CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK E, Exams of Nursing

Download CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK E and more Exams Nursing in PDF only on Docsity! CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers MULTIPLE CHOICE 1. The clinic nurse is working with a mother and her 3-year-old child who have arrived for the childs routine checkup. The nurse encourages the mother to return for her childs measles-mumps-rubella immunization prior to the childs entering school. This intervention is an example of what type of care? A. Mandatory health care B. Primary health prevention C. Secondary health prevention D. Tertiary health prevention ANS: B Of the three levels of prevention, the most desirable level is primary prevention. This encompasses health promotion and activities specifically meant to prevent disease from occurringin this case, scheduling vaccinations. Secondary prevention refers to early identification and prompt treatment of a health problem before it has an opportunity to spread or become more serious. Tertiary prevention is intended to restore health to the highest functioning state that is possible. 2. A nurse wishing to be an advocate for access to health care would most likely choose to participate in which of the following activities? A. Lobby for improved insurance access for all individuals, whether or not they are employed. B. Help establish fast-track or minor illness areas in local emergency rooms. C. Partner with medical centers to provide free services for low-income patients. D. Work with visiting nurses associations to create on-site clinics at day-care centers. ANS: A The biggest determinant of access to and quality of health care is ones insurance status. The other actions might help improve access too, but would not be as effective as lobbying for improved ability for all individuals to get insurance. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers 3. A nurse working with an after-school program is concerned about the lack of health literacy in the students parents. What action would best address this need? A. Conduct a monthly health-related seminar for parents. B. Investigate grants or other funding for a computer bank. C. Invite parents to healthy cooking demonstrations. D. Provide brochures on a variety of health problems. ANS: B The disparity between people who have access to technology and those who do not is directly related to health literacy and knowledge. The amount of information doubles every 6 years, so it is not possible to keep track of all the latest health news by accessing brochures, books, or periodicals. Having access to computers would greatly increase health literacy. The other options are certainly helpful, but would not be as far-reaching as providing access to online material. 4. A nurse is caring for a patient near the end of life whose wishes regarding care are not known. The two sons disagreed with the two daughters about future medical plans for the patient during a recent family conference, and now the sons and daughters are not talking to one another. What action by the nurse would be best to help resolve this dilemma? A. Call the facilitys ethics committee and request a formal consultation. B. Have social work coordinate another family meeting to discuss the issue. C. Meet with the sons and daughters separately to discuss their wishes. D. Request that the physician tell the family what is in the patients best interests. ANS: A Ethical principles in health care are often in conflict, and it takes a skilled person to negotiate and mediate these situations. Ethics committees exist in most health-care facilities that are experienced in confronting these difficult situations. The best response would be for the nurse to request a consultation from the ethics committee. Another family meeting may not work, as the family already disagrees and tensions are high. The other options may be helpful, but are not as vital as a formal ethics committee consultation. Meeting privately with the sons and daughters might give the nurse some insight into their positions, but would not be as effective as utilizing the expertise on the committee. The physician should not decide what is in the patients best interests, as this is paternalistic and violates the principle of autonomy. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers 10. A nurse wants to work in the community providing secondary prevention activities. Which action would this nurse choose to do? A. Educate teenage girls about birth control options. B. Provide STD/STI testing at the local youth center. C. Staff the county health department flu shot clinic. D. Volunteer to drive cancer patients to receive their treatments. ANS: B Secondary prevention is screening, early detection, and prompt treatment for health problems. Testing youths for STD/STIs is an example of secondary prevention. Primary prevention includes activities designed to keep health problems from happening. It often includes education. Educating teenage girls about birth control options will (hopefully) prevent unintentional pregnancies and is an example of primary prevention. Likewise, staffing the flu shot clinic is also an example of primary prevention. Tertiary prevention attempts to restore health to its highest level of functioning. Driving cancer patients to their treatments is an example of tertiary prevention. 11. A nurse is interested in providing tertiary prevention activities. Which of the following activities would this nurse choose to do? A. Assist with low-cost swimming lessons at the YMCA. B. Conduct monthly educational seminars at a church. C. Join the county pandemic outbreak response team. D. Provide glucose and cholesterol screening at the mall. ANS: C Tertiary prevention attempts to restore health to its highest level of functioning. Working with a county response team in the event of a pandemic outbreak would be an example of tertiary prevention. Primary prevention includes activities designed to keep health problems from happening. It often includes education. Assisting with swimming lessons and conducting monthly seminars will educate the target audiences in order to prevent a health problem. Secondary prevention is screening, early detection, and prompt treatment for health problems. Providing glucose and cholesterol screening is an example of secondary prevention. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers 12. A practicing nurse tells a student nurse that beyond the World Health Organizations definition of health, providers must also consider which of the following factors when determining the health of a community? A. The definition of health as described by the community B. The incidence of preventable health problems in the group C. The morbidity caused by genetically related health problems D. The mortality rates that could be lowered with primary prevention ANS: A The World Health Organization (WHO) defines health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. According to Purnell and Paulanka (2008), one must also consider the definition of health as it is described by people within their own ethnocultural group. The other options are not part of this consideration. 13. A nurse wants to know the trend concerning death due to cardiovascular disease. What source should the nurse consult? A. Epidemiology data B. Morbidity data C. Mortality data D. Primary prevention data ANS: C Mortality refers to death. Government agencies keep both mortality and morbidity records on public health threats. Morbidity refers to illness. Epidemiology is the statistical analysis of factors related to disease in populations over time. Primary prevention includes activities designed to keep health problems from happening. It often includes education. 14. A nurse enjoys working with patients who have chronic illnesses. What group of people would this nurse enjoy working with most? A. Ethnic minorities B. Men and boys CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers C. Older adults D. Women and girls ANS: C The older adult population is growing steadily and rapidly and will have a huge impact on health care in the future, due to the prevalence of chronic illness in this group. Chronic illness occurs in all groups, but for the older adult population, it is a special concern. 15. A nurse would like to improve the health of the community. Which action by the nurse would have the greatest impact? A. Blood glucose screening at the local Korean church B. Blood pressure screening at a predominantly black church C. Teaching immigrants heart-healthy cooking for traditional foods D. Teaching men the signs and symptoms of heart attacks ANS: B Although all activities are good nursing interventions for specific communities, more than half of black women aged 4564 years have hypertension, so a blood pressure screening at a predominantly black church could have the greatest impact. 16. A nurse is working with a parent teacher association to combat school bullying. What action can the nurse suggest that would best help to decrease this form of interpersonal violence? A. Advise that victims parents call law enforcement and press charges. B. Begin offering martial arts classes in the school for bullied children. C. Encourage the school to adopt no-tolerance policies for bullying. D. Suggest limiting television viewing, especially for younger children. ANS: D Some research has shown that violent media exposure is linked to violent behavior. Included in media are computer games, which can also be violent. Younger children may not be able to distinguish between real and fantasy and may be overly influenced by violent images. No-tolerance policies can be helpful, as can a social environment in which children and their parents are held accountable legally. Offering martial arts classes may send the wrong message and would most likely not diminish the incidence of bullying. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers Beneficence means acting for the patients benefit, or doing good. Giving a pain medication before a therapy session helps the patient fully participate, improving his or her recovery. Allowing the patient to make informed choices demonstrates autonomy. Returning when promised is an example of fidelity. Turning patients, even though it causes temporary discomfort, is non-maleficence. 22. A nurse ensures that a patient does not have questions regarding the upcoming surgical procedure and verifies that the signature on the consent form is the patients signature. Which ethical principle is this nurse demonstrating? A. Autonomy B. Beneficence C. Fidelity D. Justice ANS: A Autonomy is the right to make decisions and to have the information necessary to make such decisions. Beneficence is doing good. Fidelity is keeping promises. Justice is treating everyone fairly. 23. A 45-year-old woman presents to the emergency department complaining of chest pain and feeling anxious. She asks to have an electrocardiogram (EKG) but is told that heart disease is a mans disease and is given a prescription for lorazepam (Ativan). What can the nurse conclude? A. If the woman were older, she may have received an EKG. B. Sex hormones play a powerful role in determining heart disease. C. Stereotyping seriously impacted the care the woman received. D. Women under the age of 45 are at low risk of having heart disease. ANS: C A stereotype is a mental image that portrays members of a specific group with the same attributes. Believing that heart disease is a mans disease is an example of a stereotype. Because the practitioner held this view, the womans health care was compromised. The other statements cannot be justified from this example. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers 24. A nurse has heard of the digital divide between people who have access to technology and those who dont. The nurse asks a mentor how this can affect health care. What response by the mentor is most accurate? A. Its just easier and faster to make appointments online. B. Much health-care information is available only digitally. C. The so-called digital divide really doesnt have much impact. D. You can chat with your doctor on social media sites. ANS: B The explosion in information makes digital access to health-care resources vital. There are even applications for smart phones that have a health-care function. Not all clinics and physician offices have online appointment scheduling. Most people surveyed would like to connect with their physicians via email but not on social networking sites. 25. One goal of the Healthy People 2020 initiative is to increase the number of people who have some form of health insurance. What percentage of the population is the target? A. 25% B. 35% C. 55% D. 100% ANS: D Healthy People 2020 has the ambitious goal of increasing the proportion of people with health insurance to 100%. 26. A nurse is working with a woman who is 4 months pregnant. The woman has had a series of temporary housing, has no job, and is wearing clothing that is obviously way too big for her. What action can the nurse take to most improve the health of this woman and child? A. Arrange transportation for her to get to a community food bank. B. Consult a social worker to help her apply for the WIC program. C. Encourage the woman to make her return appointment before leaving. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers D. Ask the woman to fill out an application for the federal Medicare program. ANS: B WIC, or the Women, Infants, and Children Program, targets pregnant women, infants, and children up to age 5 who are nutritionally at risk. WIC provides supplemental nutritious foods and nutrition counseling. Forty-five percent of infants born in this country participate in the WIC program. Helping with transportation needs and facilitating return appointments is helpful too, but not to the degree that improving this womans nutrition will be. The woman might be eligible for Medicaid, but not Medicare, which is for the elderly. MULTIPLE RESPONSE 1. A nurse working in a women’s health clinic has several patients who are from a minority culture, live in the inner city, lack employment that offers benefits, have large families, and often lack transportation to health care. Which of these factors are considered broad determinants of health? (Select all that apply.) A. Access to health care B. Employment C. Environment D. Family size E. Race ANS: A, B, C, E Broad determinants of health care are personal, community, and societal systems and include environment, employment, insurance, class, race, social support, access to health services, genetic endowment, and personal histories. Family size itself is not a broad determinant of health care; however, it could be included in the larger category of personal history. 2. The community health nurse knows that the public health intervention model is focused on which of the following intervention levels? (Select all that apply.) A. Community B. Family C. Government CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers E. Racial differences are rooted in biological factors that explain illness trends. ANS: B, D The population of ethnic minorities is expected to reach 50% by the year 2050, which increases the need for culturally competent health care. One in five people will be over the age of 65 by 2030, increasing the impact of chronic illnesses. Hispanics, blacks, Asians, and Native Americans are the historically designated minority groups. There is no biologic basis for race; racial and ethnic categories are socially created. 7. Which of the following activities should the perinatal nurse encourage women who come for preconceptional counseling to consider? (Select all that apply.) A. Choosing breastfeeding or bottle feeding B. Decreasing risk for exposure to toxoplasmosis C. Decreasing fetal risks related to the work environment D. Ensuring folic acid supplementation E. Ensuring iron supplementation ANS: B, C, D Folic acid supplementation helps to prevent certain birth defects. A fetuss exposure to harm could potentially be prevented if a woman were counseled prior to pregnancy about the adverse effects of alcohol, tobacco, toxoplasmosis, and other teratogens in her home or workplace. During the preconception period, it is too early for the woman to take iron supplements (unless she is anemic), and debating infant feeding methods is not the priority at this time. 8. A mother brings her 6-month-old infant and 18-month-old child to the health clinic for a routine visit. The nurse counsels the mother about lead exposure testing. Which information should the nurse include? (Select all that apply.) A. About one-fourth of all homes where kids under 6 live are contaminated by lead. B. Both of your children should have testing for lead at this time. C. Lead exposure may cause anemia, seizures, and mental retardation if not treated. D. Lead testing for children is recommended by the American Academy of Pediatrics. E. We can test your older child for lead exposure, but it is too early for the 6-month-old. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers ANS: A, C, D, E The American Academy of Pediatrics recommends that all children between the ages of 1 and 2 years receive testing for lead exposure, as 25% of homes presently occupied by children under the age of 6 have known lead contamination. Lead exposure has been linked to a number of medical and developmental problems, including anemia, seizures, and mental retardation. 9. The clinic nurse is interviewing a woman and her daughter who describe their address astemporary. The mother appears thin, pale, and tired. Her blood work confirms anemia and pregnancy. What actions by the nurse would be most helpful? (Select all that apply.) A. Call the Department of Children and Family Services. B. Discuss nutrition needs for pregnancy. C. Facilitate the womans opportunity to return for prenatal care. D. Determine if the family is in a safe location. E. Provide shelter information for this family. ANS: C, D, E A priority for this family is to provide information regarding shelters, to facilitate follow-up clinic visits for the mother to address her pregnancy and anemia, and to determine if the family is currently in a safe place or if the family is vulnerable to violence. Nutrition in pregnancy should be discussed, but it is not the priority intervention at this point. There is no reason to call the Department of Children and Family Services unless abuse is suspected. 10. The clinic nurse explains to a student that an appropriate nursing action is screening all children for child abuse. What other information does the nurse give the student about child abuse? (Select all that apply.) A. It is frequently carried out by a stranger. B. The most common form is neglect. C. It is most often perpetrated by a parent. D. Only 1 out of 1,000 girls is sexually abused. E. It is part of an ongoing cycle of violence. ANS: B, C, E CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers The National Child Abuse and Neglect Data System reports that three children die of child abuse in the home each day. Children are most commonly abused by someone they know, and in 79% of cases, the perpetrator is a parent. Child abuse can set up a perpetuating cycle of suffering and more violence later in life, potentially reaching to future generations. Neglect is the most common form of child abuse. One out of every four girls will be sexually abused by the time she reaches 18. 11. The jail nurse is interviewing a woman who has been brought to the clinic for prenatal care. Which of the following are appropriate actions for the nurse to perform? (Select all that apply.) A. Assess the woman for drug and alcohol abuse and possible withdrawal. B. Assess the womans health knowledge and health literacy. C. Ask if the woman has other children and who is caring for them. D. Determine if the woman has risk factors for pregnancy complications. E. Inquire about the womans criminal history and background. ANS: A, B, C, D A nurse who is able to deliver culturally competent care to incarcerated women quickly becomes cognizant of the challenges of caring for this population. These women tend to have many health problems, including substance abuse and dependency. They frequently have not had access to health- related knowledge. Because nearly 1.3 million children of incarcerated women have no mother figure in their lives, women in prison or jail are often deeply concerned about their welfare. This demonstrates caring and can often be the motivation for making changes. The nurse needs to complete a thorough obstetrical history, including determining risk factors for high-risk pregnancy. The nurse does not need to know about the womans criminal history. 12. Which childhood illnesses are the subject of a Healthy People initiative regarding vaccinations? (Select all that apply.) A. Asthma B. Measles C. Meningitis D. Mumps E. Pertussis ANS: B, D, E CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers C. Personal values D. Self-identity ANS: D During the school-aged and adolescent/teenage developmental stage, personal values are shaped and clarified and ethical development occurs. This stage provides the optimal opportunity for teaching about drugs, sex, and health promotion. 3. A new mother with a 2-month-old daughter tells the family clinic nurse that she is experiencing a lack of sleep because of infant night feedings and her husbands shift work and excessive overtime. Which of the following is the best description of this family concern? A. Caregiver strain B. Coping stress C. Lack of support D. Parental maladaptation ANS: A Caregiver strain occurs when the main caregiver becomes overwhelmed and feels underhelped regarding the tasks concerned with the care of the family member. In this situation, mounting bitterness and withdrawal from other family members may cause caregivers to push away any potential helpers. 4. A patient describes her spouses dependence on oxycodone terephthalate (Percocet), which began following knee surgery last year. Although the prescription was finished some time ago, the spouse continues to obtain and take Percocet. Because of the spouses need for the medication, the patient has to do all the yard work, child care, and meal preparation. How would the nurse describe the patients behavior? A. Enabler B. Impaired caregiver C. Inadequate dyad partner D. Overstressed parent ANS: A CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers An enabler is a common role in families with addictions. The enabler makes excuses for the addicted persons behavior. The patients behavior allows the spouse to continue with the addiction without being held accountable. 5. A mother brings her 8-year-old daughter to the clinic for the third time in 2 months. The mother states that her daughter is very active and often falls down. The mother states that her daughter eats well, but the childs weight falls below the 10th percentile. The clinic record shows the child had multiple bruises on her arms at the time of the last two visits. Today the nurse notes that the child has areas of ecchymosis on her left leg and ankle. Which action by the nurse is best? A. Ask the child and her mother again about the childs bruises. B. Question the child about her accident-prone behaviors. C. Speak with the child alone, asking if she feels safe at home. D. Teach the mother to keep a diary of what her child is eating. ANS: C This childs presentation is suspicious. If child abuse is suspected, the nurse should question the child privately. In all situations the nurse is legally obligated to report the abuse to the proper investigating agency. 6. The clinic nurse notices that each time a child with leukemia is brought in to see the doctor, her mother and aunt accompany her. The mother states that she finds her daughters illness to be very traumatic and is having difficulty coping. The childs aunt encourages the childs mother and distracts the child while her blood work is being drawn. The childs aunt could be described as taking on which of the following roles? A. Child-caregiver role B. Kinship role C. Socializer role D. Therapist role ANS: D Structural-functional theory focuses on the functioning of the family and the roles assumed by each family member to promote family function. Necessary roles include provider, housekeeper, child caregiver, socializer, sexual partner, therapist, recreational organizer, and kinship member. The therapist CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers role is assumed when one family member expresses concern for anothers health or emotional well- being. The aunt does not appear to be the primary caregiver (child-caregiver role). There is no indication that the aunt fills the socializer role by organizing family social activities. The kinship role includes maintaining family and social ties by things like remembering important dates, and the aunt does not appear to function in that role either. 7. The nurse observes a woman and her sister who live together. They are trying to support one another and provide extended care to their mother who has recently been diagnosed with Alzheimers disease. The two sisters describe their experience with a homemaker who visits their home to help bathe their mother. They say she is humorous and cheerful and absorbs their mothers attention for the whole time she is present. This is a positive description of which component of Bowens family systems theory? A. Communication B. Family relationship building C. Family rituals D. Triangulation ANS: D According to Bowen, triangulation occurs when a dyad (the sisters) focuses on a third person who draws attention away from their conflicts. The homemaker is serving this function in this family. Bowens theory looks at family problems that are rooted in family processes, such as communication. Relationship building and rituals are not part of this theory. 8. A nurse is assessing a single person at a clinic visit. How would the nurse classify this patients family? A. Family of choice B. Family of origin C. Not in a family D. Nuclear family ANS: C Most definitions of family require at least two people who self-define as being part of that family. Thus, a single individual cannot be a family. A family of choice is the family adopted through marriage or cohabitation. A family of origin includes the individuals who reared the person of interest. A nuclear family consists of a male partner, a female partner, and their children. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers B. Explain that changes in one person require changes in the others. C. Make a referral to a counselor or mental health nurse practitioner. D. Tell the family members that for the patient to recover, they have to assume his or her role. ANS: B Family systems theory recognizes that changes in one member of a family affect every other member of the family. In order for the family to function effectively, all members need to adapt to the major changes in one of the members. Making lists and assigning chores are simple tasks that might help with organization, but this does not go far enough in solving the problem. The family may or may not need a referral for counseling. Simply telling the family members a fact does not give them enough information to adapt. 14. A nurse who works with families uses Duvalls family developmental theory as the core of nursing practice. What action by this nurse takes priority? A. Assessing the developmental stage of the family B. Determining how the family interacts with society C. Observing what roles each family member assumes D. Tailoring teaching to the specific needs of the family ANS: A Developmental theory has as its core the idea that every person moves through developmental stages with tasks that must be mastered before they can move on to the next stage. Family developmental theory assumes the same progression for families as a unit. Duvalls theory identifies eight family stages. The nurse using Duvalls family developmental theory must first assess the stage the family is in, because teaching and all other interventions must be tailored to that stage. Only tailoring the teaching to specific needs does not necessarily require assessment of the family using a developmental approach. Determining how the family interacts with society is more in line with systems theory. Observing roles is part of structural-functional theory. 15. A nurse is working with a blended family of 1 year with five children aged 3, 7, 13 (twins), and 19. The parents seem overly stressed and anxious and do not seem to work well as a unit. What can the nurse conclude about this family? A. Communication problems are the core of the parents stress. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers B. Economic stressors are impacting the parental dyad. C. The family is in too many developmental stages to master any of them. D. There are too many children to give each one adequate attention. ANS: C In family developmental theory, the age of the child determines the stage the family is in. If there is more than one child, the family is probably in multiple developmental stages at the same time. The family is probably in a combination of beginning families, preschool, school-aged and adolescent, and launching stages. The competing priorities of all of these stages pave the way for chaos. Without further information, the nurse cannot conclude that economic stressors or communication problems are the root cause of the issue. Simply concluding that the family has too many children is judgmental and does not leave any room for interventions. 16. A family practice nurse is working with a patient who is asking for anti-anxiety medications to deal with the stress and frustration of an adult child who wont leave the home. Based on knowledge of the tasks of launching children, which resource should the nurse suggest first? A. Anger management counseling B. Contact numbers for vocational training C. Information on a parenting workshop D. Marriage and couples counseling ANS: B An adult child who still lives at home is either using home base as a temporary arrangement while continuing education or as a nonaction until more permanent ties have been established elsewhere. With the parents frustration and anxiety, this situation of incomplete launching needs to be addressed. The first suggestion should be about vocational assessment and training for the adult child. There is no indication the patient needs anger management, a parenting workshop, or marriage counseling. 17. A patient has been dismissed from the hospital after a serious illness and needs several weeks of home care and rehabilitation. When the visiting nurse comes to the house, it is apparent that the family is not functioning. The house is dirty, there is little food available, and one parent and an older child are arguing about picking up a younger sibling from school. What action by the nurse is most appropriate? CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers A. Ask the parents if they need financial resources for the basic necessities. B. Assess each family member for the roles he or she plays in the family. C. Contact child protective services or social work to assess the home environment. D. Provide referrals for family and couples counseling in the community. ANS: B According to structural-functional theory, each person in a family unit occupies a specific role. Sometimes roles are shared. A problem can occur when one member of the family is unable to fill his or her role and no one else is doing it. That appears to be the situation here. The nurse should assess what roles each family member plays and assist them to see how they can fulfill the role formerly held by the patient. The family may need financial resources if the patient was the breadwinner. There is no need to conduct an environmental assessment, as it does not appear that any family member is in danger. The family may or may not need counseling at this time. 18. A nurse who uses the structural-functional theory would assess which of the following when working with families? A. Communication patterns B. How things get done C. If goals are being met D. Looseness of boundaries ANS: C The structural-functional theory focuses on the outcomes, not the processes, within the family. The nurse using this theory would assess if the family goals are being met. Communication patterns are critical to communication theory. Processes are important to family developmental theory, and boundaries are important in family systems theory. 19. A nurse is providing anticipatory guidance to a mother of a toddler. Using communication theory, which information is the most appropriate? A. Dont nod your head yes when you say no. B. Explain things in several different ways. C. There is no need to see if a toddler understands. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers According to this family theory, birth order plays an important role in predicting certain patterns of behavior. Spouses who occupy the same birth order may have difficulty functioning together. In this case, both spouses probably are first-borns with a need for control. The other questions may yield helpful information as part of a thorough assessment, but are not related to this theory. 24. A nurse working in a pediatric clinic is attempting to assess a school-age child who is disrespectful of the nurse and parent and tears up a magazine when asked to sit down. What conclusion can the nurse make about this family? A. The child is not getting enough attention from the parents. B. The family is from an underserved community group. C. Financial stress has caused family strife and fighting. D. The parental disciplinary approach is inconsistent. ANS: D Children whose parents have a laissez-faire disciplinary style tend to be disrespectful, aggressive, and disobedient. A laissez-faire disciplinary style includes inconsistent use of discipline, allowing children (rather than the parents) control over the environment, few rules, and children making their own decisions rather than being guided by parents. The other options may be true, but without further assessment, the nurse cannot make those conclusions. 25. A family with a loud, disobedient child has been working with a nurse. Which action observed by the nurse indicates that goals for the diagnosis of impaired parenting have been met? A. The father delivers consequence to the child calmly. B. The father only asks the child twice not to do something. C. The mother doesnt cry when disciplining her child. D. The mother states that the child is still testing the limits. ANS: A Consistency in setting and enforcing rules is critical. Consequences should be delivered immediately, without anger, and consistently. The fathers disciplining the child without getting mad is demonstrating that goals have been (or are being) met. The other options do not show consistent, calm, immediate consequences. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers 26. A female patient from a refugee community is in the emergency department and needs urgent surgery. The patient defers making a choice on the operation, preferring to wait for a cultural elder to arrive. What action by the nurse is most appropriate? A. Encourage the patients family to talk her into having the operation. B. Explain kindly to the patient that her situation cannot wait. C. Respect the patients choice and wait for the elder to arrive. D. Take the patient to surgery under the principle of implied consent. ANS: C This is a difficult situation, but because the patients wishes are known, the nurse has no choice other than to wait. In the emergency department, sometimes surgery is performed under the principle of implied consent (for instance, on an unconscious patient with no known family), but in this case, the patient has been clear as to her wishes, so doing that would be an ethics violation. The nurse must be careful to not be coercive. The nurse (and physician) would ensure that the patient understands the risks of waiting. 27. A nurse wishes to assess how often members of a family consume alcohol or use drugs during a typical week. What type of family assessment tool would this nurse choose? A. Ecomap B. Genogram C. Qualitative D. Quantitative ANS: D A quantitative tool measures the frequency at which problems or behaviors occur. An ecomap is a tool that displays the outside systems used by the family. A genogram illustrates the family structures and compares generations within the same family. Qualitative tools measure the descriptions and depth of family experiences. 28. A mother is worried about her three children developing an inherited medical condition because many members of her family have died from this disease. To start an assessment of this family, which tool should the nurse choose? A. Ecomap CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers B. Genogram C. Problem list D. Quantitative tool ANS: B A genogram is a diagram of at least three generations that illustrates the present family structures and compares past generations with the present ones. To determine the prevalence of this inherited disorder in the family, the nurse would use a symbol to denote each family member with this disease. An ecomap displays the outside systems with which the family interacts. A problem list helps family members identify difficulties or negative characteristics. A quantitative tool assesses the frequency of a behavior or problem. A genogram has a quantitative influence, as it documents how many people in the family have the characteristic being studied, but a genogram is more specific. 29. A nurse explains the benefits of a strengths-and-problems list to a student. Which is the best explanation? A. Can use their strengths to work on identified priority problems B. Demonstrates that each family has both strengths and problems C. Forces people to be accountable and take responsibility for problems D. Lets families see which members have problems affecting them ANS: A A strengths-and-problems list requires the family members to list their strengths as well as what each member brings to the group that is positive. The problems list helps the family prioritize problems to work on. By seeing this information in writing, the family members can capitalize on their strengths to work on the problems. It does demonstrate that each family has both strengths and problems, but that is not the main purpose. It does not force families to take responsibility, although it does encourage this. Its purpose is not to point out who has which problems. 30. A nurse working with a pregnant woman who is a recent immigrant to the United States notes that her husband rarely accompanies her to prenatal visits, and when he does, he sits in the waiting room. What action by the nurse is best? A. Ask the patient what role men in her culture play in pregnancy. B. Ask the woman why her husband doesnt seem involved. C. Encourage the man to participate in order to support his wife. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers 35. A patient is being discharged from a psychiatric facility after a suicide attempt. The family consists of the patient, two parents, and two other teenage children. What action should the nurse teach the entire family as a priority? A. Assess for drugs or alcohol in the patients room. B. Encourage the patient to take medications. C. Monitor the patient for signs of suicidal thoughts. D. Plan menus that contain nutritious food items. ANS: C Safety is a priority concern in every family and all members should be made aware that the patient could have continued suicidal thoughts. If the siblings notice this, they should be taught to tell the parents immediately and could also be taught some effective communication to use. Looking for drugs or alcohol in the patients room, encouraging medication use, and planning menus are all actions more appropriate for the parents. 36. A nurse is working with a family in which one member has schizophrenia. Using systems theory, for which concern should the nurse specifically assess this family? A. Balance B. Boundaries C. Childrens ages D. Subsystems ANS: B Systems theory looks at boundaries, balance and homeostasis, and subsystems. An important concern in the family whose member is diagnosed with a mental illness is social isolation, which is related to boundaries. Some families view mental illness as shameful and try to keep the information secret. The nurse should work to ensure the family understands the importance of healthy interaction with outside systems. Childrens ages would be assessed using developmental theories. 37. A grade school nurse is conducting vision screening before school and notes the student is accompanied by an older sister who has also brought a middle school child. The older child states that time is a problem because middle school starts in a few minutes and tells the younger child to go right to CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers the classroom after the screening, then leaves. What question by the nurse would be most appropriate to ask the youngest child during the screening? A. Do you feel safe at home or is someone hurting you there? B. Does your sister always bring you and your sibling to school? C. Have you ever seen your parents drinking a lot or using drugs? D. Why arent your parents available to bring you to school? ANS: B In substance-abusing families, one child often takes the role as the responsible person, allowing the family to continue functioning. The fact that a sibling was bringing the children to school is a little unusual, and the nurse should assess the reason behind it. However, substance-abusing families often keep secrets for both social and legal reasons. The nurse should not ask directly about substance abuse, but rather open a line of discussion by introducing a nonthreatening question. There is no indication of abuse, so asking if the child is safe is not appropriate at this time. In a secret-keeping family, asking directly about drinking or drug use would most likely elicit a negative response. Asking why questions is confrontational. 38. A patient has just been admitted to the hospital in critical condition. In caring for the entire family, what action by the nurse is most important? A. Assessing who in the family will make decisions B. Determining if the family needs financial resources C. Ensuring each member understands the situation D. Orienting the family to visiting hours on the unit ANS: A All options are important activities to keep the family engaged fully with the patient. However, for a patient who is critically ill, determining who makes medical decisions (and if there are advance directives) is crucial. The other actions can occur later. 39. A hospice nurse is making the initial home visit to a patient who just returned home after a lengthy hospitalization. What action by the nurse is most appropriate to help the family continue to function? A. Assess the degree of comfort in family caregiving. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers B. Ensure the family understands the hospice concept. C. Provide information about available hospice services. D. Refer the family to a community counseling center. ANS: A In the at-home hospice setting, family members must find a balance between direct caregiving activities and their own needs for personal time. The nurse must assess this to help the family avoid caregiver strain and resentment and to maintain roles necessary for family functioning. Ensuring the family understands the hospice concept and providing information are also important, but are not directly related to family functioning. The family may or may not need counseling. 40. An immigrant family is working with a nurse on improving family dynamics. The nurse notes that the teenage children do not subscribe to their parents social and cultural mores and identify more with their native-born American friends. What description of the children is most accurate to record in the familys chart? A. Acculturated B. Assimilated C. Disconnected D. Lost children ANS: B Assimilation is the process whereby a family or individual loses its unique cultural identity and identifies more with the dominant culture. The teens appear to be assimilated. Acculturation is the changes in cultural patterns within a group to match those of the host society. Connectedness relates to with whom the family identifies and relates as a family unit. Lost children are often seen in substance-abusing families. MULTIPLE RESPONSE 1. A nurse is explaining to a student why it is so important to consider the entire family as the patient. What explanation for this is best? (Select all that apply.) A. Families are a rich source of information and support. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers B. Development of personal values and ethics C. Impact of friends and peer group D. Poor judgment about safety risks E. Toddlers increasing physical abilities ANS: A, D, E The toddler is in a stage where rapid physical development occurs but coordination and judgment are lagging behind. Thus the toddler is prone to accidents and injury. The nurse should offer anticipatory guidance so the parents can keep their child safe. Development of personal values and ethics occurs in the school-age and adolescent stage. Impact of peer group increases in this stage as well. 6. The family nurse completes a genogram map when conducting a family assessment. Appropriate information the nurse should include in the genogram map includes which of the following? (Select all that apply.) A. Congenital diseases in the family B. Country of origin for family members C. Dates of birth for all family members D. Dates of divorce and deaths for family members E. Three or more generations ANS: A, C, D, E The genogram may be used to highlight generational influences of behaviors, illnesses, vocational information, or any other pertinent information that provides a larger picture of patterns that exert influence on the familys current situation. The genogram should include at least three family generations and should list dates of births, divorces, deaths, stillbirths, and other pertinent elements of family information. 7. The nurse assesses the communication in a family that includes a single mother, a teenage son and daughter, and a grandmother. During the family interview, the daughter answers many questions while the son and mother are quiet and the grandmother is absent. What conclusions can the nurse make about this family? (Select all that apply.) A. The communication patterns are healthy. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers B. The daughter may have a lot of power. C. The grandmother does not want to be involved. D. The grandmother may have little power. E. The mother and son may have a coalition. ANS: B, D, E Communication theory asserts that patterns of communication within a family reveal much about the way the family functions, the structure of the family, the power base, decision making, affection, trust, and affiliation. Preliminary conclusions the nurse can make about this family are that the daughter may have a lot of power because she answers many questions without input from anyone else, the grandmother may not have much power because she is not even present, and the mother and son may have a coalition opposed to the daughter. The nurse will need to confirm these conclusions with further assessment. These communication patterns are not healthy. The nurse should not assume that the grandmother does not want to be involved but should assess the reason for her absence. 8. The clinic nurse keeps resource numbers and contacts for assistance with situations in which family members may potentially require assistance to restore balance and function to the family. These developmental crises may include which of the following situations? (Select all that apply.) A. Home fire requiring a lengthy hotel stay B. Hospitalization of a family member C. Identification of domestic violence D. Postpartum depression in a young family E. The anticipated birth of a new baby ANS: A, B, C, D Sometimes families are in special need of nursing intervention due to situational or developmental crises that go beyond the familys internal resources. Developmental crises occur as part of expected growth events that can take place during any developmental stage of the family or its individual members and include such situations as being displaced, hospitalization of a family member, domestic violence, and serious depression. Childbirth is a normal event that does not generally require special nursing intervention unless complications occur. 9. A nurse assessing a family includes which components in the assessment? (Select all that apply.) CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers A. Dietary habits B. Family size and structure C. Parenting style D. Religious affiliation E. Socioeconomic status ANS: B, C, D, E A family assessment includes family size and structure; parenting style; and religious, cultural, and socioeconomic orientation. Dietary habits are not specifically assessed, although this information may be part of a cultural assessment. 10. A nurse is assessing a family whose patriarch died recently. Using Kbler-Rosss stages of grieving, what stages should the nurse assess for? (Select all that apply.) A. Bargaining B. Dealing C. Denial D. Remorse E. Shock ANS: A, C Kbler-Rosss stages of grieving include denial, anger, bargaining, and acceptance. Dealing is one of Rodebaughs stages. Remorse is one of Eppersons stages. Shock is one of Harveys phases. Chapter 4: Caring for Women, Families, and Children Across the Life Span MULTIPLE CHOICE CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers Diet and nutrition are especially important for facilitating optimal growth and development during adolescence. Adequate nutritional intake is essential to accommodate the growth spurt that occurs during this time. Adolescents gain approximately 25% of their adult height and 50% of their adult weight throughout this time period. 6. A school nurse is interviewing a high school student sent to the office for frequent crying episodes. The student admits to thinking of suicide and has made a previous attempt. The nurse determines that the teen has a suicide plan but does not yet have access to the materials needed to carry out the plan. How does the nurse interpret and act on this information? A. High risk: Call the school district counselor. B. High risk: Contact 911 immediately. C. Low risk: Send a referral home with the student. D. Moderate risk: Call the parents to come get the teen. ANS: B Individuals who have suicidal thoughts should be assessed for a specific plan, the means to carry out the plan, and previous suicide attempts. This student has two of the three high-risk identifiers, so the teen should be seen by a mental health professional immediately. The safest way to ensure this occurs is to access the emergency medical system. The district counselor may not be prepared to deal with this situation and may not be available. The student is not low risk, so a referral should not be sent home. The student is not moderate risk, and the burden of ensuring immediate access to a health-care professional should not be placed on the parents, who also may be unavailable. 7. The family clinic nurse initiates conversation with a 16-year-old adolescent male who is 5 feet 10 inches and weighs 250 pounds (113.6 kg). Which of the following is the most appropriate question for the nurse to ask the adolescent regarding his weight? A. Are you willing to talk about your weight gain this year? B. Do you realize your weight puts you into an obese category? C. Do you participate in any activities or exercise? D. What do you think about your weight right now? ANS: D CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers During adolescence, body weight has a dramatic effect on the development of self-image and self- esteem and can be a sensitive issue for discussion. An important strategy in discussions about weight and weight loss with adolescents is to begin the conversation with expressions of respect that are sensitive to cultural differences related to food choices and eating patterns. Regardless of whether the patient is ready to begin a weight control program, he may still benefit from talking openly about healthy eating and exercise. To open the conversation, the nurse can begin with a simple question to determine if the patient is willing to talk about the issue. The other questions may put the teen on the defensive and close communication. Answer choice 1 particularly is an example of poor communication, as it is a yes-no question. The teen could simply answer no and the nurse would have no recourse other than to end that line of discussion. 8. A nurse is observing a mother and her 10-month-old infant. The mother is interacting happily with the child while letting the baby eat pieces of hot dog. What action by the nurse is best? A. Compliment the mother on her parenting skills. B. Document that the baby is eating finger foods now. C. Stop the mother from feeding the hot dog to the baby. D. Teach the mother that hot dogs are poor nutrition. ANS: C At this age, examples of appropriate finger foods include small pieces of lightly toasted bagel, small pieces of ripe bananas, well-cooked pasta, teething crackers, and low-sugar O shaped cereal. Protein sources such as meat should be pureed to avoid choking. The nurse should gently stop the mother from feeding the hot dog to the baby. Hot dogs are not the most nutritional food, but safety comes first, so this is not the best answer. Documentation is always important but can be done later. The nurse should find something to compliment the mother on to help establish a trusting relationship. 9. A nurse is teaching new parents about dental care for their baby. Which information should the nurse provide? A. Brush the babys teeth with special baby toothpaste. B. The child should see a dentist before the age of 2. C. All teeth should be in by age 2. D. Wipe the babys gums with moist gauze. ANS: D CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers Dental hygiene should be started early. Even before a child has teeth, the gums can be wiped with a damp cloth or gauze. Toothpaste cannot be used before age 2 (because of the risks associated with swallowing it). A dentist should examine a babys teeth within 6 months of the eruption of the first tooth, but no later than the first birthday. Children should have all 20 primary teeth by the third birthday. 10. A public health nurse is visiting a family home where there is a newborn. Which assessment finding by the nurse warrants immediate intervention? A. A cat is sitting on the kitchen counter by the stove. B. Roaches are evident in the kitchen and in the pantry. C. The baby is on a carpet that is stained and worn out. D. The crib has dirty bumper pads and a dirty comforter. ANS: D To prevent sudden infant death syndrome (SIDS), the American Academy of Pediatrics recommends that all babies be put to sleep on their backs and that cribs be free of toys, comforters, and bumpers. Vaccinations and breastfeeding are also recommended. The other options show a house that is dirty but does not rise to the level of needing immediate intervention. 11. A mother who has three older children now has a newborn. She complains to the physician that sleeping on his back has caused her baby to have a funny-shaped head that the other kids didnt have. She doesnt want to continue having the baby sleep on his back. Which action by the nurse is best? A. Document the comments and alert the physician to the concern. B. Encourage her to put the baby on his stomach during the day. C. Explain that babies need to sleep on their sides at all times. D. Tell her that back-sleeping isnt important after 5 months of age. ANS: B The American Academy of Pediatrics recommends that all infants be placed on their backs when sleeping. This is probably new information the mother did not have for her older children. If the mother is concerned about plagiocephaly (misshapen head), she can be taught to place the baby on the stomach with a small rolled towel under the arms for support and comfort. Alternating positions in the crib and side-lying for short periods in the presence of an adult are also alternatives. Documentation should CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers A. Encourage an after-school program that includes rock climbing, rafting, and hiking. B. Reassure the parents that risk taking is just a normal part of adolescence. C. Show the teen statistics on preventable injuries and deaths among teenagers. D. Tell the teen his risky behavior can lead to injuries and worries his parents. ANS: A Risk taking is a part of adolescence, but the teen needs healthy risk-taking activities. The nurse can encourage the teen to take part in a program that offers risk-taking under adult supervision. Rock climbing, hiking, and rafting are all healthy alternatives. Simply reassuring the parents that teens take risks does not give them information that helps the teen. Showing the teen statistics and explaining that he is worrying his parents are both unlikely to have much effect. 17. A school nurse is preparing educational activities for all high school students on reproductive health. The principal cautions that the program can only contain information about sexual abstinence. Which action by the nurse would be most appropriate? A. Argue that abstinence-only programs do not work and are not valuable. B. Discuss the need to have information appropriate to the teens experience. C. Plan the program but encourage questions not related to the prepared material. D. Prepare an abstinence-only program because teens should not have sex. ANS: B Education on sexual health should take into consideration the age and sexual experience of the audience. For teens who have not yet had sexual intercourse, an abstinence-only program might make sense. However, if the teens have already engaged in sexual intercourse, they are likely to continue this behavior, and the program should focus on using condoms in order to avoid unprotected sex and its risks. Abstinence-only programs cannot be characterized as being of no value. Encouraging teens to ask questions off the prepared topic is a passive-aggressive action. It is not up to the nurse to decide if teens should have sex or not. 18. A nurse is teaching conflict-resolution strategies to a group of teen mothers at risk for violence. Which statement by a participant indicates understanding? A. Friends of mine have said they would be willing to help in a crisis. B. If good communication doesnt solve the problem, I will leave. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers C. If we cant settle our differences, we will have to start talking all over again. D. My mother can help my boyfriend and me resolve a conflict. ANS: B Successful conflict resolution strategies enable the teen to remain calm and safe. If communication and respect do not work to resolve the conflict, the teen should remove herself from the situation. The other statements do not show that the teen has understood this message. 19. A young couple is in the clinic for a prenatal exam. The woman expresses concern that her husband continues to binge drink and use drugs on weekends. What action by the nurse is best? A. Assess the father for reasons why he continues to abuse alcohol and illicit drugs at his age. B. Explain that if there are drugs in a house with a baby, the baby can be taken away. C. Help the husband see how his drug and alcohol use is inconsistent with the father role. D. Warn the husband that he will be putting the baby at risk unless he stops this activity. ANS: C The most reliable theory on drug use focuses on role development. As young adults take on the roles of spouse and parent, illicit drug use can interfere with performing those roles. Also, when assuming adult roles is seen as incompatible with illicit drug use, substance use declines. The nurses best action is to help the husband see how binge drinking and drug use are not compatible with the father and role model roles. The nurse could assess the father for reasons he continues to abuse substances, but this will not help him diminish his use. Stating that the baby can be taken away may be seen as a threat and will probably cut off communication. Likewise, telling the father he will be putting his baby at risk may sound judgmental and threatening as well. 20. The nurse is assessing a young woman who is overweight. Which action by the nurse is most appropriate? A. Ask if she knows how overweight she is. B. Assess the woman for stress-related problems. C. Caution her about related chronic illnesses. D. Encourage the woman to exercise more. ANS: B CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers In young adulthood, women especially begin to manifest stress-related disorders, including comfort eating. The nurses best action is to assess the woman for this problem. The nurse can encourage her to exercise and can caution her about the relationship between poor nutrition and chronic illness, but if stress is causing the woman to overeat, she probably will not be able to make significant changes without addressing the cause. Asking the woman if she knows how heavy she is right now is disrespectful and will likely end the therapeutic relationship. 21. A nurse is teaching a 24-year-old male about reproductive health. Which information should the nurse provide this patient about testicular cancer? A. Annual screening is recommended for testicular cancer. B. If the epididymis is tender to the touch, that is concerning. C. Perform a testicular self examination after a warm shower. D. Because testicular cancer is rare at this age, no action is needed. ANS: C Although cancer of the epididymis is considered rare, it is still the most common cancer found in men aged 2034. Men should be taught the technique of testicular self-examination, which is best performed after a warm shower when the scrotum is more relaxed. Annual screening is not recommended other than during a clinical exam. The epididymis is normally slightly tender to pressure. 22. A woman presents to the family practice clinic complaining of abdominal pain, pain during ovulation, and heavy periods. What action by the nurse is best? A. Facilitate a vaginal ultrasound. B. Obtain consent for a laparoscopy. C. Prepare the woman for a pelvic exam. D. Provide education on ibuprofen (Motrin). ANS: C This woman has manifestations of endometriosis. Diagnosis can be made via a pelvic exam, although it is often difficult to do so. Some physicians will order ultrasounds or laparoscopy with biopsy. The first step, however, is the pelvic exam, so the nurse should prepare the woman for this to occur. After making a diagnosis of endometriosis, the nurse can educate the woman on medical management, which includes using ibuprofen for pain. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers 28. A nurse is volunteering for the local chapter of the cancer society and is planning breast cancer screening and educational activities in the community. In order to have the most impact on this disease, which women should the nurse target? A. African Americans B. Asian Americans C. Caucasian Americans D. Native Americans ANS: A African American women are more likely to die from breast cancer because of late diagnosis, and in women under 45 in this group, breast cancer is more common. To have the greatest impact, the nurse should target this group of women. Asian, Hispanic, and Native American women have a lower risk of developing and dying from breast cancer. Caucasian women tend to develop breast cancer more frequently than African American women, but they die less often. 29. A postmenopausal woman asks the nurse about reducing her breast cancer risk. The woman is overweight, consumes one alcoholic drink daily, does not smoke, and works at a desk. What response by the nurse is best? A. Exercise regularly. B. Lose weight. C. Stop drinking. D. Take aspirin daily. ANS: B Alcohol intake, smoking, and weight maintenance all affect breast health. However, this womans highest risk factor is being overweight. After menopause, estrogen is produced in body fat cells. The combination of estrogen and dietary fat significantly increases the chance of breast cancer development. Exercise can be part of a weight-loss regimen, but this is not the most comprehensive answer. Drinking one drink a day is not linked to increased breast cancer risk, although drinking two to five drinks a day is associated with an increased risk. Taking an aspirin daily is for promotion of heart health. 30. A preoperative nurse is caring for a patient who will undergo an open breast biopsy. What action by the nurse takes priority? A. Ensure that an informed consent is signed and witnessed. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers B. Inventory and label all of the patients belongings. C. Orient the patients significant others to the waiting room. D. Premedicate the patient on arrival to the pre-op holding area. ANS: A All actions are appropriate, but the priority action is in ensuring that an informed consent form has been signed and properly witnessed. 31. A nurse in a family practice clinic sees several generations of the same family. For which family members should the nurse arrange routine screening colonoscopies? A. Daughter, age 52 B. Grandfather, age 80, no history of polyps or cancer C. Grandmother, age 72, history of polyps D. Grandson, age 30, no gastrointestinal symptoms ANS: A Individuals aged 50 and older should have screening colonoscopies, so the daughter should be scheduled for this procedure. The CDC does not recommend routine screening for patients aged 7585 and recommends no screening after age 85, so the grandparents do not need to be screened. For patients with family history of colon polyps or cancer, screening should begin in their 40s, so the grandson does not yet need screening. 32. A nurse is reviewing the results of several patients cholesterol and lipid screenings. For which patient is the action appropriate? A. HDL cholesterol 66 mg/dL: Evaluate patient for cardiovascular risk. B. LDL cholesterol 98 mg/dL: Instruct patient to take fish oil 3 gm daily. C. Total cholesterol 240 mg/dL: Teach heart-healthy lifestyle changes. D. Triglycerides 132 mg/dL: Refer to dietician for comprehensive diet education. ANS: C CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers A cholesterol below 200 mg/dL is desirable, so this patients level is high. The nurse should plan to teach this patient about heart-healthy lifestyle changes. The other laboratory values are in the desirable range, so no action is necessary. 33. A 53-year-old woman is having her annual physical and tells the nurse she has not had a period for 7 months. She wants to know if she has undergone menopause. What response by the nurse is best? A. No, at your age, fluctuations in your menstrual cycle are normal findings. B. No, menopause only begins in women after the age of 55. C. Yes, not having a period for more than 6 months is diagnostic of menopause. D. You have to go 1 year without a menstrual period to be sure that menopause has occurred. ANS: D Menopause can only be diagnosed with certainty after 1 year without menstrual periods. Although fluctuations in a womans cycle are normal during the perimenopausal years, this answer is not correct, as it appears to signify that there is no relationship between the lack of periods and menopause, and so is misleading. The average age of menopause in the United States is 51.4 years, with a range of 3560 years. 34. A nurse is evaluating several patients for possible hormone therapy to reduce severe symptoms of menopause. For which patient would hormone therapy be recommended? A. 53 years old, smoker, estrogen-progestin therapy B. 54 years old, history of endometrial cancer 10 years ago, estrogen only C. 55 years old, history of hysterectomy 4 years ago, estrogen only D. 76 years old, went through menopause 16 years ago, estrogen-progestin ANS: C Estrogen therapy for women who have had a hysterectomy or estrogen-progestin therapy offers the greatest benefit and smallest risk to those who are within 10 years of menopause. The patient who is 55 and has had a hysterectomy would be the best candidate. The 53-year-old smoker has a double risk for venous thromboembolism (VTE) because smoking increases the risk along with the combination hormone therapy. Estrogen-only therapy increases the risk of endometrial cancer, so it is not used in patients who have a history of endometrial cancer. The smallest risk is seen in women within 10 years of menopause, so the 76-year-old woman is too far removed from menopause to receive hormone therapy. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers Older adults who are beginning to exercise for the first time in their lives (or for the first time in a long time) should begin with only 5 minutes per day. Exercise is beneficial at any age. Reminders about stretching and praising the patient are also good options, but safety comes first. 40. The nurse notes that a patients chart contains the results of an MMSE. What can the nurse surmise about this patient? A. Behind on recommended immunizations B. Concerns about cognitive functioning C. Tracking changes in bone density D. Worried about cardiovascular health ANS: B The MMSE (Mini-Mental State Examination) is a screening test for cognitive function. The other options are not related. 41. A 65-year-old patient is in the clinic for an annual influenza vaccination. What other health promotion activity should the nurse encourage specifically for this patient? A. Heart-healthy eating B. Participating in social activities C. Pneumococcal vaccination D. Regular exercise ANS: C All options are important for the older adult, but around the age of 65, the older adult should receive the pneumococcal vaccine. The nurse planning individualized care for the patient would encourage the patient to get this vaccination. 42. A nurse is educating a woman on the use of denosumab (Prolia). What information should the nurse provide? A. Return in 6 months for another injection. B. Take this medication on an empty stomach. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers C. Take this medication with milk or food. D. You may have increased night sweats. ANS: A Prolia, a medication used for the treatment of osteoporosis, is given in subcutaneous injections every 6 months. Food intake is not related to administration. Increased night sweats and hot flashes can occur with raloxifene (Evista). 43. A nurse is planning breast education for women. What information does the nurse plan to provide about breast cancer screening recommendations? A. Annual screening after age 40 B. MRI to replace mammography C. No routine screening after age 65 D. Periodic screening if high risk ANS: A Breast cancer screening is the subject of controversy. The American College of Obstetricians and Gynecologists (ACOG) recommends annual screening with mammography and clinical breast examinations every year starting at age 40. 44. A college nurse offers screening programs for students. At what age should the nurse encourage women to have their first Pap test? A. At age 19 B. At age 21 C. Before sexual activity D. No specific age ANS: B Women should have their first Pap test at age 21. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers 45. A clinic nurse sees adolescent girls frequently. Many of the girls should be screened for gonorrhea and Chlamydia infection, but they balk at having a pelvic exam. What option can the nurse offer these girls? A. Blood draw B. Limited pelvic exam C. No alternative D. Urine collection ANS: D A urine sample can be used for gonorrhea and Chlamydia testing and is a good alternative for patients aged 1318. The other options are incorrect. 46. At what age should the nurse prepare patients to begin thyroid function screening? A. 30 years B. 40 years C. 50 years D. 60 years ANS: C Thyroid hormone function screening should begin at age 50 and occur every 5 years. 47. The mother of a 5-month-old baby complains that her child seems hungry even after breastfeeding 10 times a day. What assessment question would help the nurse plan anticipatory teaching? A. Are you sure your breasts are emptying? B. Does the baby put everything in his mouth? C. Does your baby sit in a high chair yet? D. Is your baby using the pincer grasp yet? ANS: C The child may be ready for solid foods so the nurse should assess for readiness. Signs of readiness to eat solids include being able to hold the head up, being able to sit in a high chair, and being able to move the tongue around without pushing food out of the mouth. Other signs include appropriate weight gain, CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers associated with depression. The nurse should assess the teens weight, screen her for depression, draw blood for electrolyte imbalances, and discuss bulimia. 5. The clinic nurse talks with parents about the signs and symptoms of substance use because their 12- year-old twins will be attending a new school in the fall and they wish to be prepared. The nurse correctly describes the potential symptoms of substance abuse, including which of the following? (Select all that apply.) A. Chronic cough B. Euphoria C. Irritability D. Nausea and vomiting E. Red and glazed eyes ANS: A, C, E There are many warning signs to alert parents to adolescent substance abuse. Physical signs include fatigue, red and glazed eyes, chronic cough, and health complaints. Emotional signs include personality changes, sudden mood swings, irritability, poor judgment and decision making, depression, and lack of interest in things that were of previous interest. 6. The clinic nurse educates young adults that the most common infectious health risks associated with tattoos include which of the following? (Select all that apply.) A. Chlamydia infection B. Gonorrhea C. Hepatitis D. Human papilloma virus (HPV) E. Staphylococcus infection ANS: C, D, E Infectious health risks related to tattooing include viral, bacterial, and fungal diseases, most commonly infections caused by viruses and bacteria. The most common infections associated with tattooing and body piercing include hepatitis, human immunodeficiency virus (HIV), and human papilloma virus (HPV). Bacterial infections may be caused by Staphylococcus, Streptococcus, Pseudomonas, Clostridium, and Mycobacterium. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers 7. The nurse providing health promotion to a group of young adult women would plan to offer which services as a priority? (Select all that apply.) A. Aspirin prophylaxis B. Breast cancer screen C. Colorectal cancer screen D. Influenza vaccine E. Tobacco and alcohol screen ANS: D, E Priority health services for the young adult population include influenza vaccination and tobacco, alcohol, and drug screens, among other things. Aspirin prophylaxis and breast cancer screen are more appropriate for middle-aged adults. 8. A nurse works with many older patients and provides information about safer sexual practices and risks. What physical factors increase an older womans risk for acquiring human immunodeficiency virus (HIV) infection? (Select all that apply.) A. Increased promiscuity B. Isotonic dehydration C. Decreased vaginal pH D. Loss of vaginal elasticity E. Vaginal dryness ANS: D, E Physical changes in the older woman that increase susceptibility to HIV infection include loss of vaginal elasticity and vaginal dryness. Increased promiscuity is not a physical factor (and is not known to be a characteristic of the older adult). Mild isotonic dehydration is often seen in older adults, but is not related. Vaginal pH is not related. 9. The nurse working with older women knows that risk factors for osteoporosis include which of the following? (Select all that apply.) A. Asian ethnicity CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers B. Excessive consumption of caffeine C. Large frame D. Regular physical activity E. Cigarette smoking ANS: A, B, E Risk factors for osteoporosis can be found in Box 4-9 and include Asian (and Caucasian) ethnicity, excessive caffeine or alcohol use, and smoking. A small frame, not a large one, is a risk factor due to decreased stress on the bones. Regular activity (particularly weight-bearing exercise) is a preventative factor. 10. A visiting nurse is seeing an older woman with the nursing diagnosis of risk for trauma related to decreased bone density secondary to osteoporosis. Which assessment findings would indicate to the nurse that a priority goal for this diagnosis has been met? (Select all that apply.) A. All scatter rugs have been removed. B. Burned-out light bulbs have been replaced. C. Hot water heater temperature is set to 110F. D. Patient wears non-skid shoes or slippers. E. Pets have been given away to friends. ANS: A, B, D A priority goal for this diagnosis is to make the home safe. Removing scatter rugs, having the home well lit, and wearing non-skid footwear are all indications that the home is safe. The temperature on the water heater is important to prevent injury, but is not related to osteoporosis. Giving away pets is not advised, as pets often contribute to emotional well-being. However, they can get underfoot, and the nurse needs to caution the patient about this risk. 11. The reproductive care clinic nurse teaches young women about their risk for sexually transmitted infections (STIs). Which factors does the nurse include? (Select all that apply.) A. Alkaline pH of the vagina B. Increased genital mucosal surface area CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers A. Pelvic outlet B. Linea terminalis C. Sacral promontory D. Sacrum ANS: A Inferiorly, the lowest portion of the true pelvis is termed the pelvic outlet. Superiorly, the true pelvis is bounded by the sacral promontory (anterior projecting portion of the base of the sacrum) and the sacral alae (broad bilateral projections from the base of the sacrum), the linea terminalis, and the upper margins of the pubic bones. The false pelvis and the true pelvis are divided by the linea terminalis, or pelvic brim. 3. The clinic nurse knows that the part of the uterine cycle that occurs during the period of time between ovulation and the onset of menses is known as which of the following? A. Ischemic phase B. Menstrual phase C. Proliferative phase D. Secretory phase ANS: D The secretory phase occurs from the time of ovulation to the period just prior to menses, or approximately days 15 to 26. The menstrual phase is the time of vaginal bleeding, approximately days 1 to 6. The proliferative phase is the end of menses through ovulation, approximately days 7 to 14. The ischemic phase occurs from the end of the secretory phase to the onset of menstruation, approximately days 27 to 28. 4. The perinatal nurse explains to the new nurse that the maternal pelvic shape can determine the fetal presentation. A fetus in a transverse presentation may be due to which maternal pelvic type? A. Android B. Anthropoid CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers C. Gynecoid D. Platypelloid ANS: D The gynecoid pelvic type is the typical, traditional female pelvis (present in 50% of women) that is best suited for childbirth. Fetal descent through a platypelloid pelvis is usually in a transverse presentation and will not allow for a vaginal birth. Fetal descent through an anthropoid pelvis is more likely to be in a posterior (facing the womans front) rather than anterior (facing the womans back) presentation. The android pelvis resembles a typical male pelvis, and this pelvic shape can also cause difficulty during fetal descent. 5. The clinic nurse explains to a student that the hormone responsible for limiting the maternal immune response to pregnancy is which of the following? A. Human chorionic gonadotropin B. Progesterone C. Prostaglandin D. Relaxin . ANS: A Human chorionic gonadotropin may play a role in limiting the maternal immune response to the pregnancy. Prostaglandins modulate hormonal activity and have an effect on ovulation, fertility, and cervical mucus viscosity. Relaxin aids in the softening and lengthening of the uterine cervix and works on the myometrial smooth muscle to promote uterine relaxation. Progesterone functions to create a highly vascular secretory endometrium that will be suitable for implantation of a fertilized ovum. 6. A woman who might be pregnant is excited to learn when she will know the gender of the baby. What is the best response by the nurse? A. 5 weeks B. 6 weeks CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers C. 8 weeks D. 12 weeks ANS: D It takes about 8 weeks of development before the reproductive system becomes differentiated as male or female, but external genitalia are not visible until after 12 weeks. Cognitive Level: Comprehension/Understanding Content Area: Pediatrics/Maternity Patient Needs: Health Promotion and Maintenance Integrated Process: Teaching/Learning Difficulty: Easy PTS: 1 7. The pediatric nurse explains to the student that production of testosterone by the male embryo causes what to occur? A. Creation of a gonad B. Formation of the male genital tract C. Production of spermatozoa D. Stimulation of external genitalia growth ANS: B The mesonephric ducts evolve into the male genital tract due to the influence of testosterone in the 7th or 8th week of gestation. A gonad is the first reproductive structure formed. Production of spermatozoa doesn’t occur until puberty. The growth of external genitalia does not begin until the 12th week of gestation. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers B. It is regulated by follicle-stimulating hormone (FSH). C. The graafian follicle eventually secretes prolactin. D. It usually occurs in a twice-monthly cycle. ANS: B Oogenesis begins in the ovaries and is regulated by follicle-stimulating hormone (FSH). For each primary oocyte that undergoes meiosis, only one functional egg is produced; the other cells (termed polar bodies) deteriorate. The graafian follicle is a mature ovarian follicle and does not secrete prolactin. Oogenesis occurs in utero. 13. A woman is having an infertility workup and has been told she has scarring of her fallopian tubes. What action by the nurse is best? A. Ask the woman how many sexually transmitted infections she has had. B. Assess the woman for previous vaginal infections and their treatment. C. Gently tell the woman that nothing can be done about scarring of the tubes. D. Question the woman about genetic defects or family history of infertility. ANS: B Anatomically, there is a continuous passage from the vagina into the uterus and on into the fallopian tubes and ovaries. A vaginal infection can lead to residual scarring of the tubes from the inflammatory process. This puts the woman at increased risk for ectopic pregnancies and infertility. Not all vaginal infections are sexually transmitted infections (STIs), and to specifically ask about STIs sounds judgmental in addition to not providing adequate information. There are several treatment options for this woman. Genetic defects may play a role in this womans problem, but the higher likelihood is that her scarred tubes are due to a vaginal infection. 14. The nurse manager on the high-risk OB unit has been told by an OB office nurse to prepare for a woman with a spinal cord injury (SCI) to deliver there. The woman wants to try a vaginal birth. What response by the nurse manager is best? A. Assess the level of the womans spinal cord injury. B. Assure the office nurse that vaginal birth is possible. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers C. Explain that women with SCI do well with a water birth. D. Tell the office nurse that vaginal birth is impossible. ANS: A Women with SCI above the level of T6 may be able to deliver vaginally because the uterus may retain enough intrinsic motility to create effective contractions. The nurse manager should ask about the level of the SCI. The nurse should not assure the office nurse that vaginal delivery is possible without this information. A woman with an SCI probably would not do well in a water birth due to impaired mobility. The nurse should also not tell the office nurse that vaginal birth is impossible without further information. 15. A pregnant woman calls the OB clinic nurse to complain of sharp abdominal pain with coughing or sneezing. What action by the nurse is best? A. Explain that the pain is from stretching of the ligaments. B. Have the woman count her contractions each hour while awake. C. Place the woman on bedrest until her next clinic visit. D. Tell the woman to come to the clinic today. ANS: A The uterus is supported by several ligaments. The round ligaments expand in diameter and length during pregnancy and may be associated with sharp pain if they are stretched tight during sudden movement, such as with sneezing, coughing, or position changes. The nurse should reassure the woman that this is not concerning and explain the phenomenon. There is no need for the woman to count contractions, be placed on bedrest, or come in to the clinic that day. 16. A pregnant woman has a midpelvis pelvimetry measurement of 3.8 inches (9.65 cm). What action by the labor and delivery nurse is most important? A. Encourage attendance at childbirth classes. B. Explain that vaginal birth will be possible. C. Instruct her to drink 10 glasses of water daily. D. Obtain consent for possible cesarean delivery. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers ANS: D Pelvimetry measurements demonstrate the feasibility of a vaginal birth. The minimum measurement for the midpelvis (which is the narrowest lateral portion of the female pelvis) is 4.7 inches (12 cm). Pelvimetry measurements may not be accurate for several reasons, and despite findings, in most situations, the woman is allowed a trial of labor. As the joints of the pelvis soften and become more mobile, a vaginal delivery might still be possible. The nurse should obtain consent for a possible cesarean delivery. All pregnant women should attend childbirth preparation classes. The nurse should not guarantee that a vaginal birth can occur. Drinking water is not related. 17. The nurse explains to the student that the development of the lining of the uterus is mediated by which hormone? A. Follicle-stimulating hormone B. Luteinizing hormone C. Progesterone D. Prostaglandin ANS: C Estrogen and progesterone are responsible for mediating the development of the uterine lining. Follicle-stimulating hormone stimulates growth of the graafian follicle. Luteinizing hormone stimulates the development of the corpus luteum. Prostaglandins modulate hormonal activity and affect ovulation, fertility, and cervical mucus viscosity. 18. A 17-year-old female is brought to the family practice clinic by her mother, who is worried that her daughter has not yet developed secondary sex characteristics. Which action by the nurse is best? A. Assess a family pedigree for genetic influences. B. Explain that some girls dont develop until their 20s. C. Inform them that the daughter will be tested for estrogen deficiency. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers 23. A 14-year-old girl asks the school nurse why her periods are so irregular. What is the best response by the nurse? A. All young girls have irregular periods. B. Dont worry; this is totally normal. C. Estrogen levels are still pretty low. D. You should be seen by your physician. ANS: C As a girl begins menstruating, estrogen levels are usually insufficient to stimulate ovulation, and the menstrual periods are generally unpredictable and irregular. As the ovaries mature, regular ovulation and menses are established. Telling the student that all young girls have irregular periods and that her complaint is normal are both poor choices, because they do not give the girl adequate information. She does not need to be seen by her physician for this complaint. 24. A nurse reads in a female patients chart that she is Tanner stage V. What can the nurse conclude about this patient? A. Beginning puberty B. Midpoint of puberty C. Sexually immature D. Sexually mature ANS: D Guidelines of secondary sexual characteristic development, termed Tanner stages, measure the predictable stages of pubertal body changes in both genders. A female in stage V (the last stage) would be sexually mature. 25. The nursing instructor explains to a class that important effects of estrogen in the proliferative phase of the uterine cycle include which of the following? CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers A. Causes uterine spiral arteries to constrict, limiting blood flow B. Causes changes in cervical mucus to facilitate sperm penetration C. Leads to changes causing the uterus to be receptive to a fertilized ovum D. Results in rupture of endometrial blood vessels and the onset of menses ANS: B During the proliferative phase of the uterine, or endometrial, cycle, increasing amounts of estrogen lead to changes in cervical mucus that facilitate sperm penetration at midcycle. During the ischemic phase, both estrogen and progesterone levels are low, and the uterine spiral arteries constrict, limiting blood flow to the endometrium. Eventually, the endometrial blood vessels rupture and menses begin. In the secretory phase, progesterone functions to create a highly vascular secretory endometrium that is suitable for implantation of a fertilized ovum. 26. A nurse is teaching a patient how to track her menstrual cycle. What day does the nurse tell the patient to label as day 1? A. First day after the menstrual cycle B. First day of the menstrual cycle C. Last day before the menstrual cycle D. Last day of the menstrual cycle ANS: B Day 1 of the menstrual cycle begins with the onset of bleeding. 27. A woman is in the family planning clinic to learn about her cycle and the best times to get pregnant. What information should the nurse plan to teach her? A. An ovum can be fertilized for 12 to 24 hours after ovulation. B. Pregnancy can only occur during the follicular phase. C. There are no physiological signs that demonstrate ovulation. D. You cant easily get pregnant if your cycles are irregular. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers ANS: A An ovum is capable of being fertilized by a sperm cell for approximately 12 to 24 hours after ovulation. Pregnancy occurs during ovulation, which marks the end of the follicular phase and the beginning of the luteal phase. There are physiological signs of ovulation, such as changes in cervical mucus and body temperature. Women with irregular cycles can get pregnant. 28. A nurse has taught a woman about the physical signs that accompany ovulation. Which statement by the patient indicates that teaching has been effective? A. I can still conceive for up to 48 hours after ovulation. B. My temperature will go down after ovulation. C. Thin, watery cervical mucus means I am no longer fertile. D. Sticky cervical mucus helps hold the sperm in place on the egg. ANS: A The womans basal body temperature increases 24 to 48 hours after ovulation, and it is still possible to become pregnant at this point. Thin, watery cervical mucus creates a pathway for sperm to readily swim through the cervix. Sticky cervical mucus does not aid in fertilization. 29. A woman complains of irregular menstrual periods and wonders if she is in perimenopause or menopause. Her laboratory work shows high levels of follicle-stimulating hormone (FSH) and low levels of estradiol. What response by the nurse is best? A. No, in menopause the FSH is low and the estradiol is high. B. No, those two laboratory findings are not related to the climacteric phase. C. These laboratory findings usually indicate menopause or perimenopause. D. Yes you are definitely in menopause right now. ANS: C Elevated levels of FSH combined with low levels of estradiol usually indicate perimenopause or menopause. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers A. 25% B. 35% C. 40% D. 50% ANS: C In each millimeter of ejaculate, there are approximately 120 million sperm, 40% of which are motile. 35. A nurse working in the infertility clinic counsels a couple about male fertility. What assessment question to a male by the nurse would yield the most important information? A. Do you get plenty of exercise? B. Do you wear boxer shorts or briefs? C. How much alcohol do you drink? D. Have you been circumcised yet? ANS: B Factors that influence male fertility include participation in active contact sports; smoking; and wearing tight, constrictive clothing. Brief-style underwear are tighter than boxer shorts, and this is one question the nurse could ask about clothing that might yield some useful information. Exercise does not specifically address active contact sports. Alcohol use and circumcision are not related. 36. A nurse working with a couple in the infertility clinic notes the diagnosis of cryptorchidism on the mans chart. What assessment question by the nurse is most important? A. Did you have surgery for your undescended testes? B. Do you have a family history of testicular cancer? C. Do you use lead shielding when you get x-rays? D. For how long did you undergo chemotherapy? ANS: A CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers Cryptorchidism is a condition in which the testes fail to descend, and if they are not surgically placed into the scrotum, infertility can result. The other questions are not related to this condition. 37. A nurse is teaching a class about gender maturation. What information is most accurate? A. Gender is determined by 8 weeks of gestation, when sex organs are visible. B. Gender maturity is not fully complete until old age. C. It is a lengthy process that spans from the embryonic stage through puberty. D. The process begins and ends during fetal development. ANS: C Gender maturation is a lengthy process that begins during embryonic development and is completed during late adolescence, at which time full maturity is achieved. The other statements are not correct. 38. A mother brings her 9-year-old daughter to the family practice clinic. She is worried because the daughter already has definite breast buds and is asking to wear a bra. What response by the nurse is best? A. At what age did you develop breast buds or start menstruating? B. Does anyone in your family have a history of precocious development? C. The average age for breast budding is 9.8 years, so she is normal. D. This is too early for breast buds; she may need endocrine studies. ANS: C The average age that breast budding begins is 9.8 years, so this child is normal. The other responses are not relevant for this situation. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers 39. The nurse teaching a course in human reproduction informs the class that which reproductive structure is the first to form in the embryo? A. Gonad B. Mesoderm C. Mesonephric duct D. Oocyte ANS: A The first reproductive structure formed in the embryo is a gonad. This early reproductive tissue arises from the mesoderm, which is the embryos middle layer. The mesonephric ducts are a set of primitive reproductive ducts. Oocytes are eggs. 40. The nurse teaches a class that which of the following is the first gender change to occur in the embryo? A. Destruction of the Y chromosome in the female embryo B. Development of dominance in the primitive duct structure C. Formation of primitive external genitalia that are visible on ultrasound D. Spermatogenesis and oogenesis in male and female embryos, respectively ANS: B Differing male/female developmental changes in the mesonephric and paramesonephric ducts include the development of dominance in one set of the ducts. Mesonephric ducts become dominant in males; paramesonephric ducts become dominant in females. This is the first gender change that occurs. Gender is determined by the presence of an XX or XY pair of chromosomes; none are destroyed. External genitalia are usually not visible before 12 weeks of gestation, when androgens begin to stimulate their growth. Spermatogenesis occurs in puberty in boys; oogenesis begins sometime after 10 weeks of gestation when the ovaries begin to develop. 41. A nurse is providing anticipatory guidance to a group of elementary school girls and their parents. What information is most accurate? A. Around age 10, girls will get interested in shaving their underarms. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers A. Manufactures a cervical plug during pregnancy B. Produces lubrication for intercourse C. Provides a receptacle for sperm D. Serves as a lower portion of the birth canal E. Stimulates the penis during intercourse ANS: B, C, D, E The vagina has five functions: (1) to provide lubrication to facilitate intercourse, (2) to stimulate the penis during intercourse, (3) to act as a receptacle for semen, (4) to transport tissue and blood during menses to the outside, and (5) to function as the lower portion of the birth canal during childbirth. 5. The OB nurse knows the menstrual cycle is controlled by the complex interplay of hormones that are secreted by which physiological structures? (Select all that apply.) A. Anterior pituitary B. Cerebral cortex C. Hypothalamus D. Ovaries E. Posterior pituitary ANS: A, C, D The menstrual cycle is controlled by complex interactions between hormones secreted by the hypothalamus, anterior pituitary, and ovaries. 6. A nurse is planning an educational seminar focused on changes associated with perimenopause and postmenopause. Which topics should the nurse plan to include? (Select all that apply.) A. Eating foods high in calcium B. Getting plenty of rest and sleep CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers C. Keeping the room cool at night D. Need for increased antiperspirant E. Using vaginal lubricants ANS: A, B, C, E During the perimenopausal and postmenopausal periods, several physical and emotional changes occur. Long-term effects include increased risk for osteoporosis and cardiovascular disease. Appropriate teaching topics include eating foods high in calcium to help prevent osteoporosis, getting plenty of rest and sleep to combat the fatigue that often accompanies these changes, keeping the room cool at night because hot flashes often occur at night, and the use of water-based vaginal lubricants during sexual activity to combat vaginal dryness. Sweat and sebaceous glands have diminished activity, so there is usually no need for an increased use of antiperspirants. 7. A nurse is planning an educational program for middle school boys focused on physical changes they can expect with puberty. Which topics should the nurse plan to include? (Select all that apply.) A. Changes in patterns of hair B. Deepening of the voice C. Growth spurt D. Narrowing waist E. Thinning skin ANS: A, B, C, D During puberty, a boy can expect to see changes in hair patterns, deepening of the voice, a linear growth spurt, increased upper body musculature with a narrowed waist, and thickening of the skin. OTHER CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers 1. Match the pelvic types with their descriptions. Pelvic types may be used more than once. a. Gynecoid Best suited for childbirth b. Android Fetal descent more likely to be in a posterior presentation c. Anthropoid Fetal descent is often in a transverse presentation d. Platypelloid Triangular or heart-shaped Only found in 3% of women Traditional form found in about 50% of women Oval shaped at the inlet but in the anterior-posterior plane Characteristics cause difficulty during fetal descent ANS: a, c, d, b, d, a, c, b The gynecoid pelvis is the typical female pelvis best suited for vaginal delivery. The android pelvis is triangular (or heart-shaped) and the shape can cause difficulty during fetal descent. The anthropoid pelvis is more likely to result in a posterior fetal presentation due to its oval shape at the inlet that is in the anterior-posterior plane. The platypelloid pelvis usually prevents vaginal delivery owing to the fetus descending in a transverse presentation. 2. Match the hormones and their functions. a. Gonadotropin-releasing hormone 1. Controls the development and function of the adrenal cortex b. Somatostatin 2. Stimulates the maturation of the mammary glands during pregnancy c. Adrenocorticotropic hormone 3. Regulates thyroid hormones d. Oxytocin 4. Also known as growth hormoneinhibiting hormone; inhibits the release of growth hormone CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers Box 4: Mothers sex chromosome X(m2) Fathers sex chromosome Y(f) Child is a boy Chapter 6: Human Sexuality and Fertility MULTIPLE CHOICE 1. The reproductive health nurse counsels a 17-year-old woman who is interested in initiating contraception. Which of the following would be a short-term positive outcome of the visit? A. Able to describe how to obtain and use the contraceptive chosen B. Continued use and pregnancy prevention for 6 months C. Lack of side effects and complaints about the method after 3 months D. Voiced satisfaction with this method over 6 months ANS: A Short-term outcomes include the patients ability to voice an understanding about the selected contraceptive method, voice an understanding of all information necessary to provide informed consent, and voice a comfort level with the use of the contraceptive method selected. Intermediate and long- term goals include the patients correct and consistent use of the selected contraceptive method, denial of adverse side effects, continued satisfaction with the selected contraceptive method, and consistent use of the contraceptive method and avoidance of pregnancy for the following year. 2. The clinic nurse is counseling a woman who had a Nexplanon rod implanted. The nurse reminds her that she will need an appointment to replace this birth control method in what time frame? A. 12 months B. 24 months C. 36 months D. 48 months CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers ANS: C Nexplanon is a subdermal contraceptive that must be removed and replaced every 3 years if continued contraception is desired. The single-rod implant, which is inserted on the inner side of the womans upper arm, contains etonogestrel, which is a progestin. Objective: 6-3 3. A 24-year-old lactating woman asks about contraceptive options. The family planning clinic nurse recommends an oral contraceptive formulated with which ingredients? A. Biphasic formulation B. Estrogen-progestin C. Progestin only D. Triphasic formulation ANS: C Low-dose progestin-only contraceptive pills are often referred to as the mini-pill because they contain no estrogen. The mini-pill may be used during breastfeeding because it does not interfere with milk production. 4. A woman is interested in the transdermal contraceptive patch. She is 55 tall and weighs 200 lb (90.9 kg). What information should the nurse provide this patient as a priority? A. It may cause skin irritation. B. She cant use the patch at her weight. C. The patch is about 95% effective. D. Withdrawal bleeding occurs monthly. ANS: B All answers are correct; however, because this woman is obese, the nurse needs to tell her that women weighing over 198 lb should not use the patch. This is because of concerns that excessive adipose tissue may be associated with inconsistent levels of hormonal absorption. CHAPTER 2 IN CONTEMPORARY ISSUES IN WOMENS ,FAMILIES AND CHILDRENS HEALTH CARE TEST BANK Examination study guide 2022 Questions and Answers 5. A nurse works with many women who self-identify as lesbian or bisexual. What action by the nurse would best address this populations needs? A. Aggressive screening for sexually transmitted infections B. Assisting with procedures related to conception C. Providing information on increased cancer risks D. Using questions that do not assume sexual orientation ANS: D Lesbians and bisexuals are more likely to report poor physical or mental health compared with heterosexual women. Although the origins of this are not totally clear, one factor may relate to the homosexual/bisexual womans hesitancy in seeking health care. Nurses can greatly assist with this by being nonjudgmental and by using language and questions that do not assume sexual orientation. Sexually transmitted infections do occur in this population, although woman-to-woman transmission is lower than man-to-woman transmission. Some lesbian women do seek to become pregnant and bear children; they should be apprised of all available options. Lesbian women have increased risks for breast, endometrial, and ovarian cancer. Although all options are feasible, the option that has the potential to have the greatest impact is the one related to neutral language, which can be perceived as welcoming and accepting. 6. The nurse working in a family practice clinic assesses women for sexual dysfunction. Which woman would the nurse assess as having a sexual dysfunction? A. Complains about lack of arousal but still has intercourse B. Enjoys a platonic relationship with her gentleman friend C. Needs increased foreplay in order to reach an orgasm D. No desire for intimacy and is comfortable with the situation ANS: A Sexual dysfunction is defined as any sexual situation that causes personal distress for the woman herself. If the woman is comfortable with the situation, there is no dysfunction. Dysfunction can occur in the physical, emotional, or relationship aspect of sexuality. The woman who complains of lack of arousal has a dysfunction even though she still is sexually active. The other women do not manifest complaints or personal distress about their situations.