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Women’s Health Care in
Advanced Practice Nursing
2nd Edition Testbank
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Chapter 1 Women and Their Health
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The United States ranks 50th in the world for maternal mortality and 41st among industrialized nations for
1. infant mortality rate. When developing programs to assist in decreasing these rates, which factor would
most likely need to be addressed as having the greatest impact?
A) Resolving all language and cultural differences
B) Assuring early and adequate prenatal care
C) Providing more extensive womens shelters
D)Encouraging all women to eat a balanced diet
2. When integrating the principles of family-centered care, the nurse would include which of the following?
A) Childbirth is viewed as a procedural event
B) Families are unable to make informed choices
C) Childbirth results in changes in relationships
D)Families require little information to make appropriate decisions
When preparing a teaching plan for a group of first-time pregnant women, the nurse expects to review
3. how maternity care has changed over the years. Which of the following would the nurse include when
discussing events of the 20th century?
A) Epidemics of puerperal fever
B) Performance of the first cesarean birth
C) Development of the x-ray to assess pelvic size
D)Creation of free-standing birth centers
After teaching a group of students about pregnancy-related mortality, the instructor determines that
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additional teaching is needed when the students identify which condition as a leading cause?
A) Hemorrhage
B) Embolism
C) Obstructed labor
D)Infection
The nurse is working with a group of community health members to develop a plan to address the special
5. health needs of women. Which of the following conditions would the group address as the major
problem?
A) Smoking
B) Heart disease
C) Diabetes
D)Cancer
When assessing a family for possible barriers to health care, the nurse would consider which factor to be
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most important?
A) Language
B) Health care workers attitudes
C) Transportation
D)Finances
7. After teaching a group of nursing students about the issue of informed consent. Which of the following, if
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identified by the student, would indicate an understanding of a violation of informed consent?
A) Performing a procedure on a 15-year-old without consent
B) Serving as a witness to the signature process
C) Asking whether the client understands what she is signing
D)Getting verbal consent over the phone for emergency procedures
The nurse is trying to get consent to care for an 11-year-old boy with diabetic ketoacidosis. His parents
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are out of town on vacation, and the child is staying with a neighbor. Which action would be the priority?
A) Getting telephone consent with two people listening to the verbal consent
B) Providing emergency care without parental consent
C) Contacting the childs aunt or uncle to obtain their consent
D)Advocating for termination of parental rights for this situation
After teaching nursing students about the basic concepts of family-centered care, the instructor
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determines that the teaching was successful when the students state which of the following?
A) Childbirth affects the entire family, and relationships will change.
B) Families are not capable of making health care decisions for themselves.
C) Mothers are the family members affected by childbirth.
D)Childbirth is a medical procedure.
A nursing instructor is preparing a class discussion on the trends in health care and health care delivery
10.over the past several centuries. When discussing the changes during the past century, which of the
following would the instructor be least likely to include?
A) Disease prevention
B) Health promotion
C) Wellness
D) Analysis of morbidity and mortality
A nurse is assigned to care for an Asian American client. The nurse develops a plan of care with the
11.understanding that based on this clients cultural background, the client most likely views illness as which
of the following?
A) Caused by supernatural forces.
B) A punishment for sins.
C) Due to spirits or demons.
D) From an imbalance of yin and yang
A nurse is developing a plan of care for a woman to ensure continuity of care during pregnancy, labor,
12.and childbirth. Which of the following would be most important for the nurse to incorporate into that
plan?
A) Adhering to strict, specific routines
B) Involving a pediatric physician
C) Educating the client about the importance of a support person
D) Assigning several nurses as a support team
A nursing instructor is preparing a class discussion on case management in maternal and newborn health
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care. Which of the following would the instructor include as a key component? Select all that apply.
A) Advocacy
B) Coordination
C) Communication
D) Resource management
E) Event managed care
14.After teaching a group of students about the concept of maternal mortality, the instructor determines
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that additional teaching is needed when the students state which of the following?
The rate includes accidental causes for deaths.
It addresses pregnancy-related causes.
The duration of the pregnancy is not a concern.
The time frame is typically for a specified year.
A group of students are reviewing the historical aspects about childbirth. The students demonstrate
15.understanding of the information when they identify the use of twilight sleep as a key event during
which time frame?
A) 1700s
B) 1800s
C) 1900s
D) 2000s
A nurse is providing care to a woman who has just delivered a healthy newborn. Which action would
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least likely demonstrate application of the concept of family-centered care?
A) Focusing on the birth as a normal healthy event for the family
B) Creating opportunities for the family to make informed decisions
C) Encouraging the woman to keep her other children at home
D) Fostering a sense of respect for the mother and the family
When discussing fetal mortality with a group of students, a nurse addresses maternal factors. Which of
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the following would the nurse most likely include? Select all that apply.
A) Chromosomal abnormalities
B) Malnutrition
C) Preterm cervical dilation
D) Underlying disease condition
E) Poor placental attachment
A nurse is preparing a presentation for a local community group about health status and childrens
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health. Which of the following would the nurse include as one of the most significant measures?
A) Fetal mortality rate
B) Neonatal mortality rate
C) Infant mortality rate
D) Maternal mortality rate
A group of students are reviewing an article describing information related to indicators for womens
19.health and the results of a national study. Which of the following would the students identify as being
satisfactory for women? Select all that apply.
A) Smoking cessation
B) Colorectal cancer screening
C) Violence against women
D) Health insurance coverage
E) Mammograms
A nurse is preparing a presentation for a local womens group about heart disease and women. Which of
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the following would the nurse expect to address when discussing measures to promote health.
A) Women have similar symptoms as men for a heart attack.
B) Heart disease is no longer viewed as a mans disease.
C) Women experiencing a heart attack are at greater risk for dying.
D) Heart attacks in women are more easily diagnosed.
21.A nurse is working to develop a health education program for a local community to address breast cancer
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A)
B)
C)
D)
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awareness. Which of the following would the nurse expect to include when describing this problem to
the group? Select all that apply.
A) White women have higher rates of breast cancer than African American women.
B) African American women are more likely to die from breast cancer at any age.
C) Survival at any stage is worse among white women.
D) Women living in South America have the highest rates of breast cancer.
E) Breast cancer is the leading cause of cancer mortality in women.
A group of nursing students are reviewing information about factors affecting maternal, newborn, and
22.womens health. The students demonstrate understanding of the information when they identify which
of the following deficiencies as being associated with poverty? Select all that apply.
A) Literacy
B) Employment opportunities
C) Mobility
D) Political representation
E) Skills
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1. B
2. C
3. D
4. B
5. B
6. D
7. A
8. A
9. A
10.D
11.D
12.C
13.A, B, C, D
14.A
15.C
16.C
17.B, C, D
18.C
19.B, E
20.C
21.A, B
22.A, B, C, D, E
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Answer Key
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Chapter 2 Women as Health Care Providers
1. Which health occupation has the highest percentage of women?
A. Pharmacists
B. Physical therapists
C. Registered nurses
D. Dental hygienists
Answer: D
2. Which health occupation has the lowest percentage of women?
A. Physicians
B. Dentists
C. Pharmacists
D. Physical therapists
Answer: B
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3. Which health profession has the largest number of workers?
A. Health aides
B. Physicians
C. Licensed practical nurses
D. Registered nurses
Answer: D
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4. Which of the following are certifications available in advanced practice registered nursing? (Select all that
apply.)
A. Certified nurse midwife
B. Certified registered nurse anesthetist
C. Certified nurse pharmacologist
D. Clinical nurse specialist
E. Nurse practitioner
Answer: A, B, D, E
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5. What level of education is required to become a licensed practical nurse?
A. 2-year master’s degree (in addition to a 4-year bachelor’s degree)
B. 4-year bachelor’s degree
C. 2-year associate’s degree
D. 1-year certificate or diploma
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Answer: D
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6. What percentage of physicians and surgeons in the United States in 2014 were women?
A. 27%
B. 37%
C. 47%
D. 57%
Answer: B
7. What medical specialty has the highest percentage of women?
A. General pediatrics
B. Obstetrics and gynecology
C. Orthopedic surgery
D. Urology
Answer: A
8. On an average, the income of female physicians is what percentage of that of male physicians?
A. 59%
B. 79%
C. 99%
D. 109%
Answer: A
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9. What level of education is required to become a pharmacist?
A. 6-year doctorate degree
B. 2-year master’s degree (in addition to a 4-year bachelor’s degree)
C. 4-year bachelor’s degree
D. 2-year associate’s degree
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Answer: A
Answer: D
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10. Which of the following is the median income of dentists in the United States (2012)?
A. $89,310
B. $109,310
C. $129,310
D. $149,310
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11. Which of the following are the current trends in dentistry? (Select all that apply.)
A. More specialists than generalists
B. Research linking oral health to overall health
C. Focus on treatment of disease rather than prevention
D. Expected growth of 18% from 2014 to 2024
E. Increasing demand for dental implants, bridges, and cosmetic services
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12. Which allied health occupation is projected to be the fastest growing?
A. Health information technicians
B. Nursing aides
C. Occupational therapists
D. Paramedics
Answer: A
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13. One in five workers in which of the following allied health occupation is at or below the federal poverty
level?
A. Medical assistant
B. Home health aide
C. Radiology technician
D. Speech-language pathologist
Answer: B
14. Veronica is a registered nurse who pours herself into her job. She works long hours without complaint and
strives to do her best. Often, she maintains a cheerful, caring, and kind demeanor on the outside while
feeling exhausted and frustrated on the inside. The effort it takes to maintain this front before her patients
results in a lot of stress. This phenomenon can best be described as which of the following?
A. Identity crisis
B. Psychological disparity
C. Emotional dissonance
D. Gender discrimination
Answer: C
15. Tests of implicit racial bias among health professionals have revealed which of the following?
A. An unconscious preference for Whites over Blacks
B. Use of racially charged, derogatory language
C. Sharing of racist jokes
D. Lower pay for racial minorities
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Answer: A
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Chapter 3 Women and Health Care
1. To enhance women’s health care in the 21st century, researchers should do which of the following? (Select
all that apply.)
A. Design studies in collaboration with women
B. Analyze changes in women’s health data relative to men’s
C. Include homogeneous populations of women in studies
D. Translate research findings into clinical and public health practice
E. Focus on treatment approaches equally applicable to men and women
Answer: A, B, D
2. Historically, gender has been defined by which of the following? (Select all that apply.)
A. Self-identification
B. Appropriate roles
C. Division of labor
D. Economic power
E. Political influence
Answer: B, C, D, E
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3. Hammarstrӧm et al. propose a model of sex and gender that includes which of the following concepts?
(Select all that apply.)
A. Binary sexuality based on one’s chromosomes
B. Sex, interacting with gender, as a continuum
C. Biologically determined sex based on the effects of sex hormones on reproductive organ development
D. Sex and gender as an integration of body, mind, and context
E. Intersectionality and embodiment as factors significantly affecting sex and gender
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4. Which of the following is the best example of how gender bias has affected the health and health care of
women?
A. Similar rates of mental illness being found in men and women
B. Treatment outcomes among women varying based on patient compliance
C. Association of patient income level with type of diagnosis
D. Disproportionately more psychotropic medications being prescribed to women than men
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5. Krieger has proposed which of the following regarding sex, gender, and health? (Select all that apply.)
A. Gender and sex played no significant role in determining health outcomes for women
B. Gender relations influence the expression and the interpretation of biological traits
C. Sex-linked biological characteristics contribute to gender differentials in health
D. Traditional perspectives on gender and sex have resulted in better health outcomes for women than for
men
E. Equitable gender relationships have resulted in similar health outcomes in men and women
Answer: B, C
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6. When did women’s health scholarship begin to flourish?
A. 1960s
B. 1970s
C. 1980s
D. 1990s
Answer: B
7. Which of the following were the goals included in the report “Women’s Health Research: Progress, Pitfalls,
and Promise,” which was published by the Office of Research on Women’s Health in 2010? (Select all that
apply.)
A. Increase sex similarities research in basic sciences studies
B. Incorporate findings of sex and gender differences in the design of new technologies
C. Create strategic alliances to maximize domestic and global impact of women’s health research
D. Develop and implement new social networking technologies to promote men’s health and wellness
research
E. Employ innovative strategies to build a well-trained, diverse, and vigorous women’s health research
workforce
Answer: B, C, E
8. The National Institutes of Health (NIH) Revitalization Act of 1993 mandated that the NIH do which of the
following?
A. Expand health insurance coverage for women
B. Include women and minorities in clinical research
C. Research and develop new women-specific medications
D. Decrease infection rates during obstetric surgeries
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9. Historical examples of gender bias in medical textbooks include which of the following? (Select all that
apply.)
A. Portrayals of women as inherently sick
B. A recommendation that women simulate orgasms if not orgasmic with their husbands
C. Portrayals of women patients as being intellectually superior to their male physicians
D. Omission of the clitoris from anatomical illustrations of women’s genitals
E. Portrayal of women as invincible to illness and age, as long as they make the right choices
Answer: A, B, D, E
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10. Which of the following best describes the new model for health care for women?
A. Physician-centered
B. Authoritarian
C. Pluralistic
D. Disease-oriented
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CHAPTER 4
Health Care for Vulnerable Populations
1. According to a 2015 report by Buerhaus and colleagues, which type of health care provider is most likely to
care for racial or ethnic minority patients and patients who are uninsured?
A. Family practice physicians
B. Physician assistants
C. Nurse practitioners
D. Surgeons
Answer: C
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2. Which of the following are examples of people likely to be considered members of vulnerable populations?
(Select all that apply.)
A. An African American woman
B. A young woman living in an urban setting who takes mass transit
C. A single mother earning $12,000 a year
D. A transgender man
E. A homeless middle-aged man
Answer: A, C, D, E
Answer: A
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3. Which of the following is the best example of a health inequity?
A. A Mexican American woman with diabetes who receives less attention from the physician because of her
ethnicity
B. A low-income woman whose children get sick repeatedly because she refused to have them vaccinated
C. A gay man who must drive a long distance to visit the health care provider of his choice
D. A Muslim woman who is shunned by her neighbors because of her religion
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4. Which of the following are effects of social determinants of health? (Select all that apply.)
A. A higher rate of infant mortality in a poor neighborhood compared with wealthier ones
B. Increased incidence of boating injuries in a city located on a large lake
C. A murder rate five times the national average in an inner-city neighborhood plagued by gang activity
D. A man with HIV who goes without treatment because he fears the stigma associated with his condition
E. An outbreak of the flu in an area due to rapid changes in the weather
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5. Which of the following is the generally accepted view of race by the scientific community?
A. Biologically determined
B. Established by socioeconomic level
C. Determined by the country of one’s birth
D. Socially constructed
Answer: D
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6. Mary is a 51-year-old woman with 20 years of experience as an assembly line worker in the automobile
industry. She was recently interviewed for a management position in her company but did not get the job.
A coworker later tells her, “Don’t feel bad. Archie never hires women for management.” This scenario
can best be described as an example of which of the following?
A. Prejudice
B. Discrimination
C. Health inequity
D. Social justice
Answer: B
7. Jamie is a single mom who, because of her low income, is unable to consistently provide nutritious meals
for her children and self. Her food insecurity makes Brittany at a greater risk for which of the following?
A. Breast cancer
B. Type 1 diabetes
C. Type 2 diabetes
D. Chronic obstructive pulmonary disease
Answer: C
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8. Which of the following are challenges that low-income women are more likely to encounter in the
workplace than high-income women? (Select all that apply.)
A. Discrimination based on gender
B. Long commutes
C. No paid sick days
D. Pressure from a demanding boss
E. Lack of health insurance
Answer: A, C, E
Answer: A
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9. Teresa lives in a town of 3,000 people in Montana, 100 miles away from the nearest city. Which barrier to
care is Teresa most likely to face as a result of living in a rural community?
A. Lack of a women’s health specialist
B. Higher cost of care
C. Structural racism
D. Social stigma
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10. What percentage of women in the United States will experience severe physical violence by an intimate
partner in their lifetimes?
A. 15%
B. 25%
C. 35%
D. 45%
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11. Which group of women are likely to experience intimate partner violence?
A. Lesbians
B. Women with disabilities
C. Women living in rural communities
D. Women who work full time
Answer: B
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12. A nurse is preparing to assess a client for alcohol use. Which clinical tool would be appropriate for this
task?
A. Cut down, annoyed, guilty, and eye-opener (CAGE)
B. Patient Health Questionnaire (PHQ-9)
C. Mini-Cog
D. Wong-Baker FACES (Wong-Baker FACES Pain Rating Scale)
Answer: A
13. A nurse is assisting a client who is food insecure. Which agency should the nurse refer the client to for food
assistance?
A. Food and Drug Administration (FDA)
B. Centers for Disease Control and Prevention (CDC)
C. Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
D. World Health Organization (WHO)
Answer: C
14. A nurse learns from an older client, Gabby, that Gabby’s landlord is increasing her rent by 100% with only
a month’s notice. The nurse refers Gabby to a social worker to explore subsidized housing and follows up a
month later to make sure Gabby is okay. The nurse’s behavior is an example of which of the following?
A. Discrimination
B. Patient advocacy
C. Health inequity
D. Marginalization
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Answer: B
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CHAPTER 5
Legal Issues in Women’s Health Care
1. The landmark U.S. Supreme Court case Griswold v. Connecticut established which of the following?
A. Unmarried women’s right to privacy in contraception
B. Women’s right to choose to have an abortion
C. The right of women younger than 16 years to receive birth control
D. Married couples’ right to privacy in contraception
Answer: D
2. The U.S. Supreme Court case Carey v. Population Services established which of the following?
A. Unmarried women’s right to privacy in contraception
B. Women’s right to choose to have an abortion
C. The right of women younger than 16 years to receive birth control
D. Married couples’ right to privacy in contraception
Answer: C
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3. What proportion of pregnancies in the United States are unintended each year?
A. One fourth
B. One third
C. One half
D. Two thirds
B.
Answer: C
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4. By age 45, what proportion of women have had an abortion in their lifetime?
A. 1 in 10
B. 2 in 10
C. 3 in 10
D. 4 in 10
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5. In the U.S. Supreme Court case in which Hobby Lobby challenged an aspect of the Patient Protection and
Affordable Care Act, what was the outcome?
A. The Court ruled that the contraception mandate violated religious liberty
B. The Court ruled that Hobby Lobby must provide birth control coverage for its employees
C. The Court ruled that Hobby Lobby must provide abortion coverage for its employees
D. The Court ruled that the individual mandate was unconstitutional
Answer: A
6. Before 1880, what was the status of abortion in the United States?
A. It was prohibited by federal law
B. It was unregulated
C. It was outlawed by individual states, with limited exceptions
D. It was a right legally protected by federal law
Answer: B
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7. Which of the following were outcomes of the landmark U.S. Supreme Court case Roe v. Wade, 1973?
(Select all that apply.)
A. Women were granted the right to choose to have an abortion
B. Human life was defined as beginning at birth
C. States retained the right to restrict and regulate abortion
D. States retained the right to outlaw abortion
E. Physicians retained the right to make decisions regarding abortion with their patients
Answer: A, C, E
8. Which of the following are controversial aspects of in vitro fertilization? (Select all that apply.)
A. Allowing parents to select the sex of their child
B. Implanting two to three embryos at a time
C. Allowing parents to implant an embryo for the purpose of harvesting an organ to be donated to a sick
sibling
D. Allowing preimplantation genetic testing when a parent has a history of an inheritable genetic disorder
E. Allowing parents to select the hair color, eye color, and skin complexion of a child
Answer: A, C, E
9. Which U.S. Supreme Court case involved a child custody battle between parents of an embryo that was
mistakenly implanted in another woman and the woman who gave birth to this child?
A. Griswold v. Connecticut
B. Eisenstadt v. Baird
C. Rodgers v. Fasano
D. Doe v. Doe
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Answer: C
Answer: B
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10. In the case of In re Baby M, 1988, the New Jersey Supreme Court did which of the following?
A. Granted permission for the surrogate mother to have an abortion
B. Awarded custody of the child to the surrogate mother
C. Awarded custody of the child to the father, who was the client and sperm donor
D. Awarded custody of the child to the state
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11. Which state has prosecuted a woman for illegal drug use in pregnancy; allowed drug testing on women in a
public hospital without their consent and arrested and incarcerated those who tested positive; and convicted
a woman of murder after her child was stillborn as a result of her using cocaine?
A. Alabama
B. South Carolina
C. Georgia
D. Texas
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12. What percentage of women who have experienced domestic violence are diagnosed with an anxiety
disorder?
A. 26%
B. 36%
C. 46%
D. 56%
Answer: C
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CHAPTER 6
Feminist Frameworks for Advanced Practice With Women
1. Which of the following is the process of marginalizing groups of people who are not part of a dominant and
privileged group of society?
A. Critiquing
B. Colonializing
C. Othering
D. Deconstructing
Answer: C
2. Which “wave” of feminism was focused on organizing women and using feminism as a resource for
seeking equality in social organizations?
A. First wave
B. Second wave
C. Third wave
D. Fourth wave
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Answer: B
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B.
C
3. Which of the following were proponents of liberal feminism? (Select all that apply.)
A. Mary Wollstonecraft
B. Angela Davis
C. John Stuart Mill
D. Julia Kristeva
E. Shulamith Firestone
Answer: A, C
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4. Which feminist theory seeks to eradicate sexual oppression by ending women’s economic dependence on
men?
A. Marxist/socialist feminism
B. Liberal feminism
C. Radical feminism
D. Psychoanalytic feminism
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Answer: A
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5. Which feminist theory strives to eradicate the patriarchal system by replacing the institutions that support
hierarchy and dominance?
A. Womanist
B. Liberal feminism
C. Radical feminism
D. Psychoanalytic feminism
Answer: C
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6. According to radical feminism, which of the following are sources of women’s oppression? (Select all that
apply.)
A. Biology
B. Gender
C. Psyche
D. Sexuality
E. Language
Answer: A, C, D
7. Which feminist theory seeks to reveal how language constructs gender and to use language to deconstruct
gender?
A. Womanist
B. Postmodernist feminism
C. Postcolonial feminism
D. Liberal feminism
Answer: B
8. Which group of feminist theorists is concerned primarily with exploring subjectivity and agency, abjection,
and psychosexual identity formation?
A. French psychoanalytic feminists
B. Early psychoanalytic feminists
C. Queer theorists
D. Womanists
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Answer: A
Answer: D
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B.
C
9. Which group of feminist theorists is concerned primarily with pointing out the differences between the
lives of women of color and the lives of White women?
A. Queer theorists
B. Liberal feminists
C. Radical feminists
D. Womanists
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10. Who coined the term “womanist”?
A. Mary Daly
B. Julia Kristeva
C. Michel Foucault
D. Alice Walker
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Answer: D
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11. Which group of feminist theorists is known for studying sexuality via concepts such as the Oedipus
complex and for promoting dual parenting?
A. French psychoanalytic feminists
B. Early psychoanalytic feminists
C. Queer theorists
D. Womanists
Answer: B
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12. Which group of feminist theorists describes feminism from lesbian, gay, bisexual, transgendered, and queer
(LGBTQ) perspectives and emphasizes “affinity and solidarity over identity”?
A. Queer theorists
B. Postcolonial feminists
C. Radical feminists
D. Womanists
Answer: A
13. A nurse researcher is interested in studying how the phenomenon of child labor in developing nations,
resulting from globalization and the imposition of Western economic principles, has affected the health of
girls in these nations. Which feminist theory would be most appropriate to adopt in this case?
A. Queer theory
B. Postcolonial feminist theory
C. Psychoanalytic feminist theory
D. Postmodern feminist theory
Answer: B
14. A nurse researcher would like to explore how the health outcomes of low-income African American
women differ from those of low-income White women. Which feminist theory would be most appropriate
to adopt in this case?
A. Queer theory
B. Marxist feminist theory
C. Psychoanalytic feminist theory
D. Womanist theory
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Answer: D
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Answer: B
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B.
C
15. Which of the following term denotes the concept that race-, class-, and gender-based oppressions interact
and shape one another, resulting in complex, multifactorial results in the lives of women?
A. Transnationalism
B. Intersectionality
C. Poststructuralism
D. Subjectivity
18
CHAPTER 7
Women’s Bodies
1. On an average, by how much are women shorter than men?
A. 2 inches
B. 4 inches
C. 6 inches
D. 8 inches
Answer: C
2. Which of the following characteristics are generally true of women compared with men? (Select all that
apply.)
A. 42% to 68% less absolute strength
B. Thicker skin but thinner subcutaneous tissues
C. Lower levels of VO2 max and cardiovascular fitness
D. Higher fat stores in the abdomen
E. Smaller lungs and airways
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Answer: A, C, E
Answer: D
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B.
C
3. A nurse is performing a clinical breast exam on a client. Which of the following signs should the nurse note
as a possible indicator of breast cancer?
A. Slight asymmetry in breast size
B. Brown areolar pigment
C. Erect nipples
D. An invertednipple
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4. Which structure of the female anatomy is homologous to the penis of the male?
A. Perineum
B. Clitoris
C. Labia minora
D. Vaginal orifice
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Answer: B
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5. Out of the approximately 1 to 2 million germ cells present in the ovary at birth, how many, on an average,
will achieve ovulation during a woman’s reproductive life?
A. 100
B. 400
C. 800
D. 1,200
Answer: B
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6. Which three bones compose the innominate bone? (Select all that apply.)
A. Sacrum
B. Ilium
C. Pubis
D. Ischium
E. Coccyx
Answer: B, C, D
7. Which of the following denotes a substance that is produced in one part of the body that enters into the
blood circulation, travels to and stimulates target cells, and exerts specific effects?
A. Hormone
B. Neuron
C. Erythrocyte
D. Lymph
Answer: A
8. Which of the following are steroidal hormones secreted by the ovaries? (Select all that apply.)
A. Inhibin
B. Estrogen
C. Activin
D. Progesterone
E. Follistatin
Answer: B, D
C
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9. Which hormone, secreted by neurons in the hypothalamus, triggers a hormonal cascade of reproductive
processes that result in puberty?
A. Estrogen
B. Follicle-stimulating hormone (FSH)
C. Luteinizing hormone (LH)
D. Gonadotropin-releasing hormone (GnRH)
B.
Answer: D
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10. When viewing the ultrasound display of a woman in her 20th week of pregnancy, a nurse notes the
presence of labia majora in the fetus. This is a sign of which of the following?
A. Gender
B. Genetic sex
C. Gonadal sex
D. Somatic sex
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Answer: D
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11. Which of the following is the phase of the ovarian cycle that occurs following ovulation but before menses?
A. Luteal
B. Follicular
C. Proliferative
D. Secretory
Answer: A
12. Ovulation typically occurs on which day of the menstrual cycle?
A. 1
B. 7
C. 14
D. 21
Answer: C
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13. The proliferative phase of the endometrial cycle is characterized by which of the following?
A. Shedding of the endometrium
B. Growth of the endometrium
C. Secretion of progesterone
D. Growth of the follicle
Answer: B
14. The average age for the onset of the perimenopausal period is which of the following?
A. 38 years
B. 42 years
C. 46 years
D. 50 years
Answer: C
15. Kelly, a woman in her mid-40s, asks the nurse what symptoms she is most likelyto experience once she
enters the perimenopausal period. Which of the following should the nurse mention?
A. Cessation of menstrual period
B. Mood changes
C. Hot flashes
D. Night sweats
E. Nausea
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B.
C
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Answer: B, C, D
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CHAPTER 8
Young Women’s Health
1. The teen birthrate is highest among which major racial or ethnic group?
A. Latinos
B. African Americans
C. Whites
D. Asians
Answer: A
2. What percentage of the U.S. population was 10 to 19 years old in 2014?
A. 14%
B. 19%
C. 24%
D. 29%
Answer: A
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Answer: A, C, E
B.
C
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3. Which of the following are examples of protective factors for adolescents? (Select all that apply.)
A. Bonds with friends and family
B. Physical inactivity
C. A school’s high expectations of students
D. Risky sexual behaviors
E. Opportunities for youth participation in the community
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4. Rachel is a talkative, open 13-year-old who is in for a physical exam today by herself. In talking with
Rachel, the nurse should recognize which of the following as characteristics typical of this stage of
development? (Select all that apply.)
A. Criticism of her parents
B. Acceptance of the physical changes of puberty
C. Mood swings
D. Sexual feelings emerging
E. Transition to adulthood
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Answer: A, C, D
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5. Lydia is a teenager who is in the process of researching college programs. She thinks she would like to be a
lawyer. She is also searching for a summer job to save up to buy a car. Which stage of development is
Lydia most likely in?
A. Preadolescence
B. Early adolescence
C. Middle adolescence
D. Late adolescence
Answer: D
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6. Yancy is a 14-year-old with Down syndrome. She, like many teens with disabilities, is at an increased risk
of having which chronic condition?
A. Epilepsy
B. Obesity
C. Heart disease
D. Arthritis
Answer: B
7. Brooke is a 17-year-old who is questioning both her sexual orientation and her gender. She says she has
begun exploring these but that her parents do not know. Brooke is at an increased risk of experiencing
which of the following? (Select all that apply.)
A. Obesity
B. Family violence
C. Homelessness
D. Substance abuse
E. Suicidality
Answer: B, C, D, E
8. Rose is a 14-year-old refugee from Nigeria who recently came to the United States. Being a foreign born,
which of the following is Rose more likely to do than her native-born classmates?
A. Exercise
B. Succeed academically
C. Eat meals with her family
D. Develop positive peer relationships
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Answer: C
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B.
C
9. Destiny is an outgoing, fun-loving 13-year-old who has developed a strong network of friends at school.
These positive relationships make it more likely that Destiny will experience which of the following?
(Select all that apply.)
A. Academic achievement
B. A healthy diet
C. Reduced substance abuse
D. Improved mental health
E. Lack of peer conflict
Answer: A, C, D
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10. During an office visit, Jordan, a 16-year-old patient, asks her nurse if she can share something in
confidence. The nurse affirms, but adds that there were a few disclosures that would legally require
breaking confidentiality. Which of the following are issues the nurse would be obligated to report? (Select
all that apply.)
A. Sexual activity
B. Intent to self-harm
C. Evidence of abuse
D. Gender questioning
E. Religious doubts
Answer: B, C
11. What percentage of adolescents were covered by health insurance in 2013?
A. 48%
B. 63%
C. 78%
D. 93%
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Answer: D
12. A nurse is having trouble communicating with her teenaged client, Enid, who is disengaged and sullen.
What approach would most likely be effective in helping the nurse engage with Enid?
A. Giving some concrete goals to Enid for her to pursue
B. Asking Enid’s mother to join them
C. Using motivational interviewing with Enid
D. Reminding Enid of the consequences of noncompliance
Answer: C
13. Nadia is a 13-year-old who is in for her first reproductive health visit. She reports having no special
concerns and appears healthy. Which of the following is most important for the nurse to do in this visit?
A. A Pap exam
B. An internal pelvic exam
C. An assessment of menstrual issues
D. A mammogram
Answer: C
14. In a 2013 survey of the Youth Risk Behavior Surveillance System, what percentage of high school females
reported drinking more than five drinks in a row on at least 1 day in the 30 days before the survey?
A. 16.1%
B. 21.1%
C. 26.1%
D. 31.1%
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Answer: B
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Answer: A
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B.
C
15. A nurse needs to assess an adolescent client’s level of sexual development. Which diagnostic tool should
the nurse use?
A. Tanner staging
B. CRAFFT screening
C. Motivational interviewing
D. Mini-Cog assessment
24
CHAPTER 9
Midlife Women’s Health
1. Midlife is commonly defined by which of the following ways? (Select all that apply.)
A. Age
B. Proximity to menopause
C. Degree of children’s independence
D. Level of cognitive function
E. Women’s self-perception of age
Answer: A, B, C, E
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2. Vivian is an 80-year-old patient who is reminiscing about her own midlife with her nurse, who has just
entered midlife. Given her age, Vivian is most likely to identify which of the following as having been a
primary source of meaning during her midlife?
A. Her career
B. Her family
C. Her friends
D. Her artistic accomplishments
Answer: B
Answer: C
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B.
C
3. Which of the following is the definition of menopause currently used in the health sciences?
A. The date of onset of menopause-related symptoms
B. The cessation of menses, defined as the end of the final menstrual period
C. The cessation of menses, defined as 1 year after the final menstrual period
D. The date of the last menopause-related symptom
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4. Women of which U.S. ethnic group are most likely to describe menopause as “something you have to go
through” and to view it as a time to reorient and restructure their lives?
A. African Americans
B. Japanese Americans
C. European Americans
D. Urban Latinas
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Answer: D
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5. Which of the following endocrine changes are typical during the last 2 years before the final menstrual
period? (Select all that apply.)
A. Increased testosterone levels
B. Decreased antral follicle count
C. Increased follicle-stimulating hormone levels
D. Decreased progesterone levels
E. Increased estradiol levels
Answer: B, C, D
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6. Sleep disruption, a common symptom during the menopausal transition, is most often associated with
which other perimenopausal symptom?
A. Hot flashes
B. Decline in memory
C. Back pain
D. Depressed mood
Answer: A
7. Which of the following are common symptoms during the menopausal transition? (Select all that apply.)
A. Difficulty concentrating
B. Urinary incontinence
C. Vaginal dryness
D. Increased sexual desire
E. Nausea and vomiting
Answer: A, B, C
8. Which of the following statements is most accurate concerning symptoms of the menopausal transition?
A. Almost all women experience the same set of symptoms, known as menopausal syndrome.
B. Almost all women experience hot flashes, but other symptoms are too variable to predict.
C. Symptoms experienced appear to vary from culture to culture, and thus may be culture bound.
D. Symptoms are completely random, demonstrating no predictable patterns.
Answer: C
B.
C
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9. Which of the following accurately describes metabolic changes in bone, muscle, and fat that typically occur
in the menopausal transition?
A. Increases in bone, muscle, and fat mass
B. Decreases in bone, muscle, and fat mass
C. Increases in muscle and fat mass but a decrease in bone mass
D. Decreases in bone and muscle mass but an increase in fat mass
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Answer: D
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10. Which of the following are characteristics of metabolic syndrome? (Select all that apply.)
A. Increased lipid levels
B. Insulin resistance
C. Decreased inflammatory response
D. Increased risk of thrombosis
E. Increased blood pressure
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Answer: A, B, D, E
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11. The nurse is reviewing assessment and lab results of a patient at risk for metabolic syndrome. Which of the
following findings are consistent with metabolic syndrome? (Select all that apply.)
A. Waist circumference of 37 inches
B. Body mass index (BMI) of 23
C. Blood pressure of 138/86 mmHg
D. Fasting blood glucose level of 99 mg/dL
E. Triglycerides level of 161 mg/dL
Answer: A, C, E
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12. Patricia is a 50-year-old woman with a body mass index (BMI) of 31 and elevated lipid levels. Which of
the following changes would you recommend to promote Patricia’s health?
A. Exercise 60 to 90 minutes per day at moderate intensity, most days
B. Limit alcohol intake to no more than two drinks per day
C. Take omega-3 fatty acid supplements
D. No smoking or use of tobacco
E. Reduce waist circumference to less than 40 inches
Answer: A, C, D
13. Lorraine is a 46-year-old woman who has a body mass index (BMI) of 21 and who is generally healthy.
Based on current recommendations by the National Institutes of Health (NIH), what exercise program
would you suggest to Lorraine to maintain her current level of fitness?
A. None—she is already maintaining her fitness level
B. 20 minutes of light-intensity exercise per day, 3 days per week
C. 30 minutes of moderate-intensity exercise per day, 5 days per week
D. 60 minutes of heavy-intensity exercise per day, 6 days per week
Answer: C
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14. Isadora is a 49-year-old woman with a body mass index (BMI) of 18 and a family history of osteoporosis.
Which of the following health promotion recommendations specifically related to preventing osteoporosis
should the nurse give to Isadora? (Select all that apply.)
A. Take aspirin daily
B. Include plenty of calcium in the diet
C. Consume foods fortified with vitamin D
D. Limit sodium intake
E. Engage in weight-bearing exercise
C
Answer: B, C, E
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Answer: B
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B.
15. How much more likely are women to be diagnosed with depression in their lifetime than men?
A. 60%
B. 70%
C. 80%
D. 90%
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CHAPTER 10
Older Women’s Health
1. How many people in the United States were 65 years or older in 2010?
A. 3.1 million
B. 20.5 million
C. 40.3 million
D. 83.7 million
Answer: C
2. What percentage of those 85 years and older in the United States in 2010 were women?
A. 47%
B. 57%
C. 67%
D. 77%
Answer: C
B.
C
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3. What percentage of women 85 years and older in the United States in 2010 were widowed?
A. 35%
B. 52%
C. 73%
D. 91%
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Answer: C
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4. Compared with older men, older women are: (Select all that apply.)
A. More prepared to retire
B. Less likely to retire at retirement age
C. More likely to have a retirement pension from their employer
D. Less likely to report being satisfied in retirement
E. More likely to live alone
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Answer: B, D, E
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5. In 2030, which of the following is the percentage of the older population (65 years or older) that is
projected to be White?
A. 47%
B. 54%
C. 67%
D. 74%
Answer: A
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6. Which of the following cognition-related capacities typically decline with normal aging? (Select all that
apply.)
A. Motivation
B. Short- and long-term memory
C. Knowledge
D. Learning
E. Wisdom
Answer: A, B, D
7. Daisy, a 77-year-old client, reports a gradual and slight loss of hearing, especially for higher pitched tones.
The nurse should recognize this condition as which of the following?
A. Presbyopia
B. Presbycusis
C. Age-related macular degeneration
D. Otitis media
Answer: B
8. What percentage of cancers are diagnosed at age 55 years or older?
A. 55%
B. 65%
C. 75%
D. 85%
Answer: C
B.
C
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9. Which of the following is the leading cause of cancer death in women?
A. Breast cancer
B. Lung cancer
C. Colorectal cancer
D. Pancreatic cancer
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Answer: B
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10. Mamie is a 76-year-old client who is suspected of having Alzheimer’s disease. To confirm this suspicion,
the nurse should look for impairment in which of the following mental functions? (Select all that apply.)
A. Visual acuity
B. Memory
C. Language
D. Attention
E. Ability to reason
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Answer: B, C, D, E
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11. A phenotype of positive aging that has been described in older women is focused on which of the
following? (Select all that apply.)
A. Presence of chronic disease
B. Physical functioning
C. Presence of a disability
D. Social functioning
E. Emotional functioning
Answer: B, D, E
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12. Which of the following are the benefits associated with weight-bearing aerobic exercise in older women?
(Select all that apply.)
A. Decreased risk for breast cancer
B. Increased bone density
C. Reversal of Alzheimer’s disease symptoms
D. Improved balance
E. Improved insulin resistance
Answer: B, D, E
13. Opal, who is 82 years old, would like information on vaccinations recommended for clients of her age.
Which of the following should the nurse recommend? (Select all that apply.)
A. Annual influenza
B. Human papillomavirus
C. Onetime pneumococcal
D. Hepatitis B
E. Herpes zoster
Answer: A, C, E
14. What percentage of community-dwelling older adults take at least five prescription medications?
A. 29%
B. 39%
C. 49%
D. 59%
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B.
C
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Answer: A
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CHAPTER 11
Well Woman’s Health
1. Gabriella, a 21-year-old new client, just scheduled a well visit for next week. Her English is limited. Which
of the following interventions should the nurse make before and during the office visit to put Gabriella at
ease and provide excellent care? (Select all that apply.)
A. Arrange to have an interpreter present
B. Have the patient undress before the health history interview
C. Sit at eye level and face the patient
D. Include the patient’s boyfriend in the health history interview
E. Begin the interview with some casual conversation
Answer: A, C, E
C
Answer: A, C, D, E
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2. Appropriate topics to include in a patient’s social history include which of the following? (Select all that
apply.)
A. Occupation
B. Income level
C. Diet
D. Exercise
E. Sexual history
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B.
3. Appropriate topics to include in a patient’s medical historyinclude which of the following? (Select all that
apply.)
A. Medications
B. Views on abortion
C. Allergies
D. Surgeries
E. Immunizations
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Answer: A, C, D, E
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4. The primary purpose of the lipid profile assessment is to assess for risk of which of the following?
A. Obesity
B. Coronary heart disease
C. Diabetes
D. Hypertension
Answer: B
5. Mindy is a 35-year-old client with a family history of coronary heart disease and a body mass index (BMI)
of 31. How often should Mindy have a lipid profile assessment performed?
A. Every year
B. Every 5 years
C. Every 7 years
D. Every 10 years
Answer: B
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6. Isabelle is a 25-year-old client with no family history of colorectal cancer. When should the nurse tell
Isabelle to plan to have her first colonoscopy?
A. Age 30 years
B. Age 40 years
C. Age 50 years
D. Age 60 years
Answer: C
7. At what age is it recommended that women undergo their first Pap test?
A. Age 13 years
B. Age 18 years
C. Age 21 years
D. Age 30 years
Answer: C
8. A nurse is conducting a clinical breast exam on a patient. Which findings should the nurse note as unusual
and follow up on? (Select all that apply.)
A. One breast being slightly larger than the other
B. Nipple retraction
C. Puckering
D. Venous patterns
E. Dimpling
Answer: B, C, E
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B.
C
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9. The primary purpose of the bimanual examination is to assess the size, shape, lie, location, mobility, and
tenderness of which of the following? (Select all that apply.)
A. Urethral meatus
B. Uterus
C. Perineum
D. Ovaries
E. Cervix
Answer: B, D, E
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10. A nurse is preparing to conduct a bimanual examination on a client. Which position should the nurse place
the client in?
A. Sitting up
B. Lithotomy
C. Supine
D. Prone
Answer: B
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11. A nurse is preparing to palpate a client’s anus as part of the rectovaginal examination. Which of the
following should the nurse do before initiating this procedure?
A. Ask the client to relax
B. Ask the client to cough
C. Ask the client to move to a prone position
D. Ask the client to bear down
Answer: D
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12. When performing a rectovaginal examination, the nurse should assess for which of the following? (Select
all that apply.)
A. Cervical cell changes
B. Vaginal mucus consistency
C. Polyps
D. Hemorrhoids
E. Tone of the anal sphincter
Answer: C, D, E
13. How often should a woman in her 20s have a Pap test done, assuming she has no increased risk for cervical
cancer?
A. Every year
B. Every 3 years
C. Every 5 years
D. Every 10 years
Answer: B
14. The One Key Question Initiative encourages primary care providers to ask which question to their patients?
A. “Are you currently sexually active?”
B. “Do you practice safe sex?”
C. “Would you like to become pregnant in the next year?”
D. “When was your last Pap test?”
Answer: C
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B.
C
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15. Pelvic and bimanual examinations are indicated before performing which of the following procedures?
(Select all that apply.)
A. Pap test
B. Insertion of an intrauterine device
C. Fitting of a diaphragm
D. An endometrial biopsy
E. A pregnancy test
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Answer: B, C, D
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CHAPTER 12
Mental Health
1. Which of the following is the best definition for mental health, according to an emerging consensus from
research findings?
A. Absence of psychiatric symptoms
B. Well-being
C. Happiness
D. Self-realization
Answer: B
2. The eudaemonic approach to well-being concerns which of the following?
A. Happiness and life satisfaction
B. Financial and material security
C. Physical fitness and health
D. Self-realization and meaning
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Answer: D
Answer: C
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B.
C
3. Phyllis is 55-year-old client who works as a real estate agent while caring for her three teenaged children
and her elderly father. Based on Erikson’s theory of psychosocial development, which of the following is
the developmental crisis Phyllis faces?
A. Intimacy versus isolation
B. Integrity versus despair
C. Generativity versus stagnation
D. Identity versus confusion
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4. Anwara is a 78-year-old client whose husband died 2 years ago. Her daughter and son-in-law, who live in
another state, are urging her to relocate to their area, but Anwara is reluctant to leave the community she
has lived in for over 30 years. Based on Erikson’s theory of psychosocial development, which of the
following is the developmental crisis Anwara faces?
A. Intimacy versus isolation
B. Integrity versus despair
C. Generativity versus stagnation
D. Identity versus confusion
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Answer: B
5. Keiko is a 32-year-old client who recently graduated from medical school and began a residency in
neurosurgery. She loves the career she is embarking on but is single and often feels lonely. Based on Erikson’s
theory of psychosocial development, which of the following is the developmental crisis Keiko faces?
A. Intimacy versus isolation
B. Integrity versus despair
C. Generativity versus stagnation
D. Identity versus confusion
Answer: A
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6. Which of the following living arrangements is most characteristic of individuals in the phase of
psychosocial development known as emerging adulthood?
A. Living independently in a single-family home
B. Changing places of residence frequently
C. Living with a roommate in an apartment
D. Cohabiting with a life partner
Answer: B
7. Anna is a 23-year-old client who operates her own pastry business. Based on her phase of psychosocial
development, Anna is most likely concerned with establishing commitments in which of the following?
(Select all that apply.)
A. Political party identification
B. Caregiving to a spouse or parent
C. Religious beliefs
D. Love relationships
E. Leaving a legacy to the next generation
Answer: A, C, D
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8. Olivia is a junior in college who is struggling to decide on a major. She had been an education major
because her grandmother, mother, and aunt were all teachers, and she looks up to them. But after taking
some introductory-level classes in education, she decided it was just not for her. Now she feels like she is
back to square one, and is considering everything from engineering to photography. What is Olivia’s
current status related to the process of identity formation?
A. Identity diffusion
B. Foreclosure
C. Moratorium
D. Identity achievement
Answer: C
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Answer: D
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B.
C
9. Lulu is a 30-year-old client who recently gave birth to a son. Lulu is passionate about the benefits of
breastfeeding and has spent many hours researching lactation, approaches to breastfeeding, and breast
pumps. Which developmental change is Lulu demonstrating?
A. Cognitive and emotional development
B. Emotional changes and maturation
C. Shift in quality of being
D. Personal agency
Answer: A
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10. Maia is a 47-year-old client who in recent years has become a committed conservationist and is determined
to protect the existence of open lands and wildlife in her region so that her children and later generations
can enjoy the beautiful landscapes she grew with. Maia is demonstrating which quality?
A. Generativity
B. Integrity
C. Autonomy
D. Identity
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11. Denae is a 50-year-old client who identifies herself as a member of a religion primarily because she grew
up in a family and a community that was committed to this belief system. She has never really explored
other belief systems and finds it difficult to explain why she has adopted her religion. Which process of
forming a spiritual identity has Denae most likely chosen?
A. Diffused
B. Foreclosed
C. Achieved
D. Moratorium
Answer: B
12. Nancy is a 47-year-old client who has worked as a stay-at-home mom for the past 20 years, caring for her
three children. As her youngest approaches her senior year in high school, Nancy fears empty nest
syndrome. What actions can she take to ease the transition to the postparental period? (Select all that
apply.)
A. Volunteer with her church’s ministry to the homeless
B. Take classes at a local community college in preparation for starting her own business
C. Encourage her daughter to stay home and attend college locally
D. Take voice lessons with the goal of auditioning for a local choral group
E. Adopt a child from another country
Answer: A, B, D
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13. Gertrude is an 85-year-old client who lives in a long-term care facility. Whenever her grandson visits her,
she delights in telling stories about her performances as an actress on the stage decades ago and,
occasionally, about her regrets related to a failed marriage. Gertrude is engaging in which developmental
process?
A. Identity exploration
B. Social avoidance
C. Life review
D. Normative transition
B.
Answer: C
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14. Sophia is a 78-year-old client who is always upbeat and full of stories about all the accomplishments of her
children and grandchildren. It always seems as if everything goes well with her and her family and that she
never experiences any disappointments or regrets, although you are aware that one of her children recently
divorced and a grandson has been incarcerated. Which integrity status is most appropriate for Sophia?
A. Integrated
B. Pseudointegrated
C. Nonexploratory
D. Despairing
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Answer: B
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15. Maggie is a 67-year-old client who will be retiring in 6 months from the law practice she founded 30 years
ago. She is currently training one of her colleagues to take over her clients and run the practice after she
retires. This strategy for smoothing the transition to retirement is known as which of the following?
A. Instrumental support
B. Identity consolidation
C. Life review
D. Succession planning
Answer: D
36
CHAPTER 13
Nutrition for Women
1. Lipids provide how much energy per gram of lipid?
A. 2 kcal/g
B. 4 kcal/g
C. 9 kcal/g
D. 12 kcal/g
Answer: C
2. Proteins provide how much energy per gram of protein?
A. 2 kcal/g
B. 4 kcal/g
C. 9 kcal/g
D. 12 kcal/g
Answer: B
B.
C
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3. Which of the following is believed to be associated with the onset of puberty?
A. Body fat percentage
B. Height
C. Weight
D. Blood pressure
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Answer: A
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4. Daysha is a 19-year-old woman who has just learned that she is pregnant. Her body mass index (BMI) is
18. She asks the nurse how much weight she should gain during her pregnancy. The nurse should tell her
which of the following?
A. 11 to 20 lb
B. 15 to 25 lb
C. 25 to 35 lb
D. 28 to 40 lb
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Answer: D
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5. Tina is a 25-year-old woman who is moderately active, weighs 122 lb, and normally eats a diet that
provides about 1800 kcal/d, at which level of intake she is able to maintain her weight. Now in her third
trimester of pregnancy, Tina asks her nurse approximately how many kilocalories per day, total, she should
be taking for her and the baby. What should the nurse recommend?
A. 1,800 kcal/d
B. 1,950 kcal/d
C. 2,100 kcal/d
D. 2,250 kcal/d
Answer: D
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6. Miranda is a 39-year-old woman who has just learned that she is pregnant. She has heard that there is an
increased risk for neural tube defects in babies born to women of her age. The nurse should encourage
Miranda to take supplements of which vitamin, which is known to help prevent neural tube defects?
A. Vitamin A
B. Folic acid
C. Vitamin B12
D. Choline
Answer: B
7. Haley is a 16-year-old in her first trimester. The lab results from her first prenatal visit indicate a
hemoglobin level of 9 g/dL. Based on this finding, which mineral supplement should the nurse recommend
to Haley?
A. Calcium
B. Iron
C. Sodium
D. Zinc
Answer: B
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8. During a visit, a patient in her second trimester of pregnancy admits to the nurse that she has had strange
cravings and has even found herself eating dirt from a flowerpot in her home. The nurse should recognize
this condition as which of the following?
A. Pica
B. Food taboo
C. Bulimia
D. Choline
Answer: A
Answer: C
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B.
C
9. Valerie, a woman in her third trimester of pregnancy, is found to have a blood pressure level of 142/93
mmHg. On the basis of this finding, the nurse should recognize that Valerie is at risk for which serious
complication of pregnancy?
A. Gestational diabetes
B. Placenta previa
C. Eclampsia
D. Uterine rupture
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10. Approximately what percentage of adults in the United States are obese?
A. 25%
B. 30%
C. 35%
D. 40%
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Answer: C
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11. In counseling a client who is obese, the nurse should mention which of the following conditions that are
associated with obesity? (Select all that apply.)
A. Hypertension
B. Coronary heart disease
C. Diabetes mellitus
D. Lung cancer
E. Stroke
Answer: A, B, C, E
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12. Cynthia, a 33-year-old client, has just learned that her body mass index (BMI) is 27. What BMI category
applies to Cynthia?
A. Underweight
B. Normal
C. Overweight
D. Obese
Answer: C
13. Octavia is a 15-year-old who has just been diagnosed with bulimia nervosa. Which of the following are
associated with this condition? (Select all that apply.)
A. Binge eating
B. Starvation
C. Self-induced vomiting
D. Excessive use of laxatives
E. Excessive use of diuretics
Answer: A, C, D, E
14. A nurse visits an elementary school classroom, hands out copies of the MyPlate diagram, and talks about
healthy food choices. This is an example of which level of disease prevention?
A. Primary
B. Secondary
C. Tertiary
D. Quaternary
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Answer: A
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Answer: B
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B.
C
15. A nurse visits a large corporate office building and provides free blood pressure screenings to the
employees. This is an example of which level of disease prevention?
A. Primary
B. Secondary
C. Tertiary
D. Quaternary
39
CHAPTER 14
Healthy Practices: Physical Activity
1. Which of the following is known as “Expending energy by using your muscles to move your body”?
A. Physical activity
B. Exercise
C. Fitness
D. Training
Answer: A
2. Which of the following are characteristics of exercise? (Select all that apply.)
A. Unplanned
B. Structured
C. A subset of physical activity
D. Sporadic
E. Performed to maintain physical fitness
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Answer: B, C, E
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B.
C
3. Which of the following are true regarding physical activity? (Select all that apply.)
A. Decreases the risk of cardiovascular disease (CVD) mortality
B. Improves CVD risk factors
C. Increases with age
D. Is performed more by non-White women than White women
E. Is performed more as a leisure activity by women than by men
Answer: A, B
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4. For women, the risk for CVD increases significantly after which age?
A. 45 years
B. 55 years
C. 65 years
D. 75 years
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Answer: B
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5. Raquel is a 43-year-old woman who would like to begin an exercise program. Before encouraging Raquel
to begin the program, the nurse should screen her for risk factors associated with which of the following
conditions? (Select all that apply.)
A. Lung cancer
B. Cardiovascular diseases
C. Mood disorders
D. Respiratory diseases
E. Metabolic diseases
Answer: B, D, E
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6. A client, Tawanda, is preparing to undergo exercise testing by running on a treadmill. Which vital signs
should the nurse monitor before, during, and after the testing? (Select all that apply.)
A. Heart rhythm
B. Temperature
C. Heart rate
D. Blood pressure
E. Oxygen saturation level
Answer: A, C, D
7. The nurse is helping a client, Belinda, develop an exercise program. Which of Belinda’s characteristics
should the nurse take into account while developing the program?
A. Ethnicity
B. Age
C. Fitness level
D. Capabilities
E. Preferences
Answer: B, C, D, E
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8. The nurse has developed an exercise program for a client, Candace, to help her prepare for a long charity
bike ride, which will occur in a couple of months. The program includes strenuous cycling for 1 hour, 5
days a week (Tuesday through Saturday) for the first week, and then adding an hour to her Saturday ride
each subsequent week while keeping the other days the same for the next 7 weeks. What is the progression
of Candace’s program?
A. 1 hour
B. 5 days a week
C. Strenuous
D. Adding an hour on Saturdays each week
C
Answer: D
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Answer: A
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B.
9. A nurse would like to measure a client’s flexibility. Which exercise should the nurse have the client
perform for this assessment?
A. Sit-and-reach
B. Sit-up
C. Push-up
D. Pull-up
Answer: A, B, D, E
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10. Zoe is a college athlete who would like to decrease her body fat percentage to improve her performance.
The nurse should mention which of the following as methods of assessing body composition?
A. Hydrostatic weighing
B. Air displacement plethysmography
C. Goniometer
D. Body mass index
E. Skinfold measurement
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11. Muriel is a client who is planning on beginning a weight-lifting exercise program soon. She asks the nurse
whether this type of exercise would help improve her lipid levels. The nurse should point out that,
according to research, resistance training has been shown to have what significant effect on lipids?
A. Decreases triglycerides
B. Decreases total cholesterol
C. Increases high-density lipoprotein (HDL) cholesterol
D. Decreases low-density lipoprotein (LDL) cholesterol
Answer: D
12. Kathy is a client who is beginning a new jogging regimen to improve her health. What effects of exercise
related to blood pressure should the nurse mention to Kathy? (Select all that apply.)
A. Decreases blood pressure
B. Remodels the vasculature
C. Increases the number of veins
D. Decreases the number of capillaries
E. Enlarges the arteries
Answer: A, B, E
13. What are the three performance-related components of fitness?
A. Agility
B. Balance
C. Body composition
D. Flexibility
E. Coordination
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Answer: A, B, E
Answer: A
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B.
C
14. Edie is a young, healthy client with a family history of osteoporosis who would like to begin an exercise
program that will help maintain her bone mass and avoid this disease. Which exercise would be best for
Edie?
A. Jogging
B. Swimming
C. Paddling a canoe
D. Water aerobics
Answer: B, E
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15. Lilith is a 30-year-old client who exercises regularly. She has just learned that she is pregnant and asks the
nurse whether it is safe to continue exercising during her pregnancy. Which of the following
recommendations should the nurse give her? (Select all that apply.)
A. Avoid any exercise after the first trimester
B. Aim for 30 min/d of moderate exercise most days of the week
C. Avoid the side-lying position after the first trimester
D. Consider rugby
E. Consider water aerobics
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CH A P T E R 1 5
Healthy Practices: Sleep
1. According to the American Academy of Sleep Medicine, adults 18 to 60 years of age should obtain at least
how many hours of sleep per night?
A. 6
B. 7
C. 8
D. 9
Answer: B
2. Insufficient sleep has been linked to which of the following? (Select all that apply.)
A. Obesity
B. Enhanced job performance
C. Diabetes
D. Higher risk for injury
E. Daytime hyperactivity
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Answer: A, C, D
Answer: A
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B.
C
3. Abbey, a 28-year-old client, has noted that she grows sleepier and sleepier the longer she stays up past 11
p.m. This is an example of which of the following?
A. Homeostatic control
B. Circadian control
C. Sympathetic nervous system control
D. Narcolepsy
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4. Which of the following factors link circadian control of sleep and wake cycles with the environment?
(Select all that apply.)
A. Sound
B. Light
C. Physical activity
D. Melatonin
E. Caffeine
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Answer: B, C, D
5. Approximately how many complete sleep cycles does the average person go through in a full night of
sleep?
A. 3
B. 5
C. 7
D. 9
Answer: B
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6. By what age is the monophasic pattern of one long sleep episode at night fully developed?
A. 7 years
B. 10 years
C. 13 years
D. 16 years
Answer: B
7. Which method of sleep assessment measures brain waves, muscle tone, and eye movements during sleep?
A. Sleep physiology assessment
B. Wrist actigraphy
C. Video observation of sleeping behavior
D. Daily sleep log
Answer: A
8. Which of the following are tips for ritualizing cues for sleep? (Select all that apply.)
A. Use your bedroom only for sleep
B. Keep your bedroom well-lit and warm at night
C. Go to bed only when you are sleepy
D. If you haven’t fallen asleep in 20 minutes, get up and do something else
E. Sleep in a different room of the house each night
Answer: A, C, D
B.
Answer: A, B, D
C
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9. Which of the following should you avoid right before going to bed? (Select all that apply.)
A. Eating a heavy meal
B. Drinking coffee
C. Taking a short walk around your neighborhood
D. Smoking a cigarette
E. Having a glass of milk
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10. Which of the following should you do to regularize your sleep–wake rhythm? (Select all that apply.)
A. Define your optimal sleep length
B. Catch up on missed sleep over the weekend
C. Vary your bedtime by an hour or so each night
D. Get up at the same time every morning
E. Limit napping to 15 to 20 minutes during the day
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Answer: A, D, E
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CHAPTER 16
Genetics and Women’s Health
1. In which year was the structure of nucleic acid described?
A. 1794
B. 1869
C. 1965
D. 2010
Answer: B
2. In which year was the mapping of the human genome completed?
A. 1989
B. 1993
C. 2003
D. 2012
Answer: C
B.
C
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3. Essential genetic and genomic competencies for nursing were first published in which year?
A. 1995
B. 2006
C. 2009
D. 2013
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Answer: B
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4. Epigenetic influences are those that affect health and risk, and result from interactions among which of the
following? (Select all that apply.)
A. Shared genes
B. Behaviors
C. Nursing staff
D. Cultures
E. Environments
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Answer: A, B, D, E
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5. Which of the following is true of gender?
A. Same in every culture
B. Determined by genitalia
C. Socially constructed
D. Determined by chromosomes
Answer: C
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6. Dylan, a 17-year-old boy who was just in a car accident and experienced major trauma, is now in the
emergency room and stable. He is in too much pain to respond coherently to questions regarding his family
health history (FHH). His family and friends are with him in the room. Who is the person most likely to be
able to provide the nurse with detailed and accurate FHH information on Dylan’s behalf?
A. His 16-year-old girlfriend of 6 months
B. His 41-year-old aunt, with whom he has lived since he was 8 years old
C. His 35-year-old mother, whom he sees two or three times per year
D. His 43-year-old uncle, with whom he has lived since he was 8 years old
Answer: B
7. Family health history is a significant risk factor in which of the following conditions? (Select all that
apply.)
A. Traumatic spinal cord injury
B. Heart disease
C. Diabetes
D. Cancer
E. HIV
Answer: B, C, D
8. Which of the following is the most consistent disease risk factor across the life span?
A. Obesity
B. Smoking
C. Age
D. Family health history
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Answer: D
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B.
C
9. What factors allowed the Precision Medicine Initiative to be undertaken? (Select all that apply.)
A. The discovery of penicillin
B. The sequencing of the human genome
C. Improved technology for biomedical analyses
D. The advent of smart phones
E. New tools for using large data sets
Answer: B, C, E
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10. Which of the following is the primary cause for incomplete family health histories being taken by nurses?
A. Incompetent training
B. Uncooperative clients
C. Time constraints of clinical practice
D. Lack of effective tools
Answer: C
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11. For a family health history tool to meet the gold standard for clinical practice, it must allow the collection
of which of the following information? (Select all that apply.)
A. Year born for each family member
B. Place of residence for each family member
C. Information for three generations of biological relatives
D. Age at diagnosis for each family member
E. Age and cause of death for each family member
Answer: C, D, E
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12. Which of the following are topics included among the genetic and genomic competencies for advanced
practice nursing? (Select all that apply.)
A. Lifestyle modification
B. Risk assessment and interpretation
C. Nutrition education
D. Clinical management
E. Research
Answer: B, D, E
13. Pedigrees are graphic displays of family health history that reveal which of the following? (Select all that
apply.)
A. Influence of heredity on disease
B. Influence of environment on disease
C. How genetic traits are passed along within a family
D. The etiology of common infectious diseases
E. The number of incidences of an individual trait within a family
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B.
C
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Answer: A, B, C, E
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CHAPTER 17
Women and the Workplace
1. Which historical event most contributed to a rapid increase in workplace injuries?
A. The Renaissance
B. The Cold War
C. The Industrial Revolution
D. The Great Depression
Answer: C
2. A nurse is leading a smoking cessation program in the health clinic of a large corporation. This is an
example of which level of prevention?
A. Primary
B. Secondary
C. Tertiary
D. Quaternary
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Answer: A
Answer: C
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B.
C
3. A nurse refers a client injured at work to a physical therapist, who will help the client regain the range of
motion needed in the right knee to be able to return to work. This is an example of which level of
prevention?
A. Primary
B. Secondary
C. Tertiary
D. Quaternary
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4. A nurse is providing free blood pressure screening at a community health clinic. This is an example of
which level of prevention?
A. Primary
B. Secondary
C. Tertiary
D. Quaternary
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Answer: B
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5. Exposure to which workplace substance can cause respiratory system irritation in the short term and
mesothelioma in the long term?
A. Hydrochloric acid
B. Pesticide
C. Benzene
D. Asbestos
Answer: D
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6. Exposure to which workplace substance can cause skin and respiratory system irritation in the short term
and sensitization and allergic responses in the long term and is frequently encountered by laboratory
workers?
A. Hydrochloric acid
B. Pesticide
C. Benzene
D. Asbestos
Answer: A
7. The Occupational Safety and Health Administration (OSHA) limits workplace noise to what level over the
course of an 8-hour workday?
A. 70 dBA
B. 80 dBA
C. 90 dBA
D. 100 dBA
Answer: C
8. Darla is a client who works as a power line technician. She arrives at the health clinic complaining of
headaches, fatigue, dizziness, and increased sensitivity to light and sound. She says her vision has begun to
get blurry, as well. The nurse should suspect that Darla has been exposed to which workplace hazard?
A. Noise
B. Heat
C. Ionizing radiation
D. Nonionizing radiation
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Answer: D
Answer: A
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B.
C
9. Bailey is a client who works as a forklift operator in a warehouse, which she describes as dark, dank, and
musty. She says she has started having sneezing fits at work and itchy, burning eyes. Which workplace
culprit should the nurse suspect in Bailey’s case?
A. Mold
B. Asbestos
C. Silica
D. Lead
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10. Which of the following are examples of psychosocial stressors in the workplace? (Select all that apply.)
A. Having an unreasonably heavy workload
B. Working back-to-back 12-hour shifts 10 days in a row
C. Having a boss who doesn’t communicate expectations
D. Working in 100°F heat
E. Working in a building containing asbestos materials
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Answer: A, B, C
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11. Which of the following is an example of a class of hazardous drug that health care workers are likely to
encounter?
A. Methylxanthines
B. Antineoplastic cytotoxics
C. Monoamine oxidase inhibitors
D. Proton pump inhibitors
Answer: B
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12. Connie is a client who was recently injured while working as an electrician on a job site. As part of her job,
she has workers’ compensation insurance. The nurse recognizes that this type of insurance covers which of
the following? (Select all that apply.)
A. Repairs to her car in the event of a wreck while driving to the grocery store
B. Replacement of wages she lost as a result of her work-related injury
C. A disability pension, should she be unable to return to work
D. Survivor benefits to her children should she die as a result of her injury
E. Coverage of her hospital stay as a result of her work-related injury
Answer: B, C, D, E
13. Chronic disability claims constitute what percentage of all disability claims?
A. 50%
B. 60%
C. 70%
D. 80%
Answer: D
14. Which of the following is an example of primary prevention in the hospital setting?
A. Use of masks, gloves, and gowns when cleaning up patient’s blood
B. Requiring hospital staff to undergo hepatitis B screening every year
C. Encouraging employees to undergo cholesterol screening
D. Providing an office worker with carpal tunnel syndrome an ergonomic keyboard to help prevent further
injury
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Answer: A
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B.
C
15. Which of the following are functions of OSHA? (Select all that apply.)
A. Reviewing and approving new drugs
B. Establishing federal guidelines and standards for occupational safety and health
C. Inspecting work sites to ensure compliance with regulations
D. Ensuring that food products are safe and properly labeled
E. Establishing permissible exposure limits for workplace chemicals
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Answer: B, C, E
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CHAPTER 18
Health Considerations for Women Caregivers
1. Which of the following provide care to people who are ill or need help with their activities of daily living,
are more likely to be women than men and contribute 1.2 billion unpaid hours each year?
A. Nurses
B. Physicians
C. Hospice workers
D. Informal caregivers
Answer: D
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2. Nadine is a 50-year-old single mother who is experiencing tremendous stress related to the conflict between
her obligations to her teenaged children, whom she is raising, and her aging mother, who was just
diagnosed with Alzheimer’s disease. This condition is known as which of the following?
A. Strain
B. Depression
C. Bipolar disorder
D. Panic disorder
Answer: A
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B.
C
3. A nurse is assessing the emotional health of a client who is a caregiver to her 92-year-old husband. Which
conditions should the nurse specifically assess for? (Select all that apply.)
A. Caregiver stress
B. Bipolar disorder
C. Anxiety
D. Agoraphobia
E. Depression
Answer: A, C, E
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4. A caregiver who is providing care for which of the following would be at an increased risk for developing
health problems? (Select all that apply.)
A. A spouse with dementia
B. A father who requires assistance with toileting and bathing
C. A son with autism who is physically combative
D. A mother who is recovering from a bout of pneumonia
E. A sister who is undergoing chemotherapy for breast cancer
Answer: A, B, C
5. Which of the following components are included in the Caregiver Mastery Scale? (Select all that apply.)
A. Relational deprivation
B. Formal health care training
C. Economic strains
D. Role captivity
E. Caregiving competence
Answer: A, C, D, E
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6. A nurse is assessing a caregiver’s readiness for caregiving. Which of the following must the caregiver be
capable of, to be considered ready to provide care? (Select all that apply.)
A. Meet patient’s physical and emotional needs
B. Perform cardiopulmonary resuscitation
C. Handle emergencies
D. Administer an intravenous injection
E. Manage caregiving stress
Answer: A, C, E
7. Constance is a 65-year-old client who is a caregiver for her 89-year-old father, who has Alzheimer’s
disease. Which interventions should the nurse facilitate on behalf of Constance, to support her as she cares
for her father? (Select all that apply.)
A. Behavior analysis
B. Family therapy
C. Building Family Strengths program
D. Cognitive reframing
E. Respite care
Answer: A, D, E
B.
Answer: A, D
C
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8. Amy is a 59-year-old client who is providing care for her partner, who is dying of amyotrophic lateral
sclerosis and is receiving hospice care. The nurse can tell that Amy is incrediblytense and anxious and tries
to convince her take breaks from her partner’s side and get some rest, but Amy refuses. What interventions
would be especially appropriate for Amy? (Select all that apply.)
A. Grief counseling
B. Family therapy
C. Cognitive reframing
D. Group interventions to provide peer support
E. Behavior analysis
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9. Laura is a 43-year-old client who is providing care to her 13-year-old son, Jake, who has acute
myelogenous leukemia. Jake is angry about his condition and resists going to his chemotherapy treatments.
Laura is distraught because she does not know how to manage Jake’s behavior. What interventions would
be best for Laura? (Select all that apply.)
A. Building Family Strengths curriculum
B. Cognitive behavioral therapy
C. Family therapy
D. Grief counseling
E. Problem-solving therapy
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Answer: A, B, C, E
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10. Marcia is a 52-year-old client who is a caregiver to her son, who has severe intellectual disability. Marcia
admits that she has neglected eating a healthy diet due to her caregiving responsibilities and would like to
make a change. Which of the following foods should the nurse encourage Marcia to include in her diet?
(Select all that apply.)
A. Whole milk
B. Lean proteins
C. Fruits
D. Vegetables
E. Baked goods
Answer: B, C, D
52
CHAPTER 19
Women’s Sexual Health
1. Which of the following are dimensions of sexuality? (Select all that apply.)
A. Sexual desire
B. Sexual identity
C. Ethnic identity
D. Presentation of self
E. Desire for achievement
Answer: A, B, D
2. Sexual health requires which of the following? (Select all that apply.)
A. A body mass index (BMI) of 18 to 24.9
B. Awareness and acceptance of one’s body
C. Sexual intercourse two to three times per week
D. The possibility of pleasurable, safe sexual experiences
E. The absence of any sexually transmitted infection
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Answer: B, D, E
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B.
C
3. Which of the following are characteristics of women’s sexual response? (Select all that apply.)
A. Highly consistent among a woman’s life stages
B. Highly variable among different women
C. Expectations and perceptions influenced by culture
D. A complex interplay of psychological, physiological, and interpersonal components
E. Unaffected by religious beliefs
Answer: B, C, D
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4. The Masters and Johnson model of human sexual response developed in the 1960s included which series of
phases?
A. Excitement, plateau, orgasm, resolution
B. Desire, excitement, orgasm
C. Neutrality, awareness of nonsexual need to be sexual, choice to be stimulated, some sexual arousal, sexual
desire, more arousal, physical well-being, spin-offs
D. Neutrality, desire, excitement, plateau, orgasm, resolution
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Answer: A
5. The Kaplan model of human sexual response included which series of phases?
A. Excitement, plateau, orgasm, resolution
B. Desire, excitement, orgasm
C. Neutrality, awareness of nonsexual need to be sexual, choice to be stimulated, some sexual arousal, sexual
desire, more arousal, physical well-being, spin-offs
D. Neutrality, desire, excitement, plateau, orgasm, resolution
Answer: B
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6. Basson’s model of female sexual response is based on which of the following premises?
A. Women and men experience the same cycle of sexual response.
B. Desire is a critical first step in the sexual response cycle.
C. Women can enter into sexual activity for reasons other than innate desire.
D. Female sexual response follows a linear biologic progression.
Answer: C
7. According to a study by Robbins et al., what percentage of 17-year-old females reported of ever having
masturbated?
A. 28%
B. 38%
C. 48%
D. 58%
Answer: D
8. Although there is variation, during what phase of life is it most likely that females, particularlylesbians,
will establish their sexual orientation?
A. Childhood
B. Adolescence
C. Adulthood
D. Midlife
Answer: C
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Answer: D
B.
C
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9. The nurse is conducting a sexual assessment on Pamela, a 50-year-old woman. On asking whether Pamela
is involved in a sexual relationship, Pamela says “yes.” Which follow-up question would be most
appropriate for the nurse to ask next?
A. “Are you married?”
B. “Are you and your husband satisfied with your sex life?”
C. “Who are you having sex with?”
D. “Are you involved in a sexual relationship with men, women, or both?”
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10. The nurse is conducting a sexual assessment with Wendy, a 16-year-old client, who appears nervous. The
nurse sees on Wendy’s questionnaire that her period is a week later than usual. What would be the most
effective way for the nurse to begin the conversation with Wendy?
A. “Many young women your age experience irregular periods for different reasons. Is this something you
are experiencing?”
B. “So, I see that your period is late. Do you think you are pregnant?”
C. “Have you been using condoms when you have sex with your boyfriend?”
D. “Don’t worry. It’s highly unlikely that you are pregnant, only being a week late.”
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Answer: A
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11. In the PLISSIT (permission, limited information, specific suggestions, and intensive therapy) model of
sexual health care interventions, the first step is which of the following?
A. Perform a Pap smear
B. Palpate the client’s abdomen
C. Ask about the patient’s past medical history
D. Ask permission to discuss sexual function
Answer: D
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12. When conducting a sexual assessment with a client, Ellie, the client gets angry and says that her partner is
always so selfish and is only concerned with her own sexual needs. She relates a string of recent
experiences with her partner and then says, “What do you think I should do?” Which of the following
would be the most appropriate response for the nurse to give?
A. “I agree that your partner is being selfish. You might consider breaking up with her.”
B. “Why don’t we schedule a follow-up appointment with you and your partner so that we can discuss this
together.”
C. “When my husband is being selfish, I just refuse to have sex with him. Maybe you should do the same.”
D. “Let me refer you to a good sex therapist I know. She is better trained to provide the kind of care you
require.”
Answer: D
13. A patient reports chronic pain in the vulvar area that has persisted for 4 months. The nurse recognizes this
condition as which of the following?
A. Vulvodynia
B. Vestibulodynia
C. Dyspareunia
D. Genitopelvic pain/penetration disorder
Answer: A
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14. A patient reports experiencing fear and anxiety just before having intercourse related to the pain she
anticipates experiencing. She also reports feeling uncomfortable tension in her pelvic floor muscles during
intercourse. The nurse recognizes this condition as which of the following?
A. Vulvodynia
B. Vestibulodynia
C. Dyspareunia
D. Genitopelvic pain/penetration disorder
C
Answer: D
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Answer: C
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B.
15. A nurse is counseling a 15-year-old client whose boyfriend wants her to try drinking a couple of beers
before they have sex. Which of the following effects of alcohol use on sexual function should the nurse
mention to the client?
A. An intensified orgasm for both her and her boyfriend
B. Increased fear and anxiety about having sex
C. Increased risk taking in sex, such as not using a condom
D. Increased vaginal lubrication
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CHAPTER 20
Primary Care of Lesbian, Gay, Bisexual,
and Transgender Individuals
1. The primary cause of health disparities among lesbian, gay, bisexual, and transgender (LGBT) individuals
is believed to be which of the following?
A. Lack of awareness of need for care
B. Increased genetic risk
C. Hormonal changes
D. Societal stigma and marginalization
Answer: D
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2. LGBT persons are believed to comprise what percentage of the population?
A. 1% to 2.5%
B. 3.8% to 10%
C. 10.3% to 15.8%
D. 16.1% to 21.7%
Answer: B
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B.
C
3. A nurse practitioner recently joined a practice with a diverse clientele, including persons of all sexual
orientations and gender identities. How should the nurse approach these clients? (Select all that apply.)
A. Avoid bringing up sexual orientation or gender identity
B. Ask all clients openly about their sexual orientation and gender identity
C. Assume all clients are heterosexual and cisgender unless they say otherwise
D. Personalize care based on relevant risk factors and individual patient behaviors
E. Base treatment plans on risk factors associated with a person’s sexual orientation
Answer: B, D
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4. What is the prevalence of gender dysphoria in the United States?
A. 5%
B. 3%
C. 1%
D. Unknown
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Answer: D
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5. Which of the following is the most accurate statement regarding the etiology of homosexuality?
A. It is a genetic trait
B. It is determined by hormone levels
C. It is likely a combination of nature and nurture
D. It is a social construct
Answer: C
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6. What was the last year that homosexuality appeared as a pathological condition in the Diagnostic and
Statistical Manual of Mental Disorders (DSM)?
A. 1963
B. 1973
C. 1983
D. 1993
Answer: B
7. Melissa is a 62-year-old lesbian client. On the basis of her age and sexual orientation, Melissa is more
likely to do which of the following? (Select all that apply.)
A. Live alone
B. Have HIV
C. Lack family support for meeting basic needs
D. Fear discrimination when accessing medical services
E. Be homeless
Answer: A, C, D
8. What condition related to gender identity is included in the Diagnostic and Statistical Manual of Mental
Disorders, fifth edition (DSM-5)?
A. Gender dysphoria
B. Gender identity disorder
C. Transgender disorder
D. Body dysmorphic disorder
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Answer: A
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B.
C
9. Jackie is a 19-year-old transwoman who has arrived at the office today for a physical. What health
disparities should the nurse assess for in Jackie? (Select all that apply.)
A. Risky sexual behaviors
B. Depression
C. Multiple sclerosis
D. Trauma and violence
E. Substance abuse
Answer: A, B, D, E
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10. Meg is a 15-year-old bisexual client. Which of the following is Meg at a greater risk for than her
heterosexual counterparts? (Select all that apply.)
A. Spinal cord injury
B. Experiencing school bullying
C. Bipolar disorder
D. Homelessness
E. Suicidality
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Answer: B, D, E
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CHAPTER 21
Fertility Self-Management and Shared Management
1. Who opened the first birth control clinic in the United States in 1916, became an international leader of the
birth control movement, and helped establish the organization that would become Planned Parenthood?
A. Havelock Ellis
B. C. V. Drysdale
C. Margaret Sanger
D. Dorothy Bocker
Answer: C
2. The Kinsey Report, which revealed that some women masturbated, had premarital sexual experiences, and
were orgasmic, was published in which year?
A. 1943
B. 1953
C. 1963
D. 1973
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Answer: B
Answer: D
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B.
C
3. Among women aged 15 to 44 years who reported (from 2006 to 2010) being sexually active during their
lifetimes, what percentage said they had experienced some form of contraception?
A. 69.1%
B. 79.1%
C. 89.1%
D. 99.1%
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4. Among women who report using contraception, which form is the most commonly used?
A. Male condoms
B. Oral contraceptives
C. Withdrawal
D. Diaphragm
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Answer: A
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5. Cecilia, a 35-year-old client who is Roman Catholic, tells her nurse that she uses a natural method of
contraception, in which she closely monitors changes in her cervix, cervical mucus, and temperature to
determine when she is ovulating so that she can abstain from sexual intercourse during that time and avoid
conceiving. The nurse recognizes that Cecilia is using which method of contraception?
A. Cervical mucus
B. Basal body temperature
C. Symptothermal
D. Lactational amenorrhea
Answer: C
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6. During an office visit with an 18-year-old client named Kimberly, the nurse asks whether she is using any
form of birth control. Kimberly responds that she is currently breastfeeding her 6-month-old, so she doesn’t
need to be on birth control. The nurse recognizes that Kimberly is relying on which type contraception?
A. Abstinence
B. Tubal ligation
C. Symptothermal
D. Lactational amenorrhea
Answer: D
7. The nurse is reviewing contraception options for Olivia, a 37-year-old client who gave birth 3 weeks ago.
Olivia is interested in trying a combined oral contraceptive (COC) but is not sure whether it would be safe
for her. Which of the following would be contraindications for Olivia beginning COCs now, given her
situation? (Select all that apply.)
A. Breastfeeding
B. Smoking
C. History of irregular menses
D. Family history of ovarian cancer
E. Current breast cancer
Answer: A, B, E
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8. What two hormones are typically included in combined oral contraceptives (COCs)?
A. Estrogen and aldosterone
B. Testosterone and progesterone
C. Cortisol and progesterone
D. Estrogen and progesterone
Answer: D
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B.
C
9. Molly, a 22-year-old client, is planning on beginning a combined oral contraceptive (COC). The nurse
should inform Molly about which of the following common side effects of COCs which should cause her
no concern unless they persist or worsen? (Select all that apply.)
A. Chest pain
B. Shortness of breath
C. Breakthrough bleeding
D. Nausea
E. Mild headaches
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Answer: C, D, E
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10. April is a 24-year-old client who has recently become sexually active with multiple partners. She knows
she has been taking too many risks in her sexual encounters and would like to begin using contraception.
She is also concerned about acquiring a sexually transmitted infection. Which method of contraception
should the nurse recommend to April?
A. Male condom
B. Injectable depot medroxyprogesterone acetate (DMPA)
C. Nexplanon
D. Intrauterine device
Answer: A
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11. Valerie is a 39-year-old client with four children who says she and her husband have decided that their
family is complete and that they would like to consider a contraceptive option that is relativelypermanent
and has the lowest failure rate possible. Both she and her husband are open to undergoing procedures,
although they would prefer an option with as little risk of complications as possible. Which contraception
method should the nurse recommend?
A. Tubal ligation
B. Vasectomy
C. Transcervical sterilization
D. Diaphragm
Answer: B
12. Lindsey is an 18-year-old client who arrives at the community health clinic in a panic because she had sex
with her boyfriend last night and forgot to use a condom. She is worried about getting pregnant. Which of
the following are emergency contraception options that the nurse should mention to Lindsey? (Select all
that apply.)
A. Contraceptive sponge
B. Levonorgestrel
C. Ulipristal
D. Contraceptive patch
E. Copper intrauterine device
Answer: B, C, E
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13. Which of the following is the least effective barrier method of contraception?
A. Male condom
B. Female condom
C. Diaphragm
D. Contraceptive sponge
C
Answer: D
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Answer: B
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B.
14. Lakesha is a 27-year-old client who has decided to begin receiving injectable depot medroxyprogesterone
acetate (DMPA) for contraception. She asks the nurse how often she will have to come in to receive the
injections. Which of the following should the nurse tell Lakesha?
A. Every 6 weeks
B. Every 12 weeks
C. Every 24 weeks
D. Every 36 weeks
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15. Monica has decided to have a copper intrauterine device placed to meet her contraception needs. She asks
the nurse how long it is safe for the device to remain in her. The nurse should explain that it has been
approved for use for up to how long?
A. 1 year
B. 3 years
C. 5 years
D. 10 years
Answer: D
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CHAPTER 22
Preconception Counseling
1. The fetus is most susceptible to birth defects during which period of gestation?
A. Weeks 1 to 3
B. Weeks 4 to 10
C. Weeks 11 to 20
D. Weeks 31 to 30
Answer: B.
2. Toxins that primarily affect a pregnancy in the embryonic stage (up to 8 weeks of gestation) are known as
which of the following?
A. Teratogens
B. Fetotoxins
C. Carcinogens
D. Neurotoxicants
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Answer: A.
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B.
C
3. Which of the following are the examples of fetotoxins? (Select all that apply.)
A. Nicotine
B. Cocaine
C. Class D prescription medications
D. Class X prescription medications
E. Angiotensin-converting enzyme (ACE) inhibitors
Answer: A, B, E
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4. Which of the following are factors that affect the level of toxicity of a teratogen? (Select all that apply.)
A. Maternal age
B. Genotype susceptibility
C. Timing of exposure
D. Agent
E. Dose effect
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Answer: B, C, D, E
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5. Approximately what percentage of pregnant women are estimated to smoke during their pregnancy?
A. 3%
B. 9%
C. 15%
D. 21%
Answer: B
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6. Which of the following is the leading preventable cause of birth defects and congenital disabilities?
A. Obesity
B. Smoking
C. High-fat diet
D. Alcohol use
Answer: D
7. Which of the following are neurotoxicants that can cause birth defects in fetuses? (Select all that apply.)
A. Zinc
B. Iron
C. Lead
D. Copper
E. Mercury
Answer: C, E
8. Dara, a 30-year-old client, reports to her nurse that she has been feeling sick ever since she began a job at a
manufacturing plant, where she is exposed to chemicals used in making plastics. What interventions should
the nurse make? (Select all that apply.)
A. Request a Material Safety Data Sheet from Dara’s employer
B. Urge Dara to quit her job immediately
C. Encourage Dara to report her concern to her employer
D. Contact the local hazard evaluation service
E. Give Dara a surgical mask to wear at work
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Answer: A, C, D
Answer: B
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B.
C
9. Lonnie is a 28-year-old client who is trying to get pregnant. What supplement should the nurse encourage
Lonnie to take to help prevent a neural tube defect in her future fetus?
A. Ascorbic acid
B. Folic acid
C. Niacin
D. Biotin
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10. While providing preconception counseling to a client, the nurse mentions the importance of preventing
neural tube defects. What risk factors related to neural tube defects should the nurse discuss with the client?
(Select all that apply.)
A. Smoking
B. Obesity
C. Diabetes
D. Convulsant disorders
E. Alcohol use
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Answer: B, C, D
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11. Jan, a client who is receiving preconception counseling, is suspected of having diabetes. Which laboratory
test should be requested to assess for diabetes?
A. Red blood cell count
B. Hemoglobin A1C
C. International normalized ratio
D. Platelet count
Answer: B
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12. Philomena is a client who is in for preconception counseling. She is HIV-positive and is taking
antiretroviral medications. She is concerned about the possibility of transmitting the virus to her child. The
nurse should inform Philomena that the risk for transmission to the infant in this situation is which of the
following?
A. Less than 1%
B. 5% to 10%
C. 15% to 20%
D. 25% to 30%
Answer: A
13. Which condition that is caused by a dysfunction in the metabolism of an amino acid, resulting in a high
level of this amino acid in the body is screened for before pregnancy?
A. Toxoplasmosis
B. Phenylketonuria
C. Listeriosis
D. Tay-Sachs
Answer: B
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14. Nancy is a client who is in the office for preconception counseling. Nancy is a cat lover and always has five
or six cats at her apartment. “I spend a fortune on kitty litter,” she tells her nurse. The nurse recognizes that
Nancy’s fondness for cats puts her at increased risk for which of the following conditions?
A. Toxoplasmosis
B. Phenylketonuria
C. Listeriosis
D. Tay-Sachs
Answer: A
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B.
C
15. Which of the following are genetic conditions a woman may be screened for before conception? (Select all
that apply.)
A. Spina bifida
B. Down syndrome
C. Toxoplasmosis
D. Tay-Sachs
E. Sickle cell anemia
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Answer: A, B, D, E
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CHAPTER 23
Prenatal Care and Anticipating Birth
1. When is the typical onset for the nausea and vomiting of pregnancy?
A. 1 to 4 weeks
B. 5 to 9 weeks
C. 10 to 14 weeks
D. 15 to 19 weeks
Answer: B
2. Nadine, a 31-year-old client, arrives at her prenatal care appointment complaining of nausea and vomiting,
which she has experienced every morning for the past couple of weeks. What complication associated with
this condition should the nurse assess for?
A. Hemorrhage
B. Hypertension
C. Infection
D. Dehydration
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Answer: D
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B.
C
3. Wanda, a client near the end of her first trimester of pregnancy, complains to her nurse of a burning
sensation in her chest, constant belching, and an acid taste in her mouth. What interventions should the
nurse suggest to Wanda to address these symptoms? (Select all that apply.)
A. Avoid coffee
B. Take antacids
C. Eat just before going to bed
D. Elevate the head of the bed
E. Avoid spicy foods
Answer: A, B, D, E
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4. Juanita, a client in her third trimester, is complaining of back pain. What interventions should thenurse
recommend to Juanita? (Select all that apply.)
A. Taking a yoga class
B. Wearing flip-flops
C. Switching to a softer mattress
D. Receiving a massage
E. Applying a heating pad to the back
Answer: A, D, E
5. Sleep disturbance is experienced by what percentage of women during pregnancy?
A. 67%
B. 77%
C. 87%
D. 97%
Answer: D
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6.
Ruth, a client in her second trimester of pregnancy, complains of difficulty falling asleep at night, waking
in the middle of the night and not being able to return to sleep, and a low energy level during the day.
When the nurse asks whether Ruth knows what could be contributing to the insomnia, she is not sure.
Which intervention should the nurse take next?
A. Recommend that she get a continuous positive airway pressure (CPAP) mask
B. Write her a prescription for codeine
C. Ask her to begin keeping a sleep diary
D. Suggest that she elevate the head of her bed
Answer: C
7.
A client, Melinda, near the end of her third trimester says that in the past few weeks she has become short
of breath when going up and down stairs. Melinda is 24-years-old and in good health. Which of the
following would be the most appropriate response by the nurse?
A. Perform an electrocardiogram to rule out heart disease
B. Prescribe an inhaler with a corticosteroid medication
C. Advise her to take short breaks when she is out of breath
D. Draw up an exercise plan for her to help improve her cardiovascular fitness
Answer: C
8.
What interventions should the nurse take at every prenatal visit? (Select all that apply.)
A. Take vital signs
B. Perform a pelvic exam
C. Listen to fetal heart tones
D. Take a complete health history
E. Assess for signs of depression and domestic violence
Eliza gave birth 5 weeks ago and is now undergoing her postpartum visit. What screening is most important
for Eliza to undergo at this visit?
A. Depression
B. Fetal aneuploidy
C. HIV
D. Rh antibody
Answer: A
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B.
C
9.
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Answer: A, C, E
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10. The nurse is screening a client at her first prenatal visit for risk factors related to diabetes mellitus. Which
of the following should the nurse look for? (Select all that apply.)
A. Vegetarian diet
B. Native American ethnicity
C. Lower socioeconomic status
D. Sedentary lifestyle
E. Obesity
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Answer: B, C, D, E
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11. At her 12-week prenatal care visit, Sabrina complains of headache and visual disturbances. The nurse takes
her blood pressure and finds it to be 155/97 mmHg. On questioning Sabrina and reviewing her health
record, the nurse notes that Sabrina has never had problems with her blood pressure before being pregnant.
Results from a urine test taken previously indicate high levels of protein in the urine. Which condition
should the nurse most suspect in Sabrina?
A. Chronic hypertension
B. Gestational hypertension
C. Preeclampsia
D. Eclampsia
Answer: C
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12. Greta, a client in her sixth week of pregnancy, arrives at the clinic complaining of pelvic pain and vaginal
bleeding. While conducting a transvaginal ultrasound, the nurse notes that the embryo appears to have
implanted in the fallopian tube. What condition does the woman have?
A. Eclampsia
B. Ectopic pregnancy
C. Preeclampsia
D. Placenta abruption
Answer: B
13. During a pelvic exam, the nurse discovers genital warts in the client. The nurse recognizes this as a sign of
which sexually transmitted infection?
A. Chlamydia
B. Herpes simplex virus
C. Human papillomavirus
D. Human immunodeficiency virus
Answer: C
14. A client in her second trimester of pregnancy has tested positive for chlamydia. What medication should
the nurse order for treating this condition?
A. Azithromycin
B. Acyclovir
C. Valacyclovir
D. Trichloracetic acid
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Answer: A
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B.
C
15. Which of the following are changes in prenatal care that are being explored for the future to reduce costs or
improve quality?
A. Reducing the number of prenatal visits a client has
B. Reducing time devoted to client education
C. Noninvasive fetal testing
D. Group prenatal visits
E. Extending the client’s postpartum stay in the hospital by a day
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Answer: A, C, D
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CHAPTER 24
Breast Health Considerations
1. While conducting a physical examination on a female adolescent client, you note that glandular tissue has
developed under the areola of her breast and that the nipple and breast project as a single mound. At which
Tanner phase is this client?
A. 1
B. 2
C. 3
D. 4
Answer: B
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2. Tamara is a 7-year-old client who is already showing signs of breast development and growth of pubic hair.
Which condition does Tamara most likely have?
A. Premature telarche
B. Amastia
C. Precocious puberty
D. Polythelia
Answer: C
Answer: A
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B.
C
3. Denisa is a 48-year-old client who complains of spontaneous discharge of milk from both breasts. She says
she is taking valsartan for her blood pressure and bupropion Hcl for depression. A pregnancy test comes
back negative, and her prolactin level is 14 ng/mL. What condition does Denisa most likely have?
A. Galactorrhea
B. Prolactinoma
C. Increased vascularity
D. Intraductal papilloma
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4. You are teaching about breast care to Maria, a client who just gave birth and who plans to breastfeed her
child. Which instruction should you give her to help prevent nipple fissures?
A. Towel dry her breasts immediately on getting out of the shower
B. Apply lanolin to her nipples
C. Avoid wearing a bra
D. Avoid washing the breasts
Answer: B
5. You have just completed a clinical breast exam on Casey, a healthy 23-year-old client with no personal or
family history of breast cancer. You should advise Casey to have a clinical breast exam how often?
A. Every year
B. Every 2 years
C. Every 3 years
D. Every 5 years
Answer: C
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6. Margaret is a client who has a documented breast cancer (BRCA) 1 mutation and is at a high risk for breast
cancer. Which diagnostic procedure is recommended by the American Cancer Society to screen Margaret
for breast cancer?
A. Ultrasound
B. Magnetic resonance imaging
C. Mammogram
D. Chest x-ray
Answer: B
7. Tiffany is a client who has a large cyst in her breast. Which intervention would be most appropriate for
resolving the cyst and obtaining a fluid sample to send to the laboratory for cytology studies?
A. Core needle biopsy
B. Incisional biopsy
C. Excisional biopsy
D. Fine needle aspiration biopsy
Answer: D
8. Miranda is a 25-year-old client who is concerned about her risk for developing breast cancer. Which of the
following should you point out to Miranda as risk factors for breast cancer? (Select all that apply.)
A. Being 25 years old
B. Having a mutation of the BRCA 1 tumor suppressor gene
C. Drinking three beers daily
D. Menarche at age 13 years
E. Body mass index of 35
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Answer: B, C, E
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Answer: D
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B.
C
9. Katherine is a 30-year-old client who recently learned that she has the BRCA 1 gene mutation and is
terrified that she might develop breast cancer. She lost her mother to breast cancer a few years ago and is
prepared to take drastic measures to reduce her risk. She has a body mass index of 24, and drinks a glass of
wine daily. Which of the following interventions would most effectively lower Katherine’s risk for
developing breast cancer?
A. Abstaining from alcohol
B. Taking tamoxifen, as prescribed
C. Losing 20 lb
D. Undergoing surgical prophylaxis
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10. Marcy has been diagnosed with breast cancer. Her tumor is about 3 cm in diameter. What is the T stage of
Marcy’s tumor?
A. T1
B. T2
C. T3
D. T4
Answer: B
11. Kelly is a client who was recently diagnosed with breast cancer. She has a tumor 6 cm in diameter and
several positive nodes outside the axillary nodes, with no distant metastasis. What stage is Kelly’s cancer?
A. 1
B. 2
C. 3
D. 4
Answer: C
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12. Eva recently underwent a lumpectomy for treatment of her 7-cm tumor. What additional treatment should
Eva most expect to undergo in conjunction with the lumpectomy?
A. Radiation therapy
B. Chemotherapy
C. Hormonal therapy
D. Biological therapy
Answer: A
13. Harriet has been diagnosed with HER2-positive breast cancer. Which treatment would allow targeting of
the cancer cells more specifically and thus would likely produce fewer side effects?
A. Radiation therapy
B. Chemotherapy
C. Hormonal therapy
D. Biological therapy
Answer: D
14. Pamela is a client who is preparing to undergo chemotherapy to treat her breast cancer. What instructions
should you give her to help reduce the risk of acquiring infections? (Select all that apply.)
A. Avoid having dental work during treatment
B. Stay out of large crowds
C. Eat a low-calorie diet
D. Wash hands frequently
E. Get plenty of rest
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Answer: A, B, D, E
B.
C
15. Women who are diagnosed with early breast cancer are thought to have what chance of survival?
A. 60%
B. 70%
C. 80%
D. 90%
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Answer: D
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CHAPTER 25
Caring for the Transgender Patient
1. Which of the following is the definition of gender identity according to the World Professional Association
for Transgender Health (WPATH) ?
A. The biological fact of being male or female, based on one’s chromosomes
B. The biological fact of being male or female, based on one’s genitalia
C. The set of cultural roles and expectations one fulfills associated with one’s genitalia
D. The internal sense of being male or female
Answer: D
2. According to the DSM-5, the condition of experiencing an incongruence between one’s gender identity and
one’s natal sex is known as which of the following?
A. Gender dysphoria
B. Gender identity disorder
C. Homosexuality
D. Transsexualism
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Answer: A
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B.
C
3. Historically, what measures have been used as a basis for estimating the prevalence of gender dysphoria?
(Select all that apply.)
A. Polls conducted by telephone
B. Use of the diagnostic codes for gender identity disorder and gender dysphoria
C. Surveys conducted on admission and discharge from hospitals
D. Rates of gender-affirming surgery
E. Applications for legal gender change
Answer: B, D, E
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4. Which of the following include the recommended guidelines for nurse practitioners in caring for
transgender clients?
A. Use terminology that allows individuals to explore their gender in a safe environment
B. Learn each person’s particular gender identity and how they relate it to their health
C. Use the person’s preferred name
D. Use the pronoun that corresponds to the gender associated with the person’s appearance
E. Encourage the client to undergo gender-affirming surgery
Answer: A, B, C
5. Which of the following is the term applied at birth as male or female, usually based on the physical
appearance of the external genitalia?
A. Sex
B. Gender identity
C. Gender
D. Sexual orientation
Answer: A
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6. Lisa is a biologic male whose expressed gender is female. Which term most accurately describes Lisa?
A. Transman
B. Transwoman
C. Cis-gender
D. Lesbian
Answer: B
7. Melanie has two X chromosomes and was born with ovaries, a uterus, and a vagina. She has always
identified with her biologic sex and presents as a female. Which term most accurately describes Melanie?
A. Transman
B. Transwoman
C. Cis-gender
D. Lesbian
Answer: C
8. Recent biological theories emphasize that the brain develops at a different time than the genitals and can
thus be predisposed to identify with the gender opposite to that associated with the genitals. What is the
primary flaw in these theories?
A. The assumption that gender identity can differ from biological sex
B. The belief that the brain develops at a different time than the genitals
C. The assumption that gender is binary
D. The belief that the time of development of the genitals has any effect on the brain
Answer: C
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B.
C
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9. Michael is a biologic male who identifies as female. What health conditions associated with gender
dysphoria should the nurse assess for in Michael? (Select all that apply.)
A. Cardiovascular disease
B. Diabetes mellitus
C. Depression
D. Anxiety
E. Bipolar disorder
Answer: C, D
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10. Lucy is a client who would like to begin hormone therapy to start transitioning to a male gender identity.
What criteria must Lucy meet before she can begin hormone therapy? (Select all that apply.)
A. Persistent, well-documented gender dysphoria
B. Capacity to make an informed decision and give consent
C. Be at least 18 years old
D. Undergo a mental health evaluation
E. Have no history of mental health disorders
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Answer: A, B, C, D
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11. At her first visit to the physician’s office, Allison tells the nurse that she has never felt comfortable
identifying with her biologic sex and thinks that she might actually be male. Which of the following is the
priority nursing action at this time?
A. Refer Allison to a psychologist
B. Facilitate diagnosis of gender dysphoria
C. Encourage Allison to consider undergoing testosterone therapy
D. Provide Allison with literature related to gender-affirming surgery
Answer: B
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12. Sam has just been diagnosed with gender dysphoria and would like to know what his treatment options are.
The nurse should mention which of the following? (Select all that apply.)
A. Antipsychotic medications
B. Social transition through gender expression
C. Hormone therapy
D. Surgical alteration
E. Legal name and gender changes
Answer: B, C, D, E
13. Mandy is a transwoman (transitioning from male to female), and is interested in undergoing hormone
therapy. What hormone would most likely be used in this situation?
A. Testosterone
B. Spironolactone
C. Progesterone
D. Estrogen
Answer: D
14. Thomas is a transman (transitioning from female to male). What changes can this client expect from
hormone therapy? (Select all that apply.)
A. Ability to generate sperm
B. A deepening of the voice
C. Increased muscle mass
D. Cessation of menses
E. Increased growth of facial and body hair
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Answer: B, C, D, E
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B.
C
15. Marshall is a transman (transitioning from female to male), who is considering undergoing genderaffirming surgery. What surgery options would be appropriate for Marshall? (Select all that apply.)
A. Mastectomy
B. Vaginoplasty
C. Hysterectomy
D. Orchiectomy
E. Phalloplasty
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Answer: A, C, E
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CHAPTER 26
Sexual Health Problems and Dysfunctions
1. Which of the following is a major limitation of the model of the sexual response cycle formulated by
Masters and Johnson and modified by Kaplan?
A. It lacks a logical, linear progression of phases.
B. It does not allow for the possibility of multiple orgasms.
C. It does not take into account the motivations for sex other than sexual desire.
D. It overemphasizes the importance of nongenital stimulation.
Answer: C
2. According to Basson, which of the following is a significant motivator for sex that is overlooked in the
Kaplan model of sexual response?
A. Intimacy
B. Sexual desire
C. Money
D. Power
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Answer: A
Answer: B
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B.
C
3. Which substance in the body is associated with contributing to the engorgement of clitoral tissue?
A. Prolactin
B. Nitric oxide
C. Dopamine
D. Serotonin
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4. Which substance in the body is associated with increasing the sexual excitement and the desire to continue
sexual activity?
A. Prolactin
B. Nitric oxide
C. Dopamine
D. Serotonin
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Answer: C
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5. According to a survey conducted in the United States in 1992 among women 18 to 59 years old, which of
the following was the most common sexual complaint?
A. Lack of sexual interest
B. Difficulty achieving orgasm
C. Problems with lubrication
D. Painful intercourse
Answer: A
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6. Which medical condition is most likely to cause a female sexual dysfunction by reducing the blood flow to
the vagina and clitoris, thereby decreasing sexual arousal?
A. Spinal cord injury
B. Ovarian cancer
C. Stress incontinence
D. Hypertension
Answer: D
7. Margarite has been experiencing difficulty achieving orgasm during sex and has scheduled an appointment
with her nurse practitioner to address this concern. On reviewing Margarite’s health record, the nurse sees
that she has been diagnosed with major depression and is currently taking an antidepressant. Which of the
following medications are most likely to cause the problem that Margarite is experiencing, based on their
mechanisms of action? (Select all that apply.)
A. Nefazodone
B. Bupropion
C. Fluoxetine
D. Buspirone
E. Sertraline
Answer: C, E
C
Answer: A, E
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8. Which of the following are examples of sociocultural factors that contribute to female sexual dysfunction?
(Select all that apply.)
A. An upbringing in which sex was viewed as “dirty”
B. Lack of interest in sex due to depression
C. An inability to be sexually aroused due to alcoholism
D. Lack of privacy due to living in a small apartment with extended family
E. Living in a community in which sex is treated primarily as a commodity
Answer: C
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B.
9. A nurse should expect most to conduct a genital exam with a client experiencing which sexual disorder?
A. Sexual interest arousal disorder
B. Gender dysphoria
C. Chronic dyspareunia
D. Orgasmic disorder
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10. Which sexual dysfunction diagnosis is no longer included in the DSM?
A. Gender identity disorder
B. Gender dysphoria
C. Sexual interest arousal disorder
D. Noncoital sexual pain disorder
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Answer: A
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11. Grace is a client complaining of irritation and burning in her vulva. She believes it is related to her bicycle
riding, which she does daily. The nurse recognizes this condition as which of the following?
A. Dyspareunia
B. Vulvodynia
C. Genito-Pelvic pain/penetrative disorder
D. Vaginismus
Answer: B
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12. Nadine, a client in the postmenopausal period, tells her nurse that her vaginal dryness and pain during
intercourse have gotten so bad that she’s all but given up having sexual intercourse. The nurse orders a lab
test to measure Nadine’s estrogen level. Given Nadine’s symptoms, the nurse should expect an estrogen
level of which of the following?
A. Less than 35 pg/mL
B. 35 to 50 pg/mL
C. 50 to 65 pg/mL
D. 65 to 80 pg/mL
Answer: A
13. Diana, a 49-year-old client, tells her nurse that sexual intercourse with her husband has been painful lately.
What self-management interventions should the nurse recommend to Diana to address this concern? (Select
all that apply.)
A. Use of a lubricant
B. Use of erotic movies
C. Female superior position
D. Missionary position
E. A warm bath before intercourse
Answer: A, C, E
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14. Lolly, a 22-year-old client, says that she has trouble becoming aroused before sexual intercourse. As the
nurse asks Lolly about her sexual and medical history, Lolly mentions that she was sexually abused as a
child and that it is hard for her to disassociate sex from that experience. Which of the following is the
nursing action on priority?
A. Recommend that Lolly use erotic movies to distract her
B. Refer Lolly to a psychologist or sex therapist
C. Suggest an effective lubricant for sex
D. Ask Lolly what relationship problems she might be having with her partner
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B.
Answer: B
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CHAPTER 27
Vulvar and Vaginal Health
1. Which of the following allows an improved understanding of anatomic variations such as the
paramesonephric defects found in the fallopian tubes, the uterus, and the vagina?
A. Embryology
B. Oncology
C. Histology
D. Cytology
Answer: A
2. Obstetric injuries to which area are frequently associated with loss of support and prolapse of the uterus,
bladder, and rectum?
A. Prepuce
B. Mons pubis
C. Perineum
D. Vestibule
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Answer: C
Answer: D
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B.
C
3. Which of the following is known as the opening to the vagina?
A. Labia majora
B. Prepuce
C. Mons pubis
D. Introitus
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4. Which four bones form the pelvic outlet? (Select all that apply.)
A. Femur
B. Pubis
C. Ilium
D. Ischium
E. Sacrum
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Answer: B, C, D, E
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5. Which of the following are the deep muscles of the pelvic floor (levator ani)? (Select all that apply.)
A. Pubococcygeus
B. Puborectalis
C. Bulbospongiosus
D. Iliococcygeus
E. Coccygeus
Answer: A, B, D, E
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6. Brooke is 12-year-old client who underwent menarche 6 months ago. She arrives at the office today
complaining of low abdominal pain and cramping. She says that she thought she was having her period, but
there is no vaginal bleeding. Which of the following conditions should the nurse suspect most in Brooke?
A. Vaginal septa
B. Bartholin’s duct cyst
C. Skene’s duct cyst
D. Vaginal intraepithelial neoplasia
Answer: A
7. Gina, a 37-year-old client, discovered a “bump” in her vaginal introitus a few days ago. She says that it is
small and painless, but she was concerned and decided to have it checked out. After conducting a vaginal
examination, the nurse determines that the condition is a Bartholin’s duct cyst. What interventions should
the nurse take in response to this finding? (Select all that apply.)
A. Advise Gina to frequently apply warm compresses to the cyst
B. Schedule an excisional biopsy of the cyst and surrounding margin
C. Massage the area, express any accumulated fluid, and test it for infection
D. Schedule a stab incision and drainage procedure
E. Recommend that Gina to soak in a warm tub bath
Answer: A, B, E
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8. Which sexually transmitted infection (STI) is known for leading to both neoplastic and nonneoplastic
dysplasia of the cervix, vagina, and vulva?
A. Human immunodeficiency virus
B. Herpes simplex virus
C. Human papillomavirus (HPV)
D. Hepatitis B virus
C
Answer: C
Answer: C
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B.
9. Vaginal intraepithelial neoplasia is most frequently detected initially via which of the following?
A. Palpation of the lesion by the client
B. Report of symptoms such as vaginal irritation, discharge, and bleeding by the client
C. An abnormal Pap smear
D. Colposcopic examination
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10. Which of the following is the most common form of vaginal cancer?
A. Adenocarcinoma
B. Melanoma
C. Squamous carcinoma
D. Sarcoma
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Answer: C
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11. Which form of vaginal cancer has a 5-year survival rate of less than 15%?
A. Adenocarcinoma
B. Melanoma
C. Squamous carcinoma
D. Sarcoma
Answer: B
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12. Miriam, a 55-year-old postmenopausal client, complains to the nurse that she has been experiencing
pruritus, irritation, and burning in her vulvar region, along with dyspareunia. On vaginal examination, the
nurse observes that the vulvar epithelium is pallorous, shiny, and crinkly, with symmetric distribution
across the vulva, labia, and perineum. Based on these findings, which condition should the nurse suspect
most?
A. Lichen sclerosus
B. Lichen planus
C. Lichen simplex chronicus
D. Vulvar squamous intraepithelial lesion
Answer: A
13. Lucretia, a 30-year-old client, reports chronic pain in her vulvar region. She describes the pain as stinging
and says that she cannot bear to have sexual intercourse or insert a tampon. On vaginal examination, the
nurse can find no lesion. Which condition should the nurse suspect most?
A. Vulvar squamous intraepithelial lesion
B. Lichen sclerosus
C. Vulvodynia
D. Skene’s duct cyst
Answer: C
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14. What percentage of vulvar carcinomas are of the squamous type?
A. 65%
B. 75%
C. 85%
D. 95%
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B.
C
Answer: C
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CHAPTER 28
Perimenstrual and Pelvic Symptoms and Syndromes
1. Which of the following are structural causes of abnormal uterine bleeding? (Select all that apply.)
A. Leiomyoma
B. Coagulopathy
C. Endometrial
D. Polyp
E. Malignancy
Answer: A, D, E
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2. During the menstrual cycle, if conception does not occur, which of the following events take place
following ovulation? (Select all that apply.)
A. The blastocyst implants on the uterine wall
B. The corpus luteum degenerates
C. Estrogen levels rise
D. Withdrawal bleeding occurs
E. Progesterone levels fall
Answer: B, D, E
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B.
C
3. Tanya is a 21-year-old African American woman with a body mass index (BMI) of 32. She is sedentary
and smokes. Which of the following are factors that increase Tanya’s risk for developing abnormal uterine
bleeding? (Select all that apply.)
A. Age
B. Race
C. BMI
D. Activity level
E. Smoking status
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Answer: A, C
Answer: B, C, D, E
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4. Which of the following are symptoms of abnormal uterine bleeding? (Select all that apply.)
A. Soaking through a menstrual pad in 4 hours on a heavy day of menstruation
B. Bleeding 1 week after the last menstrual period ended
C. Bleeding after having sexual intercourse
D. Bleeding a year after having entered menopause
E. Spotting 2 weeks after the last menstrual period ended
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5. Indigo is a 25-year-old client who arrives at the office complaining of a high fever and heavy menstrual
bleeding. When the nurse inquires about her menstrual cycle, Indigo says that it is highly regular and that
this is the normal time of the month for her to have her period, but that she has never bled this heavily
before. Based on this information, which of the following should the nurse deduce as the most likely cause
of the abnormal uterine bleeding?
A. von Willebrand disease
B. Endometritis
C. Ovarian disorder
D. Iatrogenic
Answer: B
6. Angie is a 33-year-old client who is experiencing abnormal uterine bleeding. The nurse would like to
evaluate Angie’s endometrium to determine whether she should undergo an endometrial sampling
procedure. Which diagnostic test would be most appropriate for this purpose?
A. Saline infusion sonohysterography
B. Pelvic radiography
C. Transvaginal ultrasonography
D. Magnetic resonance imaging
Answer: C
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7. On what days of the menstrual cycle should a transvaginal ultrasound be scheduled in premenopausal
women?
A. Days 1 to 3
B. Days 4 to 6
C. Days 7 to 9
D. Days 10 to 12
C
Answer: B
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Answer: D
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B.
8. Malorie is a 15-year-old client who is concerned because she still has not had her first period. Malorie is
short for her age and appears to be prepubertal. She enjoys playing softball on a community recreation
league team and has a body mass index (BMI) index of 22. Which cause of amenorrhea should the nurse
suspect most in Malorie’s case?
A. Female athlete triad
B. Polycystic ovary syndrome
C. Pituitary tumor
D. Turner syndrome
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9. Beatrice is a 35-year-old client who has been experiencing lighter periods for the past few months and even
missed a period of 1 month. On ultrasound, the nurse observes that Beatrice’s ovaries are enlarged.
Laboratory tests indicate an elevated luteinizing hormone level but normal estrogen and follicle-stimulating
hormone levels. Which cause of amenorrhea should the nurse suspect most in Beatrice’s case?
A. Female athlete triad
B. Polycystic ovary syndrome
C. Pituitary tumor
D. Turner syndrome
Answer: B
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10. Jenny is an 18-year-old client who has been diagnosed with female athlete triad. What interventions should
the nurse make to treat Jenny? (Select all that apply.)
A. Recommend increasing intake of calcium
B. Encourage weight loss
C. Recommend eating a balanced diet with plenty of calories
D. Refer the client to a therapist who specializes in eating disorders
E. Prescribe an antidiabetic medication to help manage insulin resistance
Answer: A, C, D
11. Maria is a 38-year-old client who experiences depression, mood swings, and abdominal cramps each month
right before her period. Her symptoms are so severe that she has had to miss many days of work in the past
year. Which of the following conditions would best explain Maria’s symptoms?
A. Premenstrual syndrome
B. Premenstrual dysphoric disorder
C. Polycystic ovary syndrome
D. Turner syndrome
Answer: B
12. Trudy is a 36-year-old client who has just been diagnosed with premenstrual dysphoric disorder. Which of
the following self-management measures should the nurse recommend to Trudy? (Select all that apply.)
A. Take calcium supplements
B. Consider beginning cognitive behavioral therapy
C. Increase caffeine intake
D. Engage in aerobic exercise, especially during the luteal phase
E. Consider taking the diuretic Spironolactone
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Answer: A, B, D, E
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B.
C
13. Chloe has been experiencing migraine headaches lately, which she believes may be related to her menstrual cycle.
Which of the following symptoms are associated with menstrual migraine headaches? (Select all that apply.)
A. Bilateral presentation
B. Nausea and vomiting
C. Mild, steady pain
D. Pain aggravated by light and sounds
E. Visualizing flickering lights moments before the headache starts
Answer: B, D, E
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14. Oma is a 20-year-old client who regularly experiences menstrual migraines with aura just before her
period. Which medication should the nurse recommend to Oma to take 2 to 3 days before her period as a
short-term prophylactic treatment?
A. A triptan
B. A combined oral contraceptive
C. Progesterone therapy
D. Danazol
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Answer: A
15. Which of the following are characteristics of primary dysmenorrhea, as opposed to secondary
dysmenorrhea? (Select all that apply.)
A. Onset of 3 years after menarche
B. Pain that follows a predictable pattern, always occurring at the start of menstruation
C. Pain that is always worst on the first day of menstruation
D. Typically caused by endometriosis
E. Often accompanied by abnormally heavy menstrual bleeding
Answer: B, C
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CHAPTER 29
Urologic and Pelvic Floor Health Problems
1. Which of the following are factors that increase a person’s risk for pelvic organ prolapse? (Select all that
apply.)
A. Female
B. Age of 78 years
C. Nulliparity
D. Body mass index (BMI) of 23
E. Smoker
Answer: A, B, E
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2. Which of the following is a significant downward rotation of more than 35° of the distal anterior vaginal
wall caused by a defect in the suburethral connective tissue and pubourethral (pubovisceral) ligaments?
A. Anterior vaginal wall prolapse
B. Hypermobile urethra
C. Apical vaginal prolapse
D. Posterior vaginal wall prolapse
Answer: B
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Answer: D
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B.
C
3. Misbah is a 69-year-old client who has just been diagnosed with pelvic organ prolapse. She reports vaginal
pain when working in her garden and describes symptoms indicating urinary retention. On performing a
pelvic exam, the nurse observes that the client’s vagina appears dry and shows signs of erosion and
ulceration. On the basis of these symptoms, which stage of pelvic organ prolapse is Misbah most likely in?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
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4. Tierra has been diagnosed with Stage 2 pelvic organ prolapse. Which of the following symptoms should the
nurse expect to find in this client? (Select all that apply.)
A. Lower back pain
B. Pelvic heaviness or fullness
C. Obstructive urination
D. Pain during intercourse
E. Urinary retention
Answer: A, B, D
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5. Alex has been diagnosed with Stage 3 pelvic organ prolapse. She has been experiencing urinary
incontinence and is in need of vaginal support. Which of the following interventions would fully meet the
needs of this client, most?
A. Pelvic floor muscle therapy
B. Donut pessary
C. Neurologic stimulation therapy
D. Estrogen therapy
Answer: B
6. Which treatment for pelvic organ prolapse involves a prescriptive medical device that combines Kegel
exercises and noninvasive electrical stimulation via biphasic wave forms to stimulate pelvic nerves to
enhance contractile response?
A. Intone
B. Percutaneous tibia nerve simulation
C. Pessary therapy
D. Pelvic floor muscle therapy
Answer: A
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7. Which of the following symptoms are associated with painful bladder syndrome/interstitial cystitis? (Select
all that apply.)
A. Urinary retention
B. Urethral pain
C. Sensation of organs descending into the vagina
D. Urinary urgency
E. Nocturia
Answer: B, D, E
Answer: C
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B.
C
8. Which of the following is typically the cause of urinary frequency in clients with painful bladder
syndrome/interstitial cystitis?
A. Fear of urinary urge incontinence
B. Anxiety over developing a urinary tract infection
C. Desire to relieve pain by voiding
D. Sensation of urinary retention
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9. Tiffany, a client suspected of having painful bladder syndrome/interstitial cystitis, has been found to have
hematuria. Tiffany has a history of surgical mesh augmentation for the correction of an anterior pelvic
defect. Which diagnostic test would be best to rule out an alternative condition in this client?
A. Potassium sensitivity test
B. Symptom scale
C. Blood glucose level
D. Cystoscopy with hydrodistention
Answer: D
10. Isabelle is suspected of having painful bladder syndrome/interstitial cystitis as a result of a neurological
hypersensitivity. Given the suspected etiology in this case, which treatment would be most appropriate for
Isabelle?
A. Pentosan polysulfate sodium
B. Amitriptyline
C. Montelukast
D. Cyclosporine A
Answer: B
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11. Valerie is suspected of having painful bladder syndrome/interstitial cystitis as a result of a body-wall
abnormality. Given the suspected etiology in this case, which treatment would be most appropriate for
Valerie?
A. Physical therapy
B. Pessary therapy
C. Electrical stimulation therapy
D. Behavioral therapy
Answer: A
12. Kelly is suspected of having painful bladder syndrome/interstitial cystitis as a result of a mast-cell
response. Given the suspected etiology in this case, which treatment would be most appropriate for
Valerie?
A. Pentosan polysulfate sodium
B. Amitriptyline
C. Montelukast
D. Cyclosporine A
Answer: C
13. Which of the following are common symptoms of cystitis? (Select all that apply.)
A. Low back pain
B. Frequent urge to urinate
C. An inability to urinate due to obstruction
D. A sensation of burning during urination
E. Pain with sitting or walking
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Answer: B, D
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Answer: B
B.
C
14. Which of the following ones typically causes cystitis?
A. A defect in the connective tissue supporting the bladder
B. Bacteria entering the bladder via the urethra
C. An urothelial abnormality
D. A virus entering the uterus via the cervix
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15. What percentage of women older than 55 years experience a recurrence of a urinary tract infection within a
year?
A. 33%
B. 43%
C. 53%
D. 63%
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Answer: C
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CHAPTER 30
Sexually Transmitted Diseases
1. Of the 20 million new cases of sexually transmitted diseases (STDs) that occur each year in the United
States, about what proportion are in those aged 15 to 25 years?
A. One fourth
B. One third
C. One half
D. Two thirds
Answer: C
2. Which of the following sexually transmitted diseases (STDs) is an ectoparasitic infection?
A. Trichomoniasis
B. Vulvovaginal candidiasis
C. Syphilis
D. Pediculosis pubis
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Answer: D
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Answer: A
B.
C
3. Which of the following sexually transmitted diseases (STDs) is a protozoan infection?
A. Trichomoniasis
B. Vulvovaginal candidiasis
C. Syphilis
D. Pediculosis pubis
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4. Natasha is a 23-year-old client who reports to the office with complaints of vaginal discharge, pain while
urinating, and pain during intercourse. On performing a pelvic examination, the nurse finds a frothy,
mucopurulent, yellowish discharge that has a foul odor. Which sexually transmitted disease (STD) should
the nurse suspect most?
A. Syphilis
B. Hepatitis B
C. Trichomoniasis
D. Chlamydia
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Answer: C
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5. While performing a pelvic exam, the nurse encounters genital warts in the vagina. Which sexually
transmitted disease (STD) should the nurse suspect most in this client?
A. Genital herpes simplex virus
B. Human papillomavirus (HPV)
C. Hepatitis B
D. HIV
Answer: B
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6. While providing teaching to a client regarding health complications that occur in women and that are
associated with sexually transmitted diseases (STDs), which of the following cancers the nurse should
mention? (Select all that apply.)
A. Breast
B. Cervical
C. Ovarian
D. Vaginal
E. Anal
Answer: B, D, E
7. Kylie is an 18-year-old client who comes to the office today with complaints of a fever and severe pelvic
pain. Her temperature is 102°F, and the nurse finds uterine and adnexal tenderness on examining the pelvis.
What condition should the nurse suspect most in Kylie?
A. Pelvic inflammatory disease
B. Vulvovaginal candidiasis
C. Gonorrhea
D. Chancroid
Answer: A
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8. Which of the following qualities of the vagina make it more susceptible to infection by sexually transmitted
diseases (STDs) than the penis? (Select all that apply.)
A. Greater amount of mucous membrane exposed
B. A highly acidic pH level
C. An environment more conducive for infections to grow in
D. Susceptibility of the squamocolumnar junction/transformation zone cells to HIV
E. Greater risk for trauma
C
Answer: A, C, D, E
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B.
9. The nurse is providing teaching to a client regarding safer sex practices. Which of the following should the
nurse mention? (Select all that apply.)
A. Choosing low-risk sex partners
B. Being in a monogamous relationship
C. Having multiple sex partners
D. Having anal-genital intercourse
E. Using latex condoms
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Answer: A, D, E
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10. A nurse is preparing to provide counseling regarding sexually transmitted diseases (STDs) to a client who
is currently at risk. Which of the following approaches should the nurse adopt so that the session is most
effective? (Select all that apply.)
A. Remain detached and analytical
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B. Ask questions that may be answered with “yes” or “no”
C. Use understandable language
D. Be respectful of the client
E. Inform the client that anything she says will be held confidential, as long as it is not something that the
nurse is required by law to report
Answer: C, D, E
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11. Which diagnostic test assesses a woman’s risk for developing cervical cancer?
A. Pap smear
B. Gonococcal culture
C. Hepatitis B panel
D. Pregnancy test
Answer: A
12. A nurse is inquiring about a client’s sexual history. Which of the following should the nurse ask about?
(Select all that apply.)
A. The dates and types of sexual activities engaged in
B. The number of sexual contacts
C. Names and genders of all partners
D. Potential sites of infection
E. Ethnicity of all partners
Answer: A, B, D
13. A client has been diagnosed with bacterial vaginosis. Which of the following is the preferred treatment for
this sexually transmitted disease (STD)?
A. Azithromycin
B. Metronidazole
C. Penicillin G
D. Cefotetan
Answer: B
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Answer: C
B.
C
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14. A client has been diagnosed with syphilis. Which of the following is the preferred treatment for this
sexually transmitted disease (STD)?
A. Azithromycin
B. Metronidazole
C. Penicillin G
D. Cefotetan
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15. Which variant of hepatitis for chronic infection is associated with a 25% increased risk of premature death
from hepatocellular carcinoma and a 90% risk of transmission from a pregnant woman to her fetus?
A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
D. Hepatitis D
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CHAPTER 31
Women and HIV/AIDS
1. In 2014, what percentage of all new diagnoses of HIV did males account for?
A. 51%
B. 61%
C. 71%
D. 81%
Answer: D
2. When working with a patient with HIV, which of the following that the nurse’s role has to do? (Select all
that apply.)
A. Prepare the patient for the inevitability of death
B. Help build a support system
C. Explain the levels of care available
D. Reassure the patient that a complete recovery is expected
E. Help the patient manage HIV as a chronic condition
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Answer: B, C, E
Answer: C
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B.
C
3. Among all women living with HIV at the end of 2013, what percentage was the African American?
A. 43%
B. 53%
C. 63%
D. 73%
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4. Among African American women aged 25 to 34 years, which of the following was the cause for HIV/AIDS
in them?
A. Leading cause of death
B. Second leading cause of death
C. Third leading cause of death
D. Fourth leading cause of death
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5. Which of the following does HIV retrovirus target and bind to?
A. B-cells
B. Neutrophils
C. T-cells
D. Eosinophils
Answer: C
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6. AIDS, the final stage of HIV, is reached when the CD4+ count drops to which of the following?
A. Less than 400
B. Less than 300
C. Less than 200
D. Less than 100
Answer: C
7. Among HIV infections in women, which of the following ones result in 72% of occurrence of such
infections?
A. Unprotected heterosexual intercourse
B. Unprotected homosexual intercourse
C. Blood transfusions
D. Needle-stick injuries
Answer: A
8. Which of the following represents the greatest risk for being infected with HIV?
A. Insertive anal intercourse
B. Receptive oral intercourse
C. Receptive vaginal intercourse
D. Insertive vaginal intercourse
Answer: C
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Answer: B, C, D, E
B.
C
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9. The nurse is instructing a client on risk factors associated with being infected with HIV. Which of the
following should the nurse mention? (Select all that apply.)
A. Being male
B. Lesions being present within the vagina
C. Being pregnant
D. Having sex during menstruation
E. Douching
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10. Which of the following is the chief predictor of a risk of heterosexual transmission?
A. Duration of sexual intercourse
B. Viral load
C. Number of sexual partners of the male
D. The concentration of sperms in the semen
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Answer: B
Answer: B
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11. Which of the following present in a sexual partner is a risk factor for infection with HIV?
A. Diabetes
B. Gonorrhea
C. Cardiovascular disease
D. Breast cancer
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12. When considering offering HIV testing to clients, the nurse should keep which of the following in mind?
A. Offer it to all women who are being tested for STIs
B. The testing is completely voluntary
C. Specific signed consent for testing should be required
D. Opt-out HIV screening is recommended
E. Antigen-only tests are encouraged
Answer: A, B, D
13. To confirm a diagnosis of HIV infection, how many tests must be completed on the same sample?
A. 1
B. 2
C. 3
D. 4
Answer: B
14. When considering when to start a patient on antiretroviral therapy, the nurse should base the decision on
which of the following?
A. CD4 counts
B. Viral load
C. Red blood cell count
D. Patient’s symptoms
Answer: A
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Answer: A, C, D, E
B.
C
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15. Sheila is a client who is suspected of having HIV. Which of the following symptoms would tend to confirm
this suspicion? (Select all that apply.)
A. Recurrent vaginal candidiasis
B. Hepatitis A infection
C. Abnormal cervical cytology
D. More severe pelvic inflammatory disease
E. Bacterial vaginosis
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CHAPTER 32
Human Papillomavirus
1. Which of the following is the most common sexually transmitted infection in the United States?
A. Genital herpes simplex virus
B. Human papillomavirus
C. Chlamydia
D. Gonorrhea
Answer: B
2. What percentage of people in the Unites States who are sexually active will develop human papillomavirus
(HPV)?
A. 30%
B. 50%
C. 70%
D. 90%
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Answer: D
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B.
C
3. The nurse is reviewing the health history of a client who is concerned about developing cervical cancer.
Which of the following factors would increase the client’s risk of human papillomavirus (HPV) infection?
(Select all that apply.)
A. Having had three sexual partners in the past year
B. Drinking a glass of wine daily
C. Being HIV positive
D. Using oral contraceptives
E. Using a condom in about half of all sexual contacts
Answer: A, C, E
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4. Which types of human papillomavirus (HPV) are low-risk (nononcogenic) but cause 90% of genital warts?
A. 6 and 11
B. 16 and 18
C. 31 and 35
D. 40 and 42
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Answer: A
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5. Which type of human papillomavirus (HPV) is most commonly associated with high-grade cervical
intraepithelial neoplasia and invasive cancers?
A. 6
B. 11
C. 16
D. 31
Answer: C
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6. About what percentage of cases of cervical cancer occur in underserved populations?
A. 50%
B. 60%
C. 70%
D. 80%
Answer: B
7. At what ages routine vaccination for human papillomavirus (HPV) is recommended for females?
A. 11 to 12 years
B. 13 to 14 years
C. 15 to 16 years
D. 17 to 18 years
Answer: A
8. Merrill is a client who would like to have her genital warts removed in the outpatient setting with minimal
risk for complications. Which modality would be the best to use with Merrill?
A. Cryotherapy
B. Laser vaporization
C. Loop electrosurgical excision procedure
D. Cold knife cone biopsy
Answer: B
B.
C
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9. Mia is a client with genital warts who is at high risk for cervical cancer. On the basis of Mia’s health
history and observations made during a pelvic examination, the nurse believes Mia has a strong possibility
of having an invasive cancer. Which treatment modality would be best for Mia?
A. Cryotherapy
B. Laser vaporization
C. Loop electrosurgical excision procedure
D. Cold knife cone biopsy
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Answer: D
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10. Carol is a client who is being assessed for risk for anal human papillomavirus (HPV) infection. Which of
the following are factors that would increase Carol’s risk for having anal HPV? (Select all that apply.)
A. Presence of cervical HPV
B. CD4 count of 50
C. History of anal intercourse
D. Lesbian sexual orientation
E. Smoking
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11. A nurse works in a rural health clinic that lacks a referral source for abnormal results related to anal cancer
screening. The nurse is working with a client, Danielle, who has several risk factors for anal cancer. After
visually inspecting Danielle’s perianal region with a simple anoscope, which service should the nurse
provide next?
A. Anal cytology
B. Digital anal rectal examination
C. High-resolution anoscopy
D. A Pap smear
Answer: B
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12. The nurse is preparing to perform anal cytology on a client. What position should the nurse place the client
in?
A. High Fowler’s
B. Prone
C. Supine
D. Lithotomy
Answer: D
13. After obtaining a specimen for anal cytology, the nurse should do which of the following?
A. Smear the specimen on a glass slide
B. Agitate the swab in a liquid medium for at least 30 seconds
C. Place the swab in a specimen container and label for transport
D. Place the swab in a plastic bag and then in an ice slurry for transport
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B.
C
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Answer: B
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CHAPTER 33
Gynecologic Cancers
1. Which of the following are socioeconomic and geographical factors that increase the risk of women having
decreased access to health care services related to gynecological cancers? (Select all that apply.)
A. Being a single parent
B. Living in a large city
C. Working two jobs
D. Having a low income
E. Being a caregiver to an aging father
Answer: A, C, D, E
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2. Why do lesbian, bisexual, and gender nonconforming women statistically present later for gynecological
concerns and are at greater risk for gynecological cancers? (Select all that apply.)
A. Belief that routine gynecological care is not necessary if one is not seeking contraception
B. Falsely assumed low risk for sexuallytransmitted infections
C. Fear of discrimination by health care providers and staff
D. Having decreased body mass indices and lower rates of smoking and alcohol intake
E. Lack of engagement with genitals and menstrual cycle
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Answer: A, B, C, E
Answer: C
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B.
3. Which gynecological cancer has the highest incidence rate, in terms of number of cases per year?
A. Cervical cancer
B. Vaginal cancer
C. Uterine cancer
D. Ovarian cancer
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4. Which of the following are symptoms associated with vulvar cancer? (Select all that apply.)
A. Vaginal discharge
B. Prolonged itching or pain in the area
C. Palpation of a lump or bump
D. Whitish gray skin in the area
E. Pain and bleeding during sexual intercourse
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Answer: B, C, D
5. Maggie is a client who is wondering whether she is at increased risk for developing vaginal cancer. Which
of the following factors would increase Maggie’s risk? (Select all that apply.)
A. Being 42 years old
B. Having an HPV infection
C. Being a smoker
D. Having a body mass index (BMI) of 26
E. Exposure to diethylstilbestrol (DES) in utero
Answer: B, C, E
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6. Which one of the following infections is a significant risk factor for developing cervical cancer?
A. Human papillomavirus
B. Hepatitis D virus
C. Herpes simplex virus
D. Human immunodeficiency virus
Answer: A
7. Nellie has just been diagnosed with advanced ovarian cancer. Which of the following symptoms should the
nurse expect Nellie to have? (Select all that apply.)
A. An abnormally heavy and prolonged period
B. A sense of pressure and fullness in the abdomen
C. Bowel or bladder dysfunction
D. Foul-smelling vaginal discharge
E. Abdominal distention
Answer: B, C, E
8. Cecilia is worried about developing ovarian cancer and wonders whether anything in her health history
would increase her risk for getting it. Which of the following factors would increase Cecilia’s risk? (Select
all that apply.)
A. A history of breast cancer
B. A history of endometriosis
C. Having given birth to three children
D. Having had multiple sexual partners in the past year
E. A history of heart disease
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Answer: A, B
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B.
C
9. A nurse practitioner is trying to promote prevention of gynecological cancers in the community. In a
presentation at a women’s health fair, which of the following should the nurse mention? (Select all that
apply.)
A. Available vaccines for HPV
B. The importance of body acceptance
C. Common risk factors associated with gynecological cancers
D. Literature on smoking cessation programs
E. A list of gluten-free foods
Answer: A, B, C, D
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10. On genetic testing, Lydia has been found to have the BRCA 1 gene mutation. Which type of cancer Lydia
has with a greater risk of developing?
A. Endometrial
B. Cervical
C. Ovarian
D. Uterine
Answer: C
11. On genetic testing, Patrice has been found to have Lynch syndrome. Which types of cancer Patrice has at a
greater risk of developing? (Select all that apply.)
A. Endometrial
B. Cervical
C. Ovarian
D. Uterine
E. Primary peritoneal
Answer: A, C
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12. Laurie is experiencing mucositis after receiving radiation therapy to treat her ovarian cancer. Which of the
following should the nurse recommend to Laurie?
A. Take ginger supplements
B. Eat soft, bland foods
C. Consider estrogen therapy
D. Wear loose-fitting, light cotton clothing
Answer: B
13. Maia is experiencing nausea after receiving chemotherapy. The nurse should recommend which of the
following as a natural remedy for nausea?
A. Ginger
B. Curry
C. Cinnamon
D. Oregano
Answer: A
14. Hospice care is generally available only to those who are expected to live how long?
A. Less than 1 month
B. Less than 3 months
C. Less than 6 months
D. Less than 12 months
Answer: C
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15. Which of the following is true of palliative care but not of hospice care?
A. It manages the symptoms of pain.
B. It addresses fatigue.
C. It is intended to help eliminate the cancer.
D. It may be provided while the patient is undergoing chemotherapy.
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B.
Answer: D
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CHAPTER 34
Menopause
1. Which of the following most accurately characterizes the way Western societies view menopause?
A. A hormone deficiency disease
B. A celebrated rite of passage
C. A nonentity
D. A milestone in a spiritual journey
Answer: A
2. Postmenopausal women are at increased risk for which of the following? (Select all that apply.)
A. Heart disease
B. Lupus
C. Osteoporosis
D. Diabetes
E. Turner syndrome
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Answer: A, C, D
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Answer: C
B.
C
3. What is the average age of menopause?
A. 45 years
B. 48 years
C. 51 years
D. 54 years
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4. Which of the following is the correct definition of perimenopause?
A. The period of time between menarche and menopause
B. The period of time from the onset of menopause-related symptoms to 12 months following the last
menstrual period
C. The point in time following 12 months of amenorrhea
D. A 5-year period of time following a menopause
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Answer: B
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5. Which of the following changes typically occur in perimenopause? (Select all that apply.)
A. Increased production of follicles
B. Decreased estrogen levels
C. Decreased progesterone levels
D. Decreased testosterone levels
E. Increased blood glucose levels
Answer: B, C
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6. What effect does smoking have on the timing of the onset of menopause?
A. 3-year earlier onset
B. 1.5-year earlier onset
C. 1.5-year later onset
D. 3-year later onset
Answer: B
7. Which ethnicity has been associated with a later onset of menopause?
A. Hispanic
B. African American
C. White
D. Japanese
Answer: D
8. What percentage of women in perimenopause experience minimal to no menopause-related symptoms?
A. 3%
B. 13%
C. 23%
D. 33%
Answer: D
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9. What is the single most common menopause-related symptom among postmenopausal women?
A. Irritability
B. Sleep disturbances
C. Hot flashes
D. Fatigue
C
Answer: C
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B.
10. Kayla, a 47-year-old client, has been diagnosed with genitourinary syndrome. On the basis of this
diagnosis, the nurse recognizes that Kayla most likely experiences which of the following symptoms,
associated with this syndrome? (Select all that apply.)
A. Heavier menstrual flow
B. Vaginal dryness
C. Vulvovaginal atrophy
D. Hot flashes
E. Dyspareunia
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Answer: B, C, E
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11. A nurse practitioner is preparing to perform a physical examination on a client displaying menopauseassociated symptoms. What should the nurse include in the examination? (Select all that apply.)
A. Vital signs
B. Height and weight measurements
C. Endoscopic examination
D. Clinical breast examination
E. Pelvic examination
Answer: A, B, D, E
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12. Daphne is a 49-year-old perimenopausal client who has been experiencing severe hot flashes in recent
months. To help Daphne alleviate this symptom, the nurse should recommend that she avoid which of the
following? (Select all that apply.)
A. Caffeine
B. Alcohol
C. Dairy products
D. Spicy foods
E. Meats
Answer: A, B, D
13. Nova, a 47-year-old perimenopausal client, has heard that isoflavones can help reduce the severity of hot
flashes. Which foods should the nurse mention as containing isoflavones? (Select all that apply.)
A. Ginger
B. Red clover
C. Ginseng
D. Soy
E. Alfalfa
Answer: B, D
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14. Lyla, a 45-year-old client who recently entered perimenopause, tells her nurse that she has seen “natural”
hormones advertised and asks about them. Which of the following should the nurse tell Lyla about these
products? (Select all that apply.)
A. Unlike bioidentical hormones, they are derived from all-natural sources
B. They cause fewer side effects than do pharmaceutically manufactured hormones
C. They are identical to the hormones produced in a woman’s body
D. They are not as effective as bioidentical hormones
E. They are safer than pharmaceutically manufactured hormones
C
Answer: D
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B.
15. The nurse is providing counseling to Renee, a 37-year-old client who has entered perimenopause
prematurely. Which of the following should the nurse tell Renee to expect as a result of this condition,
compared with women who enter perimenopause at the typical time? (Select all that apply.)
A. Less severe menopause-related symptoms
B. Early loss of fertility
C. Increased risk for osteoporosis
D. Decreased risk for cardiovascular disease
E. Increased life expectancy
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Answer: B, C
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CHAPTER 35
Osteoporosis
1. How many standard deviations below the mean bone-mineral density of a young-adult reference population
define osteoporosis diagnostically?
A. 1.5
B. 2.5
C. 3.5
D. 4.5
Answer: B
2. Trina has been diagnosed with osteoporosis. The disease occurred in her gradually as she aged and became
evident only after she entered menopause. Which type of osteoporosis does Trina have?
A. Primary
B. Secondary
C. Tertiary
D. Quaternary
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Answer: A
Answer: B
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B.
C
3. At what age does peak bone mass occur in women?
A. 20 to 25 years
B. 30 to 35 years
C. 40 to 45 years
D. 50 to 55 years
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4. After the age of 35 years, bone formation occurs in response only to which of the following? (Select all that
apply.)
A. Secretion of growth hormone
B. Osteoclast activity
C. Functional load stress exerted on bone
D. Decrease in estrogen
E. Decrease in progesterone
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Answer: B, C
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5. Sandra is concerned about her risk for developing osteoporosis and wants to know what she can do to help
prevent it. Which of the following should be mentioned by the nurse as examples of potentially modifiable
risk factors? (Select all that apply.)
A. Amenorrhea related to an eating disorder
B. Weight greater than 127 lb
C. Cigarette smoking
D. Low estrogen level
E. Sedentary lifestyle
Answer: A, C, D, E
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6. Which of the following are nonmodifiable risk factors associated with osteoporosis? (Select all that apply.)
A. Advanced age
B. Dementia
C. A history of fractures
D. Poor nutrition
E. Sedentary lifestyle
Answer: A, B, C
7. Which of the following reveal the presence of painless vertebral compression fractures associated with
osteoporosis?
A. Increase in waist circumference
B. Reduction in height
C. Increase in body mass index (BMI)
D. Decrease in orthostatic blood pressure
Answer: B
8. Which of the following should be stressed as an adequate intake for a client by a nurse practitioner
providing the client with nutrition guidance related to prevention of osteoporosis? (Select all that apply.)
A. Carbohydrates
B. Calcium
C. Vitamin D
D. Chloride
E. Phosphorus
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Answer: B, C, E
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B.
C
9. A client would like recommendations for weight-bearing or resistance exercises that would be helpful in
preventing osteoporosis. Which of the following should the nurse suggest? (Select all that apply.)
A. Walking
B. Water aerobics
C. Weight lifting
D. Swimming
E. Dancing
Answer: A, C, E
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10. A woman is interested in initiating oral bisphosphonate therapy to prevent further bone loss. At what Tscore is initiating therapy appropriate according to the National Osteoporosis Foundation?
A. −2.0 or less
B. −2.5 or less
C. −3.0 or less
D. −3.5 or less
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Answer: B
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CHAPTER 36
The Challenge of Unintended Pregnancies
1.
At a population level, which of the following factors are associated with the likelihood of experiencing an
unintended pregnancy?
A. Marital status
B. Income
C. Education level
D. Age
Answer: A, B, C, D
2. Which symptoms, in a person of reproductiveage with female sexual organs, should prompt the nurse to
obtain a pregnancy test?
A. Nausea/vomiting
B. Headaches
C. Confusion
D. Missed menses
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Answer: A and D
Answer: A
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B.
C
3. The nurse is assessing a client who has come in to confirm that she is pregnant. Which type of screening
should the nurse include as a matter of routine in this assessment?
A. Intimate partner violence
B. Mental illness
C. Alcoholism
D. Cholesterol
Answer: B
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4. Emma, a 16-year-old client, came into the office to have a pregnancy test. She appears anxious and tears up
at one point. After conducting the pregnancy test and finding that it is positive, the nurse approaches Emma
to deliver the news. Which of the following would be the best thing for the nurse to tell the client?
A. “Congratulations! You’re pregnant. I’m so happy for you.”
B. “The test is positive. That means you are pregnant.”
C. “The bad news is, ‘you’re pregnant’. The good news is, ‘I have some helpful literature on abortion for you
to peruse.’”
D. “Well, you are pregnant. But don’t worry—I had my first child when I was your age, and everything has
turned out fine.”
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5. A client’s pregnancy test results are negative. After conveying this news to the client, what else should the
nurse discuss with her? (Select all that apply.)
A. Preconception counseling, if the client wants to be pregnant
B. The high level of accuracy of modern pregnancy tests
C. Contraception options, if the client does not want to be pregnant
D. The exact date of the onset of the client’s last menstrual period
E. Symptoms associated with morning sickness
Answer: A, C
6. Ruby, a 39-year-old client, has just learned that she is pregnant. As part of pregnancy options counseling,
what is the first thing the nurse should say?
A. “What kind of support systems do you have to help you during your pregnancy?”
B. “Let’s discuss your options. I have some literature on adoption, as well as some on abortion.”
C. “Are you aware of the risks of delivering a baby at your age?”
D. “How do feel about being pregnant?”
Answer: D
7. In what year did the landmark Supreme Court ruling in the case of Roe vs. Wade result in the legalization of
abortion?
A. 1968
B. 1973
C. 1978
D. 1983
Answer: B
B.
C
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8. By the age of 45 years, what proportion of women will have an abortion?
A. Two out of every 10
B. Three out of every 10
C. Four out of every 10
D. Five out of every 10
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Answer: B
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9. There are many reasons that people choose to end a pregnancy. Which of the following are among the most
common reasons for seeking an abortion?
A. Finances
B. Partner factors
C. Difficulty locating prenatal care
D. Using drugs or alcohol during the pregnancy
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Answer: A, B
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10. During which trimester do most abortion occur?
A. First
B. Second
C. Third
D. Equally divided between first and second trimesters
Answer: A
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11. Which of the following are advantages of medication abortion over aspiration abortion? (Select all that apply.)
A. Requires only one office visit to complete the abortion
B. Usually allows avoiding an invasive procedure
C. Typically involves only light bleeding after the procedure
D. Most of the experience occurs at home
E. The client may be more likely to feel that she has control over the experience
Answer: B, D, E
12. Valencia is a 19-year-old client who is in the 18th week of pregnancy and would like to have an abortion.
She lives in a large city with abundant women’s health facilities and clinicians. What method of abortion is
Valencia most likely to undergo?
A. Aspiration
B. Medication
C. Dilation and evacuation
D. Labor induction
Answer: C
13. How many states currently allow nurse practitioners to perform both medication and aspiration abortions?
A. 4
B. 14
C. 24
D. 34
Answer: A
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C
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14. Which of the following is a non-pharmacological support measure that can be offered to women
undergoing an abortion?
A. Analgesics like ibuprofen
B. Doula support
C. Verbal support
D. General anesthesia
Answer: B and C
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15. Angel is a 17-year-old client in her 10th week of pregnancy, who has arrived seeking an abortion. Which of
the following are the highest priority actions for the nurse to take in this situation?
A. Provide information on health-related public assistance programs
B. Review the state’s parental consent laws related to abortion
C. Screen for safety at home and intimate partner violence
D. Screen for sexually transmitted infections
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CHAPTER 37
Infertility
1. Ingrid is a 32-year-old client who has struggled to get pregnant and has come to the office today to find out
if she might be infertile. In Ingrid’s case, which of the following criteria must be met for infertility to be
diagnosed, as should be explained by the nurse? (Select all that apply.)
A. No prior pregnancies
B. Regular sexual intercourse
C. Unprotected sexual intercourse
D. Well-timed sexual intercourse
E. At least 12 months of actively attempting to get pregnant
Answer: B, C, D, E
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2. At what age is it estimated that fertility begins to decline in women?
A. 30
B. 35
C. 40
D. 45
Answer: B
Answer: A
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C
3. For the period 2011 to 2013, about what percentage of women aged 15 to 44 years reported difficulty
getting pregnant or carrying a baby to term?
A. 24%
B. 34%
C. 44%
D. 54%
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4. Bonnie is a 31-year-old client who has been trying to get pregnant for 18 months now. After interviewing
Bonnie and going over her health record, which of the following are the risk factors for infertility, as should
be mentioned by the nurse to Bonnie? (Select all that apply.)
A. Her age (31 years)
B. Drinking two beers per day
C. Body mass index (BMI) of 16
D. Strict vegetarian diet
E. Walking a mile each day for exercise
Answer: B, C, D
5. Minnie is a 21-year-old client who has just been diagnosed with chlamydia. What complication associated
with this infection that can lead to infertility should the nurse inform Minnie of?
A. Pelvic inflammatory disease
B. Epididymitis
C. Ovarian cancer
D. Endometriosis
Answer: A
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6. Mike, a 40-year-old client, is coming to the office to undergo assessment related to infertility. Which of the
following should the nurse tell Mike to be prepared to do?
A. Undergo a digital rectal exam
B. Have a urinary catheter placed
C. Undergo an EKG
D. Masturbate to provide a semen specimen
Answer: D
7. Which of the following are risk factors for males related to infertility? (Select all that apply.)
A. Undescended testicles
B. History of radiography of the groin
C. Onset of puberty at the age of 13 years
D. Erectile dysfunction
E. Mumps-related orchitis
Answer: A, B, D, E
8. Hope, a 35-year-old client, has been diagnosed with oligomenorrhea. Which of the following are
medications the nurse should consider prescribing to Hope to induce ovulation and aid conception? (Select
all that apply.)
A. Mifepristone
B. Levonorgestrel
C. Clomiphene citrate
D. Aromatase inhibitor
E. Human chorionic gonadotropin
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Answer: C, D, E
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Answer: C
B.
C
9. Which assistive reproductive technology has a higher fecundability than natural conception?
A. Intrauterine insemination
B. Gamete intrafallopian transfer
C. In vitro fertilization
D. Zygote intrafallopian transfer
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10. What recommendations related to use of reproductive technologies should the nurse follow to help avoid
ethical problems? (Select all that apply.)
A. Progress from invasive to conservative measures
B. Avoid excessive treatments and costs
C. Provide full disclosure regarding success rates of a procedure before initiating it
D. Offer counseling for gamete donors, surrogates, and their partners
E. Insist that the offspring conceived by gamete donation be informed of the nature of conception by the age
of 12 years
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11. A client with ovarian cancer who will be undergoing surgery and radiation therapy is concerned that she
will become infertile as a result of the treatment. Which of the following should the nurse recommend that
the client consider?
A. Cryopreservation of her oocytes
B. Estrogen therapy
C. Intrauterine insemination
D. Adoption
Answer: A
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CHAPTER 38
High-Risk Childbearing
After teaching a woman who has had an evacuation for a hydatidiform mole (molar pregnancy. about her
condition, which of the following statements indicates that the nurses teaching was successful?
A) I will be sure to avoid getting pregnant for at least 1 year.
B) My intake of iron will have to be closely monitored for 6 months.
C) My blood pressure will continue to be increased for about 6 more months.
D)I wont use my birth control pills for at least a year or two.
Which of the following findings on a prenatal visit at 10 weeks might lead the nurse to suspect a
2.
hydatidiform mole?
A) Complaint of frequent mild nausea
B) Blood pressure of 120/84 mm Hg
C) History of bright red spotting 6 weeks ago
D)Fundal height measurement of 18 cm
A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding
3.
would the nurse interpret as indicating a therapeutic level of medication?
A) Urinary output of 20 mL per hour
B) Respiratory rate of 10 breaths/minute
C) Deep tendons reflexes 2+
D)Difficulty in arousing
Upon entering the room of a client who has had a spontaneous abortion, the nurse observes the client
4.
crying. Which of the following responses by the nurse would be most appropriate?
A) Why are you crying?
B) Will a pill help your pain?
C) Im sorry you lost your baby.
D)A baby still wasnt formed in your uterus.
Which of the following data on a clients health history would the nurse identify as contributing to the
5.
clients risk for an ectopic pregnancy?
A) Use of oral contraceptives for 5 years
B) Ovarian cyst 2 years ago
C) Recurrent pelvic infections
D)Heavy, irregular menses
In a woman who is suspected of having a ruptured ectopic pregnancy, the nurse would expect to assess
6.
for which of the following as a priority?
A) Hemorrhage
B) Jaundice
C) Edema
D)Infection
Which of the following findings would the nurse interpret as suggesting a diagnosis of gestational
7.
trophoblastic disease?
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A) Elevated hCG levels, enlarged abdomen, quickening
B) Vaginal bleeding, absence of FHR, decreased hPL levels
C) Visible fetal skeleton on ultrasound, absence of quickening, enlarged abdomen
D)Gestational hypertension, hyperemesis gravidarum, absence of FHR
It is determined that a clients blood Rh is negative and her partners is positive. To help prevent Rh
8.
isoimmunization, the nurse anticipates that the client will receive RhoGAM at which time?
A) At 34 weeks gestation and immediately before discharge
B) 24 hours before delivery and 24 hours after delivery
C) In the first trimester and within 2 hours of delivery
D)At 28 weeks gestation and again within 72 hours after delivery
The nurse is developing a plan of care for a woman who is pregnant with twins. The nurse includes
9.
interventions focusing on which of the following because of the womans increased risk?
A) Oligohydramnios
B) Preeclampsia
C) Post-term labor
D)Chorioamnionitis
A woman hospitalized with severe preeclampsia is being treated with hydralazine to control blood
10.pressure. Which of the following would the lead the nurse to suspect that the client is having an adverse
effect associated with this drug?
A) Gastrointestinal bleeding
B) Blurred vision
C) Tachycardia
D) Sweating
After reviewing a clients history, which factor would the nurse identify as placing her at risk for
11.
gestational hypertension?
A) Mother had gestational hypertension during pregnancy.
B) Client has a twin sister.
C) Sister-in-law had gestational hypertension.
D) This is the clients second pregnancy.
A client with hyperemesis gravidarum is admitted to the facility after being cared for at home without
12.
success. Which of the following would the nurse expect to include in the clients plan of care?
A) Clear liquid diet
B) Total parenteral nutrition
C) Nothing by mouth
D) Administration of labetalol
The nurse is reviewing the laboratory test results of a pregnant client. Which one of the following
13.
findings would alert the nurse to the development of HELLP syndrome?
A) Hyperglycemia
B) Elevated platelet count
C) Leukocytosis
D) Elevated liver enzymes
Which of the following would the nurse have readily available for a client who is receiving magnesium
14.
sulfate to treat severe preeclampsia?
A) Calcium gluconate
B) Potassium chloride
C) Ferrous sulfate
D) Calcium carbonate
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15.Which assessment finding would lead the nurse to suspect infection as the cause of a clients PROM?
A) Yellow-green fluid
B) Blue color on Nitrazine testing
C) Ferning
D) Foul odor
While assessing a pregnant woman, the nurse suspects that the client may be at risk for hydramnios
16.
based on which of the following? (Select all that apply.)
A) History of diabetes
B) Complaints of shortness of breath
C) Identifiable fetal parts on abdominal palpation
D) Difficulty obtaining fetal heart rate
E) Fundal height below that for expected gestataional age
After teaching a group of nursing students about the possible causes of spontaneous abortion, the
17.instructor determines that the teaching was successful when the students identify which of the following
as the most common cause of first trimester abortions?
A) Maternal disease
B) Cervical insufficiency
C) Fetal genetic abnormalities
D) Uterine fibroids
A pregnant woman is admitted with premature rupture of the membranes. The nurse is assessing the
18.woman closely for possible infection. Which of the following would lead the nurse to suspect that the
woman is developing an infection? (Select all that apply.)
A) Fetal bradycardia
B) Abdominal tenderness
C) Elevated maternal pulse rate
D) Decreased C-reactive protein levels
E) Cloudy malodorous fluid
A nurse is teaching a pregnant woman with preterm premature rupture of membranes who is about to
19.be discharged home about caring for herself. Which statement by the woman indicates a need for
additional teaching?
A) I need to keep a close eye on how active my baby is each day.
B) I need to call my doctor if my temperature increases.
C) Its okay for my husband and me to have sexual intercourse.
D) I can shower but I shouldnt take a tub bath.
A nurse is assessing a pregnant woman with gestational hypertension. Which of the following would lead
20.
the nurse to suspect that the client has developed severe preeclampsia?
A) Urine protein 300 mg/24 hours
B) Blood pressure 150/96 mm Hg
C) Mild facial edema
D) Hyperreflexia
A nurse suspects that a pregnant client may be experiencing abruption placenta based on assessment of
21.
which of the following? (Select all that apply.)
A) Dark red vaginal bleeding
B) Insidious onset
C) Absence of pain
D) Rigid uterus
E) Absent fetal heart tones
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The health care provider orders PGE2 for a woman to help evacuate the uterus following a spontaneous
abortion. Which of the following would be most important for the nurse to do?
A) Use clean technique to administer the drug.
B) Keep the gel cool until ready to use.
C) Maintain the client for hour after administration.
D) Administer intramuscularly into the deltoid area.
A nursing student is reviewing an article about preterm premature rupture of membranes. Which of the
23.following would the student expect to find as factor placing a woman at high risk for this condition?
(Select all that apply.)
A) High body mass index
B) Urinary tract infection
C) Low socioeconomic status
D) Single gestations
E) Smoking
A woman with placenta previa is being treated with expectant management. The woman and fetus are
24.stable. The nurse is assessing the woman for possible discharge home. Which statement by the woman
would suggest to the nurse that home care might be inappropriate?
A) My mother lives next door and can drive me here if necessary.
B) I have a toddler and preschooler at home who need my attention.
C) I know to call my health care provider right away if I start to bleed again.
D) I realize the importance of following the instructions for my care.
A woman with hyperemesis gravidarum asks the nurse about suggestions to minimize nausea and
25.
vomiting. Which suggestion would be most appropriate for the nurse to make?
A) Make sure that anything around your waist is quite snug.
B) Try to eat three large meals a day with less snacking.
C) Drink fluids in between meals rather than with meals.
D) Lie down for about an hour after you eat
A woman with gestational hypertension experiences a seizure. Which of the following would be the
26.
priority?
A) Fluid replacement
B) Oxygenation
C) Control of hypertension
D) Delivery of the fetus
A woman is receiving magnesium sulfate as part of her treatment for severe preeclampsia. The nurse is
27.
monitoring the womans serum magnesium levels. Which level would the nurse identify as therapeutic?
A) 3.3 mEq/L
B) 6.1 mEq/L
C) 8.4 mEq/L
D) 10.8 mEq/L
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Answer Key
1.
2.
3.
4.
A
D
C
C
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5. C
6. A
7. D
8. D
9. B
10.C
11.A
12.C
13.D
14.A
15.D
16.A, B, D
17.C
18.B, C, E
19.C
20.D
21.A, D, E
22.C
23.B, C, E
24.B
25.C
26.B
27.B
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CHAPTER 39
Intrapartum and Postpartum Care
A primipara client gave birth vaginally to a healthy newborn girl 48 hours ago. The nurse palpates the
clients fundus, expecting it to be at which location?
A) Two fingerbreadths above the umbilicus
B) At the level of the umbilicus
C) Two fingerbreadths below the umbilicus
D)Four fingerbreadths below the umbilicus
2. When caring for a mother who has had a cesarean birth, the nurse would expect the clients lochia to be:
A) Greater than after a vaginal delivery
B) About the same as after a vaginal delivery
C) Less than after a vaginal delivery
D)Saturated with clots and mucus
The nurse is developing a teaching plan for a client who has decided to bottle feed her newborn. Which of
3.
the following would the nurse include in the teaching plan to facilitate suppression of lactation?
A) Encouraging the woman to manually express milk
B) Suggesting that she take frequent warm showers to soothe her breasts
C) Telling her to limit the amount of fluids that she drinks
D)Instructing her to apply ice packs to both breasts every other hour
The nurse is making a follow-up home visit to a woman who is 12 days postpartum. Which of the
4.
following would the nurse expect to find when assessing the clients fundus?
A) Cannot be palpated
B) 2 cm below the umbilicus
C) 6 cm below the umbilicus
D)10 cm below the umbilicus
A client who is breast-feeding her newborn tells the nurse, I notice that when I feed him, I feel fairly
5. strong contraction-like pain. Labor is over. Why am I having contractions now? Which response by the
nurse would be most appropriate?
A) Your uterus is still shrinking in size; thats why youre feeling this pain.
B) Let me check your vaginal discharge just to make sure everything is fine.
C) Your body is responding to the events of labor, just like after a tough workout.
D)The babys sucking releases a hormone that causes the uterus to contract.
When the nurse is assessing a postpartum client approximately 6 hours after delivery, which finding
6.
would warrant further investigation?
A) Deep red, fleshy-smelling lochia
B) Voiding of 350 cc
C) Heart rate of 120 beats/minute
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D)Profuse sweating
A postpartum client who is bottle feeding her newborn asks, When should my period return? Which
7.
response by the nurse would be most appropriate?
A) Its difficult to say, but it will probably return in about 2 to 3 weeks.
B) It varies, but you can estimate it returning in about 7 to 9 weeks.
C) You wont have to worry about it returning for at least 3 months.
D)You dont have to worry about that now. Itll be quite a while.
8. The nurse interprets which of the following as evidence that a client is in the taking-in phase?
A) Client states, He has my eyes and nose.
B) Client shows interest in caring for the newborn.
C) Client performs self-care independently.
D)Client confidently cares for the newborn.
9. Which of the following would the nurse interpret as being least indicative of paternal engrossment?
A) Demonstrating pleasure when touching or holding the newborn
B) Identifying imperfections in the newborns appearance
C) Being able to distinguish his newborn from others in the nursery
D)Showing feelings of pride with the birth of the newborn
A postpartum client comes to the clinic for her 6-week postpartum checkup. When assessing the clients
10.
cervix, the nurse would expect the external cervical os to appear:
A) Shapeless
B) Circular
C) Triangular
D) Slit-like
The nurse develops a teaching plan for a postpartum client and includes teaching about how to perform
11.
Kegel exercises. The nurse includes this information for which reason?
A) Reduce lochia
B) Promote uterine involution
C) Improve pelvic floor tone
D) Alleviate perineal pain
A father of a newborn tells the nurse, I may not know everything about being a dad, but Im going to do
12.the best I can for my son. The nurse interprets this as indicating the father is in which stage of
adaptation?
A) Expectations
B) Transition to mastery
C) Reality
D) Taking-in
A postpartum client is experiencing subinvolution. When reviewing the womans labor and birth history,
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which of the following would the nurse identify as being least significant to this condition?
A) Early ambulation
B) Prolonged labor
C) Large fetus
D) Use of anesthetics
Which of the following would lead the nurse to suspect that a postpartum woman is experiencing a
14.
problem?
A) Elevated white blood cell count
B) Acute decrease in hematocrit
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C) Increased levels of clotting factors
D) Pulse rate of 60 beats/minute
A woman who gave birth 24 hours ago tells the nurse, Ive been urinating so much over the past several
15.
hours. Which response by the nurse would be most appropriate?
A) You must have an infection, so let me get a urine specimen.
B) Your body is undergoing many changes that cause your bladder to fill quickly.
C) Your uterus is not contracting as quickly as it should.
D) The anesthesia that you received is wearing off and your bladder is working again.
A group of students are reviewing the process of breast milk production. The students demonstrate
16.
understanding when they identify which hormone as responsible for milk let-down?
A) Prolactin
B) Estrogen
C) Progesterone
D) Oxytocin
A nurse is making a home visit to a postpartum woman who delivered a healthy newborn 4 days ago. The
17.womans breasts are swollen, hard, and tender to the touch. The nurse documents this finding as which
of the following?
A) Involution
B) Engorgement
C) Mastitis
D) Engrossment
A nurse is assessing a postpartum womans adjustment to her maternal role. Which of the following
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would the nurse expect to occur first?
A) Reestablishing relationships with others
B) Demonstrating increasing confidence in care of the newborn
C) Assuming a passive role in meeting her own needs
D) Becoming preoccupied with the present
The partner of a woman who has given birth to a healthy newborn says to the nurse, I want to be
19.involved, but Im not sure that Im able to care for such a little baby. The nurse interprets this as indicating
which of the following stages?
A) Expectations
B) Reality
C) Transition to mastery
D) Taking-hold
A group of nursing students are reviewing information about maternal and paternal adaptations to the
20.birth of a newborn. The nurse observes the parents interacting with their newborn physically and
emotionally. The nurse documents this as which of the following?
A) Puerperium
B) Lactation
C) Attachment
D) Engrossment
After teaching a group of nursing students about the process of involution, the instructor determines
21.
that additional teaching is needed when the students identify which of the following as being involved?
A) Catabolism
B) Muscle fiber contraction
C) Epithelial regeneration
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D) Vasodilation
A nurse is visiting a postpartum woman who delivered a healthy newborn 5 days ago. Which of the
22.
following would the nurse expect to find?
A) Bright red discharge
B) Pinkish brown discharge
C) Deep red mucus-like discharge
D) Creamy white discharge
A nurse teaches a postpartum woman about her risk for thromboembolism. Which of the following
23.
would the nurse be least likely to include as a factor increasing her risk?
A) Increased clotting factors
B) Vessel damage
C) Immobility
D) Increased red blood cell production
A nursing student is preparing a class presentation about changes in the various body systems during the
24.postpartum period and their effects. Which of the following would the student include as influencing a
postpartum womans ability to void? (Select all that apply.)
A) Use of an opioid anesthetic during labor
B) Generalized swelling of the perineum
C) Decreased bladder tone from regional anesthesia
D) Use of oxytocin to augment labor
E) Need for an episiotomy
A postpartum woman who has experienced diastasis recti asks the nurse about what to expect related to
25.
this condition. Which response by the nurse would be most appropriate?
A) Youll notice that this will fade to silvery lines.
B) Exercise will help to improve the muscles.
C) Expect the color to lighten somewhat.
D) Youll notice that your shoe size will increase.
A group of nursing students are reviewing respiratory system adaptations that occur during the
26.postpartum period. The students demonstrate understanding of the information when they identify
which of the following as a postpartum adaptation?
A) Continued shortness of breath
B) Relief of rib aching
C) Diaphragmatic elevation
D) Decrease in respiratory rate
A woman who delivered a healthy newborn several hours ago asks the nurse, Why am I perspiring so
27.much? The nurse integrates knowledge that a decrease in which hormone plays a role in this
occurrence?
A) Estrogen
B) hCG
C) hPL
D) Progesterone
Answer Key
1. C
2. C
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3. D
4. A
5. D
6. C
7. B
8. A
9. B
10.D
11.C
12.B
13.A
14.B
15.B
16.D
17.B
18.C
19.B
20.C
21.D
22.B
23.D
24.B, C, D
25.B
26.B
27.A
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CHAPTER 40
Mental Health Challenges
1. The nurse is interviewing and reviewing the health history of a 43-year-old client recently diagnosed with
posttraumatic stress disorder (PTSD). Which of the following incidents would likely cause PTSD? (Select
all that apply.)
A. Being inundated with a persistent, recurrent impulse to brush her teeth
B. Being raped as a freshman in college
C. Being slapped and punched by her husband 5 years ago
D. Being criticized by a coworker for missing a deadline
E. Being sexually molested when 7 years old
Answer: B, C, E
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Answer: B, C
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2. Which personality traits are associated with the presence of eating disorders and concomitant mood
disorders? (Select all that apply.)
A. High self-esteem
B. Perfectionism
C. Perceived ineffectiveness
D. Low IQ
E. Lack of athletic skill
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B.
3. A nurse is assessing a client who is complaining of fatigue and insomnia in recent months. The client
denies any mood disorders but appears depressed to the nurse. What measures should the nurse take to help
reveal any underlying mental health conditions in this client? (Select all that apply.)
A. Investigate possible causes of the client’s fatigue and insomnia
B. Convey empathy and respect while questioning the client
C. Take the client’s blood pressure
D. Ask about mood changes in the client related to her menstrual cycle
E. Give the client a business card referring to a local psychiatrist
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4. Which of the following is the median age of onset for anxiety disorders?
A. 11 years
B. 14 years
C. 17 years
D. 20 years
Answer: A
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5. Which of the following are common symptoms of panic disorder? (Select all that apply.)
A. A recurrent, persistent impulse to wash one’s hands
B. A sense of having a heart attack
C. Dizziness
D. Anxiety over being in a large crowd at a concert
E. A sense of imminent doom
Answer: B, C, D, E
6. What is the normal duration of a panic attack?
A. 5 to 10 minutes
B. 20 to 30 minutes
C. 40 to 60 minutes
D. 1 to 2 hours
Answer: B
7. Wanda is a client who was recently diagnosed with generalized anxiety disorder. Which of the following
symptoms are consistent with that diagnosis? (Select all that apply.)
A. Muscle tension
B. Sudden onset and rapid progression of anxiety
C. Irritability
D. Headaches
E. Excessive worrying about everyday life
Answer: A, C, D, E
Answer: B
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8. Paige, a 16-year-old client, tells her nurse that she dreads going to her high school every day because she
fears that her fellow classmates will criticize her appearance or what she says in class. She says that the
anxiety is so bad some days that she is unable to get out of bed in the morning. Which anxiety disorder
should the nurse expect most in Paige?
A. Generalized anxiety disorder
B. Social anxiety disorder
C. Panic disorder
D. Obsessive-compulsive disorder
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9. Melanie, a 24-year-old client, tells her nurse that she brushes her teeth up to 20 times per day. Her dentist
has told her that it is causing a loss of the tooth enamel and gum recession, but Melanie feels that she has to
do it. The nurse should recognize this phenomenon as which of the following?
A. An obsession
B. A compulsion
C. A manic episode
D. A panic attack
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10. What percentage of women experience major depression in their lifetimes?
A. 11.3%
B. 21.3%
C. 31.3%
D. 41.3%
Answer: B
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11. Kellen is a client with a history of major depression. Lately, however, she describes having experienced
some “manic” episodes and wonders whether she might be bipolar. Which of the following symptoms
described by Kellen should the nurse recognize as consistent with a manic episode? (Select all that apply.)
A. Feelings of worthlessness
B. Reduced need for sleep
C. Racing thoughts
D. Loss of interest in sex
E. Talkativeness
Answer: B, C, E
12. Mindy is a 28-year-old client who gave birth 2 weeks ago. She currentlycomplains of fatigue, unexplained
crying spells, and hallucinations, all of which began just a few days after birth. What condition should the
nurse expect most in Mindy?
A. Postpartum depression
B. Postpartum psychosis
C. Bipolar disorder
D. Schizophrenia
Answer: B
B.
Answer: A, C, E
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13. The nurse is assessing a client suspected of having anorexia nervosa, restricted type. Which of the
following are DSM-5 diagnostic criteria for anorexia nervosa that the nurse should consider in her
assessment of the client? (Select all that apply.)
A. Refusal to keep body weight at or above minimal body weight for age and height
B. Consuming a larger-than-normal quantity of food in a short period of time and feeling no control over
eating during the event
C. Marked fear of gaining weight and becoming obese, although underweight
D. Recurring episodes of self-induced vomiting to reduce weight gain
E. Amenorrhea—defined as the absence of menses over three consecutive months
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14. Katie is a 17-year-old client who has just been diagnosed with anorexia nervosa. She is 20% below her
expected weight but is currently medically and nutritionally stable. Which intervention should the nurse
expect to make for Katie?
A. Admission to the hospital
B. Referral to a 2-week inpatient program
C. Referral to a 6-month inpatient program
D. Prescription for a selective serotonin reuptake inhibitor (SSRI) medication
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CHAPTER 41
Substance Abuse and Women
1. According to the definition of a substance-use disorder, which of the following would indicate an alcoholuse disorder in a client? (Select all that apply.)
A. Drinking a glass of wine every day
B. Developing cirrhosis of the liver due to excessive drinking
C. Being charged with three driving under the influence within a year
D. Having a hangover after a long night out drinking with friends
E. Being fired from a job after missing several days of work in row due to drinking
Answer: B, C, E
2. What percentage of young women aged 12 to 17 years report current use of any illicit substance?
A. 8%
B. 16%
C. 24%
D. 36%
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Answer: B
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3. What percentage of women reported tobacco smoking in 2014?
A. 8%
B. 16%
C. 24%
D. 36%
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4. Which of the following are biological risk factors associated with substance-use disorders? (Select all that
apply.)
A. Age
B. Sex
C. Body mass index (BMI)
D. Ethnicity
E. Family history
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5. Which of the following is a protective factor associated with substance-use disorders—that is, a factor that
reduces the risk of developing a substance-use disorder?
A. Lack of social support
B. Parental substance misuse
C. Being pregnant
D. Easy access to substances
Answer: C
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6. Julie tells her nurse that she uses cannabis daily to manage stress but doesn’t think she has a problem with
it. The nurse, however, decides to question Julie a little more. On the basis of the Diagnostic and Statistical
Manual, fifth edition (DSM-5) diagnostic criteria, which of the following findings would indicate that Julie
has cannabis-use disorder? (Select all that apply.)
A. Julie began smoking cannabis because all of her friends were doing it
B. Julie has tried several times unsuccessfully to cut down her use to just a few days per week
C. Julie admits that she has a constant craving to smoke cannabis
D. Julie has given up playing the piano because of her cannabis smoking
E. Julie often fights with her husband over how much money she has spent on cannabis
Answer: B, C, D, E
7. Arianna is concerned that she may have a drinking problem and shares this with her nurse. The nurse asks
about her alcohol use and reviews her health history. On the basis of the Diagnostic and Statistical Manual,
fifth edition (DSM-5) diagnostic criteria, which of the following findings would indicate that Arianna has
alcohol-use disorder? (Select all that apply.)
A. Arianna typically has two drinks when she goes out with her friends
B. Arianna has gone from being a straight-A student to failing three classes since she started drinking 6
months ago
C. Arianna has experienced headaches, nausea, tremors, and anxiety when she has tried to stop drinking
D. Arianna starts feeling buzzed after just one beer
E. Arianna has passed out from drinking on several occasions
Answer: B, C, E
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8. While the nurse is screening a client for substance use, the client admits to currently using a substance.
What further information should the nurse gather about the client’s substance use? (Select all that apply.)
A. The name of the dealer the client bought the substance from
B. The triggers that contribute to the client using the substance
C. The age of the client on first use of the substance
D. How frequently the client uses the substance
E. How much money the client has spent on the substance
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9. A nurse is conducting a mental status assessment on a client suspected of being under the influence of a
narcotic. Which of the following should the nurse include in this assessment? (Select all that apply.)
A. Orientation to time, place, and person
B. Alertness
C. IQ
D. Memory
E. Visual acuity
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10. The nurse is looking over laboratory test results for a client who is being screened for alcohol-use disorder.
What findings would be consistent with excessive alcohol use? (Select all that apply.)
A. Increased potassium level
B. Increased total cholesterol level
C. Increased triglycerides level
D. Increased aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio
E. Increased ammonia level
Answer: C, D, E
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11. A nurse rewards a client who has a substance-use disorder every time she has a negative drug screen by
letting her draw a prize from a fishbowl in the office. This type of intervention is known as which of the
following?
A. Contingency management
B. Cognitive behavioral therapy
C. Screening, brief intervention, and referral to treatment (SBIRT)
D. Motivational interviewing
Answer: A
12. A nurse is helping a client with an opioid-use disorder learn to identify the dysfunctional thought patterns
that lead her to use opioids and replace them with healthier, more effective thoughts. Which type of
intervention is this example?
A. Contingency management
B. Cognitive behavioral therapy
C. SBIRT
D. Motivational interviewing
Answer: B
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13. A nurse is planning on prescribing a medication to a client who has an addiction to oxycodone. Which of
the following is a medication approved by the Food and Drug Administration for treating opioid-use
disorder?
A. Disulfiram
B. Methadone
C. Bupropion
D. Varenicline
Answer: B
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14. A nurse is planning on prescribing a medication to a client who is a recovering alcoholic. Which of the
following is a medication approved by the Food and Drug Administration for treating alcohol-use disorder?
A. Disulfiram
B. Methadone
C. Bupropion
D. Varenicline
Answer: A, B, D, E
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15. Which of the following are among future goals related to treating women with substance-use disorders?
(Select all that apply.)
A. Educate and prepare health care providers to more effectively assess women for substance use
B. Avoid using stigmatizing language when working with women with substance-use disorders
C. Advocate for unisex treatment approaches to substance-use disorders
D. Urge the pharmaceuticals industry to improve the safety of their products for women
E. Focus on the needs of women veterans
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CHAPTER 42
Gender-Based Violence and Women’s Health
The nurse is presenting a class at a local community health center on violence during pregnancy. Which of
the following would the nurse include as a possible complication?
A) Hypertension of pregnancy
B) Chorioamnionitis
C) Placenta previa
D)Postterm labor
Which approach would be most appropriate when counseling a woman who is a suspected victim of
2.
violence?
A) Offer her a pamphlet about the local battered womens shelter.
B) Call her at home to ask her some questions about her marriage.
C) Wait until she comes in a few more times to make a better assessment.
D)Ask, Have you ever been physically hurt by your partner?
When describing an episode, the victim reports that she attempted to calm her partner down to keep
3.
things from escalating. This behavior reflects which phase of the cycle of violence?
A) Battering
B) Honeymoon
C) Tension-building
D)Reconciliation
A battered pregnant woman reports to the nurse that her husband has stopped hitting her and promises
4.
never to hurt her again. Which of the following is an appropriate response?
A) Thats great. I wish you both the best.
B) The cycle of violence often repeats itself.
C) He probably didnt mean to hurt you.
D)You need to consider leaving him.
5. Which of the following nursing actions would be least helpful for a client who is a victim of violence?
A) Assist the client to project her anger.
B) Provide information about a safe home and crisis line.
C) Teach her about the cycle of violence.
D)Discuss her legal and personal rights.
When describing the cycle of violence to a community group, the nurse explains that the first phase
6.
usually is:
A) Somehow triggered by the victims behavior
B) Characterized by tension-building and minor battery
C) Associated with loss of physical and emotional control
D)Like a honeymoon that lulls the victim
Which of the following statements would be most appropriate to empower victims of violence to take
7.
action?
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A) Give your partner more time to come around.
B) Rememberchildren do best in two-parent families.
C) Change your behavior so as not to trigger the violence.
D)You are a good person and you deserve better than this.
8. When a nurse suspects that a client may have been abused, the first action should be to:
A) Ask the client about the injuries and if they are related to abuse.
B) Encourage the client to leave the batterer immediately.
C) Set up an appointment with a domestic violence counselor.
D)Ask the suspected abuser about the victims injuries.
Which of the following would the nurse describe as a characteristic of the second phase of the cycle of
9.
violence?
A) The batterer is contrite and attempts to apologize for the behavior.
B) The physical battery is abrupt and unpredictable.
C) Verbal assaults begin to escalate toward the victim.
D)The victim accepts the anger as legitimately directed at her.
In addition to providing privacy, which of the following would be most appropriate initially in situations
10.
involving suspected abuse?
A) Allow the client to have a good cry over the situation.
B) Tell the client, Injuries like these dont usually happen by accident.
C) Call the police immediately so they can question the victim.
D) Ask the abuser to describe his side of the story first.
When the nurse is alone with a client, the client says, It was all my fault. The house was so messy when
11.
he got home and I know he hates that. Which response would be most appropriate?
A) It is not your fault. No one deserves to be hurt.
B) What else did you do to make him so angry with you?
C) You need to start to clean the house early in the day.
D) Remember, he works hard and you need to meet his needs.
When developing a presentation for a local community organization on violence, the nurse is planning to
12.include statistics on intimate partner abuse and its effects on children. In what percentage of the cases in
which a parent is abused are the children battered also?
A) 50% to 75%
B) 25% to 50%
C) 10% to 25%
D) Less than 5%
13.The primary goal when working with victims of intimate partner violence is to:
A) Convince them to leave the abuser soon
B) Help them cope with their life as it is
C) Empower them to regain control of their life
D) Arrest the abuser so he or she cant abuse again
14.Teaching for victims who are recovering from abusive situations must focus on ways to:
A) Enhance their personal appearance and hairstyle
B) Develop their creativity and work ethic
C) Improve their communication skills and assertiveness
D) Plan more nutritious meals to improve their own health
During a follow-up visit to the clinic, a victim of sexual assault reports that she has changed her job and
15.
moved to another town. She tells the nurse, I pretty much stay to myself at work and at home. The nurse
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interprets these findings to indicate that the client is in which phase of rape recovery?
Disorganization
Denial
Reorganization
Integration
A nurse is assessing a rape survivor for post-traumatic stress disorder. The nurse asks the woman, Do you
16.
feel as though you are reliving the trauma? The nurse is assessing for which of the following?
A) Physical symptoms
B) Intrusive thoughts
C) Avoidance
D) Hyperarousal
A group of students are preparing a class discussion about rape and sexual assault. Which of the
17.
following would the students include as being most accurate? (Select all that apply.)
A) Most victims of rape tell someone about it.
B) Few women falsely cry rape.
C) Women have rape fantasies desiring to be raped.
D) A rape victim feels vulnerable and betrayed afterwards.
E) Medication and counseling can help a rape victim cope.
After teaching a class on date rape, the instructor determines that the teaching was successful when the
18.
class identifies which of the following as the most common date rape drug?
A) Gamma hydroxybutyrate
B) Liquid ecstasy
C) Ketamine
D) Rohypnol
A nurse is caring for a woman who was recently raped. The nurse would expect this woman to
19.
experience which of the following first?
A) Denial
B) Disorganization
C) Reorganization
D) Integration
A group of nurses are researching information about risk factors for intimate partner violence in men.
20.Which of the following would the nurses expect to find related to the individual person? (Select all that
apply.)
A) Dysfunctional family system
B) Low academic achievement
C) Victim of childhood violence
D) Heavy alcohol consumption
E) Economic stress
A nurse is working with a victim of intimate partner violence and helping her develop a safety plan.
21.
Which of the following would the nurse suggest that the woman take with her? (Select all that apply.)
A) Drivers license
B) Social security number
C) Cash
D) Phone cards
E) Health insurance cards
22.A nurse is presenting a discussion on sexual violence at a local community college. When describing the
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B)
C)
D)
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B.
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incidence of sexual violence, the nurse would identify that a woman has which chance of experiencing a
sexual assault in her lifetime?
A) One in three
B) One in six
C) Two in 15
D) Three in 20
After teaching a class on sexual violence, the instructor determines that the teaching was successful
23.
when the class identifies which of the following as a type of sexual violence. (Select all that apply.)
A) Female genital cutting
B) Bondage
C) Infanticide
D) Human trafficking
E) Rape
A nurse is reading a journal article about sexual abuse. Which age range would the nurse expect to find
24.
as the peak age for such abuse?
A) 710 years
B) 812 years
C) 1418 years
D) 1822 years
After teaching a group of students about sexual abuse and violence, the instructor determines that the
25.
teaching was successful when the students describe incest as involving which of the following?
A) Sexual exploitation by blood or surrogate relatives
B) Sexual abuse of individuals over age 18
C) Violent aggressive assault on a person
D) Consent between perpetrator and victim.
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1. B
2. D
3. C
4. B
5. A
6. B
7. D
8. A
9. B
10.B
11.A
12.A
13.C
14.C
15.C
16.B
17.B, D, E
18.D
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19.B
20.B, C, D
21.A, B, C, E
22.B
23.A, B, C, D, E
24.B
25.A
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CHAPTER 43
Cardiovascular Disease in Women
1. On average, how much later in women than in men does cardiovascular disease typically occur?
A. 2 to 4 years
B. 6 to 8 years
C. 10 to 12 years
D. 14 to 16 years
Answer: C
2. The lifetime risk at the age of 50 years of women developing cardiovascular disease is which of the
following?
A. 9.2%
B. 19.2%
C. 29.2%
D. 39.2%
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B.
C
3. Which of the following are modifiable risk factors associated with cardiovascular disease? (Select all that
apply.)
A. Male gender
B. Age of 75 years
C. Cigarette smoking
D. Body mass index (BMI) of 31
E. Moderate exercise six times per year
Answer: C, D, E
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4. Which of the following are psychosocial risk factors associated with cardiovascular disease? (Select all that
apply.)
A. Obsessive-compulsive disorder
B. Depression
C. Anxiety
D. Premenstrual dysphoric disorder
E. Emotional stress
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5. The nurse must screen a client for the presence of cardiovascular disease (CVD). For which of the
following conditions is EKG-stress testing on a treadmill indicated? (Select all that apply.)
A. High risk for CVD
B. Symptoms of typical angina
C. Ability to achieve five metabolic equivalents (METs) of a task
D. Abnormal baseline EKG
E. Family history of CVD
Answer: B, C, E
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6. Claire, a 45-year-old client, is suspected of having atherosclerosis, and the nurse would like to have her
undergo diagnostic testing that will detect and quantify the amount of calcium in her arteries. Which
diagnostic test should the nurse select?
A. Exercise electrocardiogram stress testing
B. Computed tomography of the coronary vasculature
C. Cardiovascular magnetic resonance imaging
D. Coronary angiography and cardiac catheterization
Answer: B
7. The nurse takes a blood pressure reading of a 52-year-old client, Hazel, and finds that it is 144/96 mmHg.
Hazel has a body mass index (BMI) of 18, smokes, and is sedentary. Which of the following lifestyle
recommendations should the nurse make to this client? (Select all that apply.)
A. Lose 10 lb
B. Limit sodium intake to 2,400 mg/d
C. Quit smoking
D. Engage in moderate-to-vigorous aerobic physical activity at least 3 to 4 sessions/wk, for 40 minutes per
session
E. Increase intake of red meat
Answer: B, C, D
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8. Maisie, a 78-year-old client, reports feeling tightness and pain in her chest that occurs when she climbs
stairs or walks any distance when shopping. Her symptoms go away after she rests for a few minutes. What
condition should the nurse suspect most in Maisie, based on these symptoms?
A. Transient ischemic attack
B. Myocardial infarction
C. Atrial fibrillation
D. Angina pectoris
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Answer: D
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B.
9. Roberta is a 69-year-old client who reports having had an “episode” recently. She describes temporary
symptoms of numbness in her right side, confusion, and difficulty in speaking. She says that she was
planning on coming to the hospital about it, but the symptoms cleared up in about 20 minutes and she feel
fine now. Which condition should the nurse suspect most in Roberta?
A. Stroke
B. Transient ischemic attack
C. Angina pectoris
D. Atrial fibrillation
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10. Women are more likely than men to experience which of the following symptoms in an acute myocardial
infarction? (Select all that apply.)
A. Chest pain
B. Nausea
C. Shortness of breath
D. Cold sweats
E. Dizziness
Answer: B, C, D, E
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11. A nurse is caring for a client who just presented with signs of stent thrombosis (ST)-elevation myocardial
infarction. An emergency angioplasty with stenting procedure has been planned for the client. The nurse
knows that this procedure must be initiated on this client within how long since her first contact with the
nurse?
A. 30 minutes
B. 60 minutes
C. 90 minutes
D. 120 minutes
Answer: C
12. The nurse is evaluating a client diagnosed with heart failure, who reports severe, persistent symptoms while
at rest. Which functional class applies to this client?
A. Class I
B. Class II
C. Class III
D. Class IV
Answer: D
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13. Candace, an 86-year-old client, reports a sensation of palpitations, heart racing, and heart flutters in her
chest, as well as fatigue and shortness of breath. She was diagnosed with Class II heart failure 6 months
ago. Which condition should the nurse suspect most in Candace?
A. Atrial flutter
B. Angina pectoris
C. Transient ischemic attack
D. Mitral valve prolapse
Answer: A
Answer: B
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14. When auscultating a client’s heart, the nurse hears a high-pitched midsystolic click at the apex of the heart.
What condition should the nurse associate with this finding?
A. Mitral regurgitation
B. Mitral valve prolapse
C. Mitral stenosis
D. Aortic regurgitation
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15. Which of the following is the most common type of cardiomyopathy and the third leading cause of heart
failure in the United States after coronary artery disease and hypertension?
A. Dilated
B. Hypertrophic
C. Restrictive
D. Arrhythmogenic right ventricular
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CHAPTER 44
Endocrine-Related Problems
1. Which of the following are risk factors associated with hypothyroidism? (Select all that apply.)
A. Tumor of the thyroid
B. Age older than 60 years
C. Male gender
D. Family history
E. Surgical removal of the thyroid
Answer: B, D, E
2. Trina, a 62-year-old client, has been diagnosed with hypothyroidism. Which of the following treatments
should the nurse recommend for Trina?
A. Thyroidectomy
B. Levothyroxine
C. Methimazole
D. Prophylthiouracil
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Answer: D
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B.
C
3. Pamela is a client with Graves’ ophthalmopathy. Which of the following is the treatment of choice for this
client?
A. Radioactive iodine
B. Chinese herbal medicine
C. Levothyroxine
D. Thyroidectomy
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4. Jen is a client who has just been diagnosed with hyperparathyroidism. Which of the following symptoms
should the nurse expect to see in Jen? (Select all that apply.)
A. Bone fracture
B. Muscle cramps
C. Constipation
D. Cataract development
E. Depression
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5. Alice is a client with hypoparathyroidism. The nurse should advise Alice to take which of the following
supplements? (Select all that apply.)
A. Calcium
B. Iron
C. Vitamin C
D. Vitamin D
E. Vitamin K
Answer: A, D
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6. A nurse is assessing a client suspected of having metabolic syndrome. Which of the following findings,
taken together, are indicative of metabolic syndrome? (Select all that apply.)
A. Increased high-density lipoprotein cholesterol level
B. Body mass index (BMI) of 35
C. Blood pressure of 147/94 mm Hg
D. Fasting blood glucose level of 211 mg/dL
E. Resting heart rate of 101 bpm
Answer: B, C, D
7. What percentage of American adults of 65 years and older have diabetes?
A. 15%
B. 20%
C. 25%
D. 30%
Answer: C
8. Which of the following are risk factors associated with type 2 diabetes? (Select all that apply.)
A. Age older than 45 years
B. Body mass index (BMI) greater than 20
C. Blood pressure higher than 120/80 mm Hg
D. Delivering a baby with a birth weight greater than 9 lb
E. Obstructive sleep apnea
Answer: A, D, E
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9. Which of the following characteristics would be most likely in a client who has just been diagnosed with
type 1 diabetes, as opposed to type 2 diabetes?
A. Age of 14 years
B. Body mass index (BMI) of 31
C. Elevated blood insulin level
D. Blood glucose level of 88 mg/dL
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following?
A. Hypoglycemia
B. Normal glycemic status
C. Prediabetes
D. Diabetes
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11. A nurse is educating a client about complications associated with advanced type 2 diabetes. Which of the
following should the nurse mention? (Select all that apply.)
A. Spina bifida
B. Cardiovascular disease
C. Stroke
D. Blindness
E. Death
Answer: B, C, D, E
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12. A client tells the nurse that she is not feeling well and that she thinks she is having a “sugar low.” What
symptoms would tend to corroborate the client’s self-diagnosis? (Select all that apply.)
A. Inability to concentrate
B. Hyperactivity
C. Slurred speech
D. Confusion
E. Fruity breath
Answer: A, C, D
13. Ruth, a 32-year-old nulliparous client, reports secretion of milk from her breasts and having missed her last
menstrual period. The nurse conducts a pregnancy test on Ruth, and the result is negative. What condition
should the nurse suspect most in Ruth?
A. Hyperparathyroidism
B. Hyperthyroidism
C. Hyperglycemia
D. Hyperprolactinemia
Answer: D
14. Eileen is a client who presents with central obesity, a moon-shaped face, and a fatty hump between the
shoulders. Which condition should the nurse suspect most in Eileen?
A. Addison’s disease
B. Hirsutism
C. Cushing’s syndrome
D. Hyperprolactinemia
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C
15. Thelma, a 39-year-old client, reports feeling fatigued and weak recently. On examining her, the nurse finds
darkening areas of skin. A serum cortisol test indicates reduced levels. Which of the following conditions
should the nurse suspect most in Thelma?
A. Addison’s disease
B. Hirsutism
C. Cushing’s syndrome
D. Hyperprolactinemia
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CHAPTER 45
Chronic Illness and Women
1. Which of the following most accurately characterizes a chronic disease?
A. Develops rapidly
B. Involves an injury
C. Lasts less than 6 months
D. Can be controlled but not cured
Answer: D
2. Together, heart disease and cancer account for what percentage of all deaths in the United States?
A. 24%
B. 36%
C. 48%
D. 60%
Answer: C
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3. The overall course of a person’s experience as a result of an illness over time is known as which of the
following?
A. Chronic illness trajectory
B. Chronic illness etiology
C. Chronic illness criteria
D. Chronic illness diagnostics
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4. A chronic illness characterized by a persistent, progressive limitation of air flow caused by an
inflammatory response in the airways and lungs to noxious particles and gases is known as which of the
following?
A. Asthma
B. Chronic obstructive pulmonary disease
C. Lupus
D. Crohn’s disease
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5. Ursula is a 70-year-old client who has recently been diagnosed with chronic obstructive pulmonary disease.
In going over the treatment plan for Ursula, the nurse should mention which of the following as likely
interventions? (Select all that apply.)
A. Avoidance of rye, wheat, and barley grains
B. Smoking cessation
C. Bronchodilators
D. Inhaled corticosteroids
E. Transcutaneous electrical stimulation
Answer: B, C, D
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6. Lydia is 29-year-old client who has just been diagnosed with ulcerative colitis. Which of the following
symptoms should the nurse expect in Lydia? (Select all that apply.)
A. Erosion of tooth enamel
B. Heartburn
C. Frequent, loose bowel movements
D. Abdominal cramping
E. Blood and mucus in the stool
Answer: C, D, E
7. Nadine is a 53-year-old client who presents with complaints of blood in her urine, oral ulcers, hair loss, and
a butterfly-shaped rash on her face. Laboratory test results indicate anemia and leukopenia. Which
condition should the nurse suspect in Nadine?
A. Rheumatoid arthritis
B. Crohn’s disease
C. Systemic lupus erythematous
D. Celiac disease
Answer: C
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Answer: A, B, E
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8. Elizabeth is a 22-year-old client who complains of severe headaches that are worsened by bright lights and
loud sounds and that are often accompanied by nausea. She says it may be related to her diet, but she has
not determined what foods trigger it. Which foods should the nurse recommend that Elizabeth avoid?
(Select all that apply.)
A. Red wine
B. Blue cheese
C. Wheat
D. Dairy products
E. Coffee
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9. Marcia has just been diagnosed with celiac disease. Which grains should the nurse advise Marcia to avoid?
(Select all that apply.)
A. Wheat
B. Quinoa
C. Barley
D. Wild rice
E. Rye
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10. Sandra, a 69-year-old client, presents complaining of joint pain and stiffness in her hands. A physical
examination reveals joint erythema, warmth, and edema, along with limited range of motion. The nurse
suspects osteoarthritis. What diagnostic test should the nurse perform to confirm this diagnosis?
A. Antinuclear antibody test
B. Bone marrow biopsy
C. X-ray
D. Magnetic resonance imaging scan
Answer: C
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CHAPTER 46
Care of Women With Disabilities
1. The inability to carry out relevant roles due to the social impact of either a physical impairment or a
functional limitation is known as which of the following?
A. Disorder
B. Disease
C. Disability
D. Distress
Answer: C
2. Which of the following is a condition that is “age related” rather than “ageing related”?
A. Cardiomyopathy
B. Osteoarthritis
C. Presbyopia
D. Presbycusis
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3. Which of the following is a condition that is “ageing related” rather than “age related”?
A. Presbyopia
B. Breast cancer
C. Atherosclerosis
D. Chronic obstructive pulmonary disease
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4. Which of the following are mechanisms by which early-onset injuries and illnesses increase the risk of loss
of benefits, income, and health? (Select all that apply.)
A. Eligibility for government-sponsored assistance programs
B. Loss of work incentive
C. Loss of the ability to work
D. Development of empathy for others with disabilities
E. Exacerbation of preexisting conditions
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permanent disability. Which resources should the nurse help Sadie access benefits from? (Select all that
apply.)
A. Veterans Administration
B. Workers’ compensation
C. Women, Infants, and Children
D. Social Security Disability Insurance
E. Supplemental Nutrition Assistance Program
Answer: B, D
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6. Which of the following is a risk factor for declining health in a woman with a later onset disability?
A. Age of 40 years or older
B. Age of 50 years or older
C. Age of 60 years or older
D. Age of 70 years or older
Answer: C
7. Which of the following is a risk factor for declining health in a woman with a disability?
A. Early onset of menopause
B. Late onset of menopause
C. Early onset of menarche
D. Late onset of menarche
Answer: A
8. Which of the following is a risk factor for declining health in a woman with a disability?
A. Having only seven teeth left
B. Having had a root canal early in life
C. Having a dental implant
D. Wearing dentures
Answer: A
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9. To avoid a decline in health related to a sedentary lifestyle, the nurse should encourage Doris, a 63-year-old
woman who is blind, to engage in planned physical activity at least for how many days per week?
A. 1
B. 3
C. 5
D. 7
B.
C
Answer: B
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10. Which condition is a risk factor for declining health in a woman with a disability?
A. Dementia
B. Dyslexia
C. Attention deficit hyperactivity disorder
D. Obsessive-compulsive disorder
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