1. A woman arrives at the prenatal clinic stating that her pregnancy test is positive.

She asks the nurse

for information about an abortion. After verifying that the woman is at 8 weeks’ gestation, the nurse
counsels her that having an abortion is controversial and that many women have long-term guilt feelings
after an abortion. Legally, the:

1. nurse’s statements need not be based on current clinical research.

2. client has a right to receive correct, unbiased information.

3. nurse has a right to state feelings as long as they are identified as the nurse’s own.

4. health care provider should be notified because this is beyond the scope of nursing practice.

2. One day the family planning clinic is very busy, and the supervisor asks a nurse from the pediatric
clinic who is strongly opposed to any chemical or mechanical method of birth control to work in the
family planning clinic. What is the most professional response that this nurse could give to the
supervisor?

1. “I will go, but it is against my beliefs.”

2. “I won’t do it because I do not believe in birth control.”

3. “I would prefer another assignment that is not contrary to my beliefs.”

4. “I will have to reinforce that the rhythm method is the method of choice.”

3. The result of an amniocentesis performed at 16 weeks’ gestation reveals a fetus with Down
syndrome. The client elects to have the pregnancy terminated. What should the nurse conclude about
an abortion at this stage of the pregnancy?

1. The client is exhibiting emotional instability.

2. There is a high risk for a postoperative infection.

3. Contraceptive counseling should be deferred to a later time.

4. An opportunity to express feelings about her decision should be provided.

4. Which research-based knowledge guides a nurse regarding the emotional factors of pregnancy?

1. A rejected pregnancy will result in a rejected infant.

2. Ambivalence and anxiety about mothering are common.

3. A mother’s love usually develops within the first week after birth.
4. An effective mother does not experience ambivalence and anxiety about mothering.

5. Why is it important for a nurse to support the parents’ decision to abort a fetus with a birth defect
even if the nurse is morally against abortion?

1. Supporting them will eliminate feelings of guilt.

2. The parents are legally responsible for the decision.

3. It is essential for maintenance of the family equilibrium.

4. The nurse’s support will relieve the pressure caused by this decision.

6. During the postpartum period a client with heart disease and type 2 diabetes asks a nurse, “Which
contraceptives will I be able to use to prevent pregnancy in the near future?” How should the nurse
respond?

1. “You may use oral contraceptives because they are almost completely effective in preventing a
pregnancy.”

2. “You should use foam with a condom to prevent pregnancy because this is the safest method for
women with your illnesses.”

3. “You will find that the intrauterine device is best for you because it prevents a fertilized ovum from
implanting in the uterus.”

4. “You do not need to worry about becoming pregnant in the near future because women with your
illnesses usually become infertile.”

7. A nurse is teaching a group of women about the side effects of different types of
contraceptives .What is the most frequent side effect associated with the use of an intrauterine device
(IUD)?

1. A tubal pregnancy

2. A rupture of the uterus

3. An expulsion of the device

4. An excessive menstrual flow

8. A client asks a nurse about the most common problem associated with the use of an intrauterine
device (IUD). What should the nurse respond?

1. Perforation of the uterus

2. Spontaneous device expulsion

3. Discomfort associated with coitus

4. Development of vaginal infections

9. A client seeking advice about contraception asks a nurse about how an intrauterine device (IUD)
prevents pregnancy. How should the nurse respond?

1. “It covers the entrance to the cervical os.”

2. “The openings to the fallopian tubes are blocked.”

3. “The sperm are prevented from reaching the vagina.”

4. “It produces a spermicidal intrauterine environment.”

10. A nurse teaches women in the fertility clinic that after ovulation has occurred, the ovum is thought
to remain viable for:

1. 1 to 6 hours.

2. 12 to 18 hours.

3. 24 to 36 hours.

4. 48 to 72 hours.

11. A nurse is teaching clients to determine the time of ovulation by taking the basal temperature. What
change is expected to occur in the basal temperature during ovulation?

1. Slight drop and then rises

2. Sudden rise and then drops

3. Marked rise and remains high

4. Marked drop and remains lower

12. Oral contraceptives are prescribed for a client. What side effect should the nurse inform the client
might occur?

1. Cervicitis

2. Ovarian cysts

3. Breakthrough bleeding

4. Fibrocystic breast disease

13. What is important for a nurse to discuss with a client who just had a vasectomy?
1. Recanalization of the vas deferens is impossible.

2. Unprotected coitus is safe within 1 week to 10 days.

3. Some impotency is to be expected for several weeks.

4. There must be 15 ejaculations to clear the tract of sperm.

14. The school nurse is discussing issues concerning premarital sex with a group of adolescents taking a
health education course. The students are asked to write an essay on what they have learned about
preventing pregnancy. Which comment alerts the nurse to have a private discussion with the student?

1. “I can’t get pregnant if I have sex during my period.”

2. “The pill may prevent me from getting pregnant, but I can still get an STI.”

3. “I won’t get pregnant if I swim in a pool where a boy has just masturbated.”

4. “A condom will not always protect me from getting pregnant, but it can protect me from getting an
STI.”

15. Contraceptives that have estrogen-like and/or progesterone-like compounds are prepared in a
variety of forms. Which contraceptives should a nurse identify as having a hormonal component? Select
all that apply.

1. Oral agents

2. Diaphragms

3. Cervical caps

4. Female condoms

5. Foam spermicides

6. Transdermal agents

16. A nurse explains that the efficiency of the basal body temperature method of contraception depends
on fluctuation of the basal body temperature. What factor will alter its effectiveness?

1. Presence of stress

2. Length of abstinence

3. Age of those involved

4. Frequency of intercourse
17. A biphasic antiovulatory medication of combined progestin and estrogen is prescribed for a female
client. What should a nurse include when teaching about this oral contraceptive?

1. Report irregular vaginal bleeding.

2. Restrict sexual activity temporarily.

3. Have regular bimonthly Pap smears.

4. Increase the dietary intake of calcium.

18. A nurse is giving discharge instructions to a client who had an aspiration abortion by suction
curettage. What should the client be told?

1. Avoid showering for 2 days.

2. Tampons may be used after 1 day.

3. Sexual intercourse should be delayed for 3 weeks.

4. Report bleeding that requires a pad change every 2 hours.

19. A client at 10 weeks’ gestation elects to have an induced abortion. After receiving oral mifepristone
(Mifeprex), she returns to the clinic 2 days later to have misoprostol (Cytotec) inserted vaginally. For
when should the nurse schedule a follow-up visit?

1. 4 hours after the procedure

2. 2 weeks after the procedure

3. 4 to 8 days after the procedure

4. 8 to 24 hours after the procedure

20. A couple indicate that they do not want any more children. The woman is scheduled for a
laparoscopic bilateral tubal ligation. What should the nurse include in preoperative teaching?

1. “Menstruation will stop after the surgery.”

2. “Birth control will be needed until your follow-up visit.”

3. “You will be admitted as an outpatient for same-day surgery.”

4. “You can have the operation reversed if you decide to have more children.”

21. One of the responsibilities of a nurse in a fertility specialist’s office is to provide health teaching to
the client in relation to timing of intercourse. Which instruction addresses the best time to achieve a
pregnancy?
1. Midway between periods

2. Immediately after menses end

3. 14 days before the next period is expected

4. 14 days after the beginning of the last period

22. A nurse teaches a client that a postcoital test to evaluate fertility should be performed:

1. 1 week after ovulation.

2. immediately after menses.

3. just before the next menstrual period.

4. within 1 to 2 days of presumed ovulation.

23. A histogram (hysterosalpingography [HSG]) is performed to determine whether there is a tubal

obstruction. The nurse concludes that infertility caused by a defect in the tube is most often related to a:

1. tubal injury.

2. past infection.

3. fibroid tumor.

4. congenital anomaly.

24. A nurse is counseling a couple in the fertility clinic. Which aspect of the protocol is the most stressful
for the couple? 1. Planning when to have intercourse

2. Obtaining the necessary specimens

3. Visiting the fertility clinic frequently

4. Taking daily basal body temperatures

25. Genetic testing is being discussed with a couple at the fertility clinic. What is the nurse’s best
response when they express concerns?

1. “You should be tested because it will be to your benefit.”

2. “Environmental factors can have an impact on genetic factors.”

3. “This type of testing will determine if you’ll need in vitro fertilization.”

4. “If you have a gene for a disease there is a probability that your children will inherit it.”
26. A client is admitted with a diagnosis of torsion of the testes. How should the nurse respond when
the client asks, “Why must I have surgery immediately?”?

1. “There is no other way to control the pain.”

2. “Irreversible damage occurs after a few hours.”

3. “Swelling is excessive, which may cause the testicle to rupture.”

4. “There is a reduction in testicular blood flow, which leads to rapid death of sperm.”

27. A nurse at the fertility clinic is counseling a couple about the tests that will be needed to determine
the cause of their infertility. Which test should the nurse describe that will evaluate the woman’s organs
of reproduction?

1. Biopsy

2. Cystogram

3. Culdoscopy

4. Hysterosalpingogram

28. While preparing a client for her first routine Papanicolaou (Pap) smear, a nurse determines that she
appears anxious. What should the nurse include as part of the teaching plan?

1. Current statistics on the incidence of cervical cancer

2. Description of the early symptoms of cervical cancer

3. Explanation of why there is a small risk for cervical cancer

4. Written instructions about the purpose of the Papanicolaou smear

29. A client who menstruates regularly every 30 days asks a nurse on what day she is most likely to
ovulate. Her last menses started on January 1st. On what day in January should the nurse respond?

1. 7th

2. 16th

3. 24th

4. 29th

Nursing Care Related to Major Disorders Affecting Women’s Health

30. A client who has a diagnosis of endometriosis is concerned about the side effect of hot flashes from
her prescribed medication. She tells the nurse that her mother found them very uncomfortable during
her menopause. Which medication causes this side effect?

1. Estrogen (Premarin)

2. Leuprolide (Lupron)

3. Diclofenac (Voltaren)

4. Ergonovine (Ergotrate)

31. At 6 weeks’ gestation a client is diagnosed with gonorrhea. What medication does a nurse expect the
health care provider to prescribe?

1. Ceftriaxone (Rocephin)

2. Levofloxacin (Levaquin)

3. Sulfasalazine (Azulfidine)

4. Trimethoprim/sulfamethoxazole (Bactrim)

32. A 15-year-old adolescent tells a school nurse, “I have persistent pain during my periods.” What
should the nurse encourage her to do?

1. Continue daily activities.

2. Have a gynecologic examination.

3. Eat a nutritious diet containing iron.

4. Practice relaxation of abdominal muscles.

33. A client at the women’s health clinic tells the nurse she has endometriosis. What factors associated
with endometriosis does the nurse anticipate the client will report? Select all that apply.

1. Insomnia

2. Ecchymoses

3. Rectal pressure

4. Abdominal pain

5. Skipped periods

6. Pelvic infections
34. What does a nurse expect to be the priority concern of a 28-year-old woman who is to undergo a
laparoscopic bilateral salpingo-oophorectomy?

1. Acute pain

2. Risk for hemorrhage

3. Fear of chronic illness

4. Loss of childbearing potential

35. A nurse is assessing a client who is being admitted for surgical repair of a rectocele. What signs or
symptoms does the nurse expect the client to report? Select all that apply.

1. Painful intercourse

2. Crampy abdominal pain

3. Bearing-down sensations

4. Urinary stress incontinence

5. Recurrent urinary tract infections

36. When taking the health history of a client who is admitted for repair of a cystocele and rectocele, the
nurse should expect the client to report the occurrence of:

1. white vaginal discharge and itching.

2. sporadic bleeding and abdominal pain.

3. elevated temperature and intractable diarrhea.

4. stress incontinence and low abdominal pressure.

37. A client has an anterior and posterior surgical repair of a cystocele and rectocele and returns from
the postanesthesia care unit (PACU) with an indwelling catheter in place. What should the nurse tell the
client about the primary reasons for the catheter? Select all that apply.

1. Discomfort is minimized.

2. Bladder tone is maintained.

3. Urinary retention is prevented.

4. Pressure on the suture line is relieved.

5. Hourly urine outputs can be easily measured

38. A client past menopause undergoes an anterior-posterior colporrhaphy. What should the discharge
teaching include?

1. Eating a high-fiber diet

2. Limiting daily activities

3. Reporting signs of urinary retention

4. Observing for signs of a rectovaginal fistula

39. What potential complication does a nurse anticipate when admitting a client with the diagnosis of
severe procidentia (prolapse of the uterus)?

1. Edema

2. Fistulas

3. Exudate

4. Ulcerations

40. A client with a third-degree uterine prolapse is scheduled for a vaginoplasty. What should the nurse
anticipate the surgeon will order?

1. Encourage ambulation.

2. Elevate the foot of the bed.

3. Apply moist compresses to the uterus.

4. Support the prolapsed uterus with a sanitary pad.

41. What resting position should a nurse encourage for a client with pelvic inflammatory disease (PID)?

1. Sims

2. Fowler

3. Supine with knees flexed

4. Lithotomy with head elevated

42. A nurse explains to a client with cervical erosion that early treatment of the erosion can help
prevent:

1. cancer of the cervix.

2. pelvic inflammatory disease.

3. unexpected vaginal bleeding.

4. more erosions from occurring.

43. A client asks a nurse why she developed cervical polyps. How should the nurse respond?

1. “They are often malignant and must be removed.”

2. “Cervical polyps usually are precursors of uterine cancer.”

3. “They are usually benign and a biopsy rules out a malignancy.”

4. “Cervical polyps do not cause bleeding unless they are malignant.”

44. A nurse in the women’s health clinic is counseling clients about the signs of gynecological problems.
What early manifestation of cervical cancer should prompt a client to seek professional care?

1. Abdominal heaviness

2. Pressure on the bladder

3. Foul-smelling discharge

4. Bloody spotting after intercourse

45. After a client has a biopsy for suspected cervical cancer, the laboratory report reveals a stage 0
lesion. What does a nurse conclude about this client’s stage of cancer?

1. The lesion is carcinoma in situ.

2. There is early stromal invasion.

3. There is parametrial involvement.

4. The cancer is confined to the cervix.

46. A nurse in the women’s health clinic is obtaining a client’s health history. What question will elicit
information about the client’s risk for exposure to diethylstilbestrol (DES)?

1. “Were you born before 1971?”

2. “Have you ever taken oral contraceptives?”

3. “Have you noticed any lesions in your perineal area?”

4. “Did your mother take hormones during her pregnancy?”

47. A 35-year-old client is scheduled for a conization of the cervix to remove dysplastic cervical cells and
to determine the extent of involvement. What behavior indicates to a nurse that the client understands
the postoperative instructions?

1. States she will not resume sexual intercourse for 48 hours

2. Verbalizes expectations of a vaginal discharge for 3 to 5 days

3. Demonstrates the ability to change sterile surgical dressings

4. Affirms that because she has children she does not mind being sterile

48. A client with cancer of the cervix has an intracavity radioactive sealed implant in place. What
precaution should the nurse take to protect against excessive exposure to radiation?

1. Dispose of body fluids in special marked containers.

2. Cohort two clients who have implanted radiation therapy.

3. Exit the room walking backward while wearing a lead apron.

4. Limit visitors to individuals who are 13 years of age and older.

49. A client who is scheduled to have an abdominal panhysterectomy asks how the surgery will affect
her periods. How should the nurse respond?

1. “You will not have any more periods.”

2. “Your periods will become more regular.”

3. “Your periods will become lighter until they disappear.”

4. “You will notice that the time between periods will be longer.”

50. A client is diagnosed with uterine fibroids, and the health care provider advises a hysterectomy. The
client expresses concern about having a hysterectomy at age 45 because she has heard from friends that
she will undergo severe symptoms of menopause after surgery. What is the nurse’s most appropriate
response?

1. “You are correct, but there are medicines you can take that will ease the symptoms.”

2. “This sometimes occurs in women of your age, but you needn’t worry about it at this time.”

3. “Perhaps you should talk to your surgeon because I am not allowed to discuss this with you.”

4. “Some women may experience symptoms of menopause if their ovaries are removed with their
uterus.”