Maternity and Pediatric Nursing 3e by Ricci, Kyle & Carman TEST BANK

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Maternity and Pediatric Nursing – Third Edition

Chapter 5- Sexually Transmitted Infections

 

 

1.

The nurse is developing a plan of care for a client who is receiving highly active antiretroviral therapy (HAART) for treatment of HIV. The goal of this therapy is to:

  1. A) Promote the progression of disease
  2. B) Intervene in late-stage AIDS
  3. C) Improve survival rates
  4. D) Conduct additional drug research

2.

A woman who is HIV-positive is receiving HAART and is having difficulty with compliance. To promote adherence, which of the following areas would be most important to assess initially?

  1. A) The woman’s beliefs and education
  2. B) The woman’s financial situation and insurance
  3. C) The woman’s activity level and nutrition
  4. D) The woman’s family and living arrangements

3.

When developing a teaching plan for a community group about HIV infection, which group would the nurse identify as an emerging risk group for HIV infection?

  1. A) Native Americans
  2. B) Heterosexual women
  3. C) New health care workers
  4. D) Asian immigrants

4.

After teaching a group of adolescents about HIV, the nurse asks them to identify the major means by which adolescents are exposed to the virus. The nurse determines that the teaching was successful when the group identifies which of the

following?

  1. A) Sexual intercourse
  2. B) Sharing needles for IV drug use
  3. C) Perinatal transmission
  4. D) Blood transfusion

5.

The nurse reviews the CD4 cell count of a client who is HIV-positive. A result less than which of the following would indicate to the nurse that the client has AIDS?

  1. A) 1,000 cells/mm3
  2. B) 700 cells/mm3
  3. C) 450 cells/mm3
  4. D) 200 cells/mm3

6.

When obtaining the health history from a client, which factor would lead the nurse to suspect that the client has an increased risk for sexually transmitted infections (STIs)?

  1. A) Hive-like rash for the past 2 days
  2. B) Five different sexual partners
  3. C) Weight gain of 5 lbs in 1 year
  4. D) Clear vaginal discharge

7.

Assessment of a female client reveals a thick, white vaginal discharge. She also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has:

  1. A) Trichomoniasis
  2. B) Bacterial vaginosis
  3. C) Candidiasis
  4. D) Genital herpes simplex

8.

A client with trichomoniasis is to receive metronidazole (Flagyl). The nurse instructs the client to avoid which of the following while taking this drug?

  1. A) Alcohol
  2. B) Nicotine
  3. C) Chocolate
  4. D) Caffeine

9.

A woman gives birth to a healthy newborn. As part of the newborn’s care, the nurse instills erythromycin ophthalmic ointment as a preventive measure related to which STI?

  1. A) Genital herpes
  2. B) Hepatitis B
  3. C) Syphilis
  4. D) Gonorrhea
  5. Which findings would the nurse expect to find in a client with bacterial vaginosis?
  6. A) Vaginal pH of 3
  7. B) Fish-like odor of discharge
  8. C) Yellowish-green discharge
  9. D) Cervical bleeding on contact

11.

A pregnant woman diagnosed with syphilis comes to the clinic for a visit. The nurse discusses the risk of transmitting the infection to her newborn, explaining that this infection is transmitted to the newborn through the:

  1. A) Amniotic fluid
  2. B) Placenta
  3. C) Birth canal
  4. D) Breast milk

12.

The nurse encourages a female client with human papillomavirus (HPV) to receive continued follow-up care because she is at risk for:

  1. A) Infertility
  2. B) Dyspareunia
  3. C) Cervical cancer
  4. D) Dysmenorrhea

13.

A client is diagnosed with pelvic inflammatory disease (PID). When reviewing the client’s medical record, which of the following would the nurse expect to find? (Select all that apply.)

  1. A) Oral temperature of 100.4 degrees F
  2. B) Dysmenorrhea
  3. C) Dysuria
  4. D) Lower abdominal tenderness
  5. E) Discomfort with cervical motion
  6. F) Multiparity
  7. Which instructions would the nurse include when teaching a woman with pediculosis pubis?
  8. A) “Take the antibiotic until you feel better.”
  9. B) “Wash your bed linens in bleach and cold water.”
  10. C) “Your partner doesn’t need treatment at this time.”
  11. D) “Remove the nits with a fine-toothed comb.”

15.

A client with genital herpes simplex infection asks the nurse, “Will I ever be cured of this infection?” Which response by the nurse would be most appropriate?

  1. A) “There is a new vaccine available that prevents the infection from returning.”
  2. B) “All you need is a dose of penicillin and the infection will be gone.”
  3. C) “There is no cure, but drug therapy helps to reduce symptoms and recurrences.”
  4. D) “Once you have the infection, you develop an immunity to it.”

16.

A nurse is preparing a presentation for a group of women at the clinic who have been diagnosed with genital herpes.

Which of the following would the nurse expect to include as a possible precipitating factor for a recurrent outbreak?

(Select all that apply.)

  1. A) Exposure to ultraviolet light
  2. B) Exercise
  3. C) Use of corticosteroids
  4. D) Emotional stress
  5. E) Sexual intercourse.

17.

After teaching a class on sexually transmitted infections, the instructor determines that the teaching was successful when the class identifies which statement as true?

  1. A) STIs can affect anyone if exposed to the infectious organism.
  2. B) STIs have been addressed more on a global scale.
  3. C) Clients readily view the diagnosis of STI openly.
  4. D) Most individuals with STIs are over the age of 30.

18.

A group of students are reviewing information about STIs. The students demonstrate understanding of the information when they identify which of the following as the most common bacterial STI in the United States?

  1. A) Gonorrhea
  2. B) Chlamydia
  3. C) Syphilis
  4. D) Candidiasis

19.

A nurse is assessing a client for possible risk factors for chlamydia and gonorrhea. Which of the following would the nurse identify?

  1. A) Asian American ethnicity
  2. B) Age under 25 years
  3. C) Married
  4. D) Consistent use of barrier contraception

20.

A nurse at a local community clinic is developing a program to address STI prevention. Which of the following would the nurse least likely include in the program?

  1. A) Outlining safer sexual behavior
  2. B) Recommending screening for symptomatic individuals
  3. C) Promoting the use of barrier contraceptives
  4. D) Offering education about STI transmission

21.

After teaching a class on preventing pelvic inflammatory disease, the instructor determines that the teaching was successful when the class identifies which of the following as an effective method?

  1. A) Advising sexually active females to use hormonal contraception
  2. B) Encouraging vaginal douching on a weekly basis.
  3. C) Emphasizing the need for infected sexual partners to receive treatment
  4. D) Promoting routine treatment for asymptomatic females as risk

22.

A group of nursing students are reviewing information about vaccines used to prevent STIs. The students would expect to find information about which of the following?

  1. A) HIV
  2. B) HSV
  3. C) HPV
  4. D) HAV
  5. E) HBV

23.

A mother brings her 12-year-old daughter in for well-visit checkup. During the visit, the nurse is discussing the use of prophylactic HPV vaccine for the daughter. The mother agrees and the daughter receives her first dose. The nurse schedules the daughter for the next dose, which would be given at which time?

  1. A) In 2 month
  2. B) In 2 months
  3. C) In 3 months
  4. D) In 4 months

24.

A woman comes to the clinic complaining of a vaginal discharge. The nurse suspects trichomoniasis based on which of the following? (Select all that apply.)

  1. A) Urinary frequency
  2. B) Yellow/green discharge
  3. C) Joint pain
  4. D) Blister-like lesions
  5. E) Muscle aches

25.

A nurse is teaching a women with genital ulcers how to care for them. Which statement by the client indicates a need for additional teaching?

  1. A) “I need to wash my hands after touching any of the ulcers.”
  2. B) “I need to abstain from intercourse primarily when the lesions are present.”
  3. C) “I should avoid applying ice or heat to my genital area.”
  4. D) “I can try lukewarm sitz baths to help ease the discomfort.”

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Answer Key

  1. C
  2. A
  3. B
  4. A
  5. D
  6. B
  7. C
  8. A
  9. D
  10. B
  11. B
  12. C
  13. B, C, D, E
  14. D
  15. C
  16. A, C, D, E
  17. A
  18. B
  19. B
  20. B
  21. C
  22. C, D, E
  23. B
  24. A, B
  25. B

 

 

 

Maternity and Pediatric Nursing – Third Edition

Chapter 41 Nursing Care of the Child With an Alteration in Perfusion / Cardiovascular Disorder

 

1. The nurse is conducting a physical examination of a child with a ventricular septal defect. Which finding would the nurse expect to assess?
  A) Right ventricular heave
  B) Holosystolic harsh murmur along the left sternal border
  C) Fixed split-second heart sound
  D) Systolic ejection murmur

 

 

2. The nurse is administering digoxin as ordered and the child vomits the dose. What should the nurse do next?
  A) Contact the physician
  B) Offer a snack and administer another dose
  C) Immediately administer another dose
  D) Administer next dose as ordered in 12 hours

 

 

3. The nurse is caring for an infant with suspected patent ductus arteriosus. Which of the following assessment findings would the nurse identify as helping to confirm this suspicion?
  A) Thrill at the base of the heart
  B) Harsh, continuous, machine-like murmur under the left clavicle
  C) Faint pulses
  D) Systolic murmur best heard along the left sternal border

 

 

4. The nurse is conducting a physical examination of a child with a suspected cardiovascular disorder. Which of the following findings would the nurse most likely expect to assess if the child had transposition of the great vessels?
  A) Significant cyanosis without presence of a murmur
  B) Abrupt cessation of chest output with an increase in heart rate/filling pressure
  C) Soft systolic ejection
  D) Holosystolic murmur

 

 

5. The nurse is assessing a child with suspected infective endocarditis. Which of the following assessment findings would the nurse interpret as a sign of extracardiac emboli?
  A) Pruritus
  B) Roth spots
  C) Delayed capillary refill
  D) Erythema marginatum

 

 

6. When conducting a physical examination of a child with suspected Kawasaki disease, which of the following would the nurse expect to assess?
  A) Hirsutism or striae
  B) Strawberry tongue
  C) Malar rash
  D) Café au lait spots

 

 

7. After teaching a group of students about acute rheumatic fever, the instructor determines that the teaching was successful when the students identify which of the following as an assessment finding?
  A) Janeway lesions
  B) Jerky movements of the face and upper extremities
  C) Black lines
  D) Osler nodes

 

 

8. A nurse is reviewing the medical record of a child and finds that the child has a grade III murmur. After auscultating the child’s heart sounds, the nurse would document this murmur as which of the following?
  A) Loud without a thrill
  B) Loud with a precordial thrill
  C) Soft and easily heard
  D) Loud, audible with a stethoscope

 

 

9. The nurse is caring for a 2-month-old infant who has been diagnosed with acute heart failure. The nurse is providing teaching about nutrition. Which of the following statements by the mother indicates a need for further teaching?
  A) “The baby may need as much as 150 calories/kg/day.”
  B) “Small, frequent feedings are best if tolerated.”
  C) “I need to feed him every hour to make sure he eats enough.”
  D) “Gavage feedings may be required for now.”

 

 

10. The nurse is caring for an infant girl with a suspected cardiovascular disorder. Which of the following statements by the mother would warrant further investigation?
  A) “My baby does not make any grunting noises.”
  B) “The baby seems more comfortable over my shoulder.”
  C) “The baby usually drinks all of her bottle.”
  D) “I don’t notice any rapid breathing patterns.”

 

 

11. Auscultation of a child’s heart reveals a loud murmur with a precordial thrill. The nurse documents this as which of the following?
  A) Grade II
  B) Grade III
  C) Grade IV
  D) Grade V

 

 

12. After assessing a child’s blood pressure, the nurse determines the pulse pressure and finds that it is narrowed. Which of the following would the nurse identify as associated with this finding?
  A) Aortic stenosis
  B) Patent ductus arteriosus
  C) Aortic insufficiency
  D) Complete heart block

 

 

13. A 9-year-old child has undergone a cardiac catheterization and is being prepared for discharge. The nurse is instructing the parents and child about postprocedure care. Which statement by the parents indicates that the teaching was successful?
  A) “This pressure dressing needs to stay on for 5 days from now.”
  B) “He can’t eat but he can drink fluids for the next 24 hours.”
  C) “He should avoid taking a bath for about 3 days but he can shower.”
  D) “It’s normal if he says he feels like his heart skipped a beat.”

 

 

14. A newborn is diagnosed with patent ductus arteriosus. The nurse anticipates that the physician will most likely order which medication?
  A) Alprostadil
  B) Heparin
  C) Indomethacin
  D) Spironolactone

 

 

15. The nurse is preparing a teaching plan for the parents of a child who has been diagnosed with a congenital heart defect. Which of the following would the nurse be least likely to include?
  A) Daily weight assessment
  B) Maintenance of strict bed rest
  C) Prevention of infection
  D) Signs of complications

 

 

16. After teaching a class about the hemodynamic characteristics of congenital heart disease, the instructor determines that the teaching has been successful when the class identifies which defect as an example of a disorder involving increased pulmonary blood flow?
  A) Tetralogy of Fallot
  B) Atrial septal defect
  C) Hypoplastic left heart syndrome
  D) Transposition of the great vessels

 

 

17. A 7-year-old child with a family history of cardiovascular disease is being screened for hyperlipidemia. When reviewing the child’s laboratory test results, which total cholesterol level would be of significant concern?
  A) 120 mg/dL
  B) 150 mg/dL
  C) 180 mg/dL
  D) 210 mg/dL

 

 

18. A child with a suspected cardiovascular disorder is to undergo diagnostic testing and is scheduled for an echocardiogram. When explaining this test to the child, which of the following would the nurse most likely include?
  A) “This test will check the pattern of how your heart is beating.”
  B) “They’ll take a picture of your chest to look at the heart’s size.”
  C) “A special wand that picks up sound is used to check your heart.”
  D) “Small patches are attached to your chest to check the heart rhythm.”

 

 

19. The nurse is reviewing the medical record of a child with infective endocarditis. Which of the following would the nurse expect to find? Select all answers that apply.
  A) White blood cell count revealing leukopenia
  B) Microscopic hematuria with urinalysis
  C) Electrocardiogram with prolonged PR interval
  D) Lungs clear on auscultation
  E) Petechiae on palpebral conjunctiva

 

 

20. A child with heart failure is receiving supplemental oxygen. The nurse understands that in addition to improving oxygen saturation, this intervention also helps to do which of the following?
  A) Cause vasodilation
  B) Increase pulmonary vascular resistance
  C) Promote diuresis
  D) Mobilize secretions

 

 

21. The nurse is developing a plan of care for an infant with heart failure who is receiving digoxin. The nurse would hold the dose of digoxin and notify the physician if the infant’s apical pulse rate was:
  A) 140 beats per minute
  B) 120 beats per minute
  C) 100 beats per minute
  D) 80 beats per minute

 

 

22. A nurse is working with an adolescent who is slightly overweight and was recently diagnosed with hypertension. They are discussing nutritional management. Which statement by the adolescent demonstrates understanding of the information?
  A) “I have to make sure that I don’t eat a lot of salty foods.”
  B) “I can eat any amount at a meal as long as I don’t eat between meals.”
  C) “I should eat plenty of fresh fruits and vegetables.”
  D) “If I skip breakfast, I can eat a much bigger lunch.”

 

 

23. A child is diagnosed with Kawasaki disease and is in the acute phase of the disorder. Which of the following would the nurse expect the physician to prescribe? Select all answers that apply.
  A) Intravenous immunoglobulin
  B) Ibuprofen
  C) Acetaminophen
  D) Aspirin
  E) Alprostadil

 

 

24. An infant with congenital heart disease is to undergo surgery to correct the defect. The mother states, “I guess I’m going to have to stop breastfeeding her.” Which response by the nurse would be most appropriate?
  A) “That’s true, but we’ll make sure she gets the best intravenous nutrition.”
  B) “Unfortunately, your baby needs more nutrients than what breast milk can provide.”
  C) “Breast milk may help to boost her immune system, so you can continue to use it.”
  D) “She won’t be able to suck, so we have to give her fortified formula through a tube.”

 

 

25. During a follow-up visit, the parents of a 5-month-old infant diagnosed with congenital heart disease tell the nurse, “We’re just so tired and emotionally spent. All these tests and examinations are overwhelming. We just want to have a normal life. We’re so focused on the baby that it seems like our 3-year-old is lost in the shuffle.” Which nursing diagnosis would the nurse identify as most appropriate?
  A) Risk for delayed growth and development related to necessary treatments
  B) Deficient knowledge related to the care of a child with congenital heart disease
  C) Interrupted family processes related to demands of caring for the ill child
  D) Fear related to infant’s cardiac condition and need for ongoing care

 

 

 

Answer Key

 

1. B
2. D
3. B
4. A
5. B
6. B
7. B
8. A
9. C
10. B
11. C
12. A
13. C
14. C
15. B
16. B
17. D
18. C
19. B, C, E
20. A
21. D
22. C
23. A, C, D
24. C
25. C

 

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