30
The Nursing Care of the Childbearing Family
1
Antepartal Care
5.
Which of the following instructions about activities during menstruation would the nurse include when counseling an adolescent who has just begun to menstruate?■ 1. Take a mild analgesic if needed for menstrual pain.
■ 2. Avoid cold foods if menstrual pain persists.
■ 3. Stop exercise while menstruating.
■ 4. Avoid sexual intercourse while menstruating.
6.
After conducting a class for female adoles- cents about human reproduction, which of the fol- lowing statements indicates that the school nurse’s teaching has been effective?■ 1. “Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes, resulting in preg- nancy.”
■ 2. “I won’t become pregnant if I abstain from intercourse during the last 14 days of my menstrual cycle.”
■ 3. “Sperm from a healthy male usually remain viable in the female reproductive tract for 96 hours.”
■ 4. “After an ovum is fertilized by a sperm, the ovum then contains 21 pairs of chromosomes.”
7.
A 20-year-old nulligravid client expresses a desire to learn more about the symptothermal method of family planning. Which of the following would the nurse include in the teaching plan?■ 1. This method has a 50% failure rate during the fi rst year of use.
■ 2. Couples must abstain from coitus for 5 days after the menses.
■ 3. Cervical mucus is carefully monitored for changes.
■ 4. The male partner uses condoms for signifi cant effectiveness.
8.
Before advising a 24-year-old client desiring oral contraceptives for family planning, the nurse would assess the client for signs and symptoms of which of the following?■ 1. Anemia.
■ 2. Hypertension.
■ 3. Dysmenorrhea.
■ 4. Acne vulgaris.
9.
After instructing a 20-year-old nulligravid cli- ent about adverse effects of oral contraceptives, the nurse determines that further instruction is needed when the client states which of the following as an adverse effect?■ 1. Weight gain.
■ 2. Nausea.
■ 3. Headache.
■ 4. Ovarian cancer.
10.
A 22-year-old nulligravid client tells the nurse that she and her husband have been consider- ing using condoms for family planning. Which of the following instructions should the nurse include about the use of condoms as a method for family planning?■ 1. Using a spermicide with the condom offers added protection against pregnancy.
■ 2. Natural skin condoms protect against sexu- ally transmitted diseases.
■ 3. The typical failure rate for couples using con- doms is about 25%.
■ 4. Condom users commonly report penile gland sensitivity.
11.
Which of the following would the nurse include in the teaching plan for a 32-year-old female client requesting information about using a dia- phragm for family planning?■ 1. Douching with an acidic solution after inter- course is recommended.
■ 2. Diaphragms should not be used if the client develops acute cervicitis.
■ 3. The diaphragm should be washed in a weak solution of bleach and water.
■ 4. The diaphragm should be left in place for 2 hours after intercourse.
12.
After being examined and fi tted for a dia- phragm, a 24-year-old client receives instructions about its use. Which of the following client state- ments indicates a need for further teaching?■ 1. “I can continue to use the diaphragm for about 2 to 3 years if I keep it protected in the case.”
■ 2. “If I get pregnant, I will have to be refi tted for another diaphragm after the delivery.”
■ 3. “Before inserting the diaphragm I should coat the rim with contraceptive jelly.”
■ 4. “If I gain or lose 20 lb, I can still use the same diaphragm.”
13.
A 22-year-old client tells the nurse that she and her husband are trying to conceive a baby.When teaching the client about reducing the inci- dence of neural tube defects, the nurse would emphasize the need for increasing the intake of which of the following foods? Select all that apply.
■ 1. Leafy green vegetables.
■ 2. Strawberries.
■ 3. Beans.
■ 4. Milk.
■ 5. Sunfl ower seeds.
■ 6. Lentils.
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14.
A couple is inquiring about vasectomy as a permanent method of contraception. Which teach- ing statement would the nurse include in the teach- ing plan?■ 1. “Another method of contraception is needed until the sperm count is 0.”
■ 2. “Vasectomy is easily reversed if children are desired in the future.”
■ 3. “Vasectomy is contraindicated in males with prior history of cardiac disease.”
■ 4. “Vasectomy requires only a yearly follow-up once the procedure is completed.”
15.
A 39-year-old multigravid client asks the nurse for information about female sterilization with a tubal ligation. Which of the following client state- ments indicates effective teaching?■ 1. “My fallopian tubes will be tied off through a small abdominal incision.”
■ 2. “Reversal of a tubal ligation is easily done, with a pregnancy success rate of 80%.”
■ 3. “After this procedure, I must abstain from intercourse for at least 3 weeks.”
■ 4. “Both of my ovaries will be removed during the tubal ligation procedure.”
16.
A 23-year-old nulliparous client visiting the clinic for a routine examination tells the nurse that she desires to use the basal body temperature method for family planning. The nurse should instruct the client to do which of the following?■ 1. Check the cervical mucus to see if it is thick and sparse.
■ 2. Take her temperature at the same time every morning before getting out of bed.
■ 3. Document ovulation when her temperature decreases at least 1° F.
■ 4. Avoid coitus for 10 days after a slight rise in temperature.
17.
A couple visiting the infertility clinic for the fi rst time states that they have been trying to con- ceive for the past 2 years without success. After a history and physical examination of both partners, the nurse determines that an appropriate outcome for the couple would be to accomplish which of the following by the end of this visit?■ 1. Choose an appropriate infertility treatment method.
■ 2. Acknowledge that only 50% of infertile couples achieve a pregnancy.
■ 3. Discuss alternative methods of having a fam- ily, such as adoption.
■ 4. Describe each of the potential causes and pos- sible treatment modalities.
18.
A client is scheduled to have in vitro fertil- ization (IVF) as an infertility treatment. Which of the following client statements about IVF indicates that the client understands this procedure?■ 1. “IVF requires supplemental estrogen to enhance the implantation process.”
■ 2. “The pregnancy rate with IVF is higher than that with gamete intrafallopian transfer.”
■ 3. “IVF involves bypassing the blocked or absent fallopian tubes.”
■ 4. “Both ova and sperm are instilled into the open end of a fallopian tube.”
19.
A 20-year-old primigravid client tells the nurse that her mother had a friend who died from hemorrhage about 10 years ago during a vaginal delivery. Which of the following responses would be most helpful?■ 1. “Today’s modern technology has resulted in a low maternal mortality rate.”
■ 2. “Don’t concern yourself with things that hap- pened in the past.”
■ 3. “In the United States, mothers seldom die in childbirth.”
■ 4. “What is it that concerns you about preg- nancy, labor, and delivery?”
20.
A 19-year-old nulligravid client visiting the clinic for a routine examination asks the nurse about cervical mucus changes that occur during the menstrual cycle. Which of the following statements would the nurse expect to include in the client’s teaching plan?■ 1. About midway through the menstrual cycle, cervical mucus is thick and sticky.
■ 2. During ovulation, the cervix remains dry without any mucus production.
■ 3. As ovulation approaches, cervical mucus is abundant and clear.
■ 4. Cervical mucus disappears immediately after ovulation, resuming with menses.
21.
When instructing a client about the proper use of condoms for pregnancy prevention, which of the following instructions would be included to ensure maximum effectiveness?■ 1. Place the condom over the erect penis before coitus.
■ 2. Withdraw the condom after coitus when the penis is fl accid.
■ 3. Ensure that the condom is pulled tightly over the penis before coitus.
■ 4. Obtain a prescription for a condom with non- oxynol 9.
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22.
A multigravid client will be using medroxy- progesterone acetate (Depo-Provera) as a family planning method. After the nurse instructs the cli- ent about this method, which of the following client statements indicates effective teaching?■ 1. “This method of family planning requires monthly injections.”
■ 2. “I should have my fi rst injection during my menstrual cycle.”
■ 3. “One possible adverse effect is absence of a menstrual period.”
■ 4. “This drug will be given by subcutaneous injections.”
23.
Which of the following instructions should the nurse include in the teaching plan for a 30-year- old multiparous client who will be using an intra- uterine device (IUD) for family planning?■ 1. Amenorrhea is a common adverse effect of IUDs.
■ 2. The client needs to use additional protection for conception.
■ 3. IUDs are more costly than other forms of con- traception.
■ 4. Severe cramping may occur when the IUD is inserted.
24.
After counseling a 35-year-old client about breast self-examination and mammography, the nurse determines that the client has understood the instructions when the client states which of the fol- lowing?■ 1. “I should have a mammogram every year once I’m 40.”
■ 2. “I should schedule a mammography examina- tion during my menstrual period.”
■ 3. “Mammography screening is inexpensive.”
■ 4. “Mammography is an extremely painful procedure.”
25.
After instructing a 40-year-old woman about osteoporosis after menopause, the nurse determines that the client needs further instruction when the client states which of the following?■ 1. “One cup of yogurt is the equivalent of one glass of milk.”
■ 2. “Women who do not eat dairy products should consider calcium supplements.”
■ 3. “African American women are at the greatest risk for osteoporosis.”
■ 4. “Estrogen therapy at menopause can reduce the risk of osteoporosis.”
26.
When developing a teaching plan for an 18 year old client who asks about treatments for sexually transmitted diseases, the nurse should explain that?■ 1. Acyclovir (Zovirax) can be used to cure her- pes genitalis.
■ 2. Chlamydia trachomatis infections are usually treated with penicillin.
■ 3. Ceftriaxone sodium (Rocephin) may be used to treat Neisseria gonorrhoeae infections.
■ 4. Metronidazole (Flagyl) is used to treat condy- lomata acuminata.
27.
A couple is visiting the clinic because they have been unable to conceive a baby after 3 years of frequent coitus. After discussing the various causes of male infertility, the nurse determines that the male partner needs further instruction when he states which of the following as a cause?■ 1. Seminal fl uid with an alkaline pH.
■ 2. Frequent exposure to heat sources.
■ 3. Abnormal hormonal stimulation.
■ 4. Immunologic factors.
28.
A 24-year-old woman is being assessed for a malformation of the uterus. The fi gure below indicates which of the following uterine malformations?■ 1. Septate uterus.
■ 2. Bicornate uterus.
■ 3. Double uterus.
■ 4. Uterus didelphys.
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