Old's Maternal-Newborn Nursing and Women's Health, 11e (Davidson/London/Ladewig)

Chapter 3 Health Promotion

1. The clinic nurse is returning phone calls. Which call should the nurse return first?
2. The call from a 22-year-old reporting that she has menstrual cramps and vomiting every month
3. The call from a 17-year-old asking whether there is a problem with using one tampon for a whole day
4. The call from a 46-year-old mother of a teen wondering if her daughter should be on birth control
5. The call from a 34-year-old requesting information on douching after intercourse

Page Ref: 37

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Quality and Safety: Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care. | Nursing/Integrated Concepts Nursing Process: Implementation.

Learning Outcome: 2 Summarize information that women may need in order to implement appropriate self-care measures for dealing with menstruation.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. The nurse who is taking a sexual history from a client should do which of the following?
2. Ask questions that the client can answer with "yes" or "no."
3. Ask mostly open-ended questions.
4. Have the client fill out a comprehensive questionnaire and review it after the client leaves.
5. Try not to make much direct eye contact.

Page Ref: 36

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 1 Discuss the key points a nurse should consider when taking a sexual history.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A client asks her nurse, "Is it okay for me to take a tub bath during the heavy part of my menstruation?" What is the nurse's correct response?
2. "Tub baths are contraindicated during menstruation."
3. "You should shower and douche daily instead."
4. "Either a bath or a shower is fine at that time."
5. "You should bathe and use a feminine deodorant spray during menstruation."

Page Ref: 38

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅶ. 6. Use information and communication technologies in preventive care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 2 Summarize information that women may need in order to implement appropriate self-care measures for dealing with menstruation.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. Which client would the nurse document as exhibiting signs and symptoms of primary dysmenorrhea?
2. 17-year-old, has never had a menstrual cycle
3. 16-year-old, had regular menses for 4 years, but has had no menses in 4 months
4. 19-year-old, regular menses for 5 years that have suddenly become painful
5. 14-year-old, irregular menses for 1 year, experiences cramping every cycle

Page Ref: 39

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Diagnosis.

Learning Outcome: 4 Contrast the signs, symptoms, and nursing management of women with dysmenorrhea and those with premenstrual syndrome.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. The nurse is interviewing an adolescent client. The client reports a weight loss of 50 pounds over the last 4 months, and reports running at least 5 miles per day. The client asserts that her menarche was 5 years ago. Her menses are usually every 28 days, but her last menstrual period was 4 months ago. The client denies any sexual activity. Which is the best statement for the nurse to make?
2. "Your lack of menses might be related to your rapid weight loss."
3. "It is common and normal for runners to stop having any menses."
4. "Increase your intake of iron-rich foods to reestablish menses."
5. "Adolescents rarely have regular menses, even if they used to be regular."

Page Ref: 38

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 3 Identify causes of amenorrhea.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. 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 (I U D) for 2 years. What is the most likely cause for the client's complaint?
2. Primary dysmenorrhea
3. Secondary dysmenorrhea
4. Menorrhagia
5. Hypermenorrhea

Page Ref: 39

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Diagnosis.

Learning Outcome: 4 Contrast the signs, symptoms, and nursing management of women with dysmenorrhea and those with premenstrual syndrome.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. The nurse is teaching a group of women about menopause at a community clinic. The nurse tells them that the best indicator of menopause is which of the following symptoms?
2. No menses for 8 consecutive months
3. Hot flashes and night sweats
4. F S H levels rise and ovarian follicles cease to produce estrogen
5. Diagnosed with osteoporosis 4 months ago

Page Ref: 43

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 5 Delineate the physical and psychologic aspects of menopause.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. 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 which of the following?
2. Petroleum jelly
3. A water-soluble lubricant
4. Body cream or body lotion
5. Less-frequent intercourse

Page Ref: 49

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 5 Delineate the physical and psychologic aspects of menopause.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A 49-year-old client comes to the clinic with complaints of severe perimenopausal symptoms including hot flashes, night sweats, urinary urgency, and vaginal dryness. The physician has prescribed a combination hormone replacement therapy of estrogen and progestin. When the client asks the nurse why she must take both hormones, what is the nurse's best reply?
2. "Hot flashes respond better when replacement includes both hormones."
3. "You are having very severe symptoms, so you need more hormones replaced."
4. "There is an increased risk of tissue abnormality inside the uterus if only one is given."
5. "Your blood pressure can become elevated if only one hormone is used."

Page Ref: 46—47

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 4 Contrast the signs, symptoms, and nursing management of women with dysmenorrhea and those with premenstrual syndrome.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A female patient with amenorrhea is suspected to have pituitary dysfunction. For which health problems should the nurse explain that the patient will most likely be evaluated?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Cancer
2. Adenoma
3. Head trauma
4. Turner syndrome
5. Polycystic ovarian syndrome

Page Ref: 38

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N Essentials Competencies: Ⅸ. 4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network. | N L N Competencies: Context and Environment; Knowledge; chronic disease management. | Nursing/Integrated Concepts: Planning; Nursing Process.

Learning Outcome: 3 Identify causes of amenorrhea.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A patient in her late 40s asks the nurse what she should expect when entering menopause. In which order should the nurse identify changes that the patient will experience during menopause?
2. Amenorrhea
3. Anovulation
4. Reduced fertility
5. Changes in menstrual flow
6. Menstrual cycle irregularities

Page Ref: 44—45

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N Essentials Competencies: Ⅸ. 4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation; Teaching/Learning.

Learning Outcome: 5 Delineate the physical and psychologic aspects of menopause.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A female patient experiencing menopause is concerned that periodic lapses of memory are symptoms of Alzheimer disease. What should the nurse review with the patient to reduce the risk of developing Alzheimer disease (A D)?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Increase rest
2. Stop smoking
3. Exercise regularly
4. Eat a healthy diet
5. Maintain mental activity

Page Ref: 46

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N Essentials Competencies: Ⅸ. 4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation; Nursing Process.

Learning Outcome: 5 Delineate the physical and psychologic aspects of menopause.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A patient experiencing menopause asks what complementary and alternative therapy can be taken to reduce the symptoms. After reviewing the patient's health history, for which problems should the nurse encourage the patient to avoid taking phytoestrogens?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Allergy to soy
2. Currently taking tamoxifen
3. Treated for breast cancer 5 years ago
4. Surgery for uterine fibroids in her 20s
5. Experiences insomnia several times a week

Page Ref: 47

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N Essentials Competencies: Ⅸ. 17. Develop a beginning understanding of complementary and alternative modalities and their role in health care. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation; Nursing Process.

Learning Outcome: 7 Identify medical and complementary therapies to alleviate the discomforts of menopause.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. The nurse is preparing an educational seminar for a group of middle-aged healthy women on health screening recommendations. What information should the nurse include during this educational session?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Get a Pap test every 3 years
2. Schedule mammograms every 5 years
3. Get testing for H I V before the age of 60
4. Have a screening for colorectal cancer
5. Have blood pressure measured every year if 140/90

Page Ref: 42

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation; Teaching/Learning.

Learning Outcome: 4 Contrast the signs, symptoms, and nursing management of women with dysmenorrhea and those with premenstrual syndrome.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. The nurse is preparing to assess the sexual history of a 35-year-old female patient. Which approach should the nurse first use to facilitate this data collection?
2. Ask if the patient is sexually active
3. Review the present method of birth control
4. Determine the patient's number of children
5. Talk about the patient's medical-surgical history

Page Ref: 35—36

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation.

Learning Outcome: 1 Discuss the key points a nurse should consider when taking a sexual history.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A 40-year-old patient is being seen in the clinic for gynecological changes. Which approaches should the nurse use when completing this patient's health interview?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Avoid writing
2. Clarify terms used
3. Maintain eye contact
4. Analyze body language
5. Use simple yes-no questions

Page Ref: 35—36

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation.

Learning Outcome: 1 Discuss the key points a nurse should consider when taking a sexual history.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. When analyzing data collected during a sexual history, the nurse notes that a patient has limited information about contraception. What should the nurse do to address this patient's need?
2. Provide the patient with the information
3. Suggest that the patient talk with the nurse practitioner
4. Schedule an appointment for the patient to see the midwife
5. Discuss the implications if contraception is not used correctly

Page Ref: 35—36

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation.

Learning Outcome: 1 Discuss the key points a nurse should consider when taking a sexual history.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. During a health interview focused on sexual history, a female patient makes a statement about douching and intercourse. What should the nurse do in response to this statement?
2. Recommend the frequency of douching
3. Explain the proper procedure to douche
4. Take the time now to educate the patient about the practice
5. Document that the patient has misunderstandings about the use of douches

Page Ref: 37

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation.

Learning Outcome: 1 Discuss the key points a nurse should consider when taking a sexual history.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. The nurse is preparing an educational session for high school female students on self-care during menstruation. What should the nurse include regarding care when using a tampon?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Wash hands before inserting a tampon
2. Wash hands after inserting the tampon
3. Change the tampon every 8 to 12 hours
4. Use tampons with the minimum amount of absorbency
5. Avoid touching the part that will be inserted into the vagina

Page Ref: 37—38

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Quality and Safety: Practice; Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care. | Nursing/Integrated Concepts: Teaching/Learning.

Learning Outcome: 2 Summarize information that women may need in order to implement appropriate self-care measures for dealing with menstruation.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A female patient schedules an appointment for a gynecologic examination. Which finding should indicate to the nurse that the patient is experiencing a vaginal infection?
2. Foul odor from used tampons
3. Scant menstrual flow at the end of the cycle
4. Abdominal bloating a few days prior to menstruation
5. Saturating a tampon every 2 hours during menstruation

Page Ref: 38

Cognitive Level: Analyzing

Client Need/Sub: Physiological Integrity: Reduction of Risk Potential

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 2 Summarize information that women may need in order to implement appropriate self-care measures for dealing with menstruation.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A female patient asks what can be done to control vaginal odor. How should the nurse respond?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Wear cotton underwear
2. Use a mild vaginal deodorant
3. Schedule douching to occur weekly
4. Cleanse from front to back when toileting
5. Use soap and water to cleanse the perineum

Page Ref: 38

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Quality and Safety: Practice; Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care. | Nursing/Integrated Concepts: Teaching/Learning.

Learning Outcome: 2 Summarize information that women may need in order to implement appropriate self-care measures for dealing with menstruation.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. The nurse suspects that a female patient is experiencing amenorrhea because of ovarian failure. For which situation should the nurse assess this patient?
2. Severe stress
3. Recent head trauma
4. Treatment for cancer
5. Antianxiety medication

Page Ref: 38

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Reduction of Risk Potential

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N Essentials Competencies: Ⅸ. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 3 Identify causes of amenorrhea.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A patient with amenorrhea has an elevated serum prolactin level. Which diagnostic test should the nurse expect will be prescribed for this patient?
2. Laparoscopy
3. Abdominal ultrasound
4. C T scan of the abdomen
5. Magnetic resonance imaging (M R I)

Page Ref: 38

Cognitive Level: Analyzing

Client Need/Sub: Physiological Integrity: Reduction of Risk Potential

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N Essentials Competencies: Ⅸ. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 3 Identify causes of amenorrhea.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A 38-year-old patient is concerned that a month after becoming a widow, her menstrual cycles stopped. What should the nurse suspect as being the cause for this patient's secondary amenorrhea?
2. Ovarian failure
3. Pituitary dysfunction
4. Severe or prolonged stress such as that which occurs with an unexpected death can lead to hypothalamic dysfunction. Ovarian failure is related to exposure to radiation, chemotherapy, viral infection, and surgical removal of the ovary. Pituitary dysfunction is related to pituitary tumors or disease, use of antipsychotic medication, low prolactin levels, head trauma, and cancer. With an anatomic abnormality the patient would not have had a menstrual cycle.
5. Hypothalamic dysfunction

Page Ref: 38

Cognitive Level: Analyzing

Client Need/Sub: Physiological Integrity: Reduction of Risk Potential

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N Essentials Competencies: Ⅸ. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 3 Identify causes of amenorrhea.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A 17-year-old high school student comes into the nurse's office to find out what to do about severe menstrual cramps. What should the nurse recommend to this student?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Rest
2. Good nutrition
3. Regular exercise
4. Application of heat
5. D & C of the uterus

Page Ref: 39

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation; Teaching/Learning.

Learning Outcome: 4 Contrast the signs, symptoms, and nursing management of women with dysmenorrhea and those with premenstrual syndrome.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A 30-year-old patient who experiences severe premenstrual syndrome every month asks for nonpharmacologic suggestions to treat this disorder. What should the nurse recommend?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Eat more frequent meals
2. Engage in aerobic activity
3. Limit alcohol to two drinks per day
4. Restrict the intake of chocolate and coffee
5. Increase the intake of fruits and vegetables

Page Ref: 39—40

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation; Teaching/Learning.

Learning Outcome: 4 Contrast the signs, symptoms, and nursing management of women with dysmenorrhea and those with premenstrual syndrome.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. During an assessment, the nurse determines that a female patient is at risk for developing osteoporosis. Which information did the nurse use to make this clinical determination?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Body weight of 120 lb
2. Plays tennis twice a week
3. Smokes 2 packs per day of cigarettes
4. Ingests 2 to 3 cocktails every day
5. Mother diagnosed with osteoporosis

Page Ref: 45

Cognitive Level: Analyzing

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N Essentials Competencies: Ⅶ. 2. Conduct a health history, including environmental exposure and a family history that recognizes genetic risks, to identify current and future health problems. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 6 Explain the relationship between menopause and osteoporosis.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. The nurse is preparing a program about osteoporosis for a group of community members. What should the nurse emphasize as being the greatest risk factor for the development of this disorder?
2. Family history
3. Caucasian race
4. Sedentary lifestyle
5. Low lifetime intake of calcium

Page Ref: 45

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Planning; Teaching/Learning.

Learning Outcome: 6 Explain the relationship between menopause and osteoporosis.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A premenopausal female received a recommendation by her healthcare provider to have a bone mineral density (B M D) test done. What should the nurse identify as being the reason for the test at this time in the patient's life?
2. History of an eating disorder
3. Takes N S A I Ds for osteoarthritis
4. Lives with a spouse who smokes cigarettes
5. Surgery for carpal tunnel syndrome last year

Page Ref: 47—48

Cognitive Level: Analyzing

Client Need/Sub: Physiological Integrity: Reduction of Risk Potential

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 6 Explain the relationship between menopause and osteoporosis.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A patient who is postmenopausal is encouraged to take calcium 1500 mg every day. How should the nurse instruct the patient to take this supplement?
2. Take calcium 750 m g with breakfast and dinner
3. Take the complete dose first thing in the morning
4. Take the complete dose prior to bedtime every day
5. Take calcium 500 m g three times a day with meals

Page Ref: 48

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation/Teaching/Learning.

Learning Outcome: 6 Explain the relationship between menopause and osteoporosis.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A patient with osteoporosis wants a medication that does not need to be taken every day. What should the nurse expect to be prescribed for this patient?
2. Teriparatide (Forteo)
3. Alendronate (Fosamax)
4. Zoledronic acid (Zometa®)
5. Salmon calcitonin (Miacalcin®)

Page Ref: 48

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. A A C N 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. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Planning.

Learning Outcome: 6 Explain the relationship between menopause and osteoporosis.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. The nurse is identifying complementary and alternative therapies for a patient with a history of liver disorders who is experiencing symptoms of menopause. Which herbal supplement should this patient be counseled to avoid?
2. Ginger
3. Ginseng
4. Red clover
5. Black cohosh

Page Ref: 49

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation; Teaching/Learning.

Learning Outcome: 7 Identify medical and complementary therapies to alleviate the discomforts of menopause.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A premenopausal patient is experiencing vaginal dryness. What pharmacological intervention should the nurse suggest for this patient's symptom?
2. Local low-dose vaginal estrogen
3. Testosterone replacement therapy
4. Menopausal hormone therapy with testosterone
5. Menopausal hormone therapy with estrogen alone

Page Ref: 47

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation; Teaching/Learning.

Learning Outcome: 7 Identify medical and complementary therapies to alleviate the discomforts of menopause.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. A patient experiencing symptoms of menopause asks if there are any vitamin supplements she should take at this time. Which vitamins should the nurse suggest to this patient?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Vitamin A
2. Vitamin C
3. Vitamin D
4. Vitamin E
5. Vitamin B complex

Page Ref: 48

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation; Teaching/Learning.

Learning Outcome: 7 Identify medical and complementary therapies to alleviate the discomforts of menopause.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.

1. During a wellness visit, a 50-year-old female experiencing menopause says that she jogs three times a week and feels like her symptoms are becoming worse. What should the nurse recommend to help with the discomfort of menopause?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Yoga
2. Tai chi
3. Meditation
4. Weight lifting
5. Kegel exercises

Page Ref: 47

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation; Teaching/Learning.

Learning Outcome: 7 Identify medical and complementary therapies to alleviate the discomforts of menopause.

M N L L O: Demonstrate ability to incorporate health promotion activities for women.