WomansHealthCompanionRN
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse is aware that the risk for a woman being involved in intimate partner violence in this country is:
a.1 in 2.
b.1 in 4.
c.1 in 6.
d.1 in 8.
2.When presenting a talk to high school students on intimate partner violence, the nurse explains that:
a.proportionately, more men become homicide victims than do women.
b.violence often begins early in a relationship and gets progressively worse.
c.intimate partner abuse is generally confined to the lower socioeconomic strata.
d.violence occurs randomly without any association with family violence during childhood.
3.A nurse works with a diverse clientele. When discussing intimate partner violence (IPV) with women from differing cultural backgrounds, the nurse should emphasize that:
a.rates of IPV are roughly the same among different cultural/ethnic groups.
b.women should take advantage of the resources available to victims of IPV.
c.although cultural perceptions of abuse may differ, harming others is illegal.
d.interventions in IPV situations should not take immigration status into account.
4.A clinic nurse is taking a history from a woman who has vague complaints she can't describe well. The nurse is frustrated and consults a more experienced nurse who advises checking the chart for:
a.chronic illnesses.
b.psychiatric problems.
c.missed appointments.
d.drug or alcohol abuse.
5.A woman seen in the emergency department has facial injuries she states were the result of being hit during an attempted purse-snatching. Which diagnostic finding would lead the nurse to believe the patient's account is accurate? The patient has:
a.a mandibular fracture.
b.loose and missing teeth.
c.a zygomatic arch fracture.
d.an orbital blow out fracture.
6.A woman is complaining of a sore throat and difficulty swallowing over the last several weeks. Her complete blood count (CBC) and rapid strep swab are normal. The nurse should next assess for:
a.an intact gag reflex.
b.a history of smoking.
c.signs of strangulation.
d.intimate partner violence.
7.The nurse is counseling a pregnant woman who is in a violent relationship about some of the consequences of intimate partner violence (IPV) during pregnancy. Which statement by the nurse is inconsistent with current knowledge about this situation?
a.Violence tends to decrease when a woman is pregnant.
b.Babies born to women experiencing violence often are premature.
c.Approximately one-third of homicides of pregnant women are related to IPV.
d.Kidney infections occur more often in pregnant women experiencing IPV.
8.A woman is experiencing intimate partner violence (IPV) and the nurse is trying to assist her to identify resources. The woman states she has no real friends anymore and her family won't help her. The nurse can most likely conclude that:
a.no one believes the woman is being harmed.
b.the violence is not as bad as the woman says it is.
c.the family and friends are tired of trying to help her.
d.the abuser has isolated her and intimidated her support system.
9.The manager of a busy clinic initiates a policy for screening for intimate partner violence (IPV) in accordance with the American Nurses Association (ANA) 2000 position statement. The manager explains to the staff that this means:
a.assessing all patients for the presence of IPV at every visit.
b.asking women who have injuries if they have been harmed.
c.only asking women who share a residence with someone about IPV.
d.performing an IPV assessment if the patient shares a concern about it.
10.A nurse is counseling a woman in a violent relationship about ways to keep herself safe. Which recommendation by the nurse is inconsistent with this goal? The nurse tells the patient to:
a.change the locks on the doors and install window locks.
b.try to leave the house when it appears violence is imminent.
c.pre-pack a bag with important items in case she needs to flee.
d.hide in a closet or small room when her partner is becoming violent.
11.A woman wonders if she has premenstrual syndrome. The nurse explains that the most important criteria for this diagnosis is:
a.psychological symptoms that disrupt her life.
b.the timing of the symptoms in the menstrual cycle.
c.the presence of at least five major and three minor symptoms.
d.a constellation of symptoms that occur during her cycle.
12.The nurse understands that the "luteal phase" of the menstrual cycle is the:
a.onset and duration of the monthly menstrual cycle.
b.period of time that begins with ovulation and ends with the beginning of menstruation.
c.first half of the cycle when the ovarian graafian follicle is growing.
d.time when the corpus luteum produces 80% of the circulating estrogen.
13.A nurse is providing community education on premenstrual syndrome (PMS). Which statement by the nurse is inconsistent with current knowledge about this condition?
a."Indirect costs are higher than direct medical costs for PMS."
b."The direct economic costs associated with PMS are substantial."
c."Symptoms must occur for at least six cycles for a diagnosis of PMS to be made."
d."There are at least 100 distinct signs and symptoms related to PMS."
14.The nurse explains to a patient that the main difference between premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) is:
a.the symptoms are more severe and disabling in PMDD.
b.psychiatric symptoms are present exclusively in PMDD.
c.the absence of gastrointestinal symptoms in PMDD.
d.that no effective treatment exists for PMDD.
15.A patient is in the clinic with symptoms of premenstrual syndrome (PMS). She reports extreme fatigue, depression, and a feeling of worthlessness. Which action by the nurse takes priority? The nurse should:
a.prepare the patient for a pelvic exam.
b.order blood work for hormone levels.
c.assess the patient for suicidal thoughts.
d.take a thorough history of the patient's complaints.
16.A woman with symptoms of premenstrual syndrome (PMS) asks whether or not she should have serum hormone testing. The best response by the nurse is:
a."Yes, hormone levels are important in establishing a diagnosis of PMS."
b."Yes, we can draw serial hormone levels throughout your menstrual cycle."
c."No, actually hormone levels are similar in women with and without PMS."
d."Not right now, unless you are in the follicular stage of your menstrual cycle."
17.A patient has symptoms she thinks are related to premenstrual syndrome (PMS). A strategy the nurse can teach the patient that would help with confirming the diagnosis is to:
a.monitor how long each menstrual cycle lasts.
b.keep a symptom diary for two to three menstrual cycles.
c.avoid caffeine and other stimulants while menstruating.
d.investigate the relationship between symptoms and exercise.
18.A nurse is teaching a woman with premenstrual syndrome (PMS) about exercise as a treatment modality. Which instruction by the nurse is most accurate?
a."Avoid low-intensity exercise like yoga and stretching."
b."Vigorous exercise is better than moderate exercise for PMS."
c."You need to exercise moderately at least 75 minutes a week."
d."Exercising moderately for about 150 minutes a week can help with PMS symptoms."
19.A woman with premenstrual syndrome asks about alternative and complementary medicine practices that might be helpful for her. The nurse explains that:
a.evening primrose (Oenothera biennis) has been proven beneficial in relieving PMS symptoms.
b.chasteberry has not been approved for use for PMS symptoms in any country.
c.good randomized trials of relaxation therapy demonstrate a clear benefit in PMS symptom relief.
d.there are some herbal remedies that may help to reduce PMS symptoms, but claims about the benefits associated with other herbal products are unsubstantiated.
20.A woman who has premenstrual syndrome (PMS) has been prescribed spironolactone (Aldactone) for her symptoms. The nurse would evaluate that treatment with this medication has been effective when the patient says:
a."I am so glad I don't get my period anymore because of this medication."
b."I have really noticed a decrease in my bloating while on this medication."
c."My anxiety and depression have slowly gotten better with this medicine."
d."My partner and I like that this medication decreases my PMS symptoms and provides contraception."
21.A patient asks how obesity is related to the development of breast cancer. The best response by the nurse is that:
a.adipose tissue can hide the developing tumors easily.
b.limited exercise contributes to several types of cancer.
c.estrogen is produced in adipose tissue after menopause.
d.larger breasts in heavy women are more prone to cancer.
22.A nurse wishes to plan a breast health educational activity. In order to have the greatest potential impact, in which location should the nurse conduct the activity? The nurse should plan to conduct this activity in:
a.a busy shopping mall.
b.several local fitness centers.
c.high school and college health centers.
d.a predominantly African-American church.
23.To increase comfort, the nurse advises women to perform breast self-examination (BSE)
a.one week after their menstrual cycle.
b.one week before their menstrual cycle.
c.without regard to their menstrual cycle.
d.whenever it is most comfortable for them.
24.The nurse knows the best position for the patient to assume when performing self breast palpation is:
a.sitting upright with one arm above the head.
b.lying flat on the back on a supportive mattress.
c.standing in front of a mirror in order to see well.
d.reclining in bed with a pillow under the shoulder.
25.The nurse working with a patient in her 40s would advise her to have a clinical breast examination every:
a.one year.
b.two years.
c.three years.
d.five years.
26.A patient is complaining of tender masses in her breasts that tend to change in size related to her menstrual cycle. The nurse can counsel this patient to try:
a.drinking several cups of green tea each day.
b.reducing her intake of caffeine and other stimulants.
c.sleeping on her side with pillows supporting the breasts.
d.using ice packs on the tender areas for 20 minutes at a time.
27.A patient is complaining of tender, warm lumps in her breast and tender, swollen ipsilateral lymph nodes. Which question by the nurse would elicit the most useful information? The nurse asks:
a."Are you currently breastfeeding?"
b."Where in your menstrual cycle are you?"
c."Have you had any recent breast trauma?"
d."Do you have a family history of breast cancer?"
28.A patient has a breast lump discovered during a clinical breast examination. The provider directs the patient to return after her next menstrual period for another examination. The nurse can most likely conclude that the patient:
a.has had a screening mammogram within the last year.
b.does not have significant risk factors for breast cancer.
c.frequently has lumps detected on her clinical breast exam.
d.has fibrocystic breast disease, making clinical judgment difficult.
29.A woman has been diagnosed with breast cancer in situ and questions the nurse as to what that means. The best explanation by the nurse is that this type of cancer:
a.is only found in one area of the breast that was biopsied.
b.is confined to its original location and has not spread.
c.can be treated with locally administered chemotherapy.
d.only occurs in one breast or the other; it is not bilateral.
30.A woman has unilateral breast swelling and complains that the affected breast is itching and has peeling skin. The nurse anticipates the physician will order:
a.a mammogram.
b.a dermatology consultation.
c.magnetic resonance imaging (MRI).
d.a positron emission tomography (PET scan).
31.The nurse reviewing a patient's chart sees the term "metrorrhagia" and knows that this woman is experiencing:
a.excess bleeding in either the amount or in the length of time.
b.bleeding that occurs at abnormal times during an ovulatory cycle; more often than every 21 days.
c.variable bleeding that occurs between the regular menses.
d.bleeding at abnormal times during an anovulatory cycle.
32.A patient with painful menstrual periods (dysmenorrhea) is advised to take a nonsteroidal anti-inflammatory drug such as ibuprofen (Motrin) for her discomfort. When she asks why ibuprofen is better than acetaminophen (Tylenol), the nurse explains that ibuprofen works better because:
a.acetaminophen tends to cause more side effects when taken for cramps.
b.ibuprofen tends to work more quickly than either acetaminophen or aspirin.
c.menstrual cramps are related to an inflammation of the cervical tissue and ibuprofen decreases the inflammation.
d.the pain is related to an excessive production of prostaglandins, and ibuprofen inhibits the synthesis of prostaglandins.
33.A physician tells the nurse that a patient has a positive "whiff test." The nurse anticipates that the physician will write the patient a prescription for:
a.metronidazole (Flagyl).
b.miconazole (Monistat).
c.boric acid gelatin capsules.
d.clotrimazole (Gyne-Lotrimin).
34.A patient has come to the clinic for a physical exam and complains of having her fourth vaginal yeast infection in 6 months. The diagnostic test results that the nurse would be most interested in is the:
a.Pap test.
b.blood glucose.
c.complete blood count.
d.absolute neutrophil count.
35.The nurse evaluates that teaching related to toxic shock syndrome (TSS) has been effective when the patient states:
a."I should change my tampons frequently."
b."I can use super absorbent tampons any time."
c."I should not use tampons at all during my period."
d."I can take ibuprofen for fever if I think I have TSS."
36.A woman is being prescribed leuprolide (Lupron) for endometriosis. The nurse determines that patient teaching has been effective when the patient states:
a."Side effects will be similar to menopause."
b."A serious side effect is permanent bone loss."
c."I can take this medication for years if needed."
d."If I get ankle swelling, I should call my doctor."
37.The nurse understands that "dysfunctional uterine bleeding" is diagnosed:
a.most often in women who experience normal monthly menstrual periods.
b.more often than any other cause of abnormal vaginal bleeding.
c.after all pathologic causes of bleeding have been excluded.
d.when menstrual bleeding is either abnormally heavy or lengthy.
38.A woman with heavy vaginal bleeding who does not wish to have more children is discussing endometrial ablation with the nurse. Which statement by the nurse is inconsistent with knowledge about this procedure? The nurse tells the patient:
a."Since the endometrium scars after this procedure, the bleeding is halted."
b."Following this procedure, you will not need to use any contraception when you resume sexual activity."
c."There are several methods that have been approved for endometrial ablation."
d."Endometrial ablation is usually reserved for patients who have not responded to other treatments."
39.A patient undergoing a workup for infertility also complains of hirsutism and acne. The nurse anticipates diagnostic testing for:
a.uterine fibroids.
b. benign leiomyomata.
c.follicular ovarian cysts.
d.polycystic ovary syndrome.
40.A nurse counseling a patient about infection with the Human Immunodeficiency Virus (HIV) explains that the virus is detectable in plasma within:
a.3 days.
b.5 days.
c.1 week.
d.1 month.
41.A nurse in a women's health clinic explains to a new graduate nurse that they follow current recommendations for opt-out Human Immunodeficiency Virus (HIV) testing. The nurse explains this means that patients:
a.are told about the testing but need to give specific consent for it.
b.are informed about testing but consent is assumed unless they decline.
c.can choose not to be informed of the test results when they are available.
d.can specify that they want results sent directly to them, not to the provider.
42.A woman just diagnosed with chlamydia tells the nurse she is relieved that it's "just chlamydia" and not something "serious." The best response by the nurse is to say:
a."You're right; chlamydia is easily cured with common antibiotics."
b."Yes, chlamydia is not as serious as other STDs since it isn't associated with any long-term effects."
c."Chlamydia can increase the risk of contracting ‘serious' infections like HIV."
d."All STDs are equally serious because they show that you engage in unsafe behavior."
43.The nurse caring for a woman with a chlamydial infection anticipates an order for which medication?
a.metronidazole (Flagyl) 2 grams orally administered one time
b.ceftriaxone (Rocephin) 250 mg IM administered once
c.doxycycline (Vibramycin) 100 mg orally bid for 7 days
d.acyclovir (Zovirax) 800 mg every 4 hours orally for 7 days
44.A patient diagnosed with gonorrhea was treated in the clinic with a single dose of cefixime (Suprax), 400 mg orally. Two weeks later she returns stating her symptoms are back. The nurse would most likely conclude that:
a.the woman's sex partner(s) had not been treated.
b.cefixime is not the best drug to use in this patient.
c.the patient's particular strain of gonorrhea is resistant to this medication.
d.the prescribed dose was too low to be effective against N. gonorrhoeae.
45.A patient is being treated for trichomoniasis with metronidazole (Flagyl). Which instruction specific to this medication should the nurse give the patient?
a."Don't drink alcohol until 24 hours after you have finished this medication."
b."Avoid getting any direct sunlight for 1 week after you finish the Flagyl."
c."Make sure you take all the medication that has been prescribed for you."
d."Since only one dose is needed, we will watch you take it before you leave."
46.A nurse is assisting with a pelvic examination and the provider comments that the patient has "cervical motion tenderness." With which condition does the nurse associate this finding?
a.gonorrhea
b.chlamydia
c.trichomoniasis
d.pelvic inflammatory disease
47.A patient in the clinic has what appears to be a chancre. The nurse anticipates ordering tests to confirm which disease?
a.syphilis
b.chlamydia
c.gonorrhea
d.trichomoniasis
48.A nurse is counseling a patient who engages in risky sexual behavior about getting tested for sexually transmitted diseases (STDs). The patient is hesitant to get tested, stating she is too embarrassed to do so. Which action by the nurse would most likely result in the patient's agreeing to undergo STD screening? The nurse should advise the patient that:
a.records are kept confidential and not shared with outsiders.
b.home screening for some common diseases is now available.
c.there are serious consequences of having undiagnosed STDs.
d.health-care providers have seen many patients with STDs before.
49.The nurse knows that the transformation zone is the area where the:
a.darker pink columnar cells line the vagina.
b.cervix communicates with the uterine body.
c.process of squamous metaplasia does not occur.
d.squamous cells constantly replace columnar cells.
50.A nurse is assisting with a pelvic examination and traditional Pap testing. Which action by the nurse is most important for the accuracy of the test results? The nurse should:
a.suspend the sample in a special liquid preservative.
b.preserve the specimen on a special agar-coated slide.
c.preserve the specimen within 5 seconds of collection.
d.allow the sample to air dry on the slide before analysis.
51.A nurse is explaining recommended guidelines for cervical cancer screening to a community group. Which statement by the nurse is most accurate? The nurse explains that women:
a.aged 21 to 29 should be screened every 2 years.
b.over age 60 do not need regular cervical screening.
c.30 years of age and older need to continue annual screening.
d.need their first screen when they become sexually active.
52.A nurse explains to a patient that a colposcopy is:
a.vaporization of abnormal cells using a laser beam.
b.a treatment that involves freezing of precancerous cells.
c.a specialized examination for the early detection and treatment of cancer.
d.a sampling method that uses a curette to obtain specimens.
53.A patient had an endocervical sampling procedure 2 days ago and calls the clinic complaining of a thin vaginal discharge that looks like it contains "coffee grounds." The best response by the nurse is to say:
a."This may indicate an infection; call us if you develop a fever over 101.5°F."
b."This is an abnormal reaction to the drugs used during the procedure."
c."This is a normal result of the material used to stop cervical bleeding."
d."This might indicate an allergy to the solution used in the procedure."
54.A nurse is giving a patient post-procedure education after cryosurgery. The nurse determines that additional teaching is needed when the patient states: "I should:
a.continue to obtain repeat Pap testing as directed."
b.avoid inserting anything into my vagina for 2 to 3 weeks."
c.call the office if I develop a foul-smelling watery vaginal discharge."
d.contact my health-care provider if I develop increasing pelvic pain."
55.The nurse providing education to a group of adolescents on the human papilloma virus (HPV) explains that:
a.newer HPV vaccines require only one injection.
b.only latex condoms prevent the spread of HPV.
c.most people infected with HPV have visible warts.
d.condoms may not totally prevent the spread of HPV.
56.A nurse is counseling a woman ready to initiate a new sexual relationship about testing for sexually transmitted infections (STIs). Which information about human papilloma virus (HPV) should the nurse provide to the patient?
a."Owing to the link between HPV and cervical cancer, testing for HPV is crucial."
b."HPV screening is not recommended since it is common and difficult to diagnose."
c."Since there are no treatments for HPV, there isn't a real reason to screen for it."
d."You should be screened for all STIs, including HPV, with all new relationships."
57.A clinic nurse wants to develop a program that will impact the prevalence of cervical cancer in the community. To design a program that has maximum effects, the nurse should plan to:
a.incorporate routine screening for human papilloma virus into clinic policy.
b.create a pamphlet for patients that discusses how to avoid the known risk factors.
c.provide culturally relevant education on regular Pap testing and needed follow up.
d.lobby elected representatives for federal funds to pay for cervical cancer screening.
58.A nurse is counseling a 52-year-old woman who relates that her periods have become very heavy over the last year and wonders if she is entering menopause. The best action by the nurse would be to:
a.assure the patient that at her age, she is most likely entering into menopause.
b.discuss ways to manage irregular and heavy perimenopausal menstrual cycles.
c.provide education on medical and nonpharmacological methods to treat menopause.
d.explain that heavy bleeding needs investigation even if the patient is perimenopausal.
59.The nurse caring for perimenopausal women understands that urogenital problems associated with menopause:
a.are unusual and do not often pose much difficulty.
b.are common and often worsen with advancing age.
c.usually can't be effectively treated once they manifest.
d.often are worse at the start of menopause, then improve.
60.The nurse has instructed a patient on performing Kegel exercises. The nurse determines that further instruction is needed when the patient says, "I will:
a.hold each contraction for 6 seconds."
b.do these exercises 5 to 10 times each day."
c.perform 10 repetitions as quickly as I can."
d.contract the muscles like trying to stop my urine flow."
61.A post-menopausal woman is complaining about vaginal dryness that interferes with sexual intimacy and causes discomfort. Which statement would be inconsistent with a nurse's knowledge about sexuality in post-menopausal women?
a."Frequent sexual activity actually helps with vaginal lubrication."
b."Vegetable oil may feel better than lubricants that contain alcohol."
c."If intercourse causes discomfort, you should refrain from having it."
d."If you don't have high blood pressure, you can try vitamin E supplements."
62.A nurse providing education to a community group on symptoms of menopause relates that the most common symptom reported by perimenopausal women is:
a.hot flashes.
b.hot flushes.
c.night sweats.
d.mood swings.
63.A woman reports to the nurse that she uses a traditional healing approach to manage menopausal symptoms that includes qi gong to unblock the flow of vital energy and blood through her meridians. The nurse realizes the woman is seeing a practitioner of :
a.homeopathy.
b.ayurvedic medicine.
c.naturopathic medicine.
d.traditional Chinese medicine.
64.A woman asks the nurse about using soy products to reduce her menopausal symptoms. Which information should the nurse provide?
a."Soy can be found in many products, including ginseng tea."
b."Soy is a dietary supplement and there is no proof as to its effectiveness."
c."These products are good for long-term management of vasomotor symptoms."
d."Like all the other isoflavones, soy products are monitored for safety and purity."
65.A nurse is counseling a patient about hormone therapy (HT) for symptoms of menopause. The most appropriate information the nurse can share would be:
a."If you want an estrogen-progestogen product, they only come in pill form."
b."Hormone therapy was found to cause breast cancer in recent research trials."
c."The benefits of short-term HT may outweigh the risks if used for a short time."
d."Women with cardiovascular risks should use HT just to help decrease that risk."
66.A woman wants to have her physician write a prescription for compounded, bio-identical hormone therapy (HT). Which information from the nurse is most appropriate?
a."Compounded hormones are not yet regulated by the FDA."
b."Compounding produces bio-identical hormones that are highly effective."
c."Individualized bio-identical, compounded hormones are more natural than standard prescriptions."
d."There is research that shows compounded hormones are safe and effective."