then travel out of the vas deferens during ejaculation.
a. days
b. hours
c. minutes
d. seconds
A
a. days
24
Q
Among the causes of infertility in women are all of the following except
a. endometriosis.
b. a luteal-phase deficiency.
c. a bicornuate or septate uterus.
d. tubal scarring as a result of an STI.
A
c. a bicornuate or septate uterus.
25
The fertility test that involves radiologic imaging of an injection of a water- or oilsoluble contrast traveling through a women’s reproductive system is called
a. transvaginal ultrasound and hysteroscopy.
b. hysterosalpingogram.
c. semen analysis.
d. laparoscopy.
b. hysterosalpingogram.
26
```
All of the following diagnostic testing and procedures are now infrequently performed
in clinical practice except
a. hysterosalpingogram.
b. sperm penetration assay.
c. the postcoital test (PCT).
d. endometrial biopsy (EMB)
```
a. hysterosalpingogram.
27
The infertility evaluation is an opportune time to suggest health promotion behaviors
that may specifically improve fertility, including
a. achieving a BMI in the range of 30 to 35, if the woman is under- or overweight.
b. reducing alcohol consumption to about 4 drinks per week.
c. reducing caffeine consumption to no more than 350 per day.
d. none of the above.
b. reducing alcohol consumption to about 4 drinks per week.
28
The form of assisted reproductive technology that requires fertilization to occur within
a patent fallopian tube, instead of a laboratory dish, is called
a. intracytoplasmic sperm injection (ICSI).
b. gamete intrafallopian transfer (GIFT).
c. zygote intrafallopian transfer (ZIFT).
d. in vitro fertilization (IVF).
b. gamete intrafallopian transfer (GIFT).
29
For women and men with infertility an option that involves a sperm or egg donor is
called
a. assisted reproductive technology (ART).
b. collaborative reproduction.
c. child-free living.
d. adoption.
b. collaborative reproduction.
30
An ethical question that is specifically about pre-implantation testing with ART has to
do with
a. ownership of frozen embryos after the couple has divorced.
b. a surrogate deciding she does not want to relinquish the infant.
c. genetic engineering and the ability to reject embryos affected by inherited
disorders.
d. the implantation of multiple embryos, which can create high risk for the
embryos and the woman.
c. genetic engineering and the ability to reject embryos affected by inherited
disorders.
31
What is the major source of normal vaginal secretions?
a. Bartholin’s glands
b. Apocrine glands
c. Sebaceous glands
d. Cervical mucosa
d. Cervical mucosa
32
What is the term for the inflammation of the vagina characterized by an increased
vaginal discharge containing numerous white blood cells?
a. Vaginitis
b. Vaginosis
c. Cystitis
d. Vaginal mucosa
a. Vaginitis
33
How does vaginosis differ from vaginitis?
a. It must be treated with metronidazole.
b. The discharge does not contain white blood cells.
c. The discharge does not have an odor.
d. It causes itching and/or burning.
b. The discharge does not contain white blood cells.
34
What is the most important step in preventing vaginal infections?
a. Good personal hygiene
b. Healthy diet
c. Scented sanitary products
d. Douching
a. Good personal hygiene
35
What can bacterial vaginosis lead to?
a. Vulvovaginal candidiasis
b. Pelvic inflammatory disease
c. Toxic shock syndrome
d. Trichomoniasis
b. Pelvic inflammatory disease
36
Approximately what percentage of women with bacterial vaginosis are asymptomatic?
a. 25%
b. 40%
c. 75%
d. 50%
d. 50%
37
What is the most common symptom of bacterial vaginosis?
a. Vaginal itching and/or burning
b. Cottage cheese-like discharge
c. Fishy odor
d. Yeasty odor
c. Fishy odor
38
Vulvovaginal candidiasis accounts for what percentage of all vaginal infections?
a. 10-15%
b. 20-25%
c. 50-55%
d. 60-65%
b. 20-25%
39
Which organism causes 90% of vulvovaginal candidiasis episodes in women?
a. Candida tropicalis
b. Candida albicans
c. Candida glabrata
d. Candida krusei
b. Candida albicans
40
What is the most common symptom of vulvovaginal candidiasis?
a. Fishy odor
b. Fever
c. Thin, grayish-white discharge
d. Vulvar pruritis
d. Vulvar pruritis
41
What percentage of Toxic Shock Syndrome cases are related to menses?
a. 50%
b. 25%
c. 75%
d. 90%
a. 50%
42
```
Women who have had Toxic Shock Syndrome should be instructed not to use
tampons or
a. barrier contraception methods.
b. hormonal contraception methods.
c. intravaginal antibiotic cream.
d. oral antibiotics.
```
a. barrier contraception methods.
43
What is generally the cause of Bartholin’s cyst?
a. Complications from gonorrhea
b. Cystic fluid in Bartholin’s gland becomes infected
c. A fungal infection in Bartholin’s gland
d. Obstruction of a duct in Bartholin’s gland
d. Obstruction of a duct in Bartholin’s gland
44
```
Approximately how many Americans will contract one or more sexually transmitted
infections during their lifetime?
a. 50%
b. 25%
c. 40%
d. 60%
```
a. 50%
45
Why is it often more difficult to detect STIs in women than in men?
a. Men are two times more likely to transmit STIs to women than the reverse.
b. The risk of a woman contracting an STI is much higher than a man’s risk.
c. The anatomy of women’s genital tracts makes examination more difficult.
d. Women tend to have fewer sexual partners than men do.
c. The anatomy of women’s genital tracts makes examination more difficult.
46
Who should be screened regularly for STIs?
a. Women who have more than one sexual partner
b. Women over the age of 21
c. Women who are sexually active
d. Women over the age of 15
c. Women who are sexually active
47
Of the more than 100 known serotypes of human papillomavirus (HPV),
approximately how many can infect the genital tract?
a. 80
b. 60
c. 20
d. 40
d. 40
48
Routine HPV vaccination is recommended for girls of what age?
a. 8-9
b. 13-14
c. 6-7
d. 11-12
d. 11-12
49
An initial or primary genital herpes infection characteristically lasts about
a. one week.
b. three weeks.
c. one month.
d. six weeks.
b. three weeks.
50
How do systemic antivirul drugs treat genital herpes?
a. They can control the symptoms.
b. They can reduce the frequency of recurrences after discontinuation.
c. They can prevent transmission to sexual partners.
d. They can prevent secondary infection.
a. They can control the symptoms.
51
```
Which of the following is caused by an anaerobic one-celled protozoan that commonly
lives in the vagina?
a. Trichomoniasis
b. Chlamydia
c. Gonorrhea
d. Syphilis
```
a. Trichomoniasis
52
```
The prevalence of chlamydia is how many times higher in black women than in white
women?
a. Two times
b. Three times
c. Five times
d. Four times
```
c. five times higher
53
The second most commonly reported STI after chlamydia is
a. gonorrhea.
b. pelvic inflammatory disease.
c. syphilis.
d. hepatitis B.
a. gonorrhea
54
Why do adolescents have the highest risk of developing pelvic inflammatory disease
(PID)?
a. They have the highest risk for bacterial vaginosis.
b. They are the least at risk for developing other STIs.
c. They are the most sexually active.
d. They have decreased immunity to infectious organisms.
d. They have decreased immunity to infectious organisms.
55
What is different about syphilis as compared to other bacterial STIs?
a. The incidence in women is much higher than in men.
b. The rates are higher for white women than for black women.
c. It cannot be spread by kissing.
d. It persists past age 25, into the 30s and 40s.
d. It persists past age 25, into the 30s and 40s.
56
```
What has contributed to the decreased incidence of Hepatitis B over the past 20
years?
a. The decrease in PID
b. The HBV vaccination
c. The increase in condom use
d. More precise screening methods
```
b. The HBV vaccination
57
Patients presenting for STI treatment should be screened for HIV
a. at each visit.
b. at the end of treatment.
c. at the beginning of treatment.
d. each year.
a. at each visit.
58
Half of all women have experienced a urinary tract infection (UTI) by age
a. 18.
b. 24.
c. 40.
d. 32.
d. 32.
59
How does women’s anatomy make them more susceptible to UTIs?
a. Asymptomatic UTIs do not resolve themselves without treatment.
b. Women tend to get UTIs when they are pregnant.
c. There is a longer distance between the urethra and anus.
d. Their urethras are shorter.
d. Their urethras are shorter.
60
What is the most common type of UTI that affects women?
a. Acute bacterial cystitis
b. Pyelonephritis
c. Asymptomatic bacteruria
d. Pyelitis
a. Acute bacterial cystitis
61
Uncomplicated acute bacterial cystitis occurs in women who
a. are pregnant.
b. have no signs of upper tract infection.
c. have a high fever.
d. have had recent antibiotics.
b. have no signs of upper tract infection.
62
What distinguishes pyelonephritis from cystitis?
a. The infection has descended to the bladder.
b. The infection has ascended to the kidneys.
c. The infection is caused by E. coli bacteria.
d. The infection occurs only in pregnant women.
b. The infection has ascended to the kidneys.
63
```
An inexpensive screening tool that can be used to confirm a UTI diagnosis if the
history is ambiguous is the
a. urine culture.
b. sensitivity test.
c. urine dipstick.
d. empiric culture.
```
c. urine dipstick.
64
```
Any woman with a complicated cystitis or symptoms of upper tract disease needs a
urine culture and
a. sensitivity test.
b. blood culture.
c. urine dipstick.
d. parenteral culture.
```
a. sensitivity test.
65
```
Fever associated with pyelonephritis will usually resolve within how many hours of
treatment with antibiotics?
a. 24 hours
b. 12 hours
c. 72 hours
d. 48 hours
```
d. 48 hours
66
What has changed in terms of recommended antibiotic treatment for uncomplicated
lower UTIs?
a. Seven-day regimens are now recommended.
b. Three times a day of oral antibiotics are now recommended.
c. Three-day regimens are now recommended.
d. A single dose is now recommended.
c. Three-day regimens are now recommended.
67
What do current theories suggest as to how cranberry products can reduce UTIs?
a. The hippuric acid in cranberries inhibits the growth of E. coli bacteria.
b. The fructose keeps E. coli bacteria from adhering to bladder cell walls.
c. Ingestion of cranberry products changes the flora of the vagina.
d. The quinic acid in cranberries thins out the lining of the urethra.
b. The fructose keeps E. coli bacteria from adhering to bladder cell walls.
68
What is the reason that urinary incontinence (UI) is probably underreported?
a. Its symptoms are difficult to isolate.
b. The majority of sufferers are men.
c. People may be too embarrassed to report it to a clinician.
d. It generally occurs in women over the age of 70.
c. People may be too embarrassed to report it to a clinician.
69
In order to maintain continence bladder pressure must be
a. higher than urethral pressure.
b. equal to the pressure of the urethral sphincter.
c. higher than the pressure of the levator ani.
d. lower than urethral pressure.
d. lower than urethral pressure.
70
In women, the urethra rests on the anterior vaginal wall, which is supported by a
muscle that is known as the pelvic floor muscle or
a. Kegel muscle.
b. urethral sphincter.
c. striated muscle.
d. intra-abdominal sphincter.
a. Kegel muscle.
71
What is the name of the triangular fibrous complex that supports the pelvic muscles
during urination, defecation, and birth, when the levator ani muscle must relax?
a. Perineal membrane
b. Urethral sphincter
c. Bladder neck
d. Detrusor muscle
a. Perineal membrane
72
What is the recommended interval target between urinations?
a. 30-45 minutes
b. 3-4 hours
c. 1-2 hours
d. 4-5 hours
b. 3-4 hours
73
What is an age-related anatomic change that can lead to UI?
a. The shortening of the urethra
b. The reduction in bladder capacity
c. The increase in habitual preventative emptying of the bladder
d. The decline in number of urethral striated muscle fibers
d. The decline in number of urethral striated muscle fibers
74
Women with BMIs higher than what number were found to be more than twice as
likely to experience UI compared to women with lower BMIs?
a. 35
b. 40
c. 20
d. 25
a.35
75
What test measures intra-abdominal pressure and determines how large the pressure
increase must be to produce leakage in an individual woman?
a. The leak point pressure test
b. The urinary stress test
c. The extra-urethral pressure test
d. The urethral threshold test
a. The leak point pressure test
76
The urethra typically holds back how much fluid in the bladder several times a day?
a. 100-200mL
b. 500-600mL
c. 300-400mL
d. 700-800mL
c. 300-400mL
77
What is the name for a pelvic muscle contraction that is strategically timed to increase
intraurethral pressure just before and after the event that causes UI?
a. Kegel contraction
b. Detrusor maneuver
c. Reverse bladder contraction
d. Knack maneuver
d. Knack maneuver
78
```
What is the recommended amount of Kegel contractions per day for women whose
pelvic muscles are weak?
a. 10
b. 50
c. 30
d. 70
```
c. 30
79
What type of behavioral intervention is recommended for women with urge UI who
have no urge sensation until the bladder is excessively full and signals a strong and
uncomfortable urge?
a. Electrical stimulation
b. The Knack maneuver
c. Reverse bladder retraining
d. Kegel exercises
b. The Knack maneuver
80
What can be used as a space-filling device, replacing normal pressure on the vaginal
walls when levator ani support is unreliable?
a. Diaphragms
b. Tampons
c. Kegels
d. Sacral nerve stimulators
b. Tampons
81
What is the general goal of surgical treatment for stress UI?
a. To increase the capacity of the bladder
b. To increase pressure on the vaginal walls
c. To support and strengthen the levator ani
d. To support and stabilize the urethra
d. To support and stabilize the urethra
82
What term refers to the period from about 7 to 10 days before menstrual flow begins
until the first or second day of menstrual flow?
a. Amenorrhea
b. Premenstrual
c. Dysmenorrhea
d. Perimenstrual
d. Perimenstrual
83
```
Approximately what percentage of women experience severe recurring symptoms
associated with their menstrual cycle?
a. 10%
b. 20%
c. 5%
d. 25%
```
a. 10%
84
Why shouldn’t symptoms such as bloating and breast tenderness be considered
disordered perimenstrual symptoms?
a. Because only a small minority of women have these symptoms
b. Because these symptoms affect the majority of women
c. Because these symptoms do not affect women’s moods
d. Because it is not possible to quantify these symptoms
b. Because these symptoms affect the majority of women
85
Of the four symptom clusters of perimenstrual symptoms identified by Woods,
Mitchell & Lentz (1999), which was the dominant one in terms of explaining variance in
premenstrual symptoms?
a. Fluid retention
b. Arousal
c. Turmoil
d. Somatic symptoms
c. Turmoil
86
How is secondary dysmenorrhea defined?
a. Absence of menstruation due to an underlying pathology
b. Painful menstruation in the absence of pathology
c. An underlying pathology causing pain symptoms during menstrual flow
d. Painful menstruation that occurs in women after the age of 35
c. An underlying pathology causing pain symptoms during menstrual flow
87
```
What is the term for the exacerbation of somatic or mood symptoms in the late luteal
or menstrual phase of the cycle?
a. Premenstrual magnification
b. Perimenstrual dysmenorrhea
c. Premenstrual syndrome
d. Premenstrual dysphoric disorder
```
a. Premenstrual magnification
88
```
Which of the following is a diagnostic label that is listed in the Diagnostic and
Statistical Manual IV-TR?
a. Premenstrual dysphoric disorder
b. Premenstrual magnification
c. Dysmenorrhea
d. Premenstrual syndrome
```
a. Premenstrual dysphoric disorder
89
Women who report experiencing the most severe symptoms of PMS tend to be
a. in their late 40s.
b. in their early 20s.
c. in their late teens.
d. in their late 30s.
d. in their late 30s.
90
Which of the following is one of the key criteria for a diagnosis of PMS?
a. The symptoms markedly interfere with occupational functioning
b. One of the symptoms is depressed mood, anxiety, or irritability
c. Exclusion of other diagnoses that may better explain the symptoms
d. The symptoms are confirmed by prospective daily ratings over at least two
menstrual cycles
c. Exclusion of other diagnoses that may better explain the symptoms
91
```
All menstruating women report that which type of symptoms is highest during
menses?
a. Muscular
b. Gastrointestinal
c. Incontinent
d. Skeletal
```
b. Gastrointestinal
92
```
What hormone has been shown to help with relieving the mood discomfort cluster of
symptoms of PMS?
a. Diuretics
b. NSAID
c. Progesterone
d. Fluoxetine
```
c. Progesterone
93
Which dietary supplement has been shown to help treat PMS?
a. Calcium
b. Magnesium
c. Vitamin B12
d. Iron
a. Calcium
94
The only botanical treatment with Level I evidence to support its use in PMS is
a. echinacea.
b. chaste tree berry
c. linolenic acid.
d. cramp bark.
b. chaste tree berry.
95
Research suggests a link between PMS and
a. seasonal affective disorder.
b. celiac disease.
c. high blood pressure.
d. hypoglycemia.
a. seasonal affective disorder.
96
What is the best definition of abnormal uterine bleeding (AUB)?
a. Uterine bleeding for which no pelvic pathology is found
b. Uterine bleeding that is irregular during a woman’s menstrual cycle
c. Uterine bleeding that is irregular in amount or frequency
d. Uterine bleeding that is related to systemic conditions
c. Uterine bleeding that is irregular in amount or frequency
97
What is a good first question to ask women who present with a concern about
abnormal bleeding?
a. What is a normal pattern for you?
b. How long has this persisted?
c. What was your last menstrual cycle like?
d. How many times has this occurred?
a. What is a normal pattern for you?
98
In women of reproductive age, the most common cause of a bleeding pattern that is
suddenly different is
a. an increase in estrogen.
b. a reaction to a change in eating or exercise habits.
c. adrenal hyperplasia.
d. a complication of pregnancy
d. a complication of pregnancy.
99
Progesterone breakthrough bleeding is sometimes seen in women who
a. have polycystic ovary syndrome.
b. are obese.
c. use progesterone-only contraception.
d. have ceased progesterone therapy.
c. use progesterone-only contraception.
100
The least variation in menses occurs during the ages of
a. 30-50.
b. 40-50.
c. 12-20.
d. 20-40
d. 20-40
101
How can liver and renal diseases result in abnormal uterine bleeding?
a. They cause an imbalance in platelet aggregation.
b. They result in an inability to adequately clear estrogen from the body.
c. They cause thyroid dysfunction, which leads to bleeding abnormalities.
d. They result in elevated prolactin levels, which leads to bleeding abnormalities.
b. They result in an inability to adequately clear estrogen from the body.
102
```
Signs of endometrial or cervical cancer may present abnormal uterine bleeding, often
as heavy, prolonged bleeding or
a. menometrorrhagia.
b. amenorrhea.
c. oligomenorrhea.
d. polymenorrhea.
```
a. menometrorrhagia.
103
```
Products from which of the following herbs have been associated with alterations in
estrogen levels, resulting in AUB?
a. Gingko
b. Echinacea
c. Evening Primrose
d. Chaste tree berry
```
a. Gingko
104
```
Exercise-induced amenorrhea is probably due to the combination of low body fat and
decreased secretion of
a. estrogen.
b. prolactin.
c. progesterone.
d. GnRH.
```
d. GnRH.
105
When is a pelvic examination unnecessary for a woman who is experiencing AUB?
a. If she is not sexually active
b. If she has recently begun menstruating
c. If her bleeding is extremely heavy
d. If she also has anemia
b. If she has recently begun menstruating
106
```
What test should be ordered for a woman who is experiencing AUB as well as
headaches and peripheral vision changes?
a. Thyroid-stimulating hormone test
b. Nucleic acid amplification test
c. Complete blood count
d. Prolactin level test
```
d. Prolactin level test
107
Gonadotropin hormone-releasing agonists are recommended for only short-term use
to treat heavy bleeding due to
a. their many side effects, such as hot flashes.
b. the fact that they cause amenorrhea.
c. the fact that they are poorly understood.
d. their poor interaction with hormonal contraception.
a. their many side effects, such as hot flashes.
108
```
What treatment was introduced in the 1990s as a less invasive alternative to
hysterectomy?
a. Myomectomy
b. NSAIDs
c. Endometrial ablation
d. LNG-INS
```
c. Endometrial ablation
109
What is the definition of primary amenorrhea?
a. The cessation of menses for an interval of 6 months
b. The failure to begin menses by age 14
c. The cessation of menses due to outflow tract obstruction
d. The failure to begin menses by age 16
d. The failure to begin menses by age 16
110
Hyperandrogenism in reproductive-age women is most frequently associated with
a. hyperthyroidism.
b. polycystic ovary syndrome.
c. ovarian cancer.
d. diabetes.
b. polycystic ovary syndrome.
111
What is the hormone responsible for the clinical expression of androgen stimulation in
androgen-sensitive tissues, such as skin and hair follicles?
a. Reductase
b. DHEA
c. DHT
d. Testosterone
c.DHT
112
What is the term for excessive terminal hair growth in women?
a. Hirsutism
b. Alopecia
c. PCOS
d. Metformin
a. Hirsutism
113
Which of the following might be a sign of hyperandrogenism?
a. Irritable bowel syndrome
b. Decreased sebum secretion in the skin
c. Decreased muscle mass
d. Acne associated with menstrual dysfunction
d. Acne associated with menstrual dysfunction
114
What is the most common type of menstrual dysfunction related to hyperandrogenism?
a. Painful menstruation
b. Absence of menses
c. Irregular bleeding
d. Early menopause
c. Irregular bleeding
115
```
Approximately what percentage of patients with polycystic ovary syndrome (PCOS) is
obese?
a. 50%
b. 25%
c. 75%
d. 40%
```
a. 50%
116
Why are women with PCOS at a threefold increased risk of developing endometrial
cancer?
a. The reduction in estrogen causes excess progesterone to build up.
b. Menstrual bleeding is irregular and unpredictable.
c. Insulin resistance stimulates the production of androgens.
d. Estrogen regularly stimulates the endometrium.
d. Estrogen regularly stimulates the endometrium.
117
What medicine has been associated with causing hyperandrogenism?
a. Combined oral contraceptives
b. Antiandrogens
c. Analgesics
d. Anabolic steroids
d. Anabolic steroids
118
How can weight loss specifically control symptoms of PCOS?
a. It decreases SHBG.
b. It increases insulin resistance.
c. It decreases androgen levels.
d. It increases estrogen levels.
c. It decreases androgen levels.
119
A first-line recommended treatment for women with PCOS is
a. photoepilation.
b. anabolic steroids.
c. analgesics.
d. combined oral contraceptives.
d. combined oral contraceptives.
120
```
What should be used for women whose hirsutism remains refractory after 6 months of
combined oral contraceptive use?
a. Antiandrogens
b. Progestogens
c. Metformin
d. GnRH
```
a. Antiandrogens
121
How does the topical application of eflornithine treat facial hirsutism?
a. It slows the rate of hair growth.
b. It reduces androgen levels.
c. It reduces incidences of alopecia.
d. It inhibits gonadotropin secretion.
a. It slows the rate of hair growth.
122
What is the definitive diagnostic technique for vulvar dermatoses?
a. Pap test
b. Biopsy
c. Colposcopy
d. Physical exam
b. biopsy
123
```
Lichen sclerosis is a benign, chronic, progressive disease of the skin in which the most
common symptom is
a. vulvar pruritis.
b. vaginal discharge.
c. postcoital bleeding.
d. dyspareunia
```
a. vulvar pruritis
124
Which type of cervical polyps should be removed?
a. Erosive polyps
b. Hypertrophic polyps
c. Asymptomatic polyps
d. Atypical polyps
c. Asymptomatic polyps
125
The incidence of uterine fibroids
a. increases with age.
b. decreases with age.
c. is often caused by early menopause.
d. is related to the age of first menses.
a. increases with age.
126
Why is adenomyosis frequently underdiagnosed?
a. It cannot be detected via an ultrasound.
b. It is almost always asymptomatic.
c. It is most common in adolescents.
d. It has similar symptoms to other pelvic pain conditions.
d. It has similar symptoms to other pelvic pain conditions.
127
The most common site for endometrial implants found in other parts of the body is
a. the appendix.
b. the uterus.
c. the ovaries.
d. the fallopian tubes.
c. the ovaries.
128
Which of the following is associated with increased risk of endometriosis?
a. Late menarche
b. Long menstrual cycles
c. Early menarche
d. Late menopause
c. Early menarche
129
The most widely accepted theory for the origin of endometriosis is that reverse flow of
menses out of the fallopian tubes allows endometrial cells to enter the pelvis and become
implanted on the pelvic organs, which is the
a. induction theory.
b. retrograde menstruation theory.
c. coelomic metaplasia theory.
d. endometrial repair theory.
b. retrograde menstruation theory.
130
Most functional ovarian cysts will resolve within
a. six months.
b. three months.
c. six weeks.
d. one year.
b. three months
131
What is not a likely symptom of ovarian cysts?
a. Irregular menstrual cycle
b. Increase in blood pressure
c. Heart rate increase
d. Fever
d. Fever
132
```
Approximately what percentage of vulvar cancers occur in women older than the age
of 50?
a. 50%
b. 70%
c. 85%
d. 60%
```
c. 85%
133
What is the widely used carcinoma classification system that provides a way of
describing the size, location, and spread of a tumor?
a. The SLS classification
b. The CCS classification
c. The TSL classification
d. The TNM classification
d. The TNM classification
134
Which of the following is a preventive measure for vulvar cancer?
a. Avoiding exposure to HIV
b. Not smoking
c. There is no way to prevent it.
d. Colposcopy
b. Not smoking
135
What is now thought to be the most important causative agent in cervical cancer?
a. PCOS
b. Vulvar cancer
c. Herpes simplex
d. HPV
d. HPV
136
What symptom is present in 80 to 90% of women with cervical cancer?
a. Abnormal vaginal bleeding
b. Abnormal vaginal discharge
c. Pelvic pain
d. Ectopic pregnancy
a. Abnormal vaginal bleeding
137
Abnormal changes in the cervix can be readily detected by a
a. colposcopy.
b. STI test.
c. Pap test.
d. LEEP.
c. Pap test.
138
The HPV vaccine has been proven to be effective in protecting against the four types
of HPV that cause genital warts and cervical cancers for as long as
a. ten years.
b. two years.
c. fifteen years.
d. five years
d. five years
139
Type I endometrial cancer is caused by
a. an excess of estrogen exposure.
b. polyps in the endometrium.
c. heredity.
d. infertility treatments.
a. an excess of estrogen exposure.
140
A risk factor that could lead to endometrial cancer is
a. early menopause.
b. late menopause.
c. high blood pressure.
d. cervical cancer.
b. late menopause.
141
What screening test can be used to detect endometrial cancer?
a. STI test.
b. Colposcopy
c. Pap test
d. There is no screening test that detects it.
d. There is no screening test that detects it.
142
Which cancer has the highest mortality rate of all gynecological cancers?
a. Vulvar cancer
b. Endometrial cancer
c. Cervical cancer
d. Ovarian cancer
d. Ovarian cancer
143
Why are the majority of cases of ovarian cancer diagnosed when the disease has
already reached an advanced stage?
a. Women are not routinely screened for it.
b. The symptoms are the same as those for cervical cancer.
c. The symptoms are vague.
d. The disease usually affects women over the age of 50.
c. The symptoms are vague.
144
What is one factor that can reduce the risk for the development of ovarian cancer?
a. Multiple pregnancies
b. Transvaginal ultrasounds
c. Identification of recurrence
d. Weight loss
a. Multiple pregnancies
145
```
What the term for pain that is in the pelvis or lower abdomen and is less than three
months’ duration?
a. Terminal pelvic pain
b. Cyclic pelvic pain
c. Chronic pelvic pain
d. Acute pelvic pain
```
d. Acute pelvic pain
146
```
Of women aged 18 to 50, what percentage have chronic pelvic pain that lasts longer
than a year?
a. 15-20%
b. 10-15%
c. 5-10%
d. 25-30%
```
a. 15-20%
147
Research suggests that in terms of gender, women
a. suffer longer from pain in total number of years.
b. will rate the same type of pain lower than men.
c. have greater tolerance for pain.
d. have a lower threshold for pain.
d. have a lower threshold for pain.
148
What type of pain results from tissue injury and is experienced as acute pain?
a. Superficial pain
b. Visceral pain
c. Inflammatory pain
d. Neuropathic pain
c. Inflammatory pain
149
```
In the mnemonic “OLD CAARTS” that helps to perform a pain history, what does the
“S” stand for?
a. Severity
b. Scale
c. Somatic
d. Superficial
```
a. Severity
150
```
What is used when pelvic pathology is unable to be detected by physical examination
or other testing?
a. Biopsy
b. Laparoscopy
c. Colposcopy
d. Palpation
```
b. Laparoscopy
151
What is one of the most common gynecological-related causes of chronic pelvic pain?
a. Cervical cancer
b. Amenorrhea
c. Dysmenorrhea
d. Endometriosis
d. Endometriosis
152
Which condition can result from treatment for infertility?
a. Ovarian remnant syndrome
b. Ovarian retention syndrome
c. Ovarian neuropathic syndrome
d. Ovarian hyperstimulation syndrome
d.Ovarian hyperstimulation syndrome
153
Pharmacological treatment for chronic pelvic pain frequently begins with
a. high-dose progestins.
b. GnRH.
c. oral analgesics.
d. COCs.
c. oral analgesics,
154
Why should psychotherapy always be considered for women with chronic pelvic
pain?
a. Chronic pelvic pain is often psychosomatic.
b. Acute pelvic pain is often caused by depression.
c. Physical abuse is a significant cause of pelvic pain.
d. Dysmenorrhea is a common symptom.
c. Physical abuse is a significant cause of pelvic pain.
155
What is a common non-gynecologic cause of chronic pelvic pain?
a. Irritable bowel syndrome
b. Myofascial pain
c. Insulin resistance
d. Urinary incontinence
a. Irritable bowel syndrome
156
Pelvic pain in adolescents is almost always
a. chronic.
b. gynecological.
c. psychosocial.
d. musculoskeletal.
b. gynecological.
157
A pregnant clients mother is worried that her daughter is not big enough at 20 weeks of
gestation. The nurse palpates and measures the fundal height at 20 cm, which is even
with the womans umbilicus. Which should the nurse report to the client and her mother?
a. You're right. Well, inform the practitioner immediately.
b. Lightening has occurred, so the fundal height is lower than expected.
c. The body of the uterus is at the belly button level, just where it should be at this time.
d.
When you come for next months appointment, well check you again to make sure that the baby is
growing.
c. The body of the uterus is at the belly button level, just where it should be at this time.
158
While the vital signs of a pregnant client in her third trimester are being assessed, the
client complains of feeling faint, dizzy, and agitated. Which nursing intervention is
appropriate?
a. Have the client stand up and retake her blood pressure.
b. Have the client sit down and hold her arm in a dependent position.
c. Have the client turn to her left side and recheck her blood pressure in 5 minutes.
d. Have the client lie supine for 5 minutes and recheck her blood pressure on both arms.
c. Have the client turn to her left side and recheck her blood pressure in 5 minutes.
159
3. A pregnant client has come to the emergency department with complaints of nasal
congestion and epistaxis. Which is the correct interpretation of these symptoms by the
health care provider?
a. Nasal stuffiness and nosebleeds are caused by a decrease in progesterone.
b. These conditions are abnormal. Refer the client to an ear, nose, and throat specialist.
c.
Estrogen relaxes the smooth muscles in the respiratory tract, so congestion and epistaxis are within
normal limits.
d.
Estrogen causes increased blood supply to the mucous membranes and can result in congestion and
nosebleeds.
d.
Estrogen causes increased blood supply to the mucous membranes and can result in congestion and
nosebleeds.
160
Which suggestion is appropriate for the pregnant client who is experiencing heartburn?
a. Drink plenty of fluids at bedtime.
b. Eat only three meals a day so the stomach is empty between meals.
c. Drink coffee or orange juice immediately on arising in the morning.
d. Use Tums or Alkamints to obtain relief, as directed by the health care provider.
d. Use Tums or Alkamints to obtain relief, as directed by the health care provider.
161
While providing education to a primiparous client regarding the normal changes of
pregnancy, what is important for the nurse to explain about Braxton Hicks contractions?
a. These contractions may indicate preterm labor.
b. These are contractions that never cause any discomfort.
c. Braxton Hicks contractions only start during the third trimester.
d. These occur throughout pregnancy, but you may not feel them until the third trimester
d. These occur throughout pregnancy, but you may not feel them until the third trimester.
162
. What is the reason for vascular volume increasing by 40% to 60% during pregnancy?
a. Prevents maternal and fetal dehydration
b. Eliminates metabolic wastes of the mother
c. Provides adequate perfusion of the placenta
d. Compensates for decreased renal plasma flow
c. Provides adequate perfusion of the placenta
163
Physiologic anemia often occurs during pregnancy because of:
a. inadequate intake of iron.
b. the fetus establishing iron stores.
c. dilution of hemoglobin concentration.
d. decreased production of erythrocytes.
c. dilution of hemoglobin concentration.
164
Which is a positive sign of pregnancy?
a. Amenorrhea
b. Breast changes
c. Fetal movement felt by the woman
d. Visualization of fetus by ultrasound
d. Visualization of fetus by ultrasound
165
A client is currently pregnant; she has a 5-year-old son and a 3-year-old daughter. She
had one other pregnancy that terminated at 8 weeks. Which are her gravida and para?
a. 3, 2
b. 4, 3
c. 4, 2
d. 3, 3
c. 4, 2
166
```
10. A client's last menstrual period was June 10. What is her estimated date of birth
(EDD)?
a. April 7
b. March 17
c. March 27
d. April 17
```
b. March 17
167
Why should a woman in her first trimester of pregnancy expect to visit her health care
provider every 4 weeks?
a. Problems can be eliminated.
b. She develops trust in the health care team.
c. Her questions about labor can be answered.
d. The conditions of the expectant mother and fetus can be monitored.
d. The conditions of the expectant mother and fetus can be monitored.
168
A client in her first trimester complains of nausea and vomiting. She asks, Why does
this happen? What is the nurses best response?
a. It is due to an increase in gastric motility.
b. It may be due to changes in hormones.
c. It is related to an increase in glucose levels.
d. It is caused by a decrease in gastric secretions.
b. It may be due to changes in hormones.
169
Which advice to the client is one of the most effective methods for preventing venous
stasis?
a. Sit with the legs crossed.
b. Rest often with the feet elevated.
c. Sleep with the foot of the bed elevated.
d. Wear elastic stockings in the afternoon.
b. Rest often with the feet elevated.
170
A client notices that the health care provider writes a positive Chadwick's sign on her
chart. She asks the nurse what this means. Which is the nurse's best response?
a. It means the cervix is softening.
b. That refers to a positive sign of pregnancy.
c. It refers to the bluish color of the cervix in pregnancy.
d. The doctor was able to flex the uterus against the cervix.
c. It refers to the bluish color of the cervix in pregnancy.
171
```
Which is the gravida and para for a client who delivered triplets 2 years ago and is
now pregnant again?
a. 2, 3
b. 1, 2
c. 2, 1
d. 1, 3
```
c. 2, 1
172
To relieve a leg cramp, what should the client be instructed to perform?
a. Dorsiflex the foot.
b. Apply a warm pack.
c. Stretch and point the toe.
d. Massage the affected muscle
a. Dorsiflex the foot.
173
A client, gravida 2, para 1, comes for a prenatal visit at 20 weeks of gestation. Her
fundus is palpated 3 cm below the umbilicus. This finding is:
a. appropriate for gestational age.
b. a sign of impending complications.
c. lower than normal for gestational age.
d. higher than normal for gestational age.
c. lower than normal for gestational age.
174
Which complaint made by a client at 35 weeks of gestation requires additional
assessment?
a. Abdominal pain
b. Ankle edema in the afternoon
c. Backache with prolonged standing
d. Shortness of breath when climbing stairs
a. Abdominal pain
175
A gravida client at 32 weeks of gestation reports that she has severe lower back pain.
What should the nurses assessment include?
a. Palpation of the lumbar spine
b. Exercise pattern and duration
c. Observation of posture and body mechanics
d. Ability to sleep for at least 6 hours uninterrupted
c. Observation of posture and body mechanics
176
A pregnant woman is the mother of two children. Her first pregnancy ended in a
stillbirth at 32 weeks of gestation, her second pregnancy with the birth of her daughter at
36 weeks, and her third pregnancy with the birth of her son at 41 weeks. Using the five-digit system to describe this woman's current obstetric history, what should the nurse
record?
a. 4-1-2-0-2
b. 3-1-2-0-2
c. 4-2-1-0-1
d. 3-1-1-1-3
a. 4-1-2-0-2
177
Which laboratory result would be a cause for concern if exhibited by a client at her
first prenatal visit during the second month of her pregnancy?
a. Rubella titer, 1:6
b. Platelets, 300,000/mm3
c. White blood cell count, 6000/mm3
d. Hematocrit 38%, hemoglobin 13 g/dL
a. Rubella titer, 1:6
178
A client in her third trimester of pregnancy is asking about safe travel. Which statement should the nurse give about safe travel during pregnancy?
a. Only travel by car during pregnancy.
b. Avoid use of the seat belt during the third trimester.
c. You can travel by plane until your 38th week of gestation.
d. If you are traveling by car stop to walk every 1 to 2 hours.
d. If you are traveling by car stop to walk every 1 to 2 hours.
179
The client has just learned she is pregnant and overhears the gynecologist saying that
she has a positive Chadwicks sign. When the client asks the nurse what this means, how
should the nurse respond?
a.Chadwicks sign signifies an increased risk of blood clots in pregnant women because of a
congestion of blood.
b.That sign means the cervix has softened as the result of tissue changes that naturally occur with
pregnancy.
c.This means that a mucous plug has formed in the cervical canal to help protect you from uterine
infection.
d. This sign occurs normally in pregnancy when estrogen causes the increased blood flow in the area of
the cervix
d. This sign occurs normally in pregnancy, when estrogen causes increased blood flow in the area of
the cervix
180
When a pregnant woman develops ptyalism, what should the nurse advise?
a. Chew gum or suck on lozenges between meals.
b. Eat nutritious meals that provide adequate amounts of essential vitamins and minerals.
c. Take short walks to stimulate circulation in the legs and elevate the legs periodically.
d. Use pillows to support the abdomen and back during sleep
a. Chew gum or suck on lozenges between meals.
181
A pregnant immigrant has an unknown immunization history. When she presents for
routine vaccinations, which will the nurse administer?
a. Hepatitis B
b. Measles
c. Rubella
d. Varicella
a. Hepatitis B
182
When the pregnant woman develops changes caused by pregnancy, the nurse
recognizes that the darkly pigmented vertical midabdominal line is the:
a. epulis.
b. linea nigra.
c. melasma.
d. striae gravidarum.
b. linea nigra.
183
When documenting a client encounter, what term will the nurse use to describe the
woman who is in the 28th week of her first pregnancy?
a. Multigravida
b. Multipara
c. Nullipara
d. Primigravida
d. Primigravida
184
You are performing assessments for an obstetric client who is 5 months pregnant with
her third child. Which finding would cause you to suspect that the client was at risk?
a.Client states that she doesn't feel any Braxton Hicks contractions like she had in her prior
pregnancies.
b. Fundal height is below the umbilicus.
c. Cervical changes, such as Goodells sign and Chadwicks sign, are present.
d. She has increased vaginal secretions
b. Fundal height is below the umbilicus.
185
What is the best explanation that you can provide to a pregnant client who is
concerned that she has pseudoanemia of pregnancy?
a.Have her write down her concerns and tell her that you will ask the physician to respond once the
lab results have been evaluated.
b.Tell her that this is a benign self-limiting condition that can be easily corrected by switching to a
high-iron diet.
c.Inform her that because of the pregnancy, her blood volume has increased, leading to a substantial
dilution effect on her serum blood levels, and that most women experience this condition.
d. Contact the physician and get a prescription for iron pills to correct this condition.
c. Inform her that because of the pregnancy, her blood volume has increased, leading to a substantial
dilution effect on her serum blood levels, and that most women experience this condition.
186
Which physiologic finding is consistent with a normal pregnancy?
a. Systemic vascular resistance increases as blood pressure decrease.
b. Cardiac output increases during pregnancy.
c. Blood pressure remains consistent independent of position changes.
d. Maternal vasoconstriction occurs in response to increased metabolism.
b. Cardiac output increases during pregnancy.
187
A client with preeclampsia is being treated with bed rest and intravenous magnesium
sulfate. The drug classification of this medication is a:
a. diuretic.
b. tocolytic.
c. anticonvulsant.
d. antihypertensive.
c. anticonvulsant.
188
Which is the only known cure for preeclampsia?
a. Magnesium sulfate
b. Delivery of the fetus
c. Antihypertensive medications
d. Administration of aspirin (ASA) every day of the pregnancy
b. Delivery of the fetus
189
The clinic nurse is performing a prenatal assessment on a pregnant client at risk for
preeclampsia. Which clinical sign is not included as a symptom of preeclampsia?
a. Edema
b. Proteinuria
c. Glucosuria
d. Hypertension
c. Glucosuria
190
```
Which intrapartal assessment should be avoided when caring for a client with HELLP
syndrome?
a. Abdominal palpation
b. Venous sample of blood
c. Checking deep tendon reflexes
d. Auscultation of the heart and lungs
```
a. Abdominal palpation
191
A nurse is explaining to the nursing students working on the antepartum unit how to
assess edema. Which edema assessment score indicates edema of the lower extremities,
face, hands, and sacral area?
a. +1
b. +2
c. +3
d. +4
c. +3
192
A client is admitted with vaginal bleeding at approximately 10 weeks of gestation. Her
fundal height is 13 cm. Which potential problem should be investigated?
a. Placenta previa
b. Hydatidiform mole
c. Abruptio placentae
d. Disseminated intravascular coagulation (DIC)
b. Hydatidiform mole
193
Which maternal condition always necessitates birth by cesarean section?
a. Partial abruptio placentae
b. Total placenta previa
c. Ectopic pregnancy
d. Eclampsia
b. Total placenta previa
194
Spontaneous termination of a pregnancy is considered to be an abortion if:
a. the pregnancy is less than 20 weeks.
b. the fetus weighs less than 1000 g.
c. the products of conception are passed intact.
d. there is no evidence of intrauterine infection
a. the pregnancy is less than 20 weeks
195
An abortion when the fetus dies but is retained in the uterus is called:
a. inevitable.
b. missed.
c. incomplete.
d. threatened.
b. missed
196
. A placenta previa when the placental edge just reaches the internal os is called:
a. total.
b. partial.
c. low-lying.
d. marginal.
d. marginal
197
Which would indicate concealed hemorrhage in abruptio placentae?
a. Bradycardia
b. Hard boardlike abdomen
c. Decrease in fundal height
d. Decrease in abdominal pain
b. Hard boardlike abdomen
198
The priority nursing intervention when admitting a pregnant client who has
experienced a bleeding episode in late pregnancy is to:
a. monitor uterine contractions.
b. assess fetal heart rate and maternal vital signs.
c. place clean disposable pads to collect any drainage.
d. perform venipuncture for hemoglobin and hematocrit levels.
b. assess fetal heart rate and maternal vital signs.
199
A primigravida of 28 years of age is admitted to the antepartum unit with a diagnosis
of hyperemesis gravidarum. Nursing care is based on which of the following?
a. She should be isolated from her family.
b. This condition is caused by psychogenic factors.
c. The treatment is similar to that for morning sickness.
d. She should be assessed for signs of dehydration and starvation.
d. She should be assessed for signs of dehydration and starvation.
200
A 17-year-old primigravida has gained 4 pounds since her last prenatal visit. Her
blood pressure is 140/92 mm Hg. The most important nursing action is to:
a. advise her to cut down on fast foods that are high in fat.
b. caution her to avoid salty foods and to return in 2 weeks.
c. assess weight gain, location of edema, and urine for protein.
d. recommend she stay home from school for a few days to reduce stress
c. assess weight gain, location of edema, and urine for protein.
201
A client with preeclampsia is admitted complaining of pounding headache, visual
changes, and epigastric pain. Nursing care is based on the knowledge that these signs
indicate:
a. gastrointestinal upset.
b. effects of magnesium sulfate.
c. anxiety caused by hospitalization.
d. worsening disease and impending convulsion.
d. worsening disease and impending convulsion,
202
Rh incompatibility can occur if the client is Rh-negative and the:
a. fetus is Rh-negative.
b. fetus is Rh-positive.
c. father is Rh-positive.
d. father and fetus are both Rh-negative
b. fetus is Rh-positive.
203
In which situation would a dilation and curettage (D&C) be indicated?
a. Complete abortion at 8 weeks
b. Incomplete abortion at 16 weeks
c. Threatened abortion at 6 weeks
d. Incomplete abortion at 10 weeks
d. Incomplete abortion at 10 weeks
204
```
Which orders should the nurse expect for a client admitted with a threatened
abortion?
a. NPO
b. Pad count
c. Ritodrine IV
d. Meperidine (Demerol), 50 mg now
```
b. Pad count
205
Which data found on a clients health history would place her at risk for an ectopic
pregnancy?
a. Ovarian cyst 2 years ago
b. Recurrent pelvic infections
c. Use of oral contraceptives for 5 years
d. Heavy menstrual flow of 4 days duration
b. Recurrent pelvic infections
206
Which finding on a prenatal visit at 10 weeks might suggest a hydatidiform mole?
a. Blood pressure of 120/80 mm Hg
b. Complaint of frequent mild nausea
c. Fundal height measurement of 18 cm
d. History of bright red spotting for 1 day weeks ago
c. Fundal height measurement of 18 cm
207
Which routine nursing assessment is contraindicated for a client admitted with
suspected placenta previa?
a. Determining cervical dilation and effacement
b. Monitoring FHR and maternal vital signs
c. Observing vaginal bleeding or leakage of amniotic fluid
d. Determining frequency, duration, and intensity of contractions
a. Determining cervical dilation and effacement
208
```
The primary symptom present in abruptio placentae that distinguishes it from
placenta previa is:
a. vaginal bleeding.
b. rupture of membranes.
c. presence of abdominal pain.
d. changes in maternal vital signs
```
c. presence of abdominal pain.
209
A laboratory finding indicative of DIC is:
a. decreased fibrinogen.
b. increased platelets.
c. increased hematocrit.
d. decreased thromboplastin time.
a. decreased fibrinogen.
210
Which assessment in a client diagnosed with preeclampsia who is taking magnesium
sulfate would indicate a therapeutic level of medication?
a. Drowsiness
b. Urinary output of 20 mL/hr
c. Normal deep tendon reflexes
d. Respiratory rate of 10 to 12 breaths/min
c. Normal deep tendon reflexes
211
A client taking magnesium sulfate has a respiratory rate of 10 breaths/min. In addition
to discontinuing the medication, which action should the nurse take?
a. Increase the clients IV fluids.
b. Administer calcium gluconate.
c. Vigorously stimulate the client.
d. Instruct the client to take deep breaths.
b. Administer calcium gluconate.
212
A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy.
Nursing care is based on which of the following?
a. Hemorrhage is a major concern.
b. She will be unable to conceive in the future.
c. Bed rest and analgesics are the recommended treatment.
d. A D&C will be performed to remove the products of conception.
a. Hemorrhage is a major concern.
213
You are taking care of a client who had a therapeutic abortion following an episode of
vaginal bleeding and ultrasound confirmation of a blighted ovum. Lab work is ordered 2
weeks postprocedure as a follow-up to medical care. Which result indicates that
additional intervention is needed?
a. Hemoglobin, 13.2 mg/dL
b. White blood cell count, 10,000 mm3
c. Beta-hCG detected in serum
d. Fasting blood glucose level, 80 mg/dL
c. Beta-hCG detected in serum
214
A female client presents to the emergency room complaining of lower abdominal
cramping with scant bleeding of approximately 2 days duration. This morning, the quality
and location of the pain changed and she is now experiencing pain in her shoulder. The
clients last menstrual period was 28 days ago, but she reports that her cycle is variable,
ranging from 21 to 45 days. Which clinical diagnosis does the nurse suspect?
a. Ectopic pregnancy
b. Appendicitis
c. Food poisoning
d. Gastroenteritis
a. Ectopic pregnancy
215
A client who was pregnant had a spontaneous abortion at approximately 4 weeks
gestation. At the time of the miscarriage, it was thought that all products of conception
were expelled. Two weeks later, the client presents at the clinic office complaining of
crampy abdominal pain and a scant amount of serosanguineous vaginal drainage with a
slight odor. The pregnancy test is negative. Vital signs reveal a temperature of 100 F,
with blood pressure of 100/60 mm Hg, irregular pulse 88 beats/min (bpm), and
respirations, 20 breaths/min. Based on these assessment data, what does the nurse
anticipate as a clinical diagnosis?
a. Ectopic pregnancy
b. Uterine infection
c. Gestational trophoblastic disease
d. Endometriosis
b. Uterine infection
216
A patient presents to labor and birth with complaints of persistent acute back pain at
36 weeks gestation. The nursing assessment reveals a taught abdomen, fundal height at
40 cm, and late decelerations, with an FHR range of 124 to 128 bpm. The nurse will
implement the protocol for which obstetric condition?
a. Placenta previa
b. Hypovolemic shock
c. Abruptio placentae or abruption
d. DIC
c. Abruptio placentae or abruption
217
A labor and birth nurse receives a call from the laboratory regarding a preeclamptic
patient receiving an IV infusion of magnesium sulfate. The laboratory technician reports
that the patients magnesium level is 7.6 mg/dL. What is the nurses priority action?
a. Stop the infusion of magnesium.
b. Assess the patient's respiratory rate.
c. Assess the patient's deep tendon reflexes.
d. Notify the health care provider of the magnesium level.
b. Assess the patient's respiratory rate.
218
Which statement by a postpartum client indicates that further teaching is not needed
regarding thrombus formation?
a. Ill keep my legs elevated with pillows.
b. Ill sit in my rocking chair most of the time.
c. Ill stay in bed for the first 3 days after my baby is born.
d. Ill put my support stockings on every morning before rising.
d. Ill put my support stockings on every morning before rising.
219
The nurse knows that late postpartum hemorrhage can be prevented by:
a. manually removing the placenta.
b. inspecting the placenta after birth.
c. administering broad-spectrum antibiotics.
d. pulling on the umbilical cord to hasten the birth of the placenta.
b. inspecting the placenta after birth.
220
A multiparous client is admitted to the postpartum unit after a rapid labor and birth of a
4000-g infant. Her fundus is boggy, lochia is heavy, and vital signs are unchanged. The
nurse has the client void and massages her fundus, but the fundus remains difficult to find
and the rubra lochia remains heavy. Which action should the nurse take next?
a. Recheck vital signs.
b. Insert a Foley catheter.
c. Notify the health care provider.
d. Continue to massage the fundus.
c. Notify the health care provider.
221
Early postpartum hemorrhage is defined as a blood loss greater than:
a. 500 mL within 24 hours after a vaginal birth.
b. 750 mL within 24 hours after a vaginal birth.
c. 1000 mL within 48 hours after a cesarean birth.
d. 1500 mL within 48 hours after a cesarean birth
b. 750 mL within 24 hours after a vaginal birth.
222
```
A steady trickle of bright red blood from the vagina in the presence of a firm fundus
suggests:
a. uterine atony.
b. perineal hematoma.
c. infection of the uterus.
d. lacerations of the genital tract.
```
d. lacerations of the genital tract.
223
A postpartum client would be at increased risk for postpartum hemorrhage if she
delivered a(n):
a. 5-lb, 2-oz infant with outlet forceps.
b. 6.5-lb infant after a 2-hour labor.
c. 7-lb infant after an 8-hour labor.
d. 8-lb infant after a 12-hour labor.
b. 6.5-lb infant after a 2-hour labor
224
A rapid labor and birth may cause exhaustion of the uterine muscle and prevent
contraction. Delivering a 5-lb, 2-oz infant with outlet forceps would put this client at risk
for lacerations because of the forceps. A 7-lb infant after an 8-hour labor is a normal
labor progression. Less than 3 hours is rapid and can produce uterine muscle exhaustion.
An 8-lb infant after a 12-hour labor is a normal labor progression. Less than 3 hours is a
rapid birth and can cause the uterine muscles not to contract.
PTS: 1 DIF: Cognitive Level: Understanding REF: 605
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic Integrity
7. Which instruction should be included in the discharge teaching plan to assist the client
in recognizing early signs of complications?
a. Palpate the fundus daily to ensure that it is soft.
b. Report any decrease in the amount of brownish red lochia.
c. The passage of clots as large as an orange can be expected.
d.Notify the health care provider of any increase in the amount of lochia or a return to bright red
bleeding.
d.Notify the health care provider of any increase in the amount of lochia or a return to bright red
bleeding.
225
The nurse should expect medical intervention for subinvolution to include:
a. oral fluids to 3000 mL/day.
b. intravenous fluid and blood replacement.
c. oxytocin intravenous infusion for 8 hours.
d. oral methylergonovine maleate (Methergine) for 48 hours.
d. oral methylergonovine maleate (Methergine) for 48 hours.
226
If nonsurgical treatment for subinvolution is ineffective, which surgical procedure is
appropriate to correct the cause of this condition?
a. Hysterectomy
b. Laparoscopy
c. Laparotomy
d. Dilation and curettage (D&C)
d. Dilation and curettage (D&C)
227
A sign of thrombophlebitis is:
a. visible varicose veins.
b. positive Homans sign.
c. pedal edema in the affected leg.
d. local tenderness, heat, and swelling.
d. local tenderness, heat, and swelling.
228
Which nursing measure would be appropriate to prevent thrombophlebitis in the
recovery period following a cesarean birth?
a. Limit the clients oral intake of fluids for the first 24 hours.
b. Assist the client in performing leg exercises every 2 hours.
c. Ambulate the client as soon as her vital signs are stable.
d. Roll a bath blanket and place it firmly behind the client's knees.
b. Assist the client in performing leg exercises every 2 hours.
229
Which temperature indicates the presence of postpartum infection?
a. 99.6 F in the first 48 hours
b. 100 F for 2 days postpartum
c. 100.4 F in the first 24 hours
d. 100.8 F on the second and third postpartum days
d. 100.8 F on the second and third postpartum days
230
A white blood cell (WBC) count of 35,000 cells/mm3 on the morning of the first
postpartum day indicates:
a. possible infection.
b. normal WBC limit.
c. serious infection.
d. suspicion of a sexually transmitted disease.
a. possible infection.
231
The client who is being treated for endometritis is placed in the Fowler position
because it:
a. promotes comfort and rest.
b. facilitates drainage of lochia.
c. prevents the spread of infection to the urinary tract.
d. decreases tension on the reproductive organs
b. facilitates drainage of lochia.
232
Nursing measures that help prevent postpartum urinary tract infection include:
a. forcing fluids to at least 3000 mL/day.
b. promoting bed rest for 12 hours after birth.
c. encouraging the intake of orange, grapefruit, or apple juice.
d. discouraging voiding until the sensation of a full bladder is present.
a. forcing fluids to at least 3000 mL/day.
233
Which measure may prevent mastitis in a breastfeeding client?
a. Wearing a tight-fitting bra
b. Applying ice packs prior to feeding
c. Initiating early and frequent feedings
d. Nursing the infant for 5 minutes on each breast
c. Initiating early and frequent feedings
234
A client with mastitis is concerned about breastfeeding while she has an active
infection. Which is an appropriate response by the nurse?
a. Organisms will be inactivated by gastric acid.
b. Organisms that cause mastitis are not passed to the milk.
c. The infant is not susceptible to the organisms that cause mastitis.
d. The infant is protected from infection by immunoglobulins in the breast milk.
b. Organisms that cause mastitis are not passed to the milk.
235
The nurse expecting a uterine infection in a postpartum client should assess the:
a. episiotomy site.
b. odor of the lochia.
c. abdomen for distention.
d. pulse and blood pressure.
b. odor of the lochia.
236
Following a difficult vaginal birth of a singleton pregnancy, the client starts bleeding
heavily. Clots are expressed and a Foley catheter is inserted to empty the bladder because
the uterine fundus is soft and displaced laterally from midline. Vital signs are 99.8 F,
pulse 90 beats/min, respirations 20 breaths/min, and BP 130/90 mm Hg. Which
pharmacologic intervention is indicated?
a. Oxytocin (Pitocin) to be administered in a piggyback solution
b. Administration of methylergonovine (Methergine)
c. Administration of prostaglandin analogue
d. Increase in parenteral fluids
c. Administration of prostaglandin analogue
237
. Following a vaginal birth, a client has lost a significant amount of blood and is
starting to experience signs of hypovolemic shock. Which clinical signs would be
consistent with this clinical diagnosis?
a. Decrease in blood pressure, with an increase in pulse pressure
b. Compensatory response of tachycardia and decreased pulse pressure
c. Decrease in heart rate and an increase in respiratory effort
d. Flushed skin
b. Compensatory response of tachycardia and decreased pulse pressure.
238
A client has been treated with oxytocin (Pitocin) for postpartum hemorrhage.
Bleeding has stabilized and slowed down considerably. The peripad in place reveals a
moderate amount of bright red blood, with no clots expelled when massaging the fundus.
The client now complains of having difficulty breathing. Auscultation of breath sounds
reveals adventitious sounds. Based on this clinical presentation, the priority nursing
action is to:
a. evaluate intake and output of the past 12 hours following birth.
b. initiate a rapid response intervention.
c.
obtain an order from the physician for type and crossmatch of 2 units packed red blood cells
(PRBCs).
d. reposition the client and reassess in 15 minutes. Initiate frequent vital sign assessments
b. initiate a rapid response intervention.
239
A postpartum client has developed deep vein thrombosis (DVT) and treatment with
warfarin (Coumadin) has been initiated. Which dietary selection should be modified in
view of this treatment regimen?
a. Fresh fruits
b. Milk
c. Lentils
d. Soda
c. Lentils
240
The nurse recognizes that infection may be present in her postpartum client when the
client exhibits a temperature of:
a. 100.0 F during the first 36 hours postpartum.
b. 100.8 F twice in the first 24 hours postpartum.
c. 99.6 F on the first postpartum day and 100.4 on the second.
d. 100.4 F on the second postpartum day and 100.8 F on the fourth
d. 100.4 F on the second postpartum day and 100.8 F on the fourth
241
```
To determine an adverse response to carboprost tromethamine (Hemabate), the nurse
should frequently assess:
a. temperature.
b. lochial flow.
c. fundal height.
d. breath sounds
```
d. breath sounds
242
Which labor and birth information on the client would suggest an increased risk for
hemorrhage?
a. Precipitous birth after a 12-hour labor
b. Cesarean birth of an infant weighing 8 lb, 4 oz
c. Vaginal birth of a 7-lb infant after 2-hour labor.
d. Vaginal birth of a 6-lb infant after 7-hour labor.
c. Vaginal birth of 7-lb infant after a 2-hour labor.
243
If the nurse suspects a complication of a low forceps birth labor, she should
immediately:
a. administer a strong oral analgesic.
b. assess the perineal and vaginal areas.
c. assess the position of the uterine fundus.
d. review the labor record for duration of second stage.
b. assess the perineal and vaginal areas.
244
Prior to ambulating the client to the bathroom whose admission hemoglobin level was
10. 2 g/dL, the nurse should:
a. request repeat hemoglobin and hematocrit.
b. assess the resting pulse rate.
c. dangle her on the side of the bed.
d. administer the ordered oral analgesic.
c. dangle her on the side of the bed.
245
If a late postpartum hemorrhage is documented on a client who delivered 3 days ago,
the nurse recognizes that this hemorrhage occurred:
a. on the first postpartum day.
b. during the recovery phase of labor.
c. during the third stage of labor.
d. on the second postpartum day
d. on the second postpartum day
246
Which client data received during report should the nurse recognize as being a
postpartum risk factor?
a. Gravida 5, para 5
b. Labor duration of 4 hours
c. Infant weight greater than 3800 g
d. Epidural anesthesia for labor and birth
a. Gravida 5, para 5
247
Before administering methylergonovine (Methergine), the nurse checks the:
a. color of the lochia.
b. blood pressure.
c. location of the fundus.
d. last administration of analgesics.
b. blood pressure.
248
Methylergonovine (Methergine) elevates the blood pressure and should not be given to a
woman who is hypertensive. The color of the lochia, location of the fundus, and
analgesics are not related to the administration of or contraindicated to this medication.
PTS: 1 DIF: Cognitive Level: Application REF: 600
OBJ: Nursing Process Step: Analysis
MSC: Client Needs: Physiologic Integrity/Pharmacologic and Parenteral Therapies
31. To evaluate the desired response of methylergonovine (Methergine), the nurse would
assess the clients:
a. uterine tone.
b. pain level.
c. blood pressure.
d. last voiding.
a. uterine tone.
249
To prevent infection of the urinary tract, the nurse should instruct the client to:
a. include soft drinks in the total fluid intake.
b. drink grapefruit juice several times a day.
c. perform pericare at least twice during a shift.
d. increase fluid intake to 2500 to 3000 mL/day.
d. increase fluid intake to 2500 to 3000 mL/day.
250
What data in the client's history should the nurse recognize as being pertinent to a
possible diagnosis of postpartum depression?
a. Teenage depression episode
b. Unexpected operative birth
c. Ambivalence during the first-trimester
d. Second pregnancy in a 3-year period
a. Teenage depression episode
251
The nurse notes that the fundus of a postpartum patient is boggy, shifted to the left of
the midline, and 2 cm above the umbilicus. What is the nurse's priority action?
a. Massage the fundus of the uterus.
b. Assist the patient out of bed to void.
c. Increase the infusion of oxytocin (Pitocin).
d. Ask another nurse to bring in a straight catheter tray.
a. Massage the fundus of the uterus.
