Test bank for olds maternal newborn nursing womens health across the lifespan 10th edition by davidson

Instant download and all chapter :Test Bank for Olds' Maternal-Newborn Nursing & Women's Health Across the Lifespan 10th Edition by Davidson CLICK HERE Olds' Maternal-Newborn Nursing and Women's Health, 10e (Davidson) Chapter Women's Health: Commonly Occurring Infections 1) A nonpregnant client is diagnosed with bacterial vaginosis (BV) What does the nurse expect to administer? Penicillin G million units IM one time Zithromax mg p.o b.i.d for weeks Doxycycline 100 mg p.o b.i.d for a week Metronidazole 500 mg p.o b.i.d for a week Answer: Explanation: The nonpregnant woman who is diagnosed with bacterial vaginosis (BV) is treated with metronidazole 500 mg orally twice a day for days Page Ref: 75 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: QSEN Competencies: I B Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essentials Competencies: IX Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings | NLN Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills; apply ethical decision making models | Nursing/Integrated Concept: Nursing Process: Planning Learning Outcome: Compare vulvovaginal candidiasis and bacterial vaginosis MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic infection Copyright © 2016 Pearson Education, Inc 2) The nurse is providing discharge instructions to a client with a diagnosis of vulvovaginal candidiasis (VVC), and knows the client understands when she makes which of the following statements? "I need to apply the miconazole for 10 days." "I need to douche daily." "I need to add yogurt to my diet." "I need to wear nylon panties." Answer: Explanation: Yogurt helps reestablish normal vaginal flora Page Ref: 76 Cognitive Level: Understanding Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: I B 10 Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN Essentials Competencies: VII Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concept: Nursing Process: Evaluation Learning Outcome: Compare vulvovaginal candidiasis and bacterial vaginosis MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic infection 3) The nurse is caring for a client in the clinic whom she suspects has vaginosis Which test best determines whether this sexually active woman has the disorder? The observation of mycelia upon direct microscopy in a 10% potassium hydroxide preparation The addition of a 10% potassium hydroxide solution to the vaginal secretions A vaginal pH of less than 4.5 A Gram stain positive for the fungus Answer: Explanation: Adding a 10% potassium hydroxide solution to the vaginal secretion of a client with bacterial vaginosis, called a "whiff" test, produces a fishy smell Page Ref: 74 Cognitive Level: Understanding Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: I B Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essentials Competencies: IX Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings | NLN Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions | Nursing/Integrated Concept: Nursing Process: Diagnosis Learning Outcome: Compare vulvovaginal candidiasis and bacterial vaginosis MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic infection Copyright © 2016 Pearson Education, Inc 4) A pregnant client at 24 weeks' gestation is diagnosed with bacterial vaginosis Her doctor orders Flagyl to treat the problem What would be appropriate education for the nurse to provide? The client must be careful to observe for signs of preterm labor The client should advise her partner to seek therapy as soon as possible The main side effect of the medication is a large amount of vaginal discharge A repeat culture should be taken weeks after completing the therapy Answer: Explanation: Clients with bacterial vaginosis are at risk for preterm labor Page Ref: 74 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control Standards: QSEN Competencies: I B 10 Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN Essentials Competencies: VII Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concept: Nursing Process: Implementation Learning Outcome: Compare vulvovaginal candidiasis and bacterial vaginosis MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic infection Copyright © 2016 Pearson Education, Inc 5) A client has been diagnosed with bacterial vaginosis The nurse obtains a sexual history from the client, including contraceptive measures, number of sexual partners, and frequency of intercourse What is the rationale for the questions? Clients can infect their sexual partners The nurse is required by law to ask the questions Clients with bacterial vaginosis can become infected with HIV and other sexually transmitted diseases more easily The laboratory needs a full client history in order to know for which organisms and antibiotic sensitivities it should test Answer: Explanation: The change in normal flora increases the woman's susceptibility to other organisms, making the client more vulnerable to sexually transmitted diseases, including HIV Page Ref: 74 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: I B Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care | AACN Essentials Competencies: VII Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concept: Nursing Process: Diagnosis Learning Outcome: Compare vulvovaginal candidiasis and bacterial vaginosis MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually transmitted infections Copyright © 2016 Pearson Education, Inc 6) The nurse working in a women's clinic recognizes that which clients are most at risk for developing vulvovaginal candidiasis? Note: Credit will be given only if all correct and no incorrect choices are selected Select all that apply Clients using antibiotics Immunocompetent clients Pregnant clients Multiparous clients Diabetic clients Answer: 1, 3, Explanation: A predisposing factor to yeast infections includes the use of antibiotics Predisposing factors to yeast infections include pregnancy Predisposing factors to yeast infections include glycosuria and diabetes mellitus Page Ref: 75 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Physiological Adaptation Standards: QSEN Competencies: I B Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essentials Competencies: IX Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions | Nursing/Integrated Concept: Nursing Process: Assessment Learning Outcome: Compare vulvovaginal candidiasis and bacterial vaginosis MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic infection Copyright © 2016 Pearson Education, Inc 7) The nurse provides a couple with education about the consequences of not treating chlamydia, and knows they understand when they make which statement? "She could become pregnant." "She could have severe vaginal itching." "He could get an infection in the tube that carries the urine out." "It could cause us to develop a rash." Answer: Explanation: Chlamydia is a major cause of nongonococcal urethritis (NGU) in men Page Ref: 78 Cognitive Level: Understanding Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: I B 10 Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN Essentials Competencies: VII Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concept: Nursing Process: Evaluation Learning Outcome: Summarize modes of transmission, treatments, and descriptions of the most commonly occurring sexually transmitted infections (STIs) MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually transmitted infections 8) The nurse is seeing clients in the women's clinic Which client should be treated with ceftriaxone IM and doxycycline orally? A pregnant client with gonorrhea and a yeast infection A nonpregnant client with gonorrhea and chlamydia A pregnant client with syphilis A nonpregnant client with chlamydia and trichomoniasis Answer: Explanation: The combined treatment of ceftriaxone IM and doxycycline orally provides dual treatment for gonorrhea and chlamydia, which frequently occur together Page Ref: 79 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: QSEN Competencies: I B Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essentials Competencies: IX Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Teamwork: Function completely within one's own scope of practice as leader and member of the health care team and manage delegation effectively | Nursing/Integrated Concept: Nursing Process: Implementation Learning Outcome: Summarize modes of transmission, treatments, and descriptions of the most commonly occurring sexually transmitted infections (STIs) MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic infection Copyright © 2016 Pearson Education, Inc 9) The nurse is providing follow-up education to a client just diagnosed with vaginal herpes What statement by the client verifies correct knowledge about vaginal herpes? "I should douche daily to prevent infection." "I could have another breakout during my period." "I am more likely to develop cancer of the cervix." "I should use sodium bicarbonate on the lesions to relieve discomfort." Answer: Explanation: Menstruation seems to trigger recurrences of herpes Page Ref: 79 Cognitive Level: Understanding Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: I B 10 Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN Essentials Competencies: IX Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concept: Nursing Process: Evaluation Learning Outcome: Describe the health teaching that a nurse needs to provide to a woman with an STI MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic infection Copyright © 2016 Pearson Education, Inc 10) The nurse seeing a client just diagnosed with Chlamydia trachomatis knows that which client is at greatest risk for the infection? 16-year-old sexually active girl, using no contraceptive 22-year-old mother of two, developed dyspareunia 35-year-old woman on oral contraceptives 48-year-old woman with hot flashes and night sweats Answer: Explanation: Teens have the highest incidence of sexually transmitted infections, especially chlamydia A client not using contraceptives is not using condoms, which decrease the risk of contracting a STI Page Ref: 78 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: I B Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care | AACN Essentials Competencies: IX Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions | Nursing/Integrated Concept: Nursing Process: Assessment Learning Outcome: Summarize modes of transmission, treatments, and descriptions of the most commonly occurring sexually transmitted infections (STIs) MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually transmitted infections Copyright © 2016 Pearson Education, Inc 11) A client comes to the clinic complaining of difficulty urinating, flu-like symptoms, genital tingling, and blister-like vesicles on the upper thigh and vagina She denies having ever had these symptoms before The medication the physician is most likely to order would be: Oral acyclovir Ceftriaxone IM Azithromycin p.o Penicillin G IM Answer: Explanation: Malaise, dysuria, and tingling or painful vesicles are indicative of a primary herpes simplex outbreak Acyclovir treats herpes Page Ref: 79 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: QSEN Competencies: I B Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essentials Competencies: IX Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the lifespan, and in all healthcare settings | NLN Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills; apply ethical decision making models | Nursing/Integrated Concept: Nursing Process: Implementation Learning Outcome: Summarize modes of transmission, treatments, and descriptions of the most commonly occurring sexually transmitted infections (STIs) MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually transmitted infections Copyright © 2016 Pearson Education, Inc 12) The nurse is evaluating the outcomes of nursing care given a female client with a sexually transmitted infection (STI) Which of the following will the nurse verify about the client? Note: Credit will be given only if all correct and no incorrect choices are selected Select all that apply Had an identified infection Could identify the mode of transmission Would never cope with the infection Could recognize the symptoms of an STI Would not disclose the STI to her partner Answer: 1, 2, Explanation: The infection must be identified and cured, if possible If not, supportive therapy is provided The client and her partner should be able to describe the infection, its method of transmission, its implications, and the therapy The client must be able to recognize the symptoms of an STI Page Ref: 82 Cognitive Level: Understanding Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: IV C Value own and others' contributions to outcomes of care in local care settings | AACN Essentials Competencies: IX Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions | Nursing/Integrated Concept: Nursing Process: Evaluation Learning Outcome: Describe the health teaching that a nurse needs to provide to a woman with an STI MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually transmitted infections 10 Copyright © 2016 Pearson Education, Inc 17) After a sex education class at a high school, the nurse overhears a student discussing safe sex practices Which statement indicates that teaching was successful? "I don't have to worry about getting infected if I have oral sex." "Teen women are the group at highest risk for sexually transmitted infections." "The best thing to if I have sex a lot is to use spermicide each and every time." "Boys get the HIV virus more easily than girls do." Answer: Explanation: Teens with multiple sex partners are more susceptible to sexually transmitted diseases Page Ref: 82 Cognitive Level: Understanding Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control Standards: QSEN Competencies: I B 10 Engage patients or designated surrogates in active partnerships that promote health, safety and well-being and self-care management | AACN Essentials Competencies: IX Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in care | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concept: Nursing Process: Implementation Learning Outcome: Describe the health teaching that a nurse needs to provide to a woman with an STI MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually transmitted infections 14 Copyright © 2016 Pearson Education, Inc 18) A client asks the nurse about treatment for human papilloma viral warts The nurse's response should be based on what knowledge? An antiviral injection cures approximately 50% of all cases Aggressive treatment is required to cure warts Warts often spread when an attempt is made to remove them surgically No single treatment is best for all types of warts or for all clients Answer: Explanation: All atypical, pigmented, and persistent warts should be biopsied and treatment instituted promptly Page Ref: 80 Cognitive Level: Understanding Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: I B Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essentials Competencies: IX Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan and in all healthcare settings | NLN Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills; apply ethical decision making models | Nursing/Integrated Concept: Nursing Process: Diagnosis Learning Outcome: Summarize modes of transmission, treatments, and descriptions of the most commonly occurring sexually transmitted infections (STIs) MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic infection 15 Copyright © 2016 Pearson Education, Inc 19) The nurse is providing health education to a group of young people When teaching about the prevention of sexually transmitted infections (STIs), the nurse will teach which concepts? Note: Credit will be given only if all correct and no incorrect choices are selected Select all that apply Decision-making skills in refusing intercourse How to reduce high-risk behaviors That Pap smears might be needed more often The safety of oral sex Use of petroleum-based lubricants with condoms Answer: 1, 2, Explanation: Effective prevention and control of STIs is based on planning ahead, review of decision-making skills, and developing strategies to refuse sex Effective prevention and control of STIs is based on the reduction of high-risk behaviors Use of recreational drugs and alcohol can increase sexual risk taking The presence of a genital infection can lead to an abnormal Pap smear Women with certain infections should have more frequent Pap tests Page Ref: 83 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: I B 10 Engage patients or designated surrogates in active partnerships that promote health, safety and well-being and self-care management | AACN Essentials Competencies: IX Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in care | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concept: Nursing Process: Implementation Learning Outcome: Describe the health teaching that a nurse needs to provide to a woman with an STI MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually transmitted infections 16 Copyright © 2016 Pearson Education, Inc 20) The nurse is caring for a client hospitalized for pelvic inflammatory disease Which nursing intervention would have priority? Encourage oral fluids Administer cefotetan IV Enforce bed rest Remove IUC, if present Answer: Explanation: Administration of medications to treat the disease is the first priority Page Ref: 84 Cognitive Level: Applying Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies Standards: QSEN Competencies: I B Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essentials Competencies: IX 11 Provide nursing care based on evidence that contributes to safe and high quality patient outcomes within healthcare microsystems | NLN Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills; apply ethical decision making models | Nursing/Integrated Concept: Nursing Process: Planning Learning Outcome: Relate the implications of pelvic inflammatory disease (PID) for future fertility to its pathologic origin, signs and symptoms, and treatment MNL LO: 6.2.2 Explain the relationship between pelvic inflammatory disease and infertility 21) The nurse obtains a health history from four clients To which client should she give priority for teaching about cervical cancer prevention? Age 30, treated for PID Age 25, monogamous Age 20, pregnant Age 27, uses a diaphragm Answer: Explanation: Exposure to sexually transmitted infections increases the risk of abnormal cell changes and cervical cancer Page Ref: 81 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: I B 10 Engage patients or designated surrogates in active partnerships that promote health, safety and well-being and self-care management | AACN Essentials Competencies: IX Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in care | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concept: Nursing Process: Planning Learning Outcome: Describe the health teaching that a nurse needs to provide to a woman with an STI MNL LO: 6.2.2 Explain the relationship between pelvic inflammatory disease and infertility 17 Copyright © 2016 Pearson Education, Inc 22) The nurse is discharging a client after hospitalization for pelvic inflammatory disease (PID) Which statements indicate that teaching was effective? Note: Credit will be given only if all correct and no incorrect choices are selected Select all that apply "I might have infertility because of this infection." "It is important for me to finish my antibiotics." "Tubal pregnancy could occur after PID." "My PID was caused by a yeast infection." "I am going to have an IUD placed for contraception." Answer: 1, 2, Explanation: Women sometimes become infertile because of scarring in the fallopian tubes as a result of the inflammation of PID Antibiotic therapy should always be completed when a client is diagnosed with any infection The tubal scarring that occurs from tubal inflammation during PID can prevent a fertilized ovum from passing through the tube into the uterus, causing an ectopic or tubal pregnancy Page Ref: 84 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: I B 10 Engage patients or designated surrogates in active partnerships that promote health, safety and well-being and self-care management | AACN Essentials Competencies: IX Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in care | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concept: Nursing Process: Evaluation Learning Outcome: Relate the implications of pelvic inflammatory disease (PID) for future fertility to its pathologic origin, signs and symptoms, and treatment MNL LO: 6.2.2 Explain the relationship between pelvic inflammatory disease and infertility 18 Copyright © 2016 Pearson Education, Inc 23) The nurse's response to a client with a history of pelvic inflammatory disease who is trying to get pregnant is based on the knowledge that which condition can contribute to an infertility problem? Hepatitis Postinfection tubal damage Pelvic abscess Tubal infection Answer: Explanation: Postinfection tubal damage is the most likely cause, as the infection causes tubal damage, which can lead to infertility Page Ref: 83 Cognitive Level: Understanding Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: I B Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care | AACN Essentials Competencies: IX Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment: Apply Professional stands; show accountability for nursing judgment and actions; develop advocacy skills; apply ethical decision making models | Nursing/Integrated Concept: Nursing Process: Planning Learning Outcome: Relate the implications of pelvic inflammatory disease (PID) for future fertility to its pathologic origin, signs and symptoms, and treatment MNL LO: 6.2.2 Explain the relationship between pelvic inflammatory disease and infertility 24) Which of the following diagnostic tests would the nurse question when ordered for a client diagnosed with pelvic inflammatory disease (PID)? CBC (complete blood count) with differential Venereal Disease Research Laboratory (VDRL) Throat culture for Streptococcus A RPR (Rapid Plasma Reagin) Answer: Explanation: Streptococcus of the throat is not associated with PID Page Ref: 84 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity: Physiological Adaptation Standards: QSEN Competencies: I B Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care | AACN Essentials Competencies: IX Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills; apply ethical decision making models | Nursing/Integrated Concept: Nursing Process: Implementation Learning Outcome: Relate the implications of pelvic inflammatory disease (PID) for future fertility to its pathologic origin, signs and symptoms, and treatment MNL LO: 6.2.2 Explain the relationship between pelvic inflammatory disease and infertility 19 Copyright © 2016 Pearson Education, Inc 25) A client in the emergency department is diagnosed with pelvic inflammatory disease Before discharge, the nurse will provide the client with some health teaching about which topic? Endometriosis Menopause Ovarian hyperplasia IUD for contraception Answer: Explanation: The woman who uses an IUD for contraception and has multiple sexual partners needs to understand clearly the risk she faces Page Ref: 84 Cognitive Level: Applying Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control Standards: QSEN Competencies: I B 10 Engage patients or designated surrogates in active partnerships that promote health, safety and well-being and self-care management | AACN Essentials Competencies: IX Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in care | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concept: Nursing Process: Evaluation Learning Outcome: Relate the implications of pelvic inflammatory disease (PID) for future fertility to its pathologic origin, signs and symptoms, and treatment MNL LO: 6.2.2 Explain the relationship between pelvic inflammatory disease and infertility 20 Copyright © 2016 Pearson Education, Inc 26) Women with pyelonephritis during pregnancy are at significantly increased risk for which condition? Foul-smelling discharge Ectopic pregnancy Preterm labor A colicky large intestine Answer: Explanation: Women with pyelonephritis during pregnancy are at significantly increased risk of preterm labor, preterm birth, development of adult respiratory distress syndrome, and septicemia Page Ref: 85 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity: Basic Care and Comfort Standards: QSEN Competencies: I B Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essentials Competencies: IX Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions | Nursing/Integrated Concept: Nursing Process: Implementation Learning Outcome: Contrast cystitis and pyelonephritis MNL LO: 6.2.3 Differentiate the causes, risks, and treatment of upper and lower urinary tract infections 27) The nurse is preparing an education session for women on the prevention of urinary tract infections (UTIs) Which statement should be included? Lower urinary tract infections rarely occur in women The most common causative organism of cystitis is E coli Wiping from back to front after a BM will help prevent a UTI Back pain often develops with a lower urinary tract infection Answer: Explanation: E coli is present in 75% to 90% of women with UTIs Page Ref: 85 Cognitive Level: Understanding Client Need/Sub: Physiological Integrity: Reduction of Risk Potential Standards: QSEN Competencies: I B 10 Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN Essentials Competencies: IX Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in care | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concept: Nursing Process: Planning Learning Outcome: Contrast cystitis and pyelonephritis MNL LO: 6.2.3 Differentiate the causes, risks, and treatment of upper and lower urinary tract infections 21 Copyright © 2016 Pearson Education, Inc 28) The client demonstrates that the nurse's teaching regarding ways to prevent a recurrence of her urinary tract infection was effective when she makes which statement? "I should wipe from back to front after urination." "I should urinate when I feel the urge." "I should try to restrict my intake of fruits." "I should use a diaphragm." Answer: Explanation: Retention overdistends the bladder, and can lead to infection Page Ref: 84 Cognitive Level: Understanding Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control Standards: QSEN Competencies: I B 10 Engage patients and designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN Essentials Competencies: IX Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in care | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concept: Nursing Process: Implementation Learning Outcome: Contrast cystitis and pyelonephritis MNL LO: 6.2.3 Differentiate the causes, risks, and treatment of upper and lower urinary tract infections 22 Copyright © 2016 Pearson Education, Inc 29) The nurse is teaching a group of young women how to prevent urinary tract infections What will the nurse include in the teaching? Note: Credit will be given only if all correct and no incorrect choices are selected Select all that apply The importance of good hygiene How to recognize the signs and symptoms How to take prescribed antibiotics Fluids are restricted to 1000 ml To urinate only when the urge is strong Answer: 1, 2, Explanation: The nurse should make sure that women are aware of good hygiene practices, and should provide information on other ways to avoid UTI Women need to know the signs and symptoms of UTIs to secure prompt treatment If an infection is present, the woman needs information on how to take antibiotics, and needs to know to complete all of them Page Ref: 86 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: I B 10 Engage patients or designated surrogates in active partnerships that promote health, safety and well-being and self-care management | AACN Essentials Competencies: IX Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in care | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concept: Nursing Process: Implementation Learning Outcome: Contrast cystitis and pyelonephritis MNL LO: 6.2.3 Differentiate the causes, risks, and treatment of upper and lower urinary tract infections 23 Copyright © 2016 Pearson Education, Inc 30) The nurse is evaluating the outcomes of nursing care for a woman with a urinary tract infection Which of the following does the nurse include in the evaluation? Note: Credit will be given only if all correct and no incorrect choices are selected Select all that apply The client implements self-care measures for prevention The client completed the prescribed antibiotics The client knows self-care measures for worsening symptoms The client states that UTIs are controlled, not cured The client knows that cranberry juice can help prevent UTIs Answer: 1, Explanation: In the evaluation, the nurse should determine whether the client implements selfcare measures to help prevent recurrent UTI as part of her personal routine Evaluation includes whether the client completed her prescribed course of antibiotic therapy Page Ref: 86 Cognitive Level: Applying Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: I B Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan and evaluation of care | AACN Essentials Competencies: IX Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills; apply ethical decision making models | Nursing/Integrated Concept: Nursing Process: Evaluation Learning Outcome: Contrast cystitis and pyelonephritis MNL LO: 6.2.3 Differentiate the causes, risks, and treatment of upper and lower urinary tract infections 24 Copyright © 2016 Pearson Education, Inc 31) A nurse is teaching a middle school health class on the different types of viral hepatitis Which statement made by a student indicates the need for further teaching? "Both hepatitis A and E are not chronic infections." "Hepatitis A is characterized by symptoms of jaundice, anorexia, nausea, vomiting, malaise, and fever." "Hepatitis B, C, and D have symptoms similar to those of hepatitis A, and can also include arthralgias, arthritis and skin eruptions or rash." "Both hepatitis B and C have an incubation period of 45-160 days." Answer: Explanation: Hepatitis B has an incubation period of 45-160 days, but hepatitis C has an incubation period of 14-180 days Page Ref: 81 Cognitive Level: Understanding Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: I B 10 Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management | AACN Essentials Competencies: IX Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in care | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concept: Nursing Process: Diagnosis Learning Outcome: Compare the different types of viral hepatitis MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually transmitted infections 25 Copyright © 2016 Pearson Education, Inc 32) The client has been diagnosed with hepatitis B Which statement indicates to the nurse that the client needs more education? Note: Credit will be given only if all correct and no incorrect choices are selected Select all that apply "This infection could be sexually transmitted." "I might get jaundiced from this illness." "An immunization exists to prevent getting hepatitis B." "I might have gotten this infection from food." "The incubation period is 15-50 days." Answer: 4, Explanation: Hepatitis B is found in blood and body fluids, and therefore can be sexually transmitted Hepatitis A and E are foodborne, and transmitted by fecal-oral contamination The incubation period for hepatitis B is 45-160 days Page Ref: 81 Cognitive Level: Understanding Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control Standards: QSEN Competencies: I B 10 Engage patients or designated surrogates in active partnerships that promote health, safety and well-being and self-care management | AACN Essentials Competencies: IX Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in care | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concept: Nursing Process: Planning Learning Outcome: Compare the different types of viral hepatitis MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually transmitted infections 26 Copyright © 2016 Pearson Education, Inc 33) The nurse is teaching nursing students about the different kind of hepatitis Which statement is the nurse likely to make? Hepatitis A and B have vaccines to prevent them Hepatitis A, B, and C have vaccines to prevent them Hepatitis C, D, and E are all bloodborne Hepatitis A, C, and E are all fecal-oral contamination Answer: Explanation: Hepatitis A and B are the only two types of hepatitis that have vaccines Page Ref: 82 Cognitive Level: Remembering Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control Standards: QSEN Competencies: I B 10 Engage patients or designated surrogates in active partnerships that promote health, safety and well-being and self-care management | AACN Essentials Competencies: IX Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in care | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concept: Nursing Process: Implementation Learning Outcome: Compare the different types of viral hepatitis MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually transmitted infections 34) The nurse is admitting a client who is 12 weeks pregnant and an IV drug user She has had a number of sexual partners, complains of malaise, and has yellow in the eyes, nausea, and vomiting Having obtained this history, the nurse suspects that the client has which condition? Hepatitis E Hepatitis C Gonorrhea Hepatitis A Answer: Explanation: Hepatitis C is bloodborne, and found in drug users and those who have multiple sexual partners Page Ref: 82 Cognitive Level: Understanding Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control Standards: QSEN Competencies: I B Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care | AACN Essentials Competencies: IX Implement holistic patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare setting | NLN Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills; apply ethical decision making models | Nursing/Integrated Concept: Nursing Process: Implementation Learning Outcome: Compare the different types of viral hepatitis MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually transmitted infections 27 Copyright © 2016 Pearson Education, Inc 35) In providing community education about hepatitis, the nurse includes information on the chronic forms of hepatitis A form of hepatitis that becomes chronic is which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected Select all that apply Hepatitis A Hepatitis B Hepatitis C Hepatitis D Hepatitis E Answer: 2, 3, Explanation: Unlike hepatitis A infection, hepatitis B infection is chronic Unlike hepatitis A infection, hepatitis C infection is chronic Unlike hepatitis A infection, hepatitis D infection is chronic Page Ref: 81 Cognitive Level: Remembering Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: I B Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care | AACN Essentials Competencies: IX Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, in all healthcare setting | NLN Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct populationbased transcultural health assessments and interventions | Nursing/Integrated Concept: Nursing Process: Implementation Learning Outcome: Compare the different types of viral hepatitis MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually transmitted infections 28 Copyright © 2016 Pearson Education, Inc