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Test bank For Womens Health Care in Advanced Practice Nursing 2nd Edition by Ivy M Alexander Chapter 146 Complete Questions and Answers A

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Test bank For Women's Health Care in Advanced Practice Nursing 2nd Edition by Ivy M Alexander | 2017/2018 | 9780826190017 | Chapter 1-46 | Complete Questions and Answers A+ A 25-year-old woman comes to the clinic complaining of increased vaginal discharge, milky gray in color with a "fishy" odor t...

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Test Bank for Women's Health Care in Advanced
Practice Nursing, Second Edition by Alexander

1). A 25-year-old woman comes to the clinic complaining of increased vaginal discharge, milky
gray in color with a "fishy" odor that both she and her husband have noticed. a wet smear is
performed and the presence of "clue cells" confirmed. which type of infection does the
nurse suspect?
1
candidiasis
2
trichomoniasis
3
bacterial vaginosis
4
group b streptococcus

 Ans: -Bacterial vaginosis

Signs of bacterial vaginosis include a milky gray vaginal discharge that has a
characteristic fishy odor. "Clue cells" noted on wet smear are indicative of BV. Candidiasis
is a yeast infection caused by the organism Candida albicans. The most common
symptom of a yeast infection is vulvar and vaginal pruritus. Vaginal discharge in a
candidal infection is thick, white, and lumpy. A woman with a trichomoniasis infection
may present with a frothy yellowish-green vaginal discharge. Vulvar irritation, pruritus, and
dyspareunia are usually present. Group B Streptococcus may be considered part of the
normal vaginal flora in a woman who is not pregnant, and no treatment is necessary.

2). A 20-year-old woman visiting the clinic says that she wishes to begin using depot
medroxyprogesterone acetate (depo-provera) as a form of birth control. what important
information should the nurse include when teaching the client about depo-provera?
1
depo-provera offers protection against the herpes simplex virus.
2
to continue the contraceptive effects the client will need to return for another injection in 6
months.
3
women using depo-provera may lose more blood each month with their periods, so it is
important to add iron-rich foods to the diet to help prevent anemia.
4
calcium intake and exercise should be increased because of possible loss of bone mineral
density with increasing duration of use

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,  Ans: -Calcium intake and exercise should be increased because of possible loss of
bone mineral density with increasing duration of use

Loss of bone mineral density is a significant side effect of Depo-Provera, and increased
calcium intake and exercise should be encouraged. Depo-Provera should be administered
every 11 to 13 weeks; 6 months is too long before the next dose. Menstrual periods
usually lighten or disappear over time. Depo-Provera confers no protection against herpes
simplex virus.

3). A 24-year-old woman wants to use her basal body temperature (bbt) in natural family
planning but is unsure when to take her temperature. the nurse informs her that an accurate
bbt is best taken:
1
each night right before bed
2
on the first day of her next menstrual cycle
3
each morning prior to getting out of bed or increasing her activity
4
at bedtime beginning on day 14 of her menstrual cycle and continuing until her next period

 Ans: -Each morning prior to getting out of bed or increasing her activity

The most accurate BBT is taken before a woman gets out of bed and begins any type of
activity that could increase the body's temperature even slightly. BBT should be charted
daily on a calendar to permit interpretation of temperature fluctuations. A BBT taken in the
evening may be increased after a day of activity. Daily assessment and recording of BBT
during the first half of the menstrual cycle is also crucial, because a woman's BBT is lower
then than during the second half of her cycle. The BBT temperature may rise slightly with
ovulation.

4). A 37-year-old woman is admitted to the unit with severe menorrhagia. during assessment
the nurse learns that she has a history of fibroids, menorrhagia, pelvic pain, and depression.
the client has been undergoing hormone therapy in hopes of easing the symptoms and
reducing the size of the fibroids, without success. the lab reports hemoglobin and
hematocrit readings of 6.8 and 20.2, respectively. the client begins to sob and cries, "i don't
know what to do—the doctor is recommending a hysterectomy, but i haven't had children
yet!" what is the best response by the nurse?
1
"there are so many orphans looking for a mother."
2
"this must be so difficult for you. children are really important to you?"
3
"you really have no choice but to follow the recommendation; the doctor is right."

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, 4
"believe me when i tell you that kids are so difficult to raise—you're better off without them."

 Ans: -"This must be so difficult for you. Children are really important to you?"

Validating the client's feelings and including an open-ended question will encourage
further expression. Previous problems and health conditions could later be included in the
conversation to help the client make the best decision. Adoption is certainly an option for
this person, but this is not what she needs to hear at this time. This statement also closes
down communication. The client does have a choice, and telling her that she does not
could close down communication and cause anger and defensiveness. Telling the client
that she's better off without children is not what the client needs to hear, especially when
she is facing an operation that could end her chance of giving birth to children.

5). A 23-year-old woman comes to the clinic for a pap smear. after the examination, the client
confides that her mother died of endometrial cancer 1 year ago and says that she is afraid
that she will die of the same cancer. which risk factor stated by the client after an education
session on risk factors indicates that further teaching is needed?
1
obesity
2
high-fat diet
3
hypertension
4
late-onset menarche

 Ans: -Late-onset menarche

Early-onset, not late-onset, menarche is a risk factor for endometrial cancer. A high-fat
diet, hypertension, and obesity are all risk factors

6). A 32-year-old woman is admitted to the unit with a history of fibroids and menorrhagia.
which findings does the nurse expect to encounter during assessment of the client? select
all that apply.
1
fluid overload
2
intermittent diarrhea
3
pale mucous membranes
4
difficulty emptying the bladder
5
high hemoglobin and hematocrit

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,  Ans: -Pale mucous membranes, Difficulty emptying the bladder

Menorrhagia (heavy menstrual bleeding) can cause anemia (acute or chronic). Because
this client has a history of menorrhagia, the nurse can anticipate chronic anemia. Urinary
frequency, urgency, and incontinence are symptoms of fibroids, which can cause
menorrhagia. Constipation, not diarrhea, is a common symptom of fibroids, which can
cause menorrhagia. Menorrhagia would cause hypovolemia, not hypervolemia.
Menorrhagia would cause the hemoglobin and hematocrit levels to decrease, not
increase.

7). After treatment for a bladder infection, a client asks whether there is anything she can do to
prevent cystitis in the future. what is the best response by the nurse?
1
avoid regular use of tampons.
2
decrease intake of prune juice.
3
increase daily fluid consumption.
4
cleanse the perineum from back to front.

 Ans: -Increase daily fluid consumption.

Increasing fluid intake flushes the urinary tract of microorganisms. Tampons do not
increase the risk of cystitis. Fluids should be increased, not decreased; prune juice
promotes acidic urine, which is desirable because it discourages the growth of
microorganisms. The preferred method of cleansing is from front to back (urethra to
vagina); however, studies have shown that this method of cleansing is not a significant
factor in the prevention of cystitis.

8). A nurse in the family planning clinic reviews the health history of a sexually active 16-year-
old girl whose chief concern is a thick, burning discharge accompanied by a burning
sensation and lower abdominal pain. after an examination the girl is informed that she may
have a sexually transmitted infection (sti) that requires treatment. the adolescent is
concerned that her parents will discover that she has been sexually active and asks the
nurse whether her parents will be contacted. the nurse explains that her parents will:
incorrect1
need to know to sign a consent form for testing and treatment
2
not be contacted, because treatment at the clinic is confidential
3
be notified when the insurance company is billed for testing and treatment
4
remain uninformed if the adolescent ensures that her sexual contacts will come for testing

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