Test Bank For Women's Health: A Primary Care Clinical Guide 5th Edition By Diane Schadewald; Ursula A. Pritham; Ellis Quinn Youngkin PhD, RNC, WHCNP, ARNP; Marcia Szmania Davi 9780135458624 Full Chapt...
TEST BANK FOR WOMEN’S HEALTH: A PRIMARY CARE CLINICAL GUIDE (5TH EDITION )
Women's Health: A Primary Care Clinical Guide 5th Edition By Diane Schadewald; Ursula A. Pritham; Ellis Quinn Youngkin PhD, RNC, WHCNP, ARNP; Marcia Szmania Davi
All for this textbook (26)
Written for
Women's Health
All documents for this subject (442)
Seller
Follow
phinta004
Reviews received
Content preview
Test Bank: Women's Health: A Primary Care Clinical Guide, 5th
Edition by Diane Schadewald - Chapters 1-26, 9780135458624
| Rationals Included
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 - ANSWER: -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.
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 - ANSWER: -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.
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 -
ANSWER: -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.
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."
4
"Believe me when I tell you that kids are so difficult to raise—you're better off without them." -
ANSWER: -"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.
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 - ANSWER: -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
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 - ANSWER: -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.
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. - ANSWER: -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.
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 -
ANSWER: -Not be contacted, because treatment at the clinic is confidential
Federal law allows family planning clinics to maintain minors' confidentiality, although individual
states may have different regulations; there is a concern that these teenagers will not seek or
continue treatment if they fear disclosure. To maintain confidentiality, family planning clinics treat
these adolescents as emancipated minors who can sign their own consent forms. Most family
planning clinics receive funding and charge on a sliding scale based on income, thus encouraging
adolescents to seek treatment. Telling the client that her parents will not be notified as long as she
ensures that her sexual contacts come in for testing could be viewed as coercion; if the STI is
reportable, follow-up of sexual partners is indicated, but the adolescent is not responsible for
ensuring that they report for testing.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller phinta004. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $17.99. You're not tied to anything after your purchase.
