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1. 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?

• States she will not resume sexual intercourse for 48 hours
• Verbalizes expectations of a vaginal discharge for 3 to 5 days
• Demonstrates the ability to change sterile surgical dressings
• Affirms that because she has children she does not mind being sterile

2. 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?

• Slight drop and then rises
• Sudden rise and then drops
• Marked rise and remains high
• Marked drop and remains lower

3. 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?

• “I can’t get pregnant if I have sex during my period.”
• “The pill may prevent me from getting pregnant, but I can still get an STI.”
• “I won’t get pregnant if I swim in a pool where a boy has just masturbated.”
• “A condom will not always protect me from getting pregnant, but it can protect me from getting an STI.”

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

• Continue daily activities.
• Have a gynecologic examination.
• Eat a nutritious diet containing iron.
• Practice relaxation of abdominal muscles.

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

• 1 to 6 hours.
• 12 to 18hours.
• 24 to 36hours.
• 48 to 72hours.

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

• 1 week after ovulation.
• immediately after menses.
• just before the next menstrual period.
• within 1 to 2 days of presumed ovulation.

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

• Encourage ambulation.
• Elevate the foot of the bed.
• Apply moist compresses to the uterus.
• Support the prolapsed uterus with a sanitary pad.

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

• Sims
• Fowler
• Supine with knees flexed
• Lithotomy with head elevated

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

• “They are often malignant and must be removed.”
• “Cervical polyps usually are precursors of uterine cancer.”
• “They are usually benign and a biopsy rules out a malignancy.”
• “Cervical polyps do not cause bleeding unless they are malignant.”

10. After an abdominal hysterectomy the client returns to the unit with an indwelling catheter. The nurse identifies that the urine in the clients collection bag has become increasingly sanguineous. What complication does a nurse suspect?

• An incisional nick in the bladder
• A urinary infection from the catheter
• Disseminated intravascular coagulopathy
• Uterine relaxation with increased bleeding

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

• A tubal pregnancy
• A rupture of the uterus
• An expulsion of the device
• An excessive menstrual flow

12. A client who had a mastectomy asks about the term ERP- positive. The nurse explains that tumor cells are evaluated for estrogen receptor protein to determine the:

• need for supplemental estrogen.
• feasibility of breast reconstruction.
• degree of metastasis that has occurred.
• potential response to hormone therapy.

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

• Ceftriaxone (Rocephin)
• Levofloxacin (Levaquin)
• Sulfasalazine (Azulfidine)
• Trimethoprim/sulfamethoxazole (Bactrim)

14. 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?

• The lesion is carcinoma in situ.
• There is early stromal invasion.
• There is parametrial involvement.
• The cancer is confined to the cervix.

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

• Perforation of the uterus
• Spontaneous device expulsion
• Discomfort associated with coitus
• Development of vaginal infections

16. 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?

• Current statistics on the incidence of cervical cancer
• Description of the early symptoms of cervical cancer
• Explanation of why there is a small risk for cervical cancer
• Written instructions about the purpose of the Papanicolaou smear

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?

• Report irregular vaginal bleeding.
• Restrict sexual activity temporarily.
• Have regular bimonthly Pap smears.
• Increase the dietary intake of calcium.

18. A nurse is counseling a couple in the fertility clinic. Which aspect of the protocol is the most stressful for the couple?

• Planning when to have intercourse
• Obtaining the necessary specimens
• Visiting the fertility clinic frequently
• Taking daily basal body temperatures

19. 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:

• white vaginal discharge and itching.
• sporadic bleeding and abdominal pain.
• elevated temperature and intractable diarrhea.
• stress incontinence and low abdominal pressure.

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

• Cervicitis
• Ovarian cysts
• Breakthrough bleeding
• Fibrocystic breast disease

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

• Avoid showering for 2 days.
• Tampons may be used after 1 day.
• Sexual intercourse should be delayed for 3 weeks.
• Report bleeding that requires a pad change every 2 hours.

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

• “It covers the entrance to the cervical os.”
• “The openings to the fallopian tubes are blocked.”
• “The sperm are prevented from reaching the vagina.”
• “It produces a spermicidal intrauterine environment.”

23. What is important for a nurse to discuss with a client who just had a vasectomy?

• Recanalization of the vas deferens is impossible.
• Unprotected coitus is safe within 1 week to 10 days.
• Some impotency is to be expected for several weeks.
• There must be 15 ejaculations to clear the tract of sperm.

24. 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:

• tubal injury.
• past infection.
• fibroid tumor.
• congenital anomaly.

25. 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?

• 4 hours after the procedure
• 2 weeks after the procedure
• 4 to 8 days after the procedure
• 8 to 24 hours after the procedure

26. 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?

• “Menstruation will stop after the surgery.”
• “Birth control will be needed until your follow-up visit.”
• “You will be admitted as an outpatient for same-day surgery.”
• “You can have the operation reversed if you decide to have more children.”

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

• Edema
• Fistulas
• Exudate
• Ulcerations

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

• A rejected pregnancy will result in a rejected infant.
• Ambivalence and anxiety about mothering are common.
• A mother’s love usually develops within the first week after birth.
• An effective mother does not experience ambivalence and anxiety about mothering.

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?

• 7th
• 16th
• 24th
• 29th

30. 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?

• “I will go, but it is against my beliefs.”
• “I won’t do it because I do not believe in birth control.”
• “I would prefer another assignment that is not contrary to my beliefs.”
• “I will have to reinforce that the rhythm method is the method of choice.”

31. After a hysterosalpingo-oophorectomy, a client wants to know whether it would be wise for her to take hormones right away to prevent symptoms of menopause. What is the nurse’s most appropriate response?

• “It is best to wait because you may not have any symptoms.”
• “It is comforting to know that hormones are available if you should ever need them.”
• “You have to wait until symptoms are severe; otherwise, hormones will have no effect.”
• “Discuss this with your health care provider, because it is important to know your concerns.”

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

• Supporting them will eliminate feelings of guilt.
• The parents are legally responsible for the decision.
• It is essential for maintenance of the family equilibrium.
• The nurse’s support will relieve the pressure caused by this decision.

33. 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?

• “You may use oral contraceptives because they are almost completely effective in preventing a pregnancy.”
• “You should use foam with a condom to prevent preg­ nancy because this is the safest method for women with your illnesses.”
• “You will find that the intrauterine device is best for you because it prevents a fertilized ovum from implant­ ing in the uterus.”
• “You do not need to worry about becoming pregnant in the near future because women with your illnesses usually become infertile.”

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

• Eating a high-fiber diet
• Limiting daily activities
• Reporting signs of urinary retention
• Observing for signs of a rectovaginal fistula

35. 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?

• Estrogen (Premarin)
• Leuprolide (Lupron)
• Diclofenac (Voltaren)
• Ergonovine (Ergotrate)

36. The result of an amniocentesis performed at 16 weeks’ gesta­ tion 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?

• The client is exhibiting emotional instability.
• There is a high risk for a postoperative infection.
• Contraceptive counseling should be deferred to a later time.
• An opportunity to express feelings about her decision should be provided.

37. 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?

• Midway between periods
• Immediately after menses end
• 14 days before the next period is expected
• 14 days after the beginning of the last period

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

• “You should be tested because it will be to your benefit.”
• “Environmental factors can have an impact on genetic factors.”
• “This type of testing will determine if you’ll need in vitro fertilization.”
• “If you have a gene for a disease there is a probability that your children will inherit it.”

39. A woman arrives at the prenatal clinic stating that her preg­ nancy 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 abor­ tion is controversial and that many women have long-term guilt feelings after an abortion. Legally, the:

• nurse’s statements need not be based on current clinical research.
• client has a right to receive correct, unbiased information.
• nurse has a right to state feelings as long as they are identified as the nurse’s own.
• health care provider should be notified because this is beyond the scope of nursing practice.

40. 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?

• Biopsy
• Cystogram
• Culdoscopy
• Hysterosalpingogram

41. 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?”?

• “There is no other way to control the pain.”
• “Irreversible damage occurs after a few hours.”
• “Swelling is excessive, which may cause the testicle to rupture.”
• “There is a reduction in testicular blood flow, which leads to rapid death of sperm.”

42. 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?

• Acute pain
• Risk for hemorrhage
• Fear of chronic illness
• Loss of childbearing potential

43. 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)?

• “Were you born before 1971?”
• “Have you ever taken oral contraceptives?”
• “Have you noticed any lesions in your perineal area?”
• “Did your mother take hormones during her pregnancy?”

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?

• Abdominal heaviness
• Pressure on the bladder
• Foul-smelling discharge
• Bloody spotting after intercourse

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

• “You will not have any more periods.”
• “Your periods will become more regular.”
• “Your periods will become lighter until they disappear.”
• “You will notice that the time between periods will be longer.”

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

• cancer of the cervix.
• pelvic inflammatory disease.
• unexpected vaginal bleeding.
• more erosions from occurring.

47. 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?

• “You are correct, but there are medicines you can take that will ease the symptoms.”
• “This sometimes occurs in women of your age, but you needn’t worry about it at this time.”
• “Perhaps you should talk to your surgeon because I am not allowed to discuss this with you.”
• “Some women may experience symptoms of menopause if their ovaries are removed with their uterus.”

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

• Presence of stress
• Length of abstinence
• Age of those involved
• Frequency of intercourse

49. A nurse is caring for a client who just had a mastectomy. How should the nurse position the client’s arm on the affected side?

• In adduction supported by sandbags
• In abduction surrounded by sandbags
• On pillows with the hand higher than the arm
• With the arm lower than the level of the heart

50. 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?

• Dispose of body fluids in special marked containers.
• Cohort two clients who have implanted radiation therapy.
• Exit the room walking backward while wearing a lead apron.
• Limit visitors to individuals who are 13 years of age and older.