TEST BANK: Womens Health A Primary Care Clinical Guide 5th

Edition Youngkin Schadewald Pritham

Women’s Health A Primary Care Clinical Guide 5th Edition Youngkin Schadewald Pritham
Test Bank

2. Which health occupation has the lowest percentage of women?

A. Physicians

B. Dentists

C. Pharmacists

D. Physical therapists

Answer: B

3. Which health profession has the largest number of workers?

A. Health aides

B. Physicians

C. Licensed practical nurses

D. Registered nurses

Answer: D

Chapter 1 Access to Women’s Health Care in the United States: Affordability, Equity, Rights

1. Which health occupation has the highest percentage of women?

A. Pharmacists

B. Physical therapists

C. Registered nurses

D. Dental hygienists
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Answer: D

4. Which of the following are certifications available in advanced practice registered nursing?
(Select all that
apply.)
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A. Certified nurse midwife

B. Certified registered nurse anesthetist

C. Certified nurse pharmacologist

D. Clinical nurse specialist

E. Nurse practitioner

Answer: A, B, D, E

5. What level of education is required to become a licensed practical nurse?

A. 2-year master’s degree (in addition to a 4-year bachelor’s degree)

B. 4-year bachelor’s degree

C. 2-year associate’s degree

D. 1-year certificate or diploma

Answer: D

6. What percentage of physicians and surgeons in the United States in 2014 were women?

A. 27%

B. 37%

C. 47%

D. 57%

Answer: B

7. What medical specialty has the highest percentage of women?

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A. General pediatrics

B. Obstetrics and gynecology

C. Orthopedic surgery

D. Urology
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11. Which of the following are the current trends in dentistry? (Select all that apply.)

A. More specialists than generalists

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B. Research linking oral health to overall health

C. Focus on treatment of disease rather than prevention

D. Expected growth of 18% from 2014 to 2024

E. Increasing demand for dental implants, bridges, and cosmetic services

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Answer: B, D, E

12. Which allied health occupation is projected to be the fastest growing?

A. Health information technicians

B. Nursing aides

C. Occupational therapists

D. Paramedics

Answer: A

13. One in five workers in which of the following allied health occupation is at or below the
federal poverty

level?

A. Medical assistant

B. Home health aide

C. Radiology technician

D. Speech-language pathologist

Answer: B

14. Veronica is a registered nurse who pours herself into her job. She works long hours without
complaint andstrives to do her best. Often, she maintains a cheerful, caring, and kind demeanor on
the outside whilefeeling exhausted and frustrated on the inside. The effort it takes to maintain this
front before her patientsresults in a lot of stress. This phenomenon can best be described as which
of the following?

A. Identity crisis

B. Psychological disparity

C. Emotional dissonance

D. Gender discrimination
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Answer: C
15. Tests of implicit racial bias among health professionals have revealed which of the following?

A. An unconscious preference for Whites over Blacks

B. Use of racially charged, derogatory language

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Answer: B, C, D, E

3. Hammarstrӧm et al. propose a model of sex and gender that includes which of the following
concepts?
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(Select all that apply.)

A. Binary sexuality based on one’s chromosomes

B. Sex, interacting with gender, as a continuum

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C. Biologically determined sex based on the effects of sex hormones on reproductive organ
development

E. Equitable gender relationships have resulted in similar health outcomes in men and women

Answer: B, C
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6. When did women’s health scholarship begin to flourish?

A. 1960s

B. 1970s

C. 1980s
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D. 1990s

C. Research and develop new women-specific medications

D. Decrease infection rates during obstetric surgeries

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Answer: B
9. Historical examples of gender bias in medical textbooks include which of the following? (Select
all that

apply.)
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A. Portrayals of women as inherently sick

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2:A 36-year-old patient is to undergo removal of her uterus for benign disease. Which of
the following is an advantage of abdominal hysterectomy over vaginal hysterectomy? a:
Repair of rectocele more readily accessible
b:
Fewer incisional complications
c:
Ability to deal with smaller uterine sizes
d:
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"Flat-plate" X-ray of the lower abdomen

e:
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Ultrasonography
7:
A 35-year-old patient does not recall why she had a laparoscopy 3 years ago. Which of the
following conditions is most likely to be associated with a laparoscopy for evaluation? a:
Pelvic pain
b:
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d: transabdominal
ultrasonography e:
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Magnetic resonance imaging (MRI) 11:

A healthy, asymptomatic, nulliparous 36-year-old woman requests your advice because she has
been
unsuccessful at achieving pregnancy over the last 13 months, despite regular menses. Performing
an
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initial physical examination, you detect a firm, non-tender, multinodular uterus whose size
corresponds to that at approximately 8 to 10 weeks of pregnancy, which is consistent with
leiomyomata uteri.
The
remainder of the medical history and physical examination is within normal limits, as is her
husband's
semen analysis. Normal ovulatory status has been documented by basal body
temperature monitoring and luteal-phase progesterone measurement. Your next best step
is to recommend a:
normal pelvic ultrasonography
b:
hysterosalpingogram (HSG) c: in vitro
fertilization - embryo transfer (IVF-ET) d:
myomectomy e: arterial
embolization of the fibroids
12:
A 36-year-old woman with regular, monthly, 5-day menstrual cycles presents with a 2-year history
of
severe right-sided pelvic pain. Pelvic examination reveals no abnormalities. She reports insomnia,
loss of
appetite, and decreased libido. The patient once considered evaluation for infertility but now does
not desire childbearing. She has had three laparoscopic procedures in the last 18 months that
showed minmal peritoneal adhesions, with no change in the pain. Appropriate management of this
includes a: repeat diagnostic laparoscopy b: barium enema, intravenous pyelography, and plevic
ultrasonography c:
presacral neurectomy d: transabdominal hysterectomy and
bilateral salpingo-oophorectomy e: psychological counseling with
antidepressant therapy 13:
A 63-year-old woman with 6 months of early satiety and increased abdominal girth has an
abdominal
fluid wave and a palpable 12 cm nodular right adnexal mass. The next BEST step would be for
her to obtain a:
a diagnostic laparoscopy b: a staging laparotomy and debulking for
her presumed ovarian cancer c: a CT scan to get the exact
dimensions of the mass d:
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chemotherapy e: an ultrasonography to determine if the

mass is cystic or solid
14:
A 42-year-old woman, G2P2, who had a laparoscopic tubal fulguration 7 years ago, has abnormal
uterine
bleeding. Her menstrual cycle has been 28-30 days with a menstrual flow of 5-6 days. During the
last 6
months, the interval has varied from 14 to 35 days and the menstrual flow has lasted from 1 to 14
days.
The uterus is irregular and firm and consistent in size with an 8-week gestation. Both ovaries
are palpably normal in size. Urine pregnancy test is negative. The most appropriate next step in
management is
a:
endometrial
sampling b:
laparoscopy c:
transabdominal ultrasonography
d: pelvic CT e:
hysteroscopy
15:
A 19-year-old primigravid woman is seen because of vaginal bleeding. Her LMP was about 11
weeks ago;
the vagina contains a small amount of dark blood and the cervix is long and closed. The uterus is
enlarged and not tender. A pelvic ultrasonography demonstrates an intrauterine gestational sac but
no
fetal pole is identified. The patient is distraught but declines surgical management. Of
the following, the most appropriate management of this patient's condition is a:
combination oral contraceptive pills b:
methotrexate intramuscular injection c:
depot medroxyprogesterone acetate d:
oral broad-spectrum antibiotic thearpy e:
mifepristone pills and vaginal misoprostol
ANS: [cddbc eaecc beaae]
Chapter 4 Assessing Adolescent Women’s Health Renee Sieving, Sarah Stoddard, Deborah A.
Raines
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1. The teen birthrate is highest among which major racial or ethnic group?

A. Latinos

B. African Americans

C. Whites

D. Asians

Answer: A

2. What percentage of the U.S. population was 10 to 19 years old in 2014?

A. 14%

B. 19%

C. 24%

D. 29%

Answer: A

3. Which of the following are examples of protective factors for adolescents? (Select all that
apply.)

A. Bonds with friends and family

B. Physical inactivity

C. A school’s high expectations of students

D. Risky sexual behaviors

E. Opportunities for youth participation in the community

Answer: A, C, E

4. Rachel is a talkative, open 13-year-old who is in for a physical exam today by herself. In talking
with
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Rachel, the nurse should recognize which of the following as characteristics typical of this stage of

development? (Select all that apply.)

A. Criticism of her parents

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B. Acceptance of the physical changes of puberty

D. Arthritis
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Answer: B

7. Brooke is a 17-year-old who is questioning both her sexual orientation and her gender. She says
she has

begun exploring these but that her parents do not know. Brooke is at an increased risk of
experiencing
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which of the following? (Select all that apply.)

B. A healthy diet

C. Reduced substance abuse

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D. Improved mental health

E. Lack of peer conflict

Answer: A, C, D
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10. During an office visit, Jordan, a 16-year-old patient, asks her nurse if she can share something
in

A. Giving some concrete goals to Enid for her to pursue

B. Asking Enid’s mother to join them

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C. Using motivational interviewing with Enid

D. Reminding Enid of the consequences of noncompliance

Answer: C
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13. Nadia is a 13-year-old who is in for her first reproductive health visit. She reports having no
special

C. Motivational interviewing
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D. Mini-Cog assessment

Answer: A
Chapter 5 Assessing Adult Women’s Health Diane Marie Schadewald, Catherine Juve, Ellis
Quinn Youngkin, Marcia Szmania Davis

B. The cessation of menses, defined as the end of the final menstrual period
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C. The cessation of menses, defined as 1 year after the final menstrual period

D. The date of the last menopause-related symptom

Answer: C

4. Women of which U.S. ethnic group are most likely to describe menopause as “something you
have to go
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through” and to view it as a time to reorient and restructure their lives?

A. African Americans

B. Japanese Americans

C. European Americans

D. Urban Latinas

Answer: D

5. Which of the following endocrine changes are typical during the last 2 years before the final
menstrual

period? (Select all that apply.)

A. Increased testosterone levels

B. Decreased antral follicle count

C. Increased follicle-stimulating hormone levels

D. Decreased progesterone levels

E. Increased estradiol levels

Answer: B, C, D

6. Sleep disruption, a common symptom during the menopausal transition, is most often associated
with

which other perimenopausal symptom?

A. Hot flashes

B. Decline in memory

C. Back pain

D. Depressed mood
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Answer: A
7. Which of the following are common symptoms during the menopausal transition? (Select all that
apply.)

A. Difficulty concentrating
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B. Urinary incontinence

10. Which of the following are characteristics of metabolic syndrome? (Select all that apply.)

A. Increased lipid levels

B. Insulin resistance
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C. Decreased inflammatory response

D. Increased risk of thrombosis

E. Increased blood pressure

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Answer: A, B, D, E

Based on current recommendations by the National Institutes of Health (NIH), what exercise
program
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would you suggest to Lorraine to maintain her current level of fitness?

A. None—she is already maintaining her fitness level

B. 20 minutes of light-intensity exercise per day, 3 days per week

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C. 30 minutes of moderate-intensity exercise per day, 5 days per week

Chapter 6 Assessing Older Women’s Health Debra Hain

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1. How many people in the United States were 65 years or older in 2010?

A. 3.1 million

B. 20.5 million

C. 40.3 million

D. 83.7 million

Answer: C

2. What percentage of those 85 years and older in the United States in 2010 were women?

A. 47%

B. 57%

C. 67%

D. 77%

Answer: C

3. What percentage of women 85 years and older in the United States in 2010 were widowed?

A. 35%

B. 52%

C. 73%

D. 91%

Answer: C

4. Compared with older men, older women are: (Select all that apply.)

A. More prepared to retire

B. Less likely to retire at retirement age

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C. More likely to have a retirement pension from their employer

D. Less likely to report being satisfied in retirement

E. More likely to live alone

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Answer: B, D, E

5. In 2030, which of the following is the percentage of the older population (65 years or older) that
is

projected to be White?

A. 47%

B. 54%

C. 67%

D. 74%

Answer: A

6. Which of the following cognition-related capacities typically decline with normal aging? (Select
all that

apply.)

A. Motivation

B. Short- and long-term memory

C. Knowledge

D. Learning

E. Wisdom

Answer: A, B, D

7. Daisy, a 77-year-old client, reports a gradual and slight loss of hearing, especially for higher
pitched tones.

The nurse should recognize this condition as which of the following?

A. Presbyopia
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B. Presbycusis

C. Age-related macular degeneration

D. Otitis media

Answer: B
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8. What percentage of cancers are diagnosed at age 55 years or older?

A. 55%

B. 65%

C. 75%

D. 85%

Answer: C

9. Which of the following is the leading cause of cancer death in women?

A. Breast cancer

B. Lung cancer

C. Colorectal cancer

D. Pancreatic cancer

Answer: B

10. Mamie is a 76-year-old client who is suspected of having Alzheimer’s disease. To confirm this
suspicion,

the nurse should look for impairment in which of the following mental functions? (Select all that
apply.)

A. Visual acuity

B. Memory

C. Language

D. Attention

E. Ability to reason

Answer: B, C, D, E
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11. A phenotype of positive aging that has been described in older women is focused on which of
the

following? (Select all that apply.)

A. Presence of chronic disease

B. Physical functioning
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C. Presence of a disability

D. Social functioning

E. Emotional functioning

Answer: B, D, E

12. Which of the following are the benefits associated with weight-bearing aerobic exercise in
older women?

(Select all that apply.)

A. Decreased risk for breast cancer

B. Increased bone density

C. Reversal of Alzheimer’s disease symptoms

D. Improved balance

E. Improved insulin resistance

Answer: B, D, E

13. Opal, who is 82 years old, would like information on vaccinations recommended for clients of
her age.

Which of the following should the nurse recommend? (Select all that apply.)

A. Annual influenza

B. Human papillomavirus

C. Onetime pneumococcal

D. Hepatitis B

E. Herpes zoster

Answer: A, C, E
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14. What percentage of community-dwelling older adults take at least five prescription
medications?

A. 29%

B. 39%
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C. 49%

3. Which of the following are characteristics of women’s sexual response? (Select all that apply.)

A. Highly consistent among a woman’s life stages

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B. Highly variable among different women

C. Expectations and perceptions influenced by culture

D. A complex interplay of psychological, physiological, and interpersonal components

E. Unaffected by religious beliefs

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Answer: B, C, D

A. Women and men experience the same cycle of sexual response.

B. Desire is a critical first step in the sexual response cycle.

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C. Women can enter into sexual activity for reasons other than innate desire.

D. Female sexual response follows a linear biologic progression.

Answer: C
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7. According to a study by Robbins et al., what percentage of 17-year-old females reported ofever
having

masturbated?

A. 28%

B. 38%

C. 48%

D. 58%

Answer: D

8. Although there is variation, during what phase of life is it most likely that females, particularly
lesbians,

will establish their sexual orientation?

A. Childhood

B. Adolescence

C. Adulthood

D. Midlife

Answer: C

9. The nurse is conducting a sexual assessment on Pamela, a 50-year-old woman. On asking

whether Pamela

is involved in a sexual relationship, Pamela says “yes.” Which follow-up question would be most

appropriate for the nurse to ask next?

A. “Are you married?”

B. “Are you and your husband satisfied with your sex life?”

C. “Who are you having sex with?”

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D. “Are you involved in a sexual relationship with men, women, or both?”

Answer: D

10. The nurse is conducting a sexual assessment with Wendy, a 16-year-old client, who appears
nervous. The
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nurse sees on Wendy’s questionnaire that her period is a week later than usual. What would be the
most

experiences with her partner and then says, “What do you think I should do?” Which of the
following
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would be the most appropriate response for the nurse to give?

A. “I agree that your partner is being selfish. You might consider breaking up with her.”

B. “Why don’t we schedule a follow-up appointment with you and your partner so that we can
discuss this
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together.”

C. Dyspareunia

D. Genitopelvic pain/penetration disorder

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Answer: D
15. A nurse is counseling a 15-year-old client whose boyfriend wants her to try drinking acouple of
beers

before they have sex. Which of the following effects of alcohol use on sexual function should the
nurse
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mention to the client?

Answer: B
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3. A nurse practitioner recently joined a practice with a diverse clientele, including persons of all
sexual

orientations and gender identities. How should the nurse approach these clients? (Select all that
apply.)

A. Avoid bringing up sexual orientation or gender identity

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B. Ask all clients openly about their sexual orientation and gender identity

C. Assume all clients are heterosexual and cisgender unless they say otherwise
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C. 1983

D. 1993
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Answer: B
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7. Melissa is a 62-year-old lesbian client. On the basis of her age and sexual orientation, Melissa is
more

B. Depression

C. Multiple sclerosis
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D. Trauma and violence

E. Substance abuse

Answer: A, B, D, E
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10. Meg is a 15-year-old bisexual client. Which of the following is Meg at a greater risk for than
her

heterosexual counterparts? (Select all that apply.)

A. Spinal cord injury

B. Experiencing school bullying

C. Bipolar disorder

D. Homelessness

E. Suicidality

Answer: B, D, E

Chapter 9 Health Needs of Women with Disabilities Michele Davidson

1. The inability to carry out relevant roles due to the social impact of either a physical impairment
or a

functional limitation is known as which of the following?

A. Disorder

B. Disease

C. Disability

D. Distress

Answer: C

2. Which of the following is a condition that is “age related” rather than “ageing related”?

A. Cardiomyopathy

B. Osteoarthritis

C. Presbyopia

D. Presbycusis
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Answer: A
3. Which of the following is a condition that is “ageing related” rather than “age related”?

A. Presbyopia
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D. Social Security Disability Insurance

E. Supplemental Nutrition Assistance Program

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Answer: B, D

6. Which of the following is a risk factor for declining health in a woman with a later onset
disability?
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A. 1

B. 3
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C. 5

D. 7

Answer: B

10. Which condition is a risk factor for declining health in a woman with a disability?
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A. Dementia

B. Dyslexia

C. Attention deficit hyperactivity disorder

D. Obsessive-compulsive disorder

Answer: A

Chapter 10 Integrating Wellness: Complementary Therapies and Women’s Health J o Lynne W.

Robins

MULTIPLE CHOICE
1. A pregnant woman tells the nurse that she got relief from nausea when she had a therapy that
involves pressure and massage on meridian sites. What type of therapy does this describe? a.
Acupuncture
b. Acupressure
c. Aromatherapy
d. Ayurveda
ANS: B
Acupressure uses finger pressure and massage on the meridian sites. It can be used during
pregnancy to control nausea, backache, and pain. It has been useful for minor postpartum problems
such as constipation.
2. Which child should not receive massage therapy?
a. 15-year-old with a fractured femur
b. 12-year-old with diabetes mellitus
c. 8-year-old with Down syndrome
d. 17-year-old with an eating disorder
ANS: C
Children with Down syndrome are prone particularly to cervical spine anomalies and may be
injured by massage therapy.
3. A 12-year-old with rheumatoid arthritis finds aromatherapy helpful for relieving her joint
discomfort. Which essential oil is useful for children with chronic pain? a. Lavender
b. Ephedra
c. Ginseng
d. Kava-kava ANS: A
Lavender, chamomile, and sandalwood essential oils are useful in aromatherapy for children with
chronic pain.
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4. A pregnant woman wishes to use aromatherapy during her labor and delivery. What is the
most appropriate essential oil for the nurse to recommend?
a. Juniper
b. Wintergreen
c. Thyme
d. Citrus
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ANS: D
Citrus is one essential oil that has been shown to be useful during labor and delivery.
5. A parent asks the nurse, What is guided imagery? Which statement is the most accurate
response?
a. It is a technique where the patient focuses on an image to relieve stress.
b. It involves using water to promote relaxation.
c. The patient enters a hypnotic state of sleep to promote relaxation.
d. It helps the patient recognize tension in the muscles with responses on an electronic machine.
ANS: A
In guided imagery, by focusing on a specific image, stress reduction and improved performance
can result.
6. A woman taking St. Johns wort and ginseng daily is scheduled to have a hysterectomy in 3
weeks. What instruction should the nurse provide?
a. The herbs are not likely to cause any problems during the surgery.
b. The St. Johns wort must be stopped prior to surgery, but she can continue the ginseng.
c. The ginseng should be stopped 1 week before surgery.
d. She should discontinue taking both herbs 2 weeks before surgery.
ANS: D
Both St. Johns wort and ginseng can cause problems during surgery, and their use should be
discontinued 2 weeks before surgery.
7. Which herb can the nurse suggest to be used for discomforts associated with menopause, such as
hot flashes?
a. Evening primrose oil
b. Echinacea
c. Milk thistle
d. Black cohosh
ANS: D
Black cohosh diminishes hot flashes by reducing luteinizing hormone. It also reduces joint pain
and other menopausal discomforts.
8. A young mother asks, Is there an alternative medicine for children with asthma? Which form of
alternative medicine would be the most helpful for the nurse to suggest? a. Reflexology
b. Rolfing
c. Guided imagery
d. Acupressure
ANS: C
The use of guided imagery has helped relieve some of the symptoms of asthma.
9. What is the difference between complementary therapy and alternative therapy?
a. Complementary therapy must be administered by a medical doctor.
b. Complementary therapy is administered with conventional therapy.
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c. Complementary therapy replaces conventional therapy.

d. Complementary therapy is administered to a group of patients at the same time.
ANS: B
Complementary therapy is administered with conventional therapy, such as massage with muscle
relaxants for low back pain.
10. The nurse uses a diagram to show the location of meridians. How will the nurse explain the
definition of meridians?
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a. They are lymph nodes.

b. They are invisible pathways for energy.
c. They are lines that divide the body into 10 zones.
d. They are areas of skin that are specifically innervated. ANS: B
Meridians are invisible pathways through which energy travels to effect acupuncture treatment.
11. Which herbal remedy used by a patient taking warfarin should the nurse report to the
physician?
a. Angelica (dong quai)
b. Chamomile
c. Ginseng
d. Kava-kava
ANS: A
Angelica prolongs prothrombin time and will synergize the effect of the warfarin.
12. What should the nurse remind a parent who is considering homeopathic remedies for treatment
of her childs asthma?
a. Should be drunk with large amounts of fluid
b. Can be taken with traditional Western medications
c. Can be enhanced by drinking hot tea
d. May contain mercury, alcohol, or arsenic
ANS: D
Homeopathic remedies often contain mercury, alcohol, or arsenic and are taken sublingually. All
Western medications should be stopped when the homeopathic therapy is begun. Caffeine drinks
are to be avoided during homeopathic treatment.
13. The focus of acupressure is to restore the balance of what?
a. Chi
b. Shiatsu
c. Yin and yang
d. Ayurveda ANS: A
Acupressure is focused on the return of the balance of Chi to control disease processes.
14. A breastfeeding mother tells the nurse she is taking large doses of vitamin C to keep up her
energy. What should the nurse warn that large doses of vitamin C can cause in an infant? a.
Diarrhea
b. Jaundice
c. Colic
d. Retinal damage
ANS: C
Vitamin C can be passed on to a breastfeeding child through breast milk and can cause colic.
15. The pregnant patient with a stasis ulcer asks if she might be a candidate for hyperbaric oxygen
therapy (HBOT). What is the nurses best response?
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a. Yes. Hyperbaric oxygen therapy should have no harmful effect on your baby.
b. No. High amounts of oxygen in your system will cause changes in your babys heart.
c. Yes. Hyperbaric oxygen therapy is a much better option than using antibiotics.
d. No. Hyperbaric oxygen therapy may cause the placenta to separate fromthe uterine wall.
ANS: B
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High concentrations of oxygen in the mothers blood can cause closure of the ductus arteriosus and
cause fetal death.
16. A patient is providing history information to the admitting nurse about treatment used for
chronic pain. The patient reports she participates in a type of relaxation therapy that enables her to
recognize tension in the muscles via responses on an electronic machine and visual
electromyography responses. What type of therapy does the nurse record on admission record? a.
Guided imagery
b. Biofeedback
c. Hypnotherapy
d. Chiropractic care
ANS: B
Biofeedback is a type of relaxation therapy that enables the patient to recognize tension in the
muscles via responses on an electronic machine and visual electromyography responses. The
process is also used by traditional health care providers for drug addiction and chronic pain
control.
MULTIPLE RESPONSE
17. What conditions would a nurse expect to see treated with hyperbaric oxygen therapy (HBOT)?
(Select all that apply.) a. Wounds
b. Carbon monoxide poisoning
c. Hyperemesis gravidarum
d. Decompression illness
e. Pneumonia ANS: A, B, D
Hyperbaric oxygen therapy (HBOT) uses an airtight enclosure to provide compressed air or
oxygen under increased pressure. HBOT is used to revive children with carbon monoxide
poisoning, to aid wound healing, and to treat the diving syndrome known as decompression illness.
HBOT is contraindicated during pregnancy, because the increased oxygen saturation can cause the
ductus arteriosus to close, resulting in fetal death.
18. The mother of a pediatric patient asks the nurse about safety concerns with using herbal
supplements with children. Which herbal products would the nurse educate this mother are safe to
use in most of the pediatric population? (Select all that apply.) a. Ephedra
b. Ginger
c. Fish oil
d. Chamomile
e. Aloe vera ANS: B, C, D, E
Ginger, fish oil, chamomile and aloe vera are safe herbal products for children. However, some
herbs, such as ephedra, can be fatal to children.
19. The nurse points out that light therapy is used in the treatment of patients with which
disorder(s)? (Select all that apply.) a. Digestive disorders
b. Seasonal affective disorder
c. Inflammatory diseases
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d. Stress disorders
e. Jaundice ANS: B, E
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Light therapy has proven effective in the treatment of persons with seasonal affective disorders.
Light therapy is also used in the treatment of jaundiced babies.
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20. What advantage(s) of alternative health care should the nurse outline when providing
Womens Health A Primary Care Clinical Guide 5th Edition
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information to patients? (Select all that apply.) menses d:

at the time of ovulation

2:
In premenstrual syndrome, there is a symptom-free interval of at least
Womens Health A Primary Care Clinical Guide 5th Edition
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a:
1 week per
cycle b:
1 cycle out of

4 c:
2 weeks per

cycle d:
2 cycles per year

3:
The maximum estimated incidence of women with some physical or emotional premenstrual
symptoms is
Womens Health A Primary Care Clinical Guide 5th Edition
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a:
60%-70%
b:
45%-55%
c:
30%-40%
d:
75%-85%

4:
Premenstrual dysphoric disorder occurs in what percent of women?

a:
5%
b:
75%
c:
50%
d:
25%

5:
In making the diagnosis of premenstrual syndrome or PMDD, the characteristic that is most
distinguishing is the

a: duration
of
Womens Health A Primary Care Clinical Guide 5th Edition
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symptoms
b:
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cyclic occurrence of
symptoms c:
degree of disability in the
patient d:
severity of symptoms

6:
Which of the following is most likely related to the underlying etiology of PMDD?

a:
Serotoni
n b:
Catecholamine
s c:
Norepinephrin
e d:
Progesterone

7:
The most useful diagnostic tool with respect to premenstrual syndrome is

a:
a careful
history b:
serial progesterone
levels c:
Womens Health A Primary Care Clinical Guide 5th Edition
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a prospective menstrual diary

d:
serial blood glucose determinations
Womens Health A Primary Care Clinical Guide 5th Edition
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8:
Reduction or elimination of which of the following dietary components appears to have a
positive effect in PMS patients?

a:
Calciu
m b:
Fa
t c:
Fresh
fruit d:
Magnesium

9:
Which of the following is most likely to help a patient's PMS symptoms

a:
Vaginal
progesterone b:
Transdermal
estrogen c:
Oral medroxyprogesterone
acetate d:
Combined oral contraceptives

10:
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A 25-year-old woman with no medical problems comes in for her annual exam. She expresses the
worry that she has PMDD. She reports feeling bloated and moody when she has her period. The
most appropriate initial management for this patient is
Womens Health A Primary Care Clinical Guide 5th Edition
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a:
treating her for
hypothyroidism b:
asking her to keep a menstrual diary for 2
months c:
ordering a pelvic
ultrasound d:
giving her a prescription of fluoxetine to be taken only during the luteal phase

11:
A patient keeps a menstrual diary for 2 months. The diary reveals that she has bloating, fatigue,
anxiety, insomnia, and tearfulness in the days prior to her menses and that the symptoms resolve
completely after her menses starts. She reports that her insomnia is so bad that it prevents her
from being efficient at work because she is not well rested. The most likely diagnosis for this
patient is

a:
bipolar
disorder b:
PMDD
c:
major depressive
disorder d:
PMS

12:
A patient with PMDD asks for some treatment options. You respond that the treatment that has
clearly demonstrated benefit for her condition is
Womens Health A Primary Care Clinical Guide 5th Edition
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a:
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GnRH
agonist b:
sertralin
e c:
danazo
l d:
ovarian suppression with high-dose depot medroxyprogesterone

13:
Which of the following has been shown to significantly improve the symptoms of women with
PMS?

a:
Light therapy
b:
Vitamin
E c:
Evening
primrose d:
Aerobic exercise

14:
Which of the following would be the first line of treatment in the management of symptoms of
PMS?

a:
Selective serotonin reuptake
inhibitors b:
Womens Health A Primary Care Clinical Guide 5th Edition
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GnRH
agonist c:
Complex carbohydrate diet
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d:
Oral contraceptive

15:
An important diagnosis to distinguish from PMDD is major depressive disorder. Which of the
following is increased in patients with major depressive disorder but not in patients with PMDD?

a:
Sleep
disturbance b:
Suicide
risk c:
Anxiet
y d:
Disordered eating

[ANS: a,a,d,a,b,a,c,b,d,b,b,b,d,c,b]

Chapter 12 Contraceptive Management and Family Planning Beth Walcker, Coralie

Pederson, Kathryn A. Caufield
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Womens Health A Primary Care Clinical Guide 5th Edition
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oral
contraceptive c:
rhyth m d:
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intrauterine device
(IUD) e:
spermicidal foam

3:
C.The pregnancy rate (% pregnant in 1 year) for a couple using no method ofcontraception
typically is

a:
25
b:
65
c:
15
d:
45
e:
85

4:
D. In the first year of use, the typical use pregnancy rate for a woman using a
diagphragm and spermicide

1
6
b:
a:
Womens Health A Primary Care Clinical Guide 5th Edition
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2
0 c:
2
8 d:
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8
e:
24

5:
E.In the first year of use, the typical use pregnancy rate for a woman using a copper
intrauterine contraceptive is

a:
8
b:
1.5
c:
0.8
d:
10
e:
3

6:
F. Which of the following is the least effective birth control option?

a:

contraceptives b:
Cervical
Combination oral
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cap c:
Monthly transvaginal ring d:
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Weekly transdermal
patch e:
Three-month injectable

7:
G. The failure of oral contraceptives usually is related to

a:
interference by other medications that the patient is
taking b:
an inherent problem in the estrogen-to-progesterone
ratio c:
altered gastrointestinal absorption of the oral contraceptive caused by hormonal
influences d:
ingestion of the oral contraceptive agent with
alcohol e:
missed doses of the oral contraceptive

8:
H. Which of the following contraceptive techniques relies the least on patient compliance?

a:
Contraceptive
ring b:
Combination
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pill c:
Progestin pill
d:
Contraceptive patch
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e:
Contraceptive implant

A 24-year-old Latin American female G2P2 sees you for her annual. She is about to wean her
baby in a few months and is on the progesterone-only pill. She really likes this particular pill
because she has had no periods while breastfeeding. She wonders if she can continue to use it.

9:
A. You counsel her that one of the main reasons to consider switching to combination birth
control pills is

a:
better lipid
profile b:
better control of her
moods c:
better cycle
control d:
better weight
loss e:
better control of her acne

10:
B. Which of the following statements about the progestin-only minipill is correct?

a:
It cannot be started postpartum until at least 2 months after
delivery b:
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It is taken once per

week c:
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a:
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10-17 b:
7-14
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c:
7-17
d:
10-20

13:
C. Which of the following methods is most appropriate for this woman requesting a "natural"
method of family planning?

a:
Cervical
cap b:
Cervical mucus
method c:
Vaginal
ring d:
Female condom

A 20-year-old college student G0 sees you for her annual. Her gyn history is remarkable for
menarche at 13 years and regular cycles, but her periods last 7 to 9 days and are very painful.
Her college roommate had similar periods and got good results with birth control pills. During
the history you note that she smokes 1 pack per day. She has migraines that are preceded by
flashing lights. Her mother had breast cancer diagnosed at age 49 years and both her parents are
hypertensive.

14:

A. You are hesitant to prescribe birth control pills because of

a:
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her migrines preceded by flashing

lights b:
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her painful periods that may be consistent with

endometriosis c:
her smoking one pack per
day d:
her history of breast cancer in her
mother e:
her family history of hypertension

15:
B. What is the primary mechanism of action of oralcontraceptives?

a:
Inhibit
ovulation b:
Impose a barrier between the sperm and the
egg c:
Create an environment in the uterus that is toxic to the
sperm d:
Destroy the embryo shortly after
fertilization e:
Alter the ability of the fertilized egg to implant and grow

16:
C.Which is a contraindication to the birth control pill?

a:
Womens Health A Primary Care Clinical Guide 5th Edition
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Smoking in a woman older than 35

years b:
A family history of stomach cancer
Womens Health A Primary Care Clinical Guide 5th Edition
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c:
Dysmenorrhe
a d:
A history of ovarian cysts

17:
D. Other than investigating the cause, what action should be taken when a woman using
anoral contraceptive experiences a headache?

a:
Increase oral contraceptive to twice
daily b:
Switch to the phasic
pill c:
Continue oral
contraceptive d:
Discontinue all
contraception e:
Discontinue oral contraceptive

A 16-year-old sees you in the Derm Clinic. She is hesitant because she heard antibiotics made
"your birth control not work." You reassure her that most common antibiotics do not lessen the
effectiveness of birth control pills.

18:

A. When taken concurrently, which of the following will reduce the effecacy of oral
contraceptives?
Womens Health A Primary Care Clinical Guide 5th Edition
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a:
Tetracyclin
e b:
Womens Health A Primary Care Clinical Guide 5th Edition
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Aspiri
n c:
Phenytoi
n d:
Metronidazol
e e:
Methyldopa

19:
B. Which of the following best describes "phasic" formulation of oralcontraceptives?

a: They contain only progestin in varying doses

b: They contain varying doses of hormones throughout the cycle
pack c: They are mostly used postpartum
d: They contain a higher dose of hormones per month than monophasic
contraceptive pills e: They have a different mechanism of action than monophasic
pills

20: In which of the following casses should biphasic oral contraceptives be discontintued?

A: Galactorrhea
b:Right upper quadrant pain
c:Amenorrhea
d:Anemia
e:Hepatic mass with tenderness
ANS: [b,b,e,c,c,b,e,e,c,d,c,a,b,a,a,a,c,c,b,e]
Chapter 13 Infertility Michelle Valentine, Jennifer R. Gardella
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B. 34%

C. 44%
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D. 54%

Answer: A
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4. Bonnie is a 31-year-old client who has been trying to get pregnant for 18 months now. After
interviewing

following should the nurse tell Mike to be prepared to do?

A. Undergo a digital rectal exam

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B. Have a urinary catheter placed

C. Undergo an EKG

D. Masturbate to provide a semen specimen

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Answer: D

B. Gamete intrafallopian transfer

C. In vitro fertilization
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D. Zygote intrafallopian transfer

Answer: C

10. What recommendations related to use of reproductive technologies should the nurse follow to
help avoid
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ethical problems? (Select all that apply.)

Chapter 14 Vaginitis and Sexually Transmitted Diseases Susan D. Schaffer, Jane Houston
Womens Health A Primary Care Clinical Guide 5th Edition
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A 16-year-old virginal is brought in by her mother because of possible vaginal infections. Which
of the following descriptions is most consistent with normal (physiologic) discharge?

a:
White, clear, and
flocculent b:
White, curds, cottage cheese-
like c:
Gray-green, thin, and
adherent d:
Gray-green, frothy

2:
A 24-year-old patient requests treatment for what she believes is a bacterial infection of the
vagina. Which of the following is characteristic of vaginal discharge in cases of bacterial
vaginosis?

a:
Fishy
odor b:
pH<4.5
c:
Whitish color
d:
Curdy consistency
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3:
A 40-year-old patient has recently been treated for a urinary tract infection with antibiotics. She
now complains of a possible yeast infection. Discharge in cases of vaginal candidiasis is
characterized by
Womens Health A Primary Care Clinical Guide 5th Edition
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a:
presence of hyphae and
buds b:
thin, homogeneous
consistency c:
white cells
d:
foul odor

4:
A 30-year-old patient is seen for a vaginal discharge that started after she had relations with a new
partner. Which of the following characterizes vaginal trichomoniasis?

a:
pH of discharge less than
4.5 b:
Vaginal
dryness c:
White
discharge d:
Motile protozoa on microscopic examination

5:

A 55-year-old patient has recently developed vaginal irritation. Her last menstrual period was 9
months ago. Which of the following is characteristic of atrophic vaginitis?
Womens Health A Primary Care Clinical Guide 5th Edition
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a:
Increased circulating estrogen levels
b:
Thickened vaginal
epithelium c:
Vaginal
dryness d:
pH of vagina less than 4.5

6:
Most of the liquid portion of physiologic vaginal secretions in a woman of reproductive age
comes from

a:
vaginal
transudate b:
the cervix
c:
the Skene
glands d:
the Bartholin glands

7:
In a 33-year-old woman with regular periods, the creamy white portion of normal vaginal
secretions comes from

a:
exfoliated squamous epithelial
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cells b: vaginal
white blood cells c:
cervical mucus
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d:
the Bartholin glands

8:
A 19-year-old patient who was concerned about vaginal discharge was found to have normal
vaginal secretions. Which of the following is the most appropriate management?

a:
Return as needed.
b:
Return after a single pill of
fluconazole. c:
Return after a 3-day course of
metronidazole. d:
Return after the next period.

9:
The normal pH of vaginal secretions in a reproductive-age woman is

a:
3.5-4.5
b:
6.5-7.5
c:
5.0-6.0
d:

8.0-9.0
Womens Health A Primary Care Clinical Guide 5th Edition
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10:
What is the difference in the normal pH of the vagina before and after menopause?

a:
Same in pre- and postmenopausal
patient b:
Varies depending on the phase of the premenopausal
cycle c:
Higher in premenopausal
patient d:
Higher in postmenopausal patient

11:
A 38-year-old patient requests treatment for a yeast infection but declines an examination
because she is on her period. The most common symptom associated with vulvovaginal
candidiasis is

a:
pai
n b:
feve
r c:
fishy smelling
discharge d:
pruritus

12:
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A 38-year-old patient requests evaluation of a fishy-smelling discharge. Which of the

following is a criterion for the diagnosis of bacterial vaginosis?

a:
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Presence of clue
cells b:
Negative "whiff"
test c:
Cottage cheese-like
discharge d:
pH less than 4.5

13:
A 45-year-old woman complains of a copious vaginal discharge. Which of the following is a
common cause of increased vaginal discharge?

a:
Trichomonias
is b:
Herpe
s c:
Human
papillomavirus d:
Atrophic vaginitis

14:
A 25-year-old patient complains of vaginal discharge that is white and curdy in appearance. What
is the appropriate method to establish the diagnosis?

a:
Womens Health A Primary Care Clinical Guide 5th Edition
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Constellation of
symptoms b:

Odor of the discharge

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c:
The amount of
discharge d:
Microscopic examination of the discharge

15:
What is the normal ratio of anaerobic to aerobic bacteria in the vagina?

a:
1 to
5 b:
5 to
1 c:
1 to
1 d:
10 to 1

16:
A 21-year-old patient complains of a vaginal discharge but is also concerned about pelvic
inflammatory disease (PID). Which type of vaginitis is associated with PID?

a:
Trichomonas
vulvovaginitis b:
Atrophic
vaginitis c:
Desquamative inflammatory
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vaginitis d:
Vaginal candidiasis
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17:
Which of the following best describes a "clue cell"?

a:
Clumped white blood
cells b:
Vaginal epithelial cells with adherent
bacteria c:
Keratinized vaginal epithelial cells with adherent white
blood cells d:
Immature vaginal epithelial cells

18:
A 30-year-old patient is found to have Trichomonas. She asks about multiple other symptoms that
she is concerned about. She can be informed that Trichomonas vaginalis is a flagellate protozoan
that can live in the

a:
oropharyn
x b:
vagin
a c:
bladde
r d:
anus
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19:
In which of the following is treatment of sexual partners recommended?

a:
Trichomonas
vaginitis b:
Atrophic
vaginitis c:
Bacterial
vaginosisd:
Vulvovaginal candidiasis

20:
A 29-year-old patient is undergoing evaluation for a symptomatic discharge. Which of the
following characterizes the microscopic appearance of Trichomonas?

a:
Ground-glass
cytoplasm b:
Pseudohypha
e c:
Flagellate
protozoan d:
Bacillus

21:
What characteristic lesions may be found in the upper vagina or on the cervix of patients with
Trichomonas vaginalis?
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a:
Ulcer
s
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b:
White plaques
c:
Clear
blistersd:
Petechiae

22:
A 26-year-old patient is told by her boyfriend that he has Trichomonas. She has developed a
copious discharge recently. The standard treatment for Trichomonas vaginal infection is

a:
oral
clindamycin b:
oral
fluconazole c:
oral
metronidazole d:
topical synthetic imidazoles

23:
A 30-year-old patient is receiving a prescription for metronidazole for the treatment of
Trichomonas. What additional advice should she receive?

a:
Avoid nonsteroidal anti-inflammatory

agents b:
Avoid
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alcohol
c:
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Avoid
caffeine d:
Take vitamin supplementation

24:
A 22-year-old patient inquires as the origin of the yeast infection for which she is being treated.
She can be informed that the most common source of monilial infections of the vagina is

a:
sexual contact with an infected
partner b:
bath water retained in the vagina following
bathing c:
contaminated
clothing d:
airborne colonization

25:
Roughly 90% of vaginal "yeast" infections are caused by

a:
Candida
tropicalisb:
Torulopsis
glabrata c:
Candida
glabratad:
Candida albicans
Womens Health A Primary Care Clinical Guide 5th Edition
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ANS: [aaadc baaad daadb abbac dcbdd]

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Chapter 15 Women and HIV Dina Treloar, Susan D. Schaffer

1. Thetherapy nurse (HAART is developing) for treatment a plan of of HIV. The care for a client goal
whoof this is receivingtherapy is highly to: active antiretroviral

A) Promote the progression of disease

B) Intervene in late-stage AIDS
C) Improve survival rates
D) Conduct additional drug research
A woman who is HIV-positive is receiving HAART and is having difficulty with compliance.
2. To promote adherence, which of the following areas would be most important to assess initially?
A) The womans beliefs and education
B) The womans financial situation and insurance
C) The womans activity level and nutrition
D) The womans family and living arrangements
When developing a teaching plan for a community group about HIV infection, which group
3. would the nurse identify as an emerging risk group for HIV infection?
A) Native Americans
B) Heterosexual women
C) New health care workers
D) Asian immigrants
After teaching a group of adolescents about HIV, the nurse asks them to identify the major
4. means by which adolescents are exposed to the virus. The nurse determines that the teaching
was successful when the group identifies which of the following?
A) Sexual intercourse
B) Sharing needles for IV drug use
C) Perinatal transmission D) Blood transfusion
5. Theof the nurse following would reviews the CD4 indicate cell count to the ofnurse a client
who that the client is HIV has-positive. AIDS? A result less than which

3
A) 1,000 cells/mm
3 3
B) 700 cells/mm C) 450 cells/mm
3
D) 200 cells/mm
When obtaining the health history from a client, which factor would lead the nurse to suspect
6. that the client has an increased risk for sexually transmitted infections (STIs)?
A) Hive-like rash for the past 2 days
B) Five different sexual partners
C) Weight gain of 5 lbs in 1 year
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D) Clear vaginal discharge

7. Assessment of a female client reveals a thick, white vaginaldischarge. She also reports
intenseitching and dyspareunia. Based on these findings, the nurse would suspect that the client
has:
A) Trichomoniasis
B) Bacterial vaginosis
C) Candidiasis
D) Genital herpes simplex
8. Ato clientavoid withwhich of the trichomoniasis following while is to receive taking this
metronidazole drug? (Flagyl). The nurse instructs the client

A) Alcohol
B) Nicotine C) Chocolate
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D) Caffeine
9. Aerythromycin woman gives birth ophthalmic to a healthyointment newborn. as a preventive
As part measure of the newborns care, related to which the STI? nurse instills

A) Genital herpes
B) Hepatitis B
C) Syphilis
D)Gonorrhea
10.Which findings would the nurse expect to find in a client with bacterial vaginosis?
A) Vaginal pH of 3
B) Fish-like odor of discharge
C) Yellowish-green discharge
D) Cervical bleeding on contact
A pregnant woman diagnosed with syphilis comes to the clinic for a visit. The nurse discusses
11.the risk of transmitting the infection to her newborn, explaining that this infection is transmitted
to the newborn through the:
A) Amniotic fluid
B) Placenta
C) Birth canal
D) Breast milk
12.The nurse encourages a female client with human papillomavirus (HPV) to receive continued
follow-up care because she is at risk for:
A) Infertility
B) Dyspareunia
C) Cervical cancer
D) Dysmenorrhea
13.A client is diagnosed with pelvic inflammatory disease (PID). When reviewing the clients
medical record, which of the following would the nurse expect to find? (Select all that apply.) A)
Oral temperature of 100.4 degrees F
B) Dysmenorrhea
C) Dysuria
D) Lower abdominal tenderness
E) Discomfort with cervical motion
F) Multiparity
14.Which instructions would the nurse include when teaching a woman with pediculosis pubis?
A) Take the antibiotic until you feel better.
B) Wash your bed linens in bleach and cold water.
C) Your partner doesnt need treatment at this time.
D) Remove the nits with a fine-toothed comb.
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15.A client with genital herpes simplex infection asks the nurse, Will I ever be cured of this
infection? Which response by the nurse would be most appropriate?
A) There is a new vaccine available that prevents the infection from returning.
B) All you need is a dose of penicillin and the infection will be gone.
C) There is no cure, but drug therapy helps to reduce symptoms and recurrences.
D) Once you have the infection, you develop an immunity to it.
A nurse is preparing a presentation for a group of women at the clinic who have been diagnosed
16.with genital herpes. Which of the following would the nurse expect to include as a possible
precipitating factor for a recurrent outbreak? (Select all that apply.)
A) Exposure to ultraviolet light
B) Exercise
C) Use of corticosteroids
D) Emotional stress
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E) Sexual intercourse.
17.After teaching a class on sexually transmitted infections, the instructor determines that
the teaching was successful when the class identifies which statement as true? A) STIs can
affect anyone if exposed to the infectious organism.
B) STIs have been addressed more on a global scale.
C) Clients readily view the diagnosis of STI openly.
D) Most individuals with STIs are over the age of 30.
A group of students are reviewing information about STIs. The students demonstrate
18.understanding of the information when they identify which of the following as the most
common bacterial STI in the United States?
A) Gonorrhea
B) Chlamydia
C) Syphilis
D) Candidiasis
19.A nurse is assessing a client for possible risk factors for chlamydia and gonorrhea. Which of the
following would the nurse identify?
A) Asian American ethnicity
B) Age under 25 years
C) Married
D) Consistent use of barrier contraception
20.A nurse at a local community clinic is developing a program to address STI prevention. Which
of the following would the nurse least likely include in the program?
A) Outlining safer sexual behavior
B) Recommending screening for symptomatic individuals
C) Promoting the use of barrier contraceptives
D) Offering education about STI transmission
After teaching a class on preventing pelvic inflammatory disease, the instructor determines that
21.the teaching was successful when the class identifies which of the following as an effective
method?
A) Advising sexually active females to use hormonal contraception
B) Encouraging vaginal douching on a weekly basis.
C) Emphasizing the need for infected sexual partners to receive treatment
D) Promoting routine treatment for asymptomatic females as risk
22.A group of nursing students are reviewing information about vaccines used to prevent STIs. The
students would expect to find information about which of the following?
A) HIV
B) HSV
C) HPV
D) HAV E) HBV
A mother brings her 12-year-old daughter in for well-visit checkup. During the visit, the nurse
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23.is discussing the use of prophylactic HPV vaccine for the daughter. The mother agrees and the
daughter receives her first dose. The nurse schedules the daughter for the next dose, which
would be given at which time?
A) In 2 month
B) In 2 months
C) In 3 months
D) In 4 months
24.A woman comes to the clinic complaining of a vaginal discharge. The nurse
suspects trichomoniasis based on which of the following? (Select all that apply.) A)
Urinary frequency
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Chapter 16 Common Gynecologic Pelvic Disorders Jennifer M. Laubach, Reena P.

Lorntson, Donna E. Forrest

1:
Enterocele is defined as herniation of what organ through the vagina?

a:
Uteru
s b:
Bladde
r c:
Small bowel
d:
Urethra

2:
A 45-year-old patient complains of frequent loss of urine when she coughs, laughs, or strains.
The volume lost is small. She does not report any dysuria. Which type of incontinence does she
have?

a:
Urg
e b:
Overflo
w c:
Stres

s d:
Psychogenic
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3:
A 45-year-old patient complains of frequent loss of urine. The volume lost is small, but it occurs
almost continuously. She denies urgency, has no dysuria, and voids frequently but in small
amounts. She does
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not ever feel "full" but also never has the sense that she has completely emptied her bladder. What
type of incontinence best describes her condition?

a:
Behavior
al b:
Overflo
w c:
Urg
e d:
Stress

4:
A 22-year-old patient complains of occasional loss of urine. She reports a sense of intense
fullness and "a need to go" just before the urine is lost. She voids infrequently but in large
amounts. She does not ever feel that she "gets enough warning" to get to the bathroom. What
type of incontinence does she have?

a:
Overflo
w b:
Psychogeni
c c:
Urg
e d:
Stress

5:
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A 22-year-old patient complains of continuous loss of urine since her cesarean delivery 1
month ago. This patient's problem is most likely due to

a:
vesicovaginal
fistula b:
stress
incontinence c:
overflow
incontinence d:
behavioral incontinence

6:
A cystocele may best be demonstrated clinically by

a:
use of a Sims speculum to retract the anterior vaginal
wall b:
gentle traction on the
cervix c:
observing posterior rotation of the anterior vaginal wall in response to change in
position d:
use of a Valsalva maneuver

7:
A patient who loses urine when she coughs or sneezes most likely has a(n)
Womens Health A Primary Care Clinical Guide 5th Edition
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a: urethral
prolapse
(urethrocele) b:
enterocele
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c:
rectocel
e d:
cystocele

8:
A "Q-tip test" is used to evaluate

a:
residual urine
b:
urethral
mobilityc:
posterior vaginal wall
support d:
uterine prolapse

9:
When performing a "Q-tip test," incontinence is generally associated with upward rotation of

a:
45 degrees
b:
10 degrees
c:

20 degrees
d:
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30 degrees
10:
What term is applied when the cervix descends below the vulva?

a:
Rectocel
e b:
Enterocel
e c:
Procidenti
a d:
Cystocele

11:
Pelvic muscle training programs are most useful for what type of incontinence?

a:
Psychogeni
c b:
Overflo
w c:
Urg
e d:
Stress

12:
What is the purpose of Kegel exercises?
Womens Health A Primary Care Clinical Guide 5th Edition
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a:
Improve bladder capacity and control
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b:
Increase bladder
awareness c:
Strengthen pelvic floor
muscles d:
Tighten uterine ligaments

13:
A 45-year-old patient is undergoing nonsurgical management of genitourinary problems related to
her recent pregnancy. Kegel exercises may be useful in a patient with

a:
dyspareuni
a b:
mild stress
incontinence c:
symptomatic
rectocele d:
second-degree prolapse of the uterus

14:
What is the primary purpose of a ring pessary?

a:
Decrease bladder
capacity b:
Womens Health A Primary Care Clinical Guide 5th Edition
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Obstruct the urethra

c:
Channel intra-abdominal pressure toward the introitus
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d:
Provide mechanical support

15:
Which of the following surgical procedures obliterates the vaginal canal?

a:
Sacral
colpopexy b:
Colpocleis
is c:
Posterior
colporrhaphy d:
Burch procedure

16:
What percent of women will suffer a urinary tract infection at some point in their lives?

a:
90%
b:
10%
c:
60%
d:
30%
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17:
Asymptomatic bacteriuria is found in what percent of postmenopausal women?
Womens Health A Primary Care Clinical Guide 5th Edition
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a:
10%
b:
<5%
c:
30%
d:
20%

18:
A 30-year-old patient is evaluated for a possible urinary tract infection. The culture of a urine
sample is reported to show greater than 100,000 colonies of "mixed flora." This is most likely
indicative of

a:
trigoniti
s b:
upper urinary tract
infection c:
a contaminated
specimen d:
infection of the proximal urethra

19:

In a symptomatic patient, which of the following is indicative of lower urinary tract infection?
Womens Health A Primary Care Clinical Guide 5th Edition
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a:
>100,000 colonies of mixed
flora b:
Womens Health A Primary Care Clinical Guide 5th Edition
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1,000 colonies of Bacteroides

species c:
10,000 colonies of Staphylococcus
aureus d:
10,000 colonies of Escherichia coli

20:
Cystocele is best defined as

a:
descent or prolapse of the
rectum b:
descent or prolapse of the
urethra c:
descent or prolapse of the
bladder d:
herniation of the top of the vagina

21:
Which of the following is the best description of a rectocele?

a:
herniation of the top of the
vagina b:
descent or prolapse of the
rectum c:
Womens Health A Primary Care Clinical Guide 5th Edition
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descent or prolapse of the

urethra d:
descent or prolapse of the bladder
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22:
Procidentia describes uterine descent beyond the

a:
vulv
a b:
ischial
spines c:
level of the uterine artery
d:
plane of the pelvic inlet

23:
What is the stage of prolapse when the leading part of the prolapse is more than 1 cm beyond
the hymen but less than or equal to the total vaginal length?

a:
I
b:
III
c:
II
d:
IV

24:
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What is the condition in which the bladder forces the anterior vaginal wall down and out?
a:
Cystocel
e b:
Enterocel
e c:
Rectocel
e d:
Procidentia

25:
Which of the following is the best way to identify a urethral diverticulum?

a:
Multichannel urodynamic
testing b:
The Q-tip
test c:
Cystourethroscop
y d:
Single-channel urodynamic testing
ANS:[ ccbca dabdc dcbdb bcdcd
babac ]

Chapter 17 Breast Health Linda Christinsen-Rengel

Womens Health A Primary Care Clinical Guide 5th Edition
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she is taking valsartan for her blood pressure and bupropion Hcl for depression. A pregnancy test
comes

back negative, and her prolactin level is 14 ng/mL. What condition does Denisa most likely have?

A. Galactorrhea
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B. Prolactinoma

C. Increased vascularity

D. Intraductal papilloma
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Answer: A

for breast cancer?

A. Ultrasound
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B. Magnetic resonance imaging

C. Mammogram

D. Chest x-ray
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Answer: B
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prepared to take drastic measures to reduce her risk. She has a body mass index of 24, and drinks a
glass of wine daily. Which of the following interventions would most effectively lower Katherine’s
risk for developing breast cancer?

A. Abstaining from alcohol

B. Taking tamoxifen, as prescribed

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C. Losing 20 lb

D. Undergoing surgical prophylaxis

Answer: D

10. Marcy has been diagnosed with breast cancer. Her tumor is about 3 cm in diameter. What is the
T stage of

Marcy’s tumor?

A. T1

B. T2

C. T3

D. T4

Answer: B

11. Kelly is a client who was recently diagnosed with breast cancer. She has a tumor 6 cm in
diameter and

several positive nodes outside the axillary nodes, with no distant metastasis. What stage is Kelly’s
cancer?

A. 1

B. 2

C. 3

D. 4

Answer: C

12. Eva recently underwent a lumpectomy for treatment of her 7-cm tumor. What additional
treatment should

Eva most expect to undergo in conjunction with the lumpectomy?

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A. Radiation therapy
B. Chemotherapy

C. Hormonal therapy
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A. 60%

B. 70%
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C. 80%
D. 90%

Answer: D
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Chapter 18 The Menopausal Transition Catherine Juve, Valerie T. Cotter, Ellis Quinn Youngkin

1. Which of the following most accurately characterizes the way Western societies view
menopause?

A. A hormone deficiency disease

B. A celebrated rite of passage

C. A nonentity

D. A milestone in a spiritual journey

Answer: A

2. Postmenopausal women are at increased risk for which of the following? (Select all that apply.)

A. Heart disease

B. Lupus

C. Osteoporosis

D. Diabetes

E. Turner syndrome

Answer: A, C, D

3. What is the average age of menopause?

A. 45 years

B. 48 years

C. 51 years

D. 54 years

Answer: C

4. Which of the following is the correct definition of perimenopause?

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A. The period of time between menarche and menopause

B. The period of time from the onset of menopause-related symptoms to 12 months following the
last

menstrual period
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C. The point in time following 12 months of amenorrhea

C. White

D. Japanese
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Answer: D
8. What percentage of women in perimenopause experience minimal to no menopause-related
symptoms?

A. 3%
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B. 13%

C. 23%

D. 33%

Answer: D

9. What is the single most common menopause-related symptom among postmenopausal women?

A. Irritability

B. Sleep disturbances

C. Hot flashes

D. Fatigue

Answer: C

10. Kayla, a 47-year-old client, has been diagnosed with genitourinary syndrome. On the basis of
this

diagnosis, the nurse recognizes that Kayla most likely experiences which of the following
symptoms,

associated with this syndrome? (Select all that apply.)

A. Heavier menstrual flow

B. Vaginal dryness

C. Vulvovaginal atrophy

D. Hot flashes

E. Dyspareunia

Answer: B, C, E
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11. A nurse practitioner is preparing to perform a physical examination on a client displaying

menopauseassociated symptoms. What should the nurse include in the examination? (Select all
that apply.)

A. Vital signs

B. Height and weight measurements

C. Endoscopic examination
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E. Alfalfa
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Answer: B, D

14. Lyla, a 45-year-old client who recently entered perimenopause, tells her nurse that she has seen
“natural”

hormones advertised and asks about them. Which of the following should the nurse tell Lyla about
these
Womens Health A Primary Care Clinical Guide 5th Edition
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th st
The United States ranks 50 in the world for maternal mortality and 41 among industrialized
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1. nations for infant mortality rate. When developing programs to assist in decreasing these rates,
which factor would most likely need to be addressed as having the greatest impact?
A) Resolving all language and cultural differences
B) Assuring early and adequate prenatal care
C) Providing more extensive womens shelters
D)Encouraging all women to eat a balanced diet
2. When integrating the principles of family-centered care, the nurse would include which of the
following?
A) Childbirth is viewed as a procedural event
B) Families are unable to make informed choices
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C) Childbirth results in changes in relationships

D) Families require little information to make appropriate decisions
When preparing a teaching plan for a group of first-time pregnant women, the nurse expects to
3. review how maternity care has changed over the years. Which of the following would the nurse
th
include when discussing events of the 20 century?
A) Epidemics of puerperal fever
B) Performance of the first cesarean birth
C) Development of the x-ray to assess pelvic size
D) Creation of free-standing birth centers
4. After teaching a group of students about pregnancy-related mortality, the instructor determines
that additional teaching is needed when the students identify which condition as a leading cause? A)
Hemorrhage
B) Embolism
C) Obstructed labor D)Infection
The nurse is working with a group of community health members to develop a plan to address
5. the special health needs of women. Which ofthe following conditions would the group address
as the major problem?
A) Smoking
B) Heart disease
C) Diabetes
D)Cancer
6. When assessing a family for possible barriers to health care, the nurse would consider which
factor to be most important?
A) Language
B) Health care workers attitudes
C) Transportation D)Finances
After teaching a group of nursing students about the issue of informed consent. Which of the
7. following, if identified by the student, would indicate an understanding of a violation of
informed consent?
A) Performing a procedure on a 15-year-old without consent
B) Serving as a witness to the signature process
C) Asking whether the client understands what she is signing
D) Getting verbal consent over the phone for emergency procedures
The nurse is trying to get consent to care for an 11-year-old boy with diabetic ketoacidosis. His
8. parents are out of town on vacation, and the child is staying with a neighbor. Which action
would be the priority?
A) Getting telephone consent with two people listening to the verbal consent
B) Providing emergency care without parental consent
C) Contacting the childs aunt or uncle to obtain their consent
D)Advocating for termination of parental rights for this situation
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9. After teaching nursing students about the basic concepts of family-centered care, the instructor
determines that the teaching was successful when the students state which of the following? A)
Childbirth affects the entire family, and relationships will change.
B) Families are not capable of making health care decisions for themselves.
C) Mothers are the family members affected by childbirth.
D)Childbirth is a medical procedure.
A nursing instructor is preparing a class discussion on the trends in health care and health care
10.delivery over the past several centuries. When discussing the changes during the past century,
which of the following would the instructor be least likely to include?
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A) Disease prevention
B) Health promotion
C) Wellness
D) Analysis of morbidity and mortality
A nurse is assigned to care for an Asian American client. The nurse develops a plan of care with
11.the understanding that based on this clients cultural background, the client most likely
views illness as which of the following? A) Caused by supernatural forces.
B) A punishment for sins.
C) Due to spirits or demons.
D) From an imbalance of yin and yang
A nurse is developing a plan of care for a woman to ensure continuity of care during pregnancy,
12.labor, and childbirth. Which of the following would be most important for the nurse to
incorporate into that plan?
A) Adhering to strict, specific routines
B) Involving a pediatric physician
C) Educating the client about the importance of a support person
D) Assigning several nurses as a support team
A nursing instructor is preparing a class discussion on case management in maternal and
13.newborn health care. Which of the following would the instructor include as a key component?
Select all that apply.
A) Advocacy
B) Coordination
C) Communication
D) Resource management
E) Event managed care
14.After teaching a group of students about the concept of maternal mortality, the instructor
determines that additional teaching is needed when the students state which of the following? A)
The rate includes accidental causes for deaths.
B) It addresses pregnancy-related causes.
C) The duration of the pregnancy is not a concern.
D) The time frame is typically for a specified year.
A group of students are reviewing the historical aspects about childbirth. The students
15.demonstrate understanding of the information when they identify the use of twilight sleep as a
key event during which time frame?
A) 1700s
B) 1800s
C) 1900s
D) 2000s
16.A nurse is providing care to a woman who has just delivered a healthy newborn. Which action
would least likely demonstrate application of the concept of family-centered care?
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A) Focusing on the birth as a normal healthy event for the family

B) Creating opportunities for the family to make informed decisions
C) Encouraging the woman to keep her other children at home
D) Fostering a sense of respect for the mother and the family
17.When discussing fetal mortality with a group of students, a nurse addresses maternal factors.
Which of the following would the nurse most likely include? Select all that apply.
A) Chromosomal abnormalities
B) Malnutrition
C) Preterm cervical dilation
D) Underlying disease condition
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E) Poor placental attachment

A nurse is preparing a presentation for a local community group about health status and
18.childrens health. Which of the following would the nurse include as one of the most significant
measures?
A) Fetal mortality rate
B) Neonatal mortality rate
C) Infant mortality rate
D) Maternal mortality rate
A group of students are reviewing an article describing information related to indicators for
19.womens health and the results of a national study. Which of the following would the students
identify as being satisfactory for women? Select all that apply.
A) Smoking cessation
B) Colorectal cancer screening
C) Violence against women
D) Health insurance coverage E) Mammograms
A nurse is preparing a presentation for a local womens group about heart disease and women.
20.Which of the following would the nurse expect to address when discussing measures to promote
health.
A) Women have similar symptoms as men for a heart attack.
B) Heart disease is no longer viewed as a mans disease.
C) Women experiencing a heart attack are at greater risk for dying.
D) Heart attacks in women are more easily diagnosed.
A nurse is working to develop a health education program for a local community to address
21.breast cancer awareness. Which of the following would the nurse expect to include when
describing this problem to the group? Select all that apply.
A) White women have higher rates of breast cancer than African American women.
B) African American women are more likely to die from breast cancer at any age.
C) Survival at any stage is worse among white women.
D) Women living in South America have the highest rates of breast cancer.
E) Breast cancer is the leading cause of cancer mortality in women.
A group of nursing students are reviewing information about factors affecting maternal,
22.newborn, and womens health. The students demonstrate understanding of the information when
they identify which of the following deficiencies as being associated with poverty? Select all
that apply.
A) Literacy
B) Employment opportunities
C) Mobility
D) Political representation
E) Skills
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Answer Key

1. B
2. C
3. D
4. B
5. B
6. D
7. A
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8. A
9. A
10.D
11.D
12.C
13.A, B, C, D
14.A
15.C
16.C
17.B, C, D
18.C
19.B, E
20.C
21. A, B
22. A, B, C, D, E

Chapter 20 Maternal Conditions Impacting Risk in Pregnancy Debbie Ringdahl, Melissa Frisvold,
Joan Corder-Mabe

After teaching a woman who has had an evacuation for a hydatidiform mole (molar pregnancy.
1. about her condition, which of the following statements indicates that the nurses teaching was
successful?
A) I will be sure to avoid getting pregnant for at least 1 year.
B) My intake of iron will have to be closely monitored for 6 months.
C) My blood pressure will continue to be increased for about 6 more months.
D) I wont use my birth control pills for at least a year or two.
2. Which of the following findings on a prenatal visit at 10 weeks might lead the nurse to suspect a
hydatidiform mole?
A) Complaint of frequent mild nausea
B) Blood pressure of 120/84 mm Hg
C) History of bright red spotting 6 weeks ago
D) Fundal height measurement of 18 cm
3. A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which
finding would the nurse interpret as indicating a therapeutic level of medication?
A) Urinary output of 20 mL per hour
B) Respiratory rate of 10 breaths/minute
C) Deep tendons reflexes 2+
D)Difficulty in arousing
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4. Upon entering the room of a client who has had a spontaneous abortion, the nurse observes
the client crying. Which of the following responses by the nurse would be most appropriate? A)
Why are you crying?
B) Will a pill help your pain?
C) Im sorry you lost your baby.
D) A baby still wasnt formed in your uterus.
5. Which of the following data on a clients health history would the nurse identify as contributing
to the clients risk for an ectopic pregnancy?
A) Use of oral contraceptives for 5 years
B) Ovarian cyst 2 years ago
C) Recurrent pelvic infections
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D) Heavy, irregular menses

6. In a woman who is suspected of having a ruptured ectopic pregnancy, the nurse would expect to
assess for which of the following as a priority?
A) Hemorrhage
B) Jaundice
C) Edema
D)Infection
7. Which of the following findings would the nurse interpret as suggesting a diagnosis of
gestational trophoblastic disease?
A) Elevated hCG levels, enlarged abdomen, quickening
B) Vaginal bleeding, absence of FHR, decreased hPL levels
C) Visible fetal skeleton on ultrasound, absence of quickening, enlarged abdomen
D)Gestational hypertension, hyperemesis gravidarum, absence of FHR
8. It is determined that a clients blood Rh is negative and her partners is positive. To help prevent
Rh isoimmunization, the nurse anticipates that the client will receive RhoGAM at which time?
A) At 34 weeks gestation and immediately before discharge
B) 24 hours before delivery and 24 hours after delivery
C) In the first trimester and within 2 hours of delivery
D) At 28 weeks gestation and again within 72 hours after delivery
The nurse is developing a plan of care for a woman who is pregnant with twins. The nurse
9. includes interventions focusing on which of the following because of the womans increased
risk?
A) Oligohydramnios
B) Preeclampsia C) Post-term labor
D)Chorioamnionitis
A woman hospitalized with severe preeclampsia is being treated with hydralazine to control
10.blood pressure. Which of the following would the lead the nurse to suspect that the client is
having an adverse effect associated with this drug?
A) Gastrointestinal bleeding
B) Blurred vision
C) Tachycardia D) Sweating
11.After reviewing a clients history, which factor would the nurse identify as placing her at risk for
gestational hypertension?
A) Mother had gestational hypertension during pregnancy.
B) Client has a twin sister.
C) Sister-in-law had gestational hypertension.
D) This is the clients second pregnancy.
A client with hyperemesis gravidarum is admitted to the facility after being cared for at home
12.without success. Which of the following would the nurse expect to include in the clients plan of
care?
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A) Clear liquid diet

B) Total parenteral nutrition C) Nothing by mouth
D) Administration of labetalol
13.The nurse is reviewing the laboratory test results of a pregnant client. Which one of the
following findings would alert the nurse to the development of HELLP syndrome?
A) Hyperglycemia
B) Elevated platelet count
C) Leukocytosis
Womens Health A Primary Care Clinical Guide 5th Edition
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D) Elevated liver enzymes

14.
Whichmagnesium of the sulfate following to treat would severe the preeclampsia?nurse have
readily available for a client who is receiving
A) Calcium gluconate
B) Potassium chloride
C) Ferrous sulfate
D) Calcium carbonate
15.WhichPROM? assessment finding would lead the nurse to suspect infection as the cause of
aclients

A) Yellow-green fluid
B) Blue color on Nitrazine testing
C) Ferning
D) Foul odor
16.
Whilehydramnios based assessing a pregnanton which woman, of the following? the nurse
suspects (Select allthat that the apply.) client may be at risk for
A) History of diabetes
B) Complaints of shortness of breath
C) Identifiable fetal parts on abdominal palpation
D) Difficulty obtaining fetal heart rate
E) Fundal height below that for expected gestataional age
After teaching a group of nursing students about the possible causes of spontaneous abortion,
17.the instructor determines that the teaching was successful when the students identify which of
the following as the most common cause of first trimester abortions?
A) Maternal disease
B) Cervical insufficiency
C) Fetal genetic abnormalities D) Uterine fibroids
A pregnant woman is admitted with premature rupture of the membranes. The nurse is assessing
18.the woman closely for possible infection. Which of the following would lead the nurse to
suspect that the woman is developing an infection? (Select all that apply.) A) Fetal
bradycardia
B) Abdominal tenderness
C) Elevated maternal pulse rate
D) Decreased C-reactive protein levels
E) Cloudy malodorous fluid
A nurse is teaching a pregnant woman with preterm premature rupture of membranes who is
19.about to be discharged home about caring for herself. Which statement by the woman indicates
a need for additional teaching?
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A) I need to keep a close eye on how active my baby is each day.

B) I need to call my doctor if my temperature increases.
C) Its okay for my husband and me to have sexual intercourse.
D) I can shower but I shouldnt take a tub bath.
20.A nurse is assessing a pregnant woman with gestational hypertension. Which of the following
would lead the nurse to suspect that the client has developed severe preeclampsia?
A) Urine protein 300 mg/24 hours
B) Blood pressure 150/96 mm Hg
C) Mild facial edema
D) Hyperreflexia
21.A nurse suspects that a pregnant client may be experiencing abruption placenta based
on assessment of which of the following? (Select all that apply.) A) Dark red vaginal
bleeding
Womens Health A Primary Care Clinical Guide 5th Edition
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B) Insidious onset
C) Absence of pain
D) Rigid uterus
E) Absent fetal heart tones
The health care provider orders PGE2 for a woman to help evacuate the uterus following a
22.spontaneous abortion. Which of the following would be most important for the nurse to do?
A) Use clean technique to administer the drug.
B) Keep the gel cool until ready to use.
C) Maintain the client for hour after administration.
D) Administer intramuscularly into the deltoid area.
A nursing student is reviewing an article about preterm premature rupture of membranes.
23. Which of the following would the student expect to find as factor placing a woman at high risk
for this condition? (Select all that apply.)
A) High body mass index
B) Urinary tract infection
C) Low socioeconomic status
D) Single gestations
E) Smoking
A woman with placenta previa is being treated with expectant management. The woman and
24.fetus are stable. The nurse is assessing the woman for possible discharge home. Which
statement by the woman would suggest to the nurse that home care might be inappropriate? A)
My mother lives next door and can drive me here if necessary.
B) I have a toddler and preschooler at home who need my attention.
C) I know to call my health care provider right away if I start to bleed again.
D) I realize the importance of following the instructions for my care.
25.A woman with hyperemesis gravidarum asks the nurse about suggestions to minimize
nausea and vomiting. Which suggestion would be most appropriate for the nurse to make? A)
Make sure that anything around your waist is quite snug.
B) Try to eat three large meals a day with less snacking.
C) Drink fluids in between meals rather than with meals.
D) Lie down for about an hour after you eat
26.A woman with gestational hypertension experiences a seizure. Which of the following would be
the priority?
A) Fluid replacement
B) Oxygenation
C) Control of hypertension D) Delivery of the fetus
A woman is receiving magnesium sulfate as part of her treatment for severe preeclampsia. The
27.nurse is monitoring the womans serum magnesium levels. Which level would the nurse identify
as therapeutic?
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A) 3.3 mEq/L
B) 6.1 mEq/L
C) 8.4 mEq/L
D) 10.8 mEq/L

Answer Key

1. A
2. D
3. C
Womens Health A Primary Care Clinical Guide 5th Edition
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2. A nurse is describing advances in genetics to a group of students. Which of the following would
A) Genetic diagnosis is now available as early as the second trimester.
B) Genetic testing can identify presymptomatic conditions in children.
C) Gene therapy can be used to repair missing genes with normal ones.
Womens Health A Primary Care Clinical Guide 5th Edition
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D) Genetic agents may be used in the future to replace drugs.

After teaching a group of students about fetal development, the instructor determines that the
3. teaching was successful when the students identify which of the following as providing the
barrier to other sperm after fertilization?
A) Zona pellucida
B) Zygote C) Cleavage
D)Morula
4. A nurse is teaching a class on X-linked recessive disorders. Which of the following statements
would the nurse most likely include?
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A) Males are typically carriers of the disorders.

B) No male-to-male transmission occurs.
C) Daughters are more commonly affected with the disorder.
D) Both sons and daughters have a 50% risk of the disorder.
A pregnant woman undergoes maternal serum alpha-fetoprotein (MSAFP) testing at 16 to 18
5. weeks gestation. Which of the following would the nurse suspect if the womans level is
decreased?
A) Down syndrome
B) Sickle-cell anemia
C) Cardiac defects
D) Open neural tube defect
The nurse is developing a presentation for a community group of young adults discussing fetal
6. development and pregnancy. The nurse would identify that the sex of offspring is determined at
the time of:
A) Meiosis
B) Fertilization
C) Formation of morula
D)Oogenesis
7. When describing amniotic fluid to a pregnant woman, the nurse would include which of the
following?
A) This fluid acts as transport mechanism for oxygen and nutrients.
B) The fluid is mostly protein to provide nourishment to your baby.
C) This fluid acts as a cushion to help to protect your baby from injury.
D) The amount of fluid remains fairly constant throughout the pregnancy.
8. Assessment of a pregnant woman reveals oligohydramnios. The nurse would be alert for the
development of which of the following?
A) Maternal diabetes
B) Placental insufficiency
C) Neural tube defects
D) Fetal gastrointestinal malformations
A couple comes to the clinic for preconception counseling and care. As part of the visit, the
9. nurse teaches the couple about fertilization and initial development, stating that the zygote
formed by the union of the ovum and sperm consists of how many chromosomes? A) 22
B) 23
C) 44
D) 46
10.A woman just delivered a healthy term newborn. Upon assessing the umbilical cord, the nurse
would identify which of the following as normal? (Select all that apply.)
A) One vein
B) Two veins
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C) One artery
D) Two arteries
E) One ligament
F) Two ligaments
After teaching a pregnant woman about the hormones produced by the placenta, the nurse
11.determines that the teaching was successful when the woman identifies which hormone
produced as being the basis for pregnancy tests?
A) Human placental lactogen (hPL)
B) Estrogen (estriol)
C) Progesterone (progestin)
Womens Health A Primary Care Clinical Guide 5th Edition
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D) Human chorionic gonadotropin (hCG)

After the nurse describes fetal circulation to a pregnant woman, the woman asks why her fetus
12.has a different circulation pattern than hers. In planning a response, the nurse integrates
understanding of which of the following?
A) Fetal blood is thicker than that of adults and needs different pathways.
B) Fetal circulation carries highly oxygenated blood to vital areas first.
C) Fetal blood has a higher oxygen saturation and circulates more slowly.
D) Fetal heart rates are rapid and circulation time is double that of adults.
13.When describing genetic disorders to a group of childbearing couples, the nurse would identify
which as an example of an autosomal dominant inheritance disorder?
A) Huntingtons disease
B) Sickle cell disease
C) Phenylketonuria D) Cystic fibrosis
Prenatal testing is used to assess for genetic risks and to identify genetic disorders. In
explaining
14.to a couple about an elevated alpha-fetoprotein screening test result, the nurse would discuss the
need for:
A) Special care needed for a Down syndrome infant
B) A more specific determination of the acidbase status
C) Further, more definitive evaluations to conclude anything
D) Immediate termination of the pregnancy based on results
A nursing instructor is preparing a teaching plan for a group of nursing students about the
15.potential for misuse of genetic discoveries and advances. Which the following would the
instructor most likely include?
A) Gene replacement therapy for defective genes
B) Individual risk profiling and confidentiality
C) Greater emphasis on the causes of diseases
D) Slower diagnosis of specific diseases
After teaching a class on the stages of fetal development, the instructor determines that the
16.teaching was successful when the students identify which of the following as a stage? (Select all
that apply.)
A) Placental
B) Preembryonic
C) Umbilical
D) Embryonic E) Fetal
A nurse is discussing fetal development with a pregnant woman. The woman is 12 weeks
17.pregnant and asks, Whats happening with my baby? Which of the following would the nurse
integrate into the response? (Select all that apply.)
A) Continued sexual differentiation
B) Eyebrows forming
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C) Startle reflex present

D) Digestive system becoming active
E) Lanugo present on the head
After teaching a group of students about fetal development, the instructor determines that the
18.teaching was successful when the students identify which of the following as essential for fetal
lung development?
A) Umbilical cord
B) Amniotic fluid
C) Placenta
D) Trophoblasts
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During a prenatal class for a group of new mothers, the nurse is describing the hormones
19.produced by the placenta. Which of the following would the nurse include? (Select all that
apply.)
A) Prolactin
B) Estriol
C) Relaxin
D) Progestin
E) Human chorionic somatomammotropin
20.When describing the structures involved in fetal circulation, the nursing instructor describes
which structure as the opening between the right and left atrium?
A) Ductus venosus
B) Foramen ovale
C) Ductus arteriosus D) Umbilical artery
A group of students are reviewing information about genetic inheritance. The students
21.demonstrate understanding of the information when they identify which of the following as an
example of an autosomal recessive disorder? (Select all that apply.)
A) Cystic fibrosis
B) Phenylketonuria
C) Tay-Sachs disease
D) Polycystic kidney disease
E) Achondroplasia
22.A nurse is assessing a child with Klinefelters syndrome. Which of the following would the
nurse expect to assess? (Select all that apply.)
A) Gross mental retardation
B) Long arms
C) Profuse body hair D) Gynecomastia
E) Enlarged testicles
23.A woman is scheduled to undergo fetal nuchal translucency testing. Which of the following
would the nurse include when describing this test?
A) A needle will be inserted directly into the fetuss umbilical vessel.
B) Youll have an intravaginal ultrasound to measure fluid in the fetus.
C) The doctor will take a sample of fluid from your bag of waters.
D) A small piece of tissue from the fetal part of the placenta is taken.

Answer Key

1 .......................................................................................................................................................... 70
2 .......................................................................................................................................................... 82
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3 ........................................................................................................................................................ 122
4 ........................................................................................................................................................ 190
5 ........................................................................................................................................................ 190
6 ........................................................................................................................................................ 190
7 ........................................................................................................................................................ 190

8. B
9. D
10.A
11.D
12.B
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18-20 weeks
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During your interview the patient expresses concern that she and her partner attempted intercourse
several weeks ago. It was painful and she is afraid there may be something wrong.

2:
The best treatment for dyspareunia in the post partum period is
Womens Health A Primary Care Clinical Guide 5th Edition
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a:
analgesic
b:
antidepressan
t c:
Womens Health A Primary Care Clinical Guide 5th Edition
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oral estrogen
d:
lubrican
t e:
topical estrogen

Is it possible that she could get pregnant? She is not breast-feeding.

3:
A. The mean time to ovulation in the nonlactating postpartum woman is approximately

a:
75
days b:
45 days
c:
60
days d:
15
days e:
30 days

4:
B. Approximately of non-nursing women are fertile at 6-week postpartum.

a:
10
% b:
15
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%
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c:
20%
d:
25%
e:
5%

The patient's crying escalates. This was an unplanned pregnancy and she is terrified of being
pregnant again. She is grouchy and moody all day and things just get worse at night with the baby
getting colicky after the formula, her boyfriend just watching TV, and her mother giving
unwanted advice. She has not slept in days.

5:
A. The incidence of postpartum blues is approximately .

a:
50%-60%
b:
70%-80%
c:
90%-99%
d:
30%-40%
e:
10%-20%

6:
B. Approximately what percent of new mothers experience postpartum depression?
Womens Health A Primary Care Clinical Guide 5th Edition
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a:
Womens Health A Primary Care Clinical Guide 5th Edition
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20%-25%
b:
1%-5%
c:
10%-15%
d:
30%-45%
e:
50%-65%

7:
C.The incidence of postpartum psychosis is approximately

a:
0.05%-0.1%
b:
0.7%-0.8%
c:
0.1%-0.2%
d:
0.5%-0.6%
e:
0.3%-0.4%

During your review of systems she admits to leaking urine during coughing or sneezing.

8:
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A. The best treatment fo postpartum stress incontinence is

a:
topical estrogen
medication b:
empirical antibiotic treatment for
cystitis c:
anticholinergic
medication d:
tricyclic antidepressant
medication e:
reassurance and re-evaluation in 2 months

9:
B. The return of normal tone to the pelvic floor muscles postpartum may be enhanced by

a:
exogenous estrogen
supplementation b:
Kegel
exercisesc:
avoiding coitus fo 3 to 6
months d:
endogenous estrogen
supplementation e:
endogenous progesterone supplementation
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On continuation of your review of systems she also admits to bleeding with bowel movements
and she thinks it is due to the hemorrhoids she developed during her 2 hours of pushing.

10:
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Surgical management of postpartum hemorrhoids may be considered how soon postpartum?

a:
3 months
b:
18
months c:
6 months
d:
12 months
e:
Immediately

Your physical exam is within normal limits, including normal thyroid, heart, lungs, and breast
exam. On pelvic exam you find that vaginal mucosa is intact but moderately atrophic and her
uterus is anteverted, small, and firm with minimal lochia. She is noted to have some
nonthrombosed hemorrhoids.

11:
A. Uterine involution is a result of a decrease in the

a:
size of the intercellular spaces in the uterine
myometrium b:
increased intravascular volume, especially venous space
volume c:
number of cells in the uterine
Womens Health A Primary Care Clinical Guide 5th Edition
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myometrium d:
number of intercellular spaces in the uterine
myometrium e:
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size of cells in the uterine myometrium

12:
B. How many weeks does it take for the uterus to return to its pre-pregnancy position in the true
pelvis?

a:
2
b:
4
c:
8
d:
10
e:
6

13:
C.How many weeks does it take for the uterus to return to its pre-pregnancy size?

a
:
2
b
:
6
c
:
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8 d:
1
0
e
:
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4
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You receive a call from the Labor and Delivery nurse. The patient you delivered by forceps 3
hours ago is bleeding more than usual. Her pulse is now 110 bpm and she is rapidly soaking
pads.

14:
A. Immediate postpartum uterine hemostasis is maintained by

a:
primary clotting of blood in the uterine
artery b:
tamponade effect of
clots c:
scar formation within the uterine
cavity d:
contraction of the uterine smooth
muscle e:
decrease in myometrial cell volume

15:
B. The elevated pulse rate characteristic of pregnancy

a:
decreases approxiamately 1 hour after
delivery b:
decreases approximately 6 hours after
delivery c:

persists for approximately 3 weeks

postpartum d:
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decreases at the end of the third stage of labor

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A. Postpartum uterine contractile pain is greater in breast-feeding women bcause suckling releases

a:
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oxytocin
b:
Womens Health A Primary Care Clinical Guide 5th Edition
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estroge
n c:
progesteron
e d:
prostaglandin
s e:
inhibin

18:
B. When is the endometrium re-established after delivery in most patients?

a:
First
week b:
Fourth
week c:
Third
week d:
Second
week e:
Fifth week

You return later and find the bleeding has stabilized. The urine output is 100 to 200 mL per hour.

19:
A. In a normal patient immediately after delivery, what is the weight of fluid lost through
diuresis and loss of extravascular fluid?
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a:
 Womens Health A Primary Care Clinical Guide 5th Edition
Youngkin Schadewald Pritham Test Bank Questions And
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3
k
g
b:
7
k
g
c:
9
k
g
d:
1
k
g
e:
5 kg

20:
B. In the intrapartum and postpartum periods, the glomerular filtration rate decreases tonormal

a:

delivery b:
at the time of
1-2 days after
Womens Health A Primary Care Clinical Guide 5th Edition
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delivery c: 3-
5 days after
delivery d:
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several weeks after

delivery e:
at the onset of labor
ANS: [c,e,b,b,b,c,c,e,b,c,c,a,b,d,a,b,d,a,b,a,c,e,d]

IV Primary Care Conditions Affecting Women’s Health

Chapter 23 Common Medical Problems: Cardiovascular through Hematological Disorders Mary

Benbenek, Mary Dierich, Elaine Ferrary, Rita A. Seeger Jablonski

1. On average, how much later in women than in men does cardiovascular disease typically
occur?

A. 2 to 4 years

B. 6 to 8 years

C. 10 to 12 years

D. 14 to 16 years

Answer: C

2. The lifetime risk at the age of 50 years of women developing cardiovascular disease is which
of the

following?

A. 9.2%

B. 19.2%

C. 29.2%

D. 39.2%

Answer: D
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3. Which of the following are modifiable risk factors associated withcardiovascular disease?
(Select all that

apply.)
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A. Male gender

B. Age of 75 years

C. Cigarette smoking

D. Body mass index (BMI) of 31

E. Moderate exercise six times per year

Answer: C, D, E

4. Which ofthe following are psychosocial risk factors associated with cardiovascular disease?
(Select all that

apply.)

A. Obsessive-compulsive disorder

B. Depression

C. Anxiety

D. Premenstrual dysphoric disorder

E. Emotional stress

Answer: B, C, E

5. The nurse must screen a client for the presence of cardiovascular disease (CVD). For which of
the

following conditions is EKG-stress testing on a treadmill indicated? (Select all that apply.)

A. High risk for CVD

B. Symptoms of typical angina

C. Ability to achieve five metabolic equivalents (METs) of a task

D. Abnormal baseline EKG

E. Family history of CVD

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Answer: B, C, E
6. Claire, a 45-year-old client, is suspected of having atherosclerosis, and the nurse would like to
have her

Answer: B, C, D
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8. Maisie, a 78-year-old client, reports feeling tightness and pain in her chest that occurs when she
climbs
stairs or walks any distance when shopping. Her symptoms go away after she rests for a few
minutes. What

infarction? (Select all that apply.)

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A. Chest pain

B. Nausea

C. Shortness of breath
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D. Cold sweats

D. Class IV

Answer: D
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13. Candace, an 86-year-old client, reports a sensation of palpitations, heart racing, and heart
flutters in her
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chest, as well as fatigue and shortness of breath. She was diagnosed with Class II heart failure 6
months

ago. Which condition should the nurse suspect most in Candace?

A. Atrial flutter

B. Angina pectoris

C. Transient ischemic attack

D. Mitral valve prolapse

Answer: A

14. When auscultating a client’s heart, the nurse hears a high-pitched midsystolic click atthe
apex of the heart.

What condition should the nurse associate with this finding?

A. Mitral regurgitation

B. Mitral valve prolapse

C. Mitral stenosis

D. Aortic regurgitation

Answer: B

15. Which of the following is the most common type of cardiomyopathy and the third leading
cause of heart

failure in the United States after coronary artery disease and hypertension?

A. Dilated

B. Hypertrophic

C. Restrictive

D. Arrhythmogenic right ventricular

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Answer: A
Chapter 24 Common Medical Problems: Musculoskeletal Injuries through Urinary Tract
Disorders Gwen Short, Rita A. Seeger Jablonski, Elaine Ferrary

pain when working in her garden and describes symptoms indicating urinary retention. On
performing a
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pelvic exam, the nurse observes that the client’s vagina appears dry and shows signs of erosion
and
ulceration. On the basis of these symptoms, which stage of pelvic organ prolapse is Misbah most
likely in?

A. Pelvic floor muscle therapy

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B. Donut pessary

C. Neurologic stimulation therapy

D. Estrogen therapy

Answer: B

6. Which treatment for pelvic organ prolapse involves a prescriptive medical device that
combines Kegel

exercises and noninvasive electrical stimulation via biphasic wave forms to stimulate pelvic
nerves to

enhance contractile response?

A. Intone

B. Percutaneous tibia nerve simulation

C. Pessary therapy

D. Pelvic floor muscle therapy

Answer: A

7. Which of the following symptoms are associated with painful bladdersyndrome/interstitial

cystitis? (Select

all that apply.)

A. Urinary retention

B. Urethral pain

C. Sensation of organs descending into the vagina

D. Urinary urgency

E. Nocturia

Answer: B, D, E
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8. Which of the following is typically the cause of urinary frequency in clients with painful
bladder

syndrome/interstitial cystitis?

A. Fear of urinary urge incontinence

B. Anxiety over developing a urinary tract infection
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D. Cyclosporine A

Answer: B
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11. Valerie is suspected of having painful bladder syndrome/interstitial cystitis as a result of a

body-wall

abnormality. Given the suspected etiology in this case, which treatment would be most
appropriate for

Valerie?

A. Physical therapy

B. Pessary therapy

C. Electrical stimulation therapy

D. Behavioral therapy

Answer: A

12. Kelly is suspected of having painful bladder syndrome/interstitial cystitis as a result of a

mast-cell

response. Given the suspected etiology in this case, which treatment would be most appropriate
for

Valerie?

A. Pentosan polysulfate sodium

B. Amitriptyline

C. Montelukast

D. Cyclosporine A

Answer: C

13. Which of the following are common symptoms of cystitis? (Select all that apply.)

A. Low back pain

B. Frequent urge to urinate

C. An inability to urinate due to obstruction

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D. A sensation of burning during urination

E. Pain with sitting or walking

Answer: B, D

14. Which of the following ones typically causes cystitis?

A. A defect in the connective tissue supporting the bladder

B. Bacteria entering the bladder via the urethra

C. An urothelial abnormality

D. A virus entering the uterus via the cervix

Answer: B

15. What percentage of women older than 55 years experience a recurrence of a urinary tract
infection within a

year?

A. 33%

B. 43%

C. 53%

D. 63%

Answer: C

Chapter 25 Psychosocial Health Concerns Ann Bateman,Eugenia Zelanko

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B. Integrity versus despair

C. Generativity versus stagnation

D. Identity versus confusion

Answer: C
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4. Anwara is a 78-year-old client whose husband died 2 years ago. Her daughter and son-in-law,
who live in
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6. Which of the following living arrangements is most characteristic of individuals in the phase
of

psychosocial development known as emerging adulthood?

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A. Living independently in a single-family home

back to square one, and is considering everything from engineering to photography. What is
Olivia’s
Womens Health A Primary Care Clinical Guide 5th Edition
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current status related to the process of identity formation?

A. Identity diffusion
B. Foreclosure
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D. Identity

Answer: A
11. Denae is a 50-year-old client who identifies herself as a member of a religion primarily
because she grew

D. Take voice lessons with the goal of auditioning for a local choral group
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E. Adopt a child from another country

Answer: A, B, D

13. Gertrude is an 85-year-old client who lives in a long-term care facility. Whenever her
grandson visits her,
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she delights in telling stories about her performances as an actress on the stage decades ago and,

15. Maggie is a 67-year-old client who will be retiring in 6 months from the law practice she
founded 30 years
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ago. She is currently training one of her colleagues to take over her clients and run the practice
after she
retires. This strategy for smoothing the transition to retirement is known as which of the
following?
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4. Which of the following statements from an alcoholic patient reflects a good understanding of her
condition?
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A. I will stick to wine or beer from now on.

B. Ill be OK if my wife will just stop nagging me.

C. I plan to take my sobriety 1 day at a time.

D. I wont need AA after I am sober for 1 year.
5. Your 42-year-old patient in the alcohol treatment unit tells you she often cant remember
events while she was drinking. What is this most likely an example of?
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A. Denial
B. Blackouts
C. Psychosis
D. Depression
6. A teenager admits to you that she has been smoking marijuana. The nurse knows that marijuana
is a(n):
A. Cannabinol.
B. Amphetamine.
C. Hallucinogen.
D. Narcotic.
7. Which drug cannot be given if the patient reports alcohol intake in the last 24 hours?
A. Chlorpromazine
B. Chlordiazepoxide
C. Disulfiram
D. Risperidone
8. Your patient in the ER waiting room is inebriated. She becomes increasingly loud
and abusive while waiting to be seen. What would be the best intervention for the nurse? A.
Tell him he has to wait his turn, as others were here first.
B. Inform him he will be asked to leave if this behavior continues.
C. Offer to take him to an exam room to wait for the doctor.
D. Do nothing, as he is still in the waiting room.
9. Your patient tells you her husband has a serious drinking problem. Which statement tells
you she may be in a codependent relationship?
A. Ive reached my limit with his drinking.
B. I called his job and told them he was sick when he couldnt go to work.
C. The kids are ashamed of their father. I feel bad about that.
D. He is drinking less this week.
10. What should be your response to the wife who says, I should get out of this bad situation with
his drinking?
A. That happened to me. Its best to get out while you can.
B. Tell me more about the bad situation.
C. Why dont you talk to your husband about his drinking?
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D. Youll do whats right.

11. Your new patient is at risk for alcohol withdrawal. You know that alcohol withdrawal
tends to develop within what period after the last drink?

A. 1 week

B. 24 to 48 hours

C. 1 hour

D. More than 1 week

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12. The wife of your alcoholic patient has been attending Al-Anon meetings for the past 2
weeks. Which statement tells you the wife is benefitting from the meetings?
A. I can tolerate his destructive behavior now that I see how bad other women have it.
B. I realize that I provoke his drinking when I go out with my friends.
C. I no longer feel that I have to tolerate his berating me.
D. It is great to get out of the house and away from the tension.
13. Which of the following are signs of withdrawal from heroin?
A. Insomnia, muscle cramps, vomiting
B. Excessive sleeping, low blood pressure, depression
C. Seizures, brain damage, excessive sleeping
D. Lethargy, panic disorder, increased appetite
14. Ms. Thomas, who is 50 years old, is being treated for pneumonia and dehydration. She has a
history of alcoholism and admits to starting to drink heavily again. She tells you, Im a horrible person.
My family deserves someone better than me to care for them. Your most therapeutic response to him
is:
It sounds as though you are feeling guilty about drinking, Ms. Thomas. Tell me more about
A. what you mean by that.
B. Why do you say that, Ms. Thomas?
C. Im sure that your family is satisfied, Ms. Thomas.
D. Your drinking doesnt sound that serious.
15. You are caring for a patient who has a long history of alcohol abuse. Recently, this patient went
on a 5-day drinking binge, of which she has no memory. This is an example of: A. Selective memory.
B. Wernickes syndrome.
C. Blackout.
D. Denial.
16. Nurses understand that in people who are addicted to alcohol, the person who is most
responsible for the patients recovery is the:
A. Psychiatrist.
B. Nurse.
C. AA sponsor.
D. Patient.
17. You are socializing with a group of nurses who you work with on a routine basis. Terri is
getting very loud and tells you that she usually has six or eight beers most evenings. She is
defensive about your reaction to the amount of alcohol she consumes. She says, I have days where I
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cant remember what happened the night before, sure, but only once in a while. If you were Terris
friend, the best action you could suggest to her would be:

A. Maybe you should stop at four beers, Terri.

B. I wont tell your husband what you told me.

It sounds to me like your drinking is getting out of control. I cant continue to socialize with
C. you if you continue to drink this much.
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D. Terri, I will call AA for you when you are ready.

18. Randi is a young model. She had been taking high doses of amphetamines to keep her
weight down. She recently decided to cut back on the drugs and she is now experiencing
amphetamine withdrawal. She presented to the clinic with which of the following sets of symptoms
of amphetamine withdrawal?
A. Chest pain, palpitations, and diaphoresis
B. Depression, vivid dreams, and confusion
C. Euphoria, hyperactivity, and hyperalertness
D. Diaphoresis, clammy palms, and diarrhea
19. A young adult arrives in the after-hours clinic with dilated pupils, an elevated heart rate, extreme
sensitivity to sounds around her, sense of being outside of his body, and fine tremors of the hands.
The patient admits to recent use of an illegal street drug. As the nurse collecting this data, you suspect:
A. LSD.
B. Crack cocaine.
C. Amphetamines.
D. Downers.
20. Alcohol is a(n):
A. Central nervous system (CNS) stimulant.
B. CNS depressant.
C. Antipsychotic.
D. Antidepressant.
21. You are caring for a female patient who is a long-term alcoholic. She screams, Get the bugs off
of my skin. I feel them all over my body! Get them off! She is experiencing what type of hallucination?
A. Auditory
B. Visual
C. Taste
D. Tactile
22. A 35-year-old female patient signs in as a voluntary commitment for treatment for drug
abuse. She strongly maintains that he does not have a problem and states, Im only here because
my boss threatened to fire me if I didnt come in. The best nursing response to this patient is: A. I
wonder why your boss said that, if you dont have a problem.
B. What happened that your boss threatened to fire you?

C. Your boss sounds pretty harsh!

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D. Well, you are here on your own, so you can leave whenever you want to.
23. A patient has completed treatment for alcoholism. If treatment was successful, a nurse

might expect which of the following outcome statements from this patient upon discharge?
A. Now, if my family will just be good, I wont be back!

B. I just know I can have an occasional drink and be fine. I know how to handle it now.

C. I realize that Alcoholics Anonymous will always be a requirement. I am responsible for my

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own sobriety.
D. I am so glad I found out what my problem is. I am cured now!
24. Which of the following is a club drug?
A. Rohypnal
B. Crack
C. Placidyl
D. Angel dust
Completion
Complete each statement.
25. You are completing the discharge plan for an alcoholic patient. Which support group should be
included in the plan?
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
26. You find out that your schizophrenic patient is also using opioids to counteract the
frightening hallucinations. What term(s) is used to describe this? (Select all that apply)
A. Dual diagnosis
B. Bipolar schizophrenia
C. Co-occurring disorder
D. Opioid-related schizophrenia
E. Schizophrenia: Addiction type
27. Which of the following are true about Alcoholics Anonymous? (Select all that apply)
A. A physician referral is needed.
B. Family and friends are encouraged to attend the regular meetings with the alcoholic.
C. No last names are used at the meetings.
D. The group for family members is Al-Anon.
E. Offshoots such as Narcotics Anonymous follow a different philosophy.
F. The individual is encouraged to admit he or she is powerless over alcohol.
Answer Section MULTIPLE CHOICE
1. ANS: C
These three symptoms are common with a stimulant such as cocaine. They could occur with the other
substances but are not the hallmark symptoms.
2. ANS: A
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This medication is often initially used to treat alcohol withdrawal symptoms. Response B is a
treatment for alcoholism not withdrawal. Response C is an antipsychotic and response D is used
in opioid addiction. PTS: 1
3. ANS: B
This response indicates the person is minimizing or not acknowledging that she has a problem. In
the other responses the patient is acknowledging drinking but rationalizing the causes.
4. ANS: C
Responses A, B, and D all reinforce use of ineffective defense mechanisms, including denial,
rationalization, and minimization. Response C reflects understanding of the disease as a lifelong
struggle.
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PTS: 1
5. ANS: B
Blackouts are gaps in memory that are symptomatic of advanced alcoholism.
6. ANS: A
Marijuana is a cannabinol. It is not a narcotic or an amphetamine.
7. ANS: C
Disulfiram (Antabuse) is used to treat alcoholism by producing severe adverse effects in the
presence of alcohol. Responses A and D are antipsychotics, and response B is an antianxiety
medication used to treat alcohol withdrawal. 8. ANS: C
This response supports a safe environment for this patient, the other patients, visitors, and staff.
Ignoring him will escalate the situation. Because her judgment is impaired, trying to reason with her
will be unsuccessful.
9. ANS: B
This response shows that the wife is covering for her husband so he doesnt have to take responsibility
for his actions. Response D is more denial. Responses A and C are indications of facing the reality of
this situation. PTS: 1
10. ANS: B
Supporting problem solving and helping her express herself is most important. Response A is advice
giving, which is not appropriate. You dont have enough information to know if response C or D is
correct.
11. ANS: B
Withdrawal symptoms in a heavy drinker generally begin within 24 to 48 hours after the last drink,
although they can occur as early as 8 hours after the last drink.
12. ANS: C
This is the healthiest response that she is not accepting a victim role. In response A she continues to
accept his bad behavior. In response B she is taking responsibility for his drinking, which is
codependent. Response D views the meetings as escape rather than a place to work on issues.
13. ANS: A
These are classic symptoms along with irritability, rhinorrhea, and chills.
14. ANS: A
Response A is an open-ended statement to help her identify her feelings and encourage further
exploration. Response B asks for him to understand why he feels this way and he may not know.
Responses C and D reinforce denial.
15. ANS: C
Blackouts are indications of advanced alcoholism when the person has no memory of recent events.
16. ANS: D
Taking personal responsibility for the misuse of alcohol and the distress it has caused others is key
to beginning recovery. It is the basis of Alcoholics Anonymous. Blaming others for ones problem
may be an initial coping mechanism.
PTS: 1
17. ANS: C
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Response C is reality based and avoids any enabling behavior that reinforce/support her drinking.
The other responses are enabling.
18. ANS: B
Withdrawal symptoms also include insomnia and lethargy.
19. ANS: A
Hallucinogenics like LSD produce a sense of enhanced perception of the environment, which can
contribute to a sense of depersonalization and panic.
20. ANS: B
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Though the initial reaction may be more like a stimulant, it is a CNS depressant.
21. ANS: D
Tactile hallucinations are false perceptions of the sense of touch that often are described as
something crawling on or under ones skin. Tactile hallucinations can occur as part of delirium
tremens from long-term alcohol use and withdrawal.
PTS: 1
22. ANS: B
This response asks the patient to focus on reality rather than blaming others. This is the best
response to challenge the probable denial.
23. ANS: C
This response indicates the patient understands his or her personal responsibility to stay sober. The
other responses show a lack of understanding that alcoholism is a lifelong disorder and that it is not
caused by family problems.
24. ANS: A
Rohypnal along with Ecstasy create disinhibition and amnesia.
PTS: 1
COMPLETION
25. ANS:
Alcoholics Anonymous
Alcoholics Anonymous is the most accepted support group widely available throughout the world.
PTS: 1
MULTIPLE RESPONSE
26. ANS: A, C
Dual diagnosis, also known as co-occurring disorder, is very common in people with psychiatric
disorders who self-medicate for uncomfortable symptoms.
27. ANS: C, D, F
One of the strengths of this program is its anonymity, so last names are never used and meetings are
closed. Admitting powerlessness over the substance abused is key to making progress.