Maternal and Child Health Nursing 7th Edition By Pillitteri Pillitteri – Test Bank

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Sample Questions Posted Below

 

1. After an examination, a pregnant patient is diagnosed with a cystocele. How should the nurse explain this finding to the patient?
A) A fold of peritoneum behind the uterus
B) Pouching of the bladder into the vaginal wall
C) A part of the rectum is pushing into the vaginal wall.
D) Folds of peritoneum that cover the uterus front and back
Ans: B
Feedback:
Pouching of the bladder into the vaginal wall is a cystocele. A fold of peritoneum behind the uterus is posterior ligament. A part of the rectum pushing into the vaginal wall is a rectocele. Folds of peritoneum that cover the uterus front and back are the broad ligaments.
2. A pregnant patient is concerned about a sharp pain that is felt in the lower abdomen when making a quick move. What action should the nurse take to help this patient?
A) Assess when the patient’s last bowel movement occurred.
B) Explain that the sharp pain is tension on a uterine ligament.
C) Notify the physician because of manifestations of appendicitis.
D) Instruct that the pain is a pulled muscle and a heating pad will help.
Ans: B
Feedback:
If a pregnant woman moves quickly, she may pull one of the round or broad ligaments causing a quick, sharp pain of frightening intensity in one of the lower abdominal quadrants. This pain is not associated with bowel function. Pain of this type calls for conscientious assessment or it can be mistaken for labor or appendicitis pain. This pain is not because of a pulled muscle and application of heat is not indicated.
3. After an assessment, a pregnant patient asks the nurse questions about her changing uterus and body. Which nursing diagnosis would be appropriate for the patient at this time?
A) Anxiety related to being pregnant
B) Ineffective coping related to being pregnant
C) Health-seeking behaviors related to reproductive functioning
D) Disturbance in body image related to body changes with pregnancy
Ans: C
Feedback:
The patient is asking questions related to reproductive functioning which indicates health-seeking behaviors. The patient’s questions do not indicate that the patient is experiencing anxiety, ineffective coping, or a disturbance in body image.
4. The nurse is planning expected outcomes for a female patient who will be celebrating her 40th birthday in a few months. Which outcome would be appropriate for this patient?
A) Patient will follow safer sex practices.
B) Patient will explain the process of reproduction.
C) Patient will perform breast self-examination every 2 months.
D) Patient will schedule a mammogram shortly after 40th birthday.
Ans: D
Feedback:
To help patients better understand reproductive functioning and sexual health throughout their life, an expected outcome might include encouraging women over 40 to have mammograms. The process of reproduction would be appropriate for younger patients. Teaching on safer sex practices would be appropriate for an adolescent. Breast self-examinations should be conducted every month.
5. A patient is diagnosed with a uterus that is slightly retroverted. When discussing the implications of this finding, what should the nurse include?
A) This finding indicates the need for surgery.
B) This finding will render the patient infertile.
C) This finding should not cause fertility issues.
D) This finding could interfere with conception.
Ans: C
Feedback:
A retroverted uterus means the uterus tips back. Minor variations of these positions do not tend to cause reproductive problems. A retroverted uterus does not mean that the patient needs surgery. A retroverted uterus does not interfere with fertility. The only way that a retroverted uterus will interfere with conception is if the abnormal position is extreme because the sharp bend can block the deposition or migration of sperm.
6. A patient sustains a vaginal tear during the labor and delivery process and is experiencing profuse vaginal bleeding. What should the nurse instruct the patient about this injury?
A) This injury will heal rapidly.
B) Surgery is needed to repair the tear.
C) Future vaginal deliveries will be compromised.
D) Bleeding will continue for several weeks to months.
Ans: A
Feedback:
The blood supply to the vagina is furnished by the vaginal artery, a branch of the internal iliac artery. Vaginal tears at childbirth tend to bleed profusely because of this rich blood supply. The same rich blood supply is the reason any vaginal trauma at birth heals rapidly. Surgery is not needed to repair the tear. Future vaginal deliveries will not be compromised. Bleeding will not continue for several weeks to months.
7. An adolescent female patient asks the nurse questions about menstruation. What should the nurse include when instructing the patient?
A) Keeping active increases discomfort.
B) A prostaglandin inhibitor best relieves pain.
C) Eating sour foods contributes to discomfort.
D) Hair permanents do not take during a menstrual flow.
Ans: B
Feedback:
Prostaglandin inhibitors such as ibuprofen (Motrin) are most effective for menstrual pain because they reduce inflammation as well as relieve pain. Activity reduces the discomfort of menstrual pain. Eating sour foods does not influence menstruation. Menstruation does not affect hair care needs.
8. The nurse is preparing instruction about the menstrual cycle for adolescent patients. What will the nurse include about changes in the uterine endometrium during the second half of the cycle?
A) It is corkscrew-like because of progesterone stimulation.
B) It is thick and purple-hued because of estrogen stimulation.
C) It is thin and transparent because of progesterone stimulation.
D) It is twisted and ragged because of follicle-stimulating hormone.
Ans: A
Feedback:
During the second half of the menstrual cycle, the formation of progesterone in the corpus luteum causes the glands of the uterine endometrium to become corkscrew or twisted in appearance and dilated. The uterine endometrium is thin and transparent immediately after the end of the menstrual cycle. The uterine endometrium does not become thick and purple in color because of estrogen stimulation. The uterine endometrium does not become twisted and ragged because of follicle-stimulating hormone.
9. The nurse completes an assessment of an adolescent patient’s menstrual pattern. Which finding should the nurse identify as being within normal limits?
A) The usual cycle is 19 days.
B) Flow usually lasts 4 to 6 days.
C) Menstruation started at age 10 years.
D) The average amount of flow is 500 ml.
Ans: B
Feedback:
The duration of menstrual flow averages between 4 and 6 days. The average menstrual cycle is 28 days. The average age at onset of menstruation is 12.4 years. The average amount of flow is 30 to 80 ml per menstrual period.
10. The nurse is preparing an educational session about menstruation for a group of adolescents. Which hormone should the nurse instruct as initiating ovulation?
A) Estrogen
B) Progesterone
C) Luteinizing hormone
D) Follicle-stimulating hormone
Ans: C
Feedback:
Luteinizing hormone is responsible for ovulation or release of the mature egg cell from the ovary. Estrogen, progesterone, and follicle-stimulating hormone are not hormones responsible for initiating ovulation.
11. The nurse is determining the topics to include in an educational program to meet the 2020 National Health Goals for sexuality and reproductive health. What should the nurse include when planning this program? (Select all that apply.)
A) Outline safer sex practices.
B) Discuss the disadvantages of annual mammography.
C) Review skills to use to negate unwanted sexual advances.
D) Stress the importance of abstinence when teaching adolescent patients.
E) Explain the advantages of obtaining the human papillomavirus vaccination.
Ans: A, C, D, E
Feedback:
The nurse can help the nation achieve the 2020 National Health Goals for sexuality and reproductive health by outlining safer sex practices, reviewing refusal skills, teaching about abstinence, and explaining the advantages of obtaining the human papillomavirus vaccination. Annual mammography is not a disadvantage for women of a specific age range.
12. The nurse is determining a patient’s gender role. What is the nurse doing to make this determination?
A) Assessing the patient’s sexual preferences
B) Asking what gender the patient identifies with
C) Analyzing the patient’s chromosomal inheritance
D) Analyzing the patient’s demonstrated sexual behaviors
Ans: D
Feedback:
Gender role is the male or female behavior a person exhibits which may or may not be the same as biologic gender or gender identity. Assessing the patient’s sexual preferences, asking what gender the patient identifies, and analyzing the patient’s chromosomal inheritance will not determine the patient’s gender role.
13. A patient with vaginismus has attended counseling to treat the disorder. Which patient statement indicates that treatment has been effective?
A) “Lacking an interest in sex is a normal part of aging.”
B) “I can learn to tolerate sex if I want to have a family.”
C) “I can use lubricants to help with the pain of having sex.”
D) “Sex is not a bad thing but can be enjoyed with my husband.”
Ans: D
Feedback:
Vaginismus is involuntary contraction of the muscles at the outlet of the vagina when coitus is attempted that prohibits penile penetration and may occur in women who have been raped. Other causes are unknown, but it could also be the result of early learning patterns in which sexual relations were viewed as bad or sinful. As with other sexual problems, sexual or psychological counseling to reduce this response may be necessary. A lack of interest in sex is not a normal part of aging. Learning to tolerate sex and using lubricants does not help with the problem of vaginismus.
14. The nurse is planning an education seminar on safer sexual practices for a group of young adults. Which information should the nurse include in this teaching? (Select all that apply.)
A) Use a latex condom for intercourse.
B) Void immediately after having sex.
C) Avoid sex with intravenous drug users.
D) Hand-to-genital sex is the safest sexual practice.
E) Inspect your sexual partner for lesions in the genital area.
Ans: A, B, C, E
Feedback:
Safer sexual practices include using a latex condom for intercourse, voiding immediately after having sex, avoiding sex with intravenous drug users, and inspecting the sexual partner for genital lesions. Hand-to-genital sex is not the safest sexual practice. Abstinence is the only 100% guarantee against not contracting a sexually transmitted infection.
15. The nurse is teaching a male patient about sildenafil citrate (Viagra) prescribed for erectile dysfunction. Which patient statement indicates that teaching has been effective?
A) “A change in vision is to be expected.”
B) “This medication is birth control for men.”
C) “I can take this medication several times a day.”
D) “I should report to my health care provider an erection that lasts longer than 4 hours.”
Ans: D
Feedback:
An erection lasting more than 4 hours can occur when taking sildenafil citrate (Viagra). This condition can lead to penile tissue damage and should be reported to a health care provider. A change in vision should be reported to the health care provider. Sildenafil citrate (Viagra) is not birth control. This medication should be taken up to one dose per day.

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