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London et al.

, Maternal & Child Nursing Care, 3e


2011 by Pearson Education, Inc.

Chapter 5: Health Promotion for Women

Chapter 05_LO01_Q01
A client asks her nurse, Is it okay for me to take a tub bath during the heavy part of my
menstruation? The correct response by the nurse is:
1. Tub baths are contraindicated during menstruation.
2. You should shower and douche daily instead.
3. Either a bath or a shower is fine at that time.
4. You should bathe and use a feminine deodorant spray during menstruation.
Correct Answer: 3
Rationale:
1. Bathing, whether it is a tub bath or shower, is as important (if not more so) during menses as at
any other time.
2. Bathing, whether it is a tub bath or shower, is as important (if not more so) during menses as at
any other time. Douching should be avoided during menstruation.
3. Bathing, whether it is a tub bath or shower, is as important (if not more so) during menses as at
any other time.
4. Bathing, whether it is a tub bath or shower, is as important (if not more so) during menses as at
any other time. Feminine deodorant sprays are unnecessary.
Cognitive Level: Implementation
Category of Client Need: Physiological Integrity
Nursing Process: Application
Learning Outcome: 5.1 Determine accurate information to be provided to girls and women so
that they can implement effective self-care measures for dealing with menstruation.
Chapter 05_LO01_Q02
When taking a sexual history from a client, the nurse should:
1. Ask questions that the client can answer with a yes or no.
2. Ask mostly open-ended questions.

London et al., Maternal & Child Nursing Care, 3e


2011 by Pearson Education, Inc.

3. Have the client fill out a comprehensive questionnaire, and review it after the client
leaves.
4. Try not to make much direct eye contact.
Correct Answer: 2
Rationale:
1. Open-ended questions are often useful in eliciting information. Yes-or-no answers will not
provide the necessary information.
2. Open-ended questions are often useful in eliciting information.
3. Filling out a questionnaire is not appropriate.
4. It is helpful to use direct eye contact as much as possible, unless culturally unacceptable.
Cognitive Level: Assessment
Category of Client Need: Health Promotion and Maintenance
Nursing Process: Application
Learning Outcome: 5.1 Determine accurate information to be provided to girls and women so
that they can implement effective self-care measures for dealing with menstruation.
Chapter 05_LO02_Q03
A client comes to the clinic complaining of severe menstrual cramps. She has never been
pregnant, has been diagnosed with ovarian cysts, and has had an intrauterine device (IUD) for 2
years. The most likely cause for the clients complaint is:
1. Primary dysmenorrhea.
2. Secondary dysmenorrhea.
3. Menorrhagia.
4. Hypermenorrhea.
Correct Answer: 2
Rationale:
1. Primary dysmenorrhea is defined as cramps without underlying disease.
2. Secondary dysmenorrhea is associated with pathology of the reproductive tract, and usually
appears after menstruation has been established. Conditions that most frequently cause secondary
dysmenorrhea include ovarian cysts and the presence of an intrauterine device.
3. Menorrhagia is excessive, profuse flow.

London et al., Maternal & Child Nursing Care, 3e


2011 by Pearson Education, Inc.

4. Hypermenorrhea is an abnormally long menstrual flow.


Cognitive Level: Assessment
Category of Client Need: Health Promotion and Maintenance
Nursing Process: Analysis
Learning Outcome: 5.2 Discriminate between the signs, symptoms, and nursing management of
women with dysmenorrhea and premenstrual syndrome.
Chapter 05_LO02_Q04
A teaching plan for a client with premenstrual syndrome (PMS) should include a
recommendation to restrict her intake of:
1. High-starch foods such as potatoes and spaghetti.
2. Chicken, eggs, and fish.
3. Breads, cereals, and beans.
4. Coffee, colas, and chocolate cake.
Correct Answer: 4
Rationale:
1. She should increase her intake of complex carbohydrates and proteins.
2. She should increase her intake of complex carbohydrates and proteins.
3. She should increase her intake of complex carbohydrates and proteins.
4. A client with PMS is advised to restrict her intake of foods containing methylxanthines, such
as chocolate, cola, and coffee. She should increase her intake of complex carbohydrates and
proteins.
Cognitive Level: Application
Category of Client Need: Physiological Integrity
Nursing Process: Planning
Learning Outcome: 5.2 Discriminate between the signs, symptoms, and nursing management of
women with dysmenorrhea and premenstrual syndrome.
Chapter 05_LO03_Q05
In using the natural method of contraception, the nurse should instruct the client to begin
counting the first day of her cycle as:

London et al., Maternal & Child Nursing Care, 3e


2011 by Pearson Education, Inc.

1. The day her menstrual period ceases.


2. The first day after her menstrual period ceases.
3. The first day of her menstrual period.
4. The day of ovulation.
Correct Answer: 3
Rationale:
1. The first day of menstruation is the first day of the cycle. The day her menstrual period ceases
is not an indicator of the first day of the cycle.
2. The first day of menstruation is the first day of the cycle. The first day after her menstrual
period ceases is not an indicator of the first day of the cycle.
3. The first day of menstruation is the first day of the cycle.
4. The first day of menstruation is the first day of the cycle. The day of ovulation is not an
indicator of the first day of the cycle.
Cognitive Level: Application
Category of Client Need: Health Promotion and Maintenance
Nursing Process: Implementation
Learning Outcome: 5.3 Compare the advantages, disadvantages, and effectiveness of the various
methods of contraception available today.
Chapter 05_LO03_Q06
How is the cervical mucus method of contraception different from the calendar (rhythm)
method? The cervical mucus method:
1. Is more effective for women with irregular cycles.
2. Is free, safe, and acceptable to women of many religions.
3. Provides an increased awareness of the body.
4. Requires no artificial substances or devices.
Correct Answer: 1
Rationale:
1. The cervical mucus method can be used by women with irregular cycles. The other choices
apply to both methods.
2. The cervical mucus method can be used by women with irregular cycles. The other choices

London et al., Maternal & Child Nursing Care, 3e


2011 by Pearson Education, Inc.

apply to both methods.


3. The cervical mucus method can be used by women with irregular cycles. The other choices
apply to both methods.
4. The cervical mucus method can be used by women with irregular cycles. The other choices
apply to both methods.
Cognitive Level: Evaluation
Category of Client Need: Health Promotion and Maintenance
Nursing Process: Application
Learning Outcome: 5.3 Compare the advantages, disadvantages, and effectiveness of the various
methods of contraception available today.
Chapter 05_LO03_Q07
A client who wants to use the vaginal sponge as a method of contraception shows that she
understands the appropriate usage with which of the following statements?
1. I need to use a lubricant prior to insertion.
2. I need to add spermicidal cream prior to intercourse.
3. I need to moisten it with water prior to use.
4. I need to leave it in no longer than 6 hours.
Correct Answer: 3
Rationale:
1. Lubricant and spermicidal cream are not needed.
2. Lubricant and spermicidal cream are not needed.
3. To activate the spermicide in the vaginal sponge, it must be moistened thoroughly with water.
4. The sponge can remain in place for 24 hours.
Cognitive Level: Application
Category of Client Need: Health Promotion and Maintenance
Nursing Process: Evaluation
Learning Outcome: 5.3 Compare the advantages, disadvantages, and effectiveness of the various
methods of contraception available today.
Chapter 05_LO03_Q08

London et al., Maternal & Child Nursing Care, 3e


2011 by Pearson Education, Inc.

The nurse at the family planning clinic has done some teaching on oral contraceptives in the
waiting room. The nurse knows that the teaching has been effective when one of the clients
responds:
1. I cant take the pill if Im over 30.
2. I can take the pill, even though I smoke heavily.
3. My periods will become slightly heavier when I take the pill.
4. I cant take the pill if I have gallbladder disease.
Correct Answer: 4
Rationale:
1. There is no age specification for using the pill.
2. Oral contraceptive is contraindicated in women who smoke heavily.
3. Menstrual flow is decreased with the use of oral contraceptives.
4. Oral contraceptive is contraindicated in women with gallbladder disease and those who smoke
heavily.
Cognitive Level: Application
Category of Client Need: Physiological Integrity
Nursing Process: Evaluation
Learning Outcome: 5.3 Compare the advantages, disadvantages, and effectiveness of the various
methods of contraception available today.
Chapter 05_LO03_Q09
A client who is 36 years old, weighs 200 pounds, is monogamous, and does not smoke desires
birth control. The nurse understands that which of the following is inappropriate for this client?
1. Intrauterine device
2. Vaginal sponge
3. Combined oral contraceptives
4. Transdermal hormonal contraception
Correct Answer: 4
Rationale:
1. This client may use an intrauterine device, the vaginal sponge, or combined oral
contraceptives.

London et al., Maternal & Child Nursing Care, 3e


2011 by Pearson Education, Inc.

2. This client may use an intrauterine device, the vaginal sponge, or combined oral
contraceptives.
3. This client may use an intrauterine device, the vaginal sponge, or combined oral
contraceptives.
4. Transdermal hormonal contraception is contraindicated because of the clients obesity.
Cognitive Level: Analysis
Category of Client Need: Health Promotion and Maintenance
Nursing Process: Diagnosis
Learning Outcome: 5.3 Compare the advantages, disadvantages, and effectiveness of the various
methods of contraception available today.
Chapter 05_LO03_Q10
Which client would not be a good candidate for Depo-Provera (DMPA)?
1. One who wishes to get pregnant within 3 months
2. A nursing mother
3. One with a vaginal prolapse
4. One who weighs 200 pounds
Correct Answer: 1
Rationale:
1. Return of fertility after the use of Depo-Provera takes an average of 9 months.
2. A nursing mother can use Depo-Provera.
3. Obesity and vaginal prolapse do not prevent the use of Depo-Provera.
4. Obesity and vaginal prolapse do not prevent the use of Depo-Provera.
Cognitive Level: Application
Category of Client Need: Physiological Integrity
Nursing Process: Implementation
Learning Outcome: 5.3 Compare the advantages, disadvantages, and effectiveness of the various
methods of contraception available today.
Chapter 05_LO03_Q11
A couple asks the nurse what the safest method of sterilization would be. The nurse should reply,

London et al., Maternal & Child Nursing Care, 3e


2011 by Pearson Education, Inc.

Generally, the safest method of permanent sterilization would be a:


1. "Laparotomy tubal ligation.
2. "Laparoscopy tubal ligation.
3. "Minilaparotomy.
4. "Vasectomy.
Correct Answer: 4
Rationale:
1. This is a female sterilization procedure that involves more risks.
2. This is a female sterilization procedure that involves more risks.
3. This is a female sterilization procedure that involves more risks.
4. Vasectomy is a relatively minor procedure.
Cognitive Level: Implementation
Category of Client Need: Health Promotion and Maintenance
Nursing Process: Application
Learning Outcome: 5.3 Compare the advantages, disadvantages, and effectiveness of the various
methods of contraception available today.
Chapter 05_LO03_Q12
When teaching a woman about the use of a diaphragm, it is important to instruct her that the
diaphragm should be rechecked for correct size:
1. Every five years routinely.
2. When weight gain or loss beyond five pounds has occurred.
3. After each birth.
4. Only after significant weight loss.
Correct Answer: 3
Rationale:
1. The diaphragm should be rechecked for correct size after each childbirth and whenever a
woman has gained or lost 10 pounds or more.
2. The diaphragm should be rechecked for correct size after each childbirth and whenever a
woman has gained or lost 10 pounds or more.
3. The diaphragm should be rechecked for correct size after each childbirth and whenever a

London et al., Maternal & Child Nursing Care, 3e


2011 by Pearson Education, Inc.

woman has gained or lost 10 pounds or more.


4. The diaphragm should be rechecked for correct size after each childbirth and whenever a
woman has gained or lost 10 pounds or more.
Cognitive Level: Application
Category of Client Need: Health Promotion and Maintenance
Nursing Process: Implementation
Learning Outcome: 5.3 Compare the advantages, disadvantages, and effectiveness of the various
methods of contraception available today.
Chapter 05_LO04_Q13
A nurse is providing a client with instructions regarding breast self-examination (BSE). Which of
the following statements by the client would indicate that the teaching has been successful?
Select all that apply.
1.

I should perform BSE 1 week prior to the start of my period.

2. When I reach menopause, I will perform BSE every 2 months.


3. Knowing the texture of my breasts is important.
4. I should inspect my breasts while standing with my arms down at my sides.
5. I should inspect my breasts while in a supine position with my arms at my sides.
Correct Answers: 3; 4
Rationale:
1. BSE should be performed 1 week after the start of each menstrual period.
2. BSE should be performed monthly, on the same day each month, during menopause.
3. A woman who knows the texture and feel of her own breasts is far more likely to detect
changes that develop. The breasts should be inspected while standing with arms at sides.
4. A woman who knows the texture and feel of her own breasts is far more likely to detect
changes that develop. The breasts should be inspected while standing with arms at sides.
5. Supine is not a correct position for BSE.
Cognitive Level: Application
Category of Client Need: Health Promotion and Maintenance
Nursing Process: Evaluation

London et al., Maternal & Child Nursing Care, 3e


2011 by Pearson Education, Inc.

Learning Outcome: 5.4 Delineate basic gynecologic screening procedures indicated for well
women.
Chapter 05_LO05_Q14
A menopausal woman tells her nurse that she experiences discomfort from vaginal dryness
during sexual intercourse, and asks, What should I use as a lubricant? The nurse should
recommend:
1. Petroleum jelly.
2. A water-soluble lubricant.
3. Body cream or body lotion.
4. Less-frequent intercourse.
Correct Answer: 2
Rationale:
1. A water-soluble jelly should be used. Petroleum jelly is not water-soluble
2. A water-soluble jelly should be used.
3. A water-soluble jelly should be used. Body creams and body lotions are not water-soluble.
4. A water-soluble jelly should be used. Less-frequent intercourse is an inappropriate response.
Cognitive Level: Application
Category of Client Need: Physiological Integrity
Nursing Process: Implementation
Learning Outcome: 5.5 Consider the physical and psychologic aspects and clinical treatment
options of menopause when caring for menopausal women.
Chapter 05_LO06_Q15
When a woman who has been raped is admitted to the Emergency Department, which nursing
intervention has priority?
1. Explain exactly what will need to be done to preserve legal evidence.
2. Assure the woman that everything will be all right.
3. Create a safe, secure atmosphere for her.
4. Contact family members.
Correct Answer: 3

London et al., Maternal & Child Nursing Care, 3e


2011 by Pearson Education, Inc.

Rationale:
1. The first priority in caring for a survivor of a sexual assault is to create a safe, secure
atmosphere. The other interventions would not take priority over safety at this time.
2. The first priority in caring for a survivor of a sexual assault is to create a safe, secure
atmosphere. The other interventions would not take priority over safety at this time.
3. The first priority in caring for a survivor of a sexual assault is to create a safe, secure
atmosphere. The other interventions would not take priority over safety at this time.
4. The first priority in caring for a survivor of a sexual assault is to create a safe, secure
atmosphere. The other interventions would not take priority over safety at this time.
Cognitive Level: Analysis
Category of Client Need: Safe, Effective Care Environment
Nursing Process: Planning
Learning Outcome: 5.6 Delineate the nurses role in screening and caring for women who have
experienced domestic violence or rape.