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

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Olds' Maternal-Newborn Nursing and Women's Health, 10e (Davidson)
Chapter 5 Women's Health: Commonly Occurring Infections
1) A nonpregnant client is diagnosed with bacterial vaginosis (BV). What does the nurse expect
to administer?
1. Penicillin G 2 million units IM one time
2. Zithromax 1 mg p.o. b.i.d. for 2 weeks
3. Doxycycline 100 mg p.o. b.i.d. for a week
4. Metronidazole 500 mg p.o. b.i.d. for a week
Answer: 4
Explanation: 4. The nonpregnant woman who is diagnosed with bacterial vaginosis (BV) is
treated with metronidazole 500 mg orally twice a day for 7 days.
Page Ref: 75
Cognitive Level: Understanding
Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and
respect for the diversity of human experience. | AACN Essentials Competencies: IX. 3.
Implement holistic, patient-centered care that reflects an understanding of human growth and
development, pathophysiology, pharmacology, medical management, and nursing management
across the health-illness continuum, across the lifespan, and in all healthcare settings. | NLN
Competencies: Context and Environment: Apply professional standards; show accountability for
nursing judgment and actions; develop advocacy skills; apply ethical decision making models. |
Nursing/Integrated Concept: Nursing Process: Planning
Learning Outcome: 1 Compare vulvovaginal candidiasis and bacterial vaginosis.
MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic
infection.

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2) The nurse is providing discharge instructions to a client with a diagnosis of vulvovaginal
candidiasis (VVC), and knows the client understands when she makes which of the following
statements?
1. "I need to apply the miconazole for 10 days."
2. "I need to douche daily."
3. "I need to add yogurt to my diet."
4. "I need to wear nylon panties."
Answer: 3
Explanation: 3. Yogurt helps reestablish normal vaginal flora.
Page Ref: 76
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being, and self-care management. | AACN
Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health
counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up
throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Evaluation
Learning Outcome: 1 Compare vulvovaginal candidiasis and bacterial vaginosis.
MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic
infection.
3) The nurse is caring for a client in the clinic whom she suspects has vaginosis. Which test best
determines whether this sexually active woman has the disorder?
1. The observation of mycelia upon direct microscopy in a 10% potassium hydroxide preparation
2. The addition of a 10% potassium hydroxide solution to the vaginal secretions
3. A vaginal pH of less than 4.5

4. A Gram stain positive for the fungus
Answer: 2
Explanation: 2. Adding a 10% potassium hydroxide solution to the vaginal secretion of a client
with bacterial vaginosis, called a "whiff" test, produces a fishy smell.
Page Ref: 74
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and
respect for the diversity of human experience. | AACN Essentials Competencies: IX. 3.
Implement holistic, patient-centered care that reflects an understanding of human growth and
development, pathophysiology, pharmacology, medical management, and nursing management
across the health-illness continuum, across the lifespan, and in all healthcare settings | NLN
Competencies: Context and Environment: Read and interpret data; apply health
promotion/disease prevention strategies; apply health policy; conduct population-based
transcultural health assessments and interventions. | Nursing/Integrated Concept: Nursing
Process: Diagnosis
Learning Outcome: 1 Compare vulvovaginal candidiasis and bacterial vaginosis.
MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic
infection.
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4) A pregnant client at 24 weeks' gestation is diagnosed with bacterial vaginosis. Her doctor
orders Flagyl to treat the problem. What would be appropriate education for the nurse to
provide?
1. The client must be careful to observe for signs of preterm labor.
2. The client should advise her partner to seek therapy as soon as possible.
3. The main side effect of the medication is a large amount of vaginal discharge.
4. A repeat culture should be taken 2 weeks after completing the therapy.

Answer: 1
Explanation: 1. Clients with bacterial vaginosis are at risk for preterm labor.
Page Ref: 74
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being, and self-care management. | AACN
Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health
counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up
throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Implementation
Learning Outcome: 1 Compare vulvovaginal candidiasis and bacterial vaginosis.
MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic
infection.

3
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5) A client has been diagnosed with bacterial vaginosis. The nurse obtains a sexual history from
the client, including contraceptive measures, number of sexual partners, and frequency of
intercourse. What is the rationale for the questions?
1. Clients can infect their sexual partners.
2. The nurse is required by law to ask the questions.
3. Clients with bacterial vaginosis can become infected with HIV and other sexually transmitted
diseases more easily.
4. The laboratory needs a full client history in order to know for which organisms and antibiotic
sensitivities it should test.
Answer: 3

Explanation: 3. The change in normal flora increases the woman's susceptibility to other
organisms, making the client more vulnerable to sexually transmitted diseases, including HIV.
Page Ref: 74
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs
as part of clinical interview, implementation of care plan, and evaluation of care. | AACN
Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health
counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up
throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Diagnosis
Learning Outcome: 1 Compare vulvovaginal candidiasis and bacterial vaginosis.
MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually
transmitted infections.

4
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6) The nurse working in a women's clinic recognizes that which clients are most at risk for
developing vulvovaginal candidiasis?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. Clients using antibiotics
2. Immunocompetent clients
3. Pregnant clients
4. Multiparous clients
5. Diabetic clients
Answer: 1, 3, 5

Explanation: 1. A predisposing factor to yeast infections includes the use of antibiotics.
3. Predisposing factors to yeast infections include pregnancy.
5. Predisposing factors to yeast infections include glycosuria and diabetes mellitus.
Page Ref: 75
Cognitive Level: Applying
Client Need/Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and
respect for the diversity of human experience. | AACN Essentials Competencies: IX. 3.
Implement holistic, patient-centered care that reflects an understanding of human growth and
development, pathophysiology, pharmacology, medical management, and nursing management
across the health-illness continuum, across lifespan, and in all healthcare settings. | NLN
Competencies: Context and Environment: Read and interpret data; apply health
promotion/disease prevention strategies; apply health policy; conduct population-based
transcultural health assessments and interventions. | Nursing/Integrated Concept: Nursing
Process: Assessment
Learning Outcome: 1 Compare vulvovaginal candidiasis and bacterial vaginosis.
MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic
infection.

5
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7) The nurse provides a couple with education about the consequences of not treating chlamydia,
and knows they understand when they make which statement?
1. "She could become pregnant."
2. "She could have severe vaginal itching."
3. "He could get an infection in the tube that carries the urine out."
4. "It could cause us to develop a rash."
Answer: 3

Explanation: 3. Chlamydia is a major cause of nongonococcal urethritis (NGU) in men.
Page Ref: 78
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being, and self-care management. | AACN
Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health
counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up
throughout the lifespan. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Evaluation
Learning Outcome: 2 Summarize modes of transmission, treatments, and descriptions of the
most commonly occurring sexually transmitted infections (STIs).
MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually
transmitted infections.
8) The nurse is seeing clients in the women's clinic. Which client should be treated with
ceftriaxone IM and doxycycline orally?
1. A pregnant client with gonorrhea and a yeast infection
2. A nonpregnant client with gonorrhea and chlamydia
3. A pregnant client with syphilis
4. A nonpregnant client with chlamydia and trichomoniasis
Answer: 2
Explanation: 2. The combined treatment of ceftriaxone IM and doxycycline orally provides dual
treatment for gonorrhea and chlamydia, which frequently occur together.
Page Ref: 79
Cognitive Level: Applying
Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and
respect for the diversity of human experience. | AACN Essentials Competencies: IX. 3.
Implement evidence-based nursing interventions as appropriate for managing the acute and

chronic care of patients and promoting health across the lifespan. | NLN Competencies:
Teamwork: Function completely within one's own scope of practice as leader and member of the
health care team and manage delegation effectively. | Nursing/Integrated Concept: Nursing
Process: Implementation
Learning Outcome: 2 Summarize modes of transmission, treatments, and descriptions of the
most commonly occurring sexually transmitted infections (STIs).
MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic
infection.
6
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9) The nurse is providing follow-up education to a client just diagnosed with vaginal herpes.
What statement by the client verifies correct knowledge about vaginal herpes?
1. "I should douche daily to prevent infection."
2. "I could have another breakout during my period."
3. "I am more likely to develop cancer of the cervix."
4. "I should use sodium bicarbonate on the lesions to relieve discomfort."
Answer: 2
Explanation: 2. Menstruation seems to trigger recurrences of herpes.
Page Ref: 79
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being, and self-care management. | AACN
Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in their care. | NLN Competencies: Relationship-Centered Care:
Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated
Concept: Nursing Process: Evaluation

Learning Outcome: 3 Describe the health teaching that a nurse needs to provide to a woman
with an STI.
MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic
infection.

7
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10) The nurse seeing a client just diagnosed with Chlamydia trachomatis knows that which client
is at greatest risk for the infection?
1. 16-year-old sexually active girl, using no contraceptive
2. 22-year-old mother of two, developed dyspareunia
3. 35-year-old woman on oral contraceptives
4. 48-year-old woman with hot flashes and night sweats
Answer: 1
Explanation: 1. Teens have the highest incidence of sexually transmitted infections, especially
chlamydia. A client not using contraceptives is not using condoms, which decrease the risk of
contracting a STI.
Page Ref: 78
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs
as part of clinical interview, implementation of care plan and evaluation of care. | AACN
Essentials Competencies: IX. 2. Recognize the relationship of genetics and genomics to health,
prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of
treatment effectiveness, using a constructed pedigree from collected family history information
as well as standardized symbols and terminology. | NLN Competencies: Context and
Environment: Read and interpret data; apply health promotion/disease prevention strategies;
apply health policy; conduct population-based transcultural health assessments and interventions.

| Nursing/Integrated Concept: Nursing Process: Assessment
Learning Outcome: 2 Summarize modes of transmission, treatments, and descriptions of the
most commonly occurring sexually transmitted infections (STIs).
MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually
transmitted infections.

8
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11) A client comes to the clinic complaining of difficulty urinating, flu-like symptoms, genital
tingling, and blister-like vesicles on the upper thigh and vagina. She denies having ever had these
symptoms before. The medication the physician is most likely to order would be:
1. Oral acyclovir
2. Ceftriaxone IM
3. Azithromycin p.o.
4. Penicillin G IM
Answer: 1
Explanation: 1. Malaise, dysuria, and tingling or painful vesicles are indicative of a primary
herpes simplex outbreak. Acyclovir treats herpes.
Page Ref: 79
Cognitive Level: Understanding
Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and
respect for the diversity of human experience. | AACN Essentials Competencies: IX. 3.
Implement holistic, patient-centered care that reflects an understanding of human growth and
development, pathophysiology, pharmacology, medical management, and nursing management
across the lifespan, and in all healthcare settings. | NLN Competencies: Context and
Environment: Apply professional standards; show accountability for nursing judgment and
actions; develop advocacy skills; apply ethical decision making models. | Nursing/Integrated

Concept: Nursing Process: Implementation
Learning Outcome: 2 Summarize modes of transmission, treatments, and descriptions of the
most commonly occurring sexually transmitted infections (STIs).
MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually
transmitted infections.

9
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12) The nurse is evaluating the outcomes of nursing care given a female client with a sexually
transmitted infection (STI). Which of the following will the nurse verify about the client?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. Had an identified infection
2. Could identify the mode of transmission
3. Would never cope with the infection
4. Could recognize the symptoms of an STI
5. Would not disclose the STI to her partner
Answer: 1, 2, 4
Explanation: 1. The infection must be identified and cured, if possible. If not, supportive therapy
is provided.
2. The client and her partner should be able to describe the infection, its method of transmission,
its implications, and the therapy.
4. The client must be able to recognize the symptoms of an STI.
Page Ref: 82
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: IV. C. 2. Value own and others' contributions to outcomes of
care in local care settings. | AACN Essentials Competencies: IX. 9. Monitor client outcomes to

evaluate the effectiveness of psychobiological interventions. | NLN Competencies: Context and
Environment: Read and interpret data; apply health promotion/disease prevention strategies;
apply health policy; conduct population-based transcultural health assessments and interventions.
| Nursing/Integrated Concept: Nursing Process: Evaluation
Learning Outcome: 3 Describe the health teaching that a nurse needs to provide to a woman
with an STI.
MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually
transmitted infections.

10
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13) A client comes to the clinic complaining of a thick, white, tenacious discharge and vulvular
soreness. Which medication treatment will the nurse teach the client about?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. Silver sulfadiazine
2. Metronidazole
3. Clindamycin cream
4. Ceftriaxone sodium
5. Doxycycline
Answer: 2, 3
Explanation: 2. Metronidazole is the preferred treatment for vulvovaginal candidiasis.
3. Although less effective than metronidazole, clindamycin cream can be used to treat
vulvovaginal candidiasis.
Page Ref: 74, 75
Cognitive Level: Applying
Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active

partnerships that promote health, safety and well-being, and self-care management. | AACN
Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in care. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Planning
Learning Outcome: 2 Summarize modes of transmission, treatments, and descriptions of the
most commonly occurring sexually transmitted infections (STIs).
MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic
infection.

11
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14) A 12-year-old girl and her mother are at the doctor's office for a routine check-up for the
daughter. The mother tells the nurse that she would like the daughter to have the Gardasil
vaccine that is effective against the human papilloma virus. The nurse does some teaching, and
knows it has been successful when the mother makes which statement?
1. "The human papilloma virus is spread through casual contact in schools."
2. "Gardasil will protect against all types of the human papilloma virus."
3. "The human papilloma virus affects a million people in the United States."
4. "Gardasil will be given to my daughter in three doses."
Answer: 4
Explanation: 4. This is true. The vaccine is given in three doses.
Page Ref: 81
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being, and self-care management. | AACN

Essentials Competencies: IX. 9. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in care. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Implementation
Learning Outcome: 3 Describe the health teaching that a nurse needs to provide to a woman
with an STI.
MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic
infection.
15) The clinic nurse teaches the pregnant client being treated for trichomoniasis about the risks
to her pregnancy due to this infection. Which statement would indicate successful teaching?
1. "I am at risk of having a preterm birth because of this infection."
2. "I might need to have my membranes ruptured because of this infection."
3. "I am at risk of having a baby with a high birth weight."
4. "I may have intercourse with my husband while bring treated for this infection."
Answer: 1
Explanation: 1. There is a risk of preterm birth and rupture of membranes.
Page Ref: 77
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being, and self-care management. | AACN
Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in care. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Evaluation
Learning Outcome: 3 Describe the health teaching that a nurse needs to provide to a woman
with an STI.
MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic

infection.
12
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16) The nurse is educating a group of female adolescents regarding sexually transmitted
infections. The nurse knows that learning was achieved when an individual states that the most
common symptom is which of the following?
1. Menstrual cramps
2. Heavy menstrual periods
3. Flu-like symptoms
4. Usually there are no signs or symptoms
Answer: 4
Explanation: 4. It is common for women to experience no signs or symptoms when they have
contracted a sexually transmitted disease.
Page Ref: 82
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being, and self-care management. | AACN
Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in care. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Implementation
Learning Outcome: 3 Describe the health teaching that a nurse needs to provide to a woman
with an STI.
MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic
infection.

13
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17) After a sex education class at a high school, the nurse overhears a student discussing safe sex
practices. Which statement indicates that teaching was successful?
1. "I don't have to worry about getting infected if I have oral sex."
2. "Teen women are the group at highest risk for sexually transmitted infections."
3. "The best thing to do if I have sex a lot is to use spermicide each and every time."
4. "Boys get the HIV virus more easily than girls do."
Answer: 2
Explanation: 2. Teens with multiple sex partners are more susceptible to sexually transmitted
diseases.
Page Ref: 82
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being and self-care management. | AACN
Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in care. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Implementation
Learning Outcome: 3 Describe the health teaching that a nurse needs to provide to a woman
with an STI.
MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually
transmitted infections.

14
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18) A client asks the nurse about treatment for human papilloma viral warts. The nurse's
response should be based on what knowledge?
1. An antiviral injection cures approximately 50% of all cases.
2. Aggressive treatment is required to cure warts.
3. Warts often spread when an attempt is made to remove them surgically.
4. No single treatment is best for all types of warts or for all clients.
Answer: 4
Explanation: 4. All atypical, pigmented, and persistent warts should be biopsied and treatment
instituted promptly.
Page Ref: 80
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and
respect for the diversity of human experience. | AACN Essentials Competencies: IX. 3.
Implement holistic, patient-centered care that reflects an understanding of human growth and
development, pathophysiology, pharmacology, medical management, and nursing management
across the health-illness continuum, across lifespan and in all healthcare settings. | NLN
Competencies: Context and Environment: Apply professional standards; show accountability for
nursing judgment and actions; develop advocacy skills; apply ethical decision making models. |
Nursing/Integrated Concept: Nursing Process: Diagnosis
Learning Outcome: 2 Summarize modes of transmission, treatments, and descriptions of the
most commonly occurring sexually transmitted infections (STIs).
MNL LO: 6.2.4 Utilize the nursing process in caring for women at risk for or with a gynecologic
infection.

15
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19) The nurse is providing health education to a group of young people. When teaching about the
prevention of sexually transmitted infections (STIs), the nurse will teach which concepts?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. Decision-making skills in refusing intercourse
2. How to reduce high-risk behaviors
3. That Pap smears might be needed more often
4. The safety of oral sex
5. Use of petroleum-based lubricants with condoms
Answer: 1, 2, 3
Explanation: 1. Effective prevention and control of STIs is based on planning ahead, review of
decision-making skills, and developing strategies to refuse sex.
2. Effective prevention and control of STIs is based on the reduction of high-risk behaviors. Use
of recreational drugs and alcohol can increase sexual risk taking.
3. The presence of a genital infection can lead to an abnormal Pap smear. Women with certain
infections should have more frequent Pap tests.
Page Ref: 83
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being and self-care management. | AACN
Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in care. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Implementation
Learning Outcome: 3 Describe the health teaching that a nurse needs to provide to a woman
with an STI.
MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually

transmitted infections.

16
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20) The nurse is caring for a client hospitalized for pelvic inflammatory disease. Which nursing
intervention would have priority?
1. Encourage oral fluids
2. Administer cefotetan IV
3. Enforce bed rest
4. Remove IUC, if present
Answer: 2
Explanation: 2. Administration of medications to treat the disease is the first priority.
Page Ref: 84
Cognitive Level: Applying
Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and
respect for the diversity of human experience. | AACN Essentials Competencies: IX. 11. Provide
nursing care based on evidence that contributes to safe and high quality patient outcomes within
healthcare microsystems. | NLN Competencies: Context and Environment: Apply professional
standards; show accountability for nursing judgment and actions; develop advocacy skills; apply
ethical decision making models. | Nursing/Integrated Concept: Nursing Process: Planning
Learning Outcome: 4 Relate the implications of pelvic inflammatory disease (PID) for future
fertility to its pathologic origin, signs and symptoms, and treatment.
MNL LO: 6.2.2 Explain the relationship between pelvic inflammatory disease and infertility.
21) The nurse obtains a health history from four clients. To which client should she give priority
for teaching about cervical cancer prevention?
1. Age 30, treated for PID
2. Age 25, monogamous

3. Age 20, pregnant
4. Age 27, uses a diaphragm
Answer: 1
Explanation: 1. Exposure to sexually transmitted infections increases the risk of abnormal cell
changes and cervical cancer.
Page Ref: 81
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being and self-care management. | AACN
Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in care. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Planning
Learning Outcome: 3 Describe the health teaching that a nurse needs to provide to a woman
with an STI.
MNL LO: 6.2.2 Explain the relationship between pelvic inflammatory disease and infertility.

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22) The nurse is discharging a client after hospitalization for pelvic inflammatory disease (PID).
Which statements indicate that teaching was effective?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. "I might have infertility because of this infection."
2. "It is important for me to finish my antibiotics."
3. "Tubal pregnancy could occur after PID."

4. "My PID was caused by a yeast infection."
5. "I am going to have an IUD placed for contraception."
Answer: 1, 2, 3
Explanation: 1. Women sometimes become infertile because of scarring in the fallopian tubes as
a result of the inflammation of PID.
2. Antibiotic therapy should always be completed when a client is diagnosed with any infection.
3. The tubal scarring that occurs from tubal inflammation during PID can prevent a fertilized
ovum from passing through the tube into the uterus, causing an ectopic or tubal pregnancy.
Page Ref: 84
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being and self-care management. | AACN
Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in care. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Evaluation
Learning Outcome: 4 Relate the implications of pelvic inflammatory disease (PID) for future
fertility to its pathologic origin, signs and symptoms, and treatment.
MNL LO: 6.2.2 Explain the relationship between pelvic inflammatory disease and infertility.

18
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23) The nurse's response to a client with a history of pelvic inflammatory disease who is trying to
get pregnant is based on the knowledge that which condition can contribute to an infertility
problem?
1. Hepatitis

2. Postinfection tubal damage
3. Pelvic abscess
4. Tubal infection
Answer: 2
Explanation: 2. Postinfection tubal damage is the most likely cause, as the infection causes tubal
damage, which can lead to infertility.
Page Ref: 83
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs
as part of clinical interview, implementation of care plan and evaluation of care. | AACN
Essentials Competencies: IX. 3. Implement holistic, patient-centered care that reflects an
understanding of human growth and development, pathophysiology, pharmacology, medical
management, and nursing management across the health-illness continuum, across lifespan, and
in all healthcare settings. | NLN Competencies: Context and Environment: Apply Professional
stands; show accountability for nursing judgment and actions; develop advocacy skills; apply
ethical decision making models. | Nursing/Integrated Concept: Nursing Process: Planning
Learning Outcome: 4 Relate the implications of pelvic inflammatory disease (PID) for future
fertility to its pathologic origin, signs and symptoms, and treatment.
MNL LO: 6.2.2 Explain the relationship between pelvic inflammatory disease and infertility.
24) Which of the following diagnostic tests would the nurse question when ordered for a client
diagnosed with pelvic inflammatory disease (PID)?
1. CBC (complete blood count) with differential
2. Venereal Disease Research Laboratory (VDRL)
3. Throat culture for Streptococcus A
4. RPR (Rapid Plasma Reagin)
Answer: 3
Explanation: 3. Streptococcus of the throat is not associated with PID.
Page Ref: 84
Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs
as part of clinical interview, implementation of care plan and evaluation of care. | AACN
Essentials Competencies: IX. 3. Implement holistic, patient-centered care that reflects an
understanding of human growth and development, pathophysiology, pharmacology, medical
management, and nursing management across the health-illness continuum, across lifespan, and
in all healthcare settings. | NLN Competencies: Context and Environment: Apply professional
standards; show accountability for nursing judgment and actions; develop advocacy skills; apply
ethical decision making models. | Nursing/Integrated Concept: Nursing Process: Implementation
Learning Outcome: 4 Relate the implications of pelvic inflammatory disease (PID) for future
fertility to its pathologic origin, signs and symptoms, and treatment.
MNL LO: 6.2.2 Explain the relationship between pelvic inflammatory disease and infertility.
19
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25) A client in the emergency department is diagnosed with pelvic inflammatory disease. Before
discharge, the nurse will provide the client with some health teaching about which topic?
1. Endometriosis
2. Menopause
3. Ovarian hyperplasia
4. IUD for contraception
Answer: 4
Explanation: 4. The woman who uses an IUD for contraception and has multiple sexual partners
needs to understand clearly the risk she faces.
Page Ref: 84
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being and self-care management. | AACN

Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in care. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Evaluation
Learning Outcome: 4 Relate the implications of pelvic inflammatory disease (PID) for future
fertility to its pathologic origin, signs and symptoms, and treatment.
MNL LO: 6.2.2 Explain the relationship between pelvic inflammatory disease and infertility.

20
Copyright © 2016 Pearson Education, Inc.


26) Women with pyelonephritis during pregnancy are at significantly increased risk for which
condition?
1. Foul-smelling discharge
2. Ectopic pregnancy
3. Preterm labor
4. A colicky large intestine
Answer: 3
Explanation: 3. Women with pyelonephritis during pregnancy are at significantly increased risk
of preterm labor, preterm birth, development of adult respiratory distress syndrome, and
septicemia.
Page Ref: 85
Cognitive Level: Understanding
Client Need/Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and
respect for the diversity of human experience. | AACN Essentials Competencies: IX. 3.
Implement holistic, patient-centered care that reflects an understanding of human growth and
development, pathophysiology, pharmacology, medical management, and nursing management

across the health-illness continuum, across lifespan, and in all healthcare settings. | NLN
Competencies: Context and Environment: Apply professional standards; show accountability for
nursing judgment and actions; develop advocacy skills; apply health promotion/disease
prevention strategies; apply health policy; conduct population-based transcultural health
assessments and interventions. | Nursing/Integrated Concept: Nursing Process: Implementation
Learning Outcome: 5 Contrast cystitis and pyelonephritis.
MNL LO: 6.2.3 Differentiate the causes, risks, and treatment of upper and lower urinary tract
infections.
27) The nurse is preparing an education session for women on the prevention of urinary tract
infections (UTIs). Which statement should be included?
1. Lower urinary tract infections rarely occur in women.
2. The most common causative organism of cystitis is E. coli.
3. Wiping from back to front after a BM will help prevent a UTI.
4. Back pain often develops with a lower urinary tract infection.
Answer: 2
Explanation: 2. E. coli is present in 75% to 90% of women with UTIs.
Page Ref: 85
Cognitive Level: Understanding
Client Need/Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being, and self-care management. | AACN
Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in care. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Planning
Learning Outcome: 5 Contrast cystitis and pyelonephritis.
MNL LO: 6.2.3 Differentiate the causes, risks, and treatment of upper and lower urinary tract
infections.
21

Copyright © 2016 Pearson Education, Inc.


28) The client demonstrates that the nurse's teaching regarding ways to prevent a recurrence of
her urinary tract infection was effective when she makes which statement?
1. "I should wipe from back to front after urination."
2. "I should urinate when I feel the urge."
3. "I should try to restrict my intake of fruits."
4. "I should use a diaphragm."
Answer: 2
Explanation: 2. Retention overdistends the bladder, and can lead to infection.
Page Ref: 84
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I. B. 10. Engage patients and designated surrogates in active
partnerships that promote health, safety and well-being, and self-care management. | AACN
Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in care. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Implementation
Learning Outcome: 5 Contrast cystitis and pyelonephritis.
MNL LO: 6.2.3 Differentiate the causes, risks, and treatment of upper and lower urinary tract
infections.

22
Copyright © 2016 Pearson Education, Inc.


29) The nurse is teaching a group of young women how to prevent urinary tract infections. What

will the nurse include in the teaching?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. The importance of good hygiene
2. How to recognize the signs and symptoms
3. How to take prescribed antibiotics
4. Fluids are restricted to 1000 ml
5. To urinate only when the urge is strong
Answer: 1, 2, 3
Explanation: 1. The nurse should make sure that women are aware of good hygiene practices,
and should provide information on other ways to avoid UTI.
2. Women need to know the signs and symptoms of UTIs to secure prompt treatment.
3. If an infection is present, the woman needs information on how to take antibiotics, and needs
to know to complete all of them.
Page Ref: 86
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being and self-care management. | AACN
Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in care. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Implementation
Learning Outcome: 5 Contrast cystitis and pyelonephritis.
MNL LO: 6.2.3 Differentiate the causes, risks, and treatment of upper and lower urinary tract
infections.

23
Copyright © 2016 Pearson Education, Inc.

30) The nurse is evaluating the outcomes of nursing care for a woman with a urinary tract
infection. Which of the following does the nurse include in the evaluation?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. The client implements self-care measures for prevention.
2. The client completed the prescribed antibiotics.
3. The client knows self-care measures for worsening symptoms.
4. The client states that UTIs are controlled, not cured.
5. The client knows that cranberry juice can help prevent UTIs.
Answer: 1, 2
Explanation: 1. In the evaluation, the nurse should determine whether the client implements selfcare measures to help prevent recurrent UTI as part of her personal routine.
2. Evaluation includes whether the client completed her prescribed course of antibiotic therapy.
Page Ref: 86
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences and expressed needs
as part of clinical interview, implementation of care plan and evaluation of care. | AACN
Essentials Competencies: IX. 3. Implement holistic, patient-centered care that reflects an
understanding of human growth and development, pathophysiology, pharmacology, medical
management, and nursing management across the health-illness continuum, across lifespan, and
in all healthcare settings. | NLN Competencies: Context and Environment: Apply professional
standards; show accountability for nursing judgment and actions; develop advocacy skills; apply
ethical decision making models. | Nursing/Integrated Concept: Nursing Process: Evaluation
Learning Outcome: 5 Contrast cystitis and pyelonephritis.
MNL LO: 6.2.3 Differentiate the causes, risks, and treatment of upper and lower urinary tract
infections.

24

Copyright © 2016 Pearson Education, Inc.


31) A nurse is teaching a middle school health class on the different types of viral hepatitis.
Which statement made by a student indicates the need for further teaching?
1. "Both hepatitis A and E are not chronic infections."
2. "Hepatitis A is characterized by symptoms of jaundice, anorexia, nausea, vomiting, malaise,
and fever."
3. "Hepatitis B, C, and D have symptoms similar to those of hepatitis A, and can also include
arthralgias, arthritis and skin eruptions or rash."
4. "Both hepatitis B and C have an incubation period of 45-160 days."
Answer: 4
Explanation: 4. Hepatitis B has an incubation period of 45-160 days, but hepatitis C has an
incubation period of 14-180 days.
Page Ref: 81
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being, and self-care management. | AACN
Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in care. | NLN Competencies: Relationship-Centered Care: Communicate
information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing
Process: Diagnosis
Learning Outcome: 6 Compare the different types of viral hepatitis.
MNL LO: 6.2.1 Recognize client behaviors associated with the acquisition of sexually
transmitted infections.

25
Copyright © 2016 Pearson Education, Inc.