1 Women’s Health Care in Advanced Practice Nursing 2 nd Edition Testbank 2 Chapter 1 Women and Their Health 1. The United States ranks 50 th in the world for maternal mortality and 41 st among industrialized nations for infant mortality rate. When developing programs to assist in decreasing these rates, which factor would most likely need to be addressed as having the greatest impact? A) Resolving all language and cultural differences B) Assuring early and adequate prenatal care C) Providing more extensive womens shelters D)Encouraging all women to eat a balanced diet 2. When integrating the principles of family-centered care, the nurse would include which of the following? A) Childbirth is viewed as a procedural event B) Families are unable to make informed choices C) Childbirth results in changes in relationships D)Families require little information to make appropriate decisions 3. When preparing a teaching plan for a group of first-time pregnant women, the nurse expects to review how maternity care has changed over the years. Which of the following would the nurse include when discussing events of the 20 th century? A) Epidemics of puerperal fever B) Performance of the first cesarean birth C) Development of the x-ray to assess pelvic size D)Creation of free-standing birth centers 4. After teaching a group of students about pregnancy-related mortality, the instructor determines that additional teaching is needed when the students identify which condition as a leading cause? A) Hemorrhage B) Embolism C) Obstructed labor D)Infection 5. The nurse is working with a group of community health members to develop a plan to address the special health needs of women. Which of the following conditions would the group address as the major problem? A) Smoking B) Heart disease C) Diabetes D)Cancer 6. When assessing a family for possible barriers to health care, the nurse would consider which factor to be most important? A) Language B) Health care workers attitudes C) Transportation D)Finances 7. After teaching a group of nursing students about the issue of informed consent. Which of the following, if 3 identified by the student, would indicate an understanding of a violation of informed consent? A) P erforming a procedure on a 15 - year - old without consent B) Serving as a witness to the signature process C) Asking whether the client understands what she is signing D) Getting verbal consent over the phone for emergency procedures 8. The nurse is tryi ng to get consent to care for an 11 - year - old boy with diabetic ketoacidosis. His parents are out of town on vacation, and the child is staying with a neighbor. Which action would be the priority? A) Getting telephone consent with two people listening to t he verbal consent B) Providing emergency care without parental consent C) Contacting the childs aunt or uncle to obtain their consent D) Advocating for termination of parental rights for this situation 9. After teaching nursing students about the basi c concepts of family - centered care, the instructor determines that the teaching was successful when the students state which of the following? A) Childbirth affects the entire family, and relationships will change. B) Families are not capable of making h ealth care decisions for themselves. C) Mothers are the family members affected by childbirth. D) Childbirth is a medical procedure. 10. A nursing instructor is preparing a class discussion on the trends in health care and health care delivery over the past several centuries. When discussing the changes during the past century, which of the following would the instructor be least likely to include? A) Disease prevention B) Health promotion C) Wellness D) Analysis of morbidity and mortality 11. A nurse is assigned to care for an Asian American client. The nurse develops a plan of care with the understanding that based on this clients cultural background, the client most likely views illness as which of the following? A) Caused by supernatural forces. B) A punishment for sins. C) Due to spirits or demons. D) From an imbalance of yin and yang 12. A nurse is developing a plan of care for a woman to ensure continuity of care during pregnancy, labor, and childbirth. Which of the following would be most important for the nurse to incorporate into that plan? A) Adhering to strict, specific routines B) Involving a pediatric physician C) Educating the client about the importance of a support person D) Assigning several nurses as a support team 13. A nursing instructor is preparing a class discussion on case management in maternal and newborn health care. Which of the following would the instructor include as a key component? Select all that apply. A) Advocacy B) Coordination C) Communication D) Resource management E) Event managed care 14.After teaching a group of students about the concept of maternal mortality, the instructor determines 4 that additional teaching is needed when the students state which of the following? A) The rate includes accidental causes for deaths. B) It addresses pregnancy - related causes. C) The duration of the pregnancy is not a concern. D) The time frame is typically for a specified year. 15. A group of students are reviewing the historical aspects about childbir th. The students demonstrate understanding of the information when they identify the use of twilight sleep as a key event during which time frame? A) 1700s B) 1800s C) 1900s D) 2000s 16. A nurse is providing care to a woman who has just delivered a h ealthy newborn. Which action would least likely demonstrate application of the concept of family - centered care? A) Focusing on the birth as a normal healthy event for the family B) Creating opportunities for the family to make informed decisions C) Enco uraging the woman to keep her other children at home D) Fostering a sense of respect for the mother and the family 17. When discussing fetal mortality with a group of students, a nurse addresses maternal factors. Which of the following would the nurse m ost likely include? Select all that apply. A) Chromosomal abnormalities B) Malnutrition C) Preterm cervical dilation D) Underlying disease condition E) Poor placental attachment 18. A nurse is preparing a presentation for a local community group abo ut health status and childrens health. Which of the following would the nurse include as one of the most significant measures? A) Fetal mortality rate B) Neonatal mortality rate C) Infant mortality rate D) Maternal mortality rate 19. A group of stude nts are reviewing an article describing information related to indicators for womens health and the results of a national study. Which of the following would the students identify as being satisfactory for women? Select all that apply. A) Smoking cessatio n B) Colorectal cancer screening C) Violence against women D) Health insurance coverage E) Mammograms 20. A nurse is preparing a presentation for a local womens group about heart disease and women. Which of the following would the nurse expect to add ress when discussing measures to promote health. A) Women have similar symptoms as men for a heart attack. B) Heart disease is no longer viewed as a mans disease. C) Women experiencing a heart attack are at greater risk for dying. D) Heart attacks in w omen are more easily diagnosed. 21. A nurse is working to develop a health education program for a local community to address breast cancer 5 awareness. Which of the following would the nurse expect to include when describing this problem to the group? Sel ect all that apply. A) White women have higher rates of breast cancer than African American women. B) African American women are more likely to die from breast cancer at any age. C) Survival at any stage is worse among white women. D) Women living in S outh America have the highest rates of breast cancer. E) Breast cancer is the leading cause of cancer mortality in women. 22. A group of nursing students are reviewing information about factors affecting maternal, newborn, and womens health. The student s demonstrate understanding of the information when they identify which of the following deficiencies as being associated with poverty? Select all that apply. A) Literacy B) Employment opportunities C) Mobility D) Political representation E) Skills Answer Key 1. B 2. C 3. D 4. B 5. B 6. D 7. A 8. A 9. A 10.D 11.D 12.C 13.A, B, C, D 14.A 15.C 16.C 17.B, C, D 18.C 19.B, E 20.C 21.A, B 22.A, B, C, D, E 6 Chapter 2 Women as Health Care Providers 1. Which health occupation has the highest percentage of women? A. Pharmacists B. Physical therapists C. Registered nurses D. Dental hygienists Answer: D 2. Which health occupation has the lowest percentage of women? A. Physicians B. Dentists C. Pharmacists D. Physical therapists Answer: B 3. Which health profession has the largest number of workers? A. Health aides B. Physicians C. Licensed practical nurses D. Registered nurses Answer: D 4. Which of the following are certifications available in advanced practice registered nursing? (Select all that apply.) A. Certified nurse midwife B. Certified registered nurse anesthetist C. Certified nurse pharmacologist D. Clinical nurse specialist E. Nurse practitioner Answer: A, B, D, E 5. What level of education is required to become a licensed practical nurse? A. 2-year master’s degree (in addition to a 4-year bachelor’s degree) B. 4-year bachelor’s degree C. 2-year associate’s degree D. 1-year certificate or diploma Answer: D 7 6. What percentage of physicians and surgeons in the United States in 2014 were women? A. 27% B. 37% C. 47% D. 57% Answer: B 7. What medical specialty has the highest percentage of women? A. General pediatrics B. Obstetrics and gynecology C. Orthopedic surgery D. Urology Answer: A 8. On an average, the income of female physicians is what percentage of that of male physicians? A. 59% B. 79% C. 99% D. 109% Answer: A 9. What level of education is required to become a pharmacist? A. 6-year doctorate degree B. 2-year master’s degree (in addition to a 4-year bachelor’s degree) C. 4-year bachelor’s degree D. 2-year associate’s degree Answer: A 10. Which of the following is the median income of dentists in the United States (2012)? A. $89,310 B. $109,310 C. $129,310 D. $149,310 Answer: D 11. Which of the following are the current trends in dentistry? (Select all that apply.) A. More specialists than generalists B. Research linking oral health to overall health C. Focus on treatment of disease rather than prevention D. Expected growth of 18% from 2014 to 2024 E. Increasing demand for dental implants, bridges, and cosmetic services Answer: B, D, E 12. Which allied health occupation is projected to be the fastest growing? A. Health information technicians B. Nursing aides C. Occupational therapists D. Paramedics Answer: A 8 13. One in five workers in which of the following allied health occupation is at or below the federal poverty level? A. Medical assistant B. Home health aide C. Radiology technician D. Speech-language pathologist Answer: B 14. Veronica is a registered nurse who pours herself into her job. She works long hours without complaint and strives to do her best. Often, she maintains a cheerful, caring, and kind demeanor on the outside while feeling exhausted and frustrated on the inside. The effort it takes to maintain this front before her patients results in a lot of stress. This phenomenon can best be described as which of the following? A. Identity crisis B. Psychological disparity C. Emotional dissonance D. Gender discrimination Answer: C 15. Tests of implicit racial bias among health professionals have revealed which of the following? A. An unconscious preference for Whites over Blacks B. Use of racially charged, derogatory language C. Sharing of racist jokes D. Lower pay for racial minorities Answer: A 9 Chapter 3 Women and Health Care 1. To enhance women’s health care in the 21st century, researchers should do which of the following? (Select all that apply.) A. Design studies in collaboration with women B. Analyze changes in women’s health data relative to men’s C. Include homogeneous populations of women in studies D. Translate research findings into clinical and public health practice E. Focus on treatment approaches equally applicable to men and women Answer: A, B, D 2. Historically, gender has been defined by which of the following? (Select all that apply.) A. Self-identification B. Appropriate roles C. Division of labor D. Economic power E. Political influence Answer: B, C, D, E 3. Hammarstrӧm et al. propose a model of sex and gender that includes which of the following concepts? (Select all that apply.) A. Binary sexuality based on one’s chromosomes B. Sex, interacting with gender, as a continuum C. Biologically determined sex based on the effects of sex hormones on reproductive organ development D. Sex and gender as an integration of body, mind, and context E. Intersectionality and embodiment as factors significantly affecting sex and gender Answer: B, D, E 4. Which of the following is the best example of how gender bias has affected the health and health care of women? A. Similar rates of mental illness being found in men and women B. Treatment outcomes among women varying based on patient compliance C. Association of patient income level with type of diagnosis D. Disproportionately more psychotropic medications being prescribed to women than men Answer: D 5. Krieger has proposed which of the following regarding sex, gender, and health? (Select all that apply.) A. Gender and sex played no significant role in determining health outcomes for women B. Gender relations influence the expression and the interpretation of biological traits C. Sex-linked biological characteristics contribute to gender differentials in health D. Traditional perspectives on gender and sex have resulted in better health outcomes for women than for men E. Equitable gender relationships have resulted in similar health outcomes in men and women Answer: B, C 10 6. When did women’s health scholarship begin to flourish? A. 1960s B. 1970s C. 1980s D. 1990s Answer: B 7. Which of the following were the goals included in the report “Women’s Health Research: Progress, Pitfalls, and Promise,” which was published by the Office of Research on Women’s Health in 2010? (Select all that apply.) A. Increase sex similarities research in basic sciences studies B. Incorporate findings of sex and gender differences in the design of new technologies C. Create strategic alliances to maximize domestic and global impact of women’s health research D. Develop and implement new social networking technologies to promote men’s health and wellness research E. Employ innovative strategies to build a well-trained, diverse, and vigorous women’s health research workforce Answer: B, C, E 8. The National Institutes of Health (NIH) Revitalization Act of 1993 mandated that the NIH do which of the following? A. Expand health insurance coverage for women B. Include women and minorities in clinical research C. Research and develop new women-specific medications D. Decrease infection rates during obstetric surgeries Answer: B 9. Historical examples of gender bias in medical textbooks include which of the following? (Select all that apply.) A. Portrayals of women as inherently sick B. A recommendation that women simulate orgasms if not orgasmic with their husbands C. Portrayals of women patients as being intellectually superior to their male physicians D. Omission of the clitoris from anatomical illustrations of women’s genitals E. Portrayal of women as invincible to illness and age, as long as they make the right choices Answer: A, B, D, E 10. Which of the following best describes the new model for health care for women? A. Physician-centered B. Authoritarian C. Pluralistic D. Disease-oriented Answer: C 11 C H A P T E R 4 Health Care for Vulnerable Populations 1. According to a 2015 report by Buerhaus and colleagues, which type of health care provider is most likely to care for racial or ethnic minority patients and patients who are uninsured? A. Family practice physicians B. Physician assistants C. Nurse practitioners D. Surgeons Answer: C 2. Which of the following are examples of people likely to be considered members of vulnerable populations? (Select all that apply.) A. An African American woman B. A young woman living in an urban setting who takes mass transit C. A single mother earning $12,000 a year D. A transgender man E. A homeless middle-aged man Answer: A, C, D, E 3. Which of the following is the best example of a health inequity? A. A Mexican American woman with diabetes who receives less attention from the physician because of her ethnicity B. A low-income woman whose children get sick repeatedly because she refused to have them vaccinated C. A gay man who must drive a long distance to visit the health care provider of his choice D. A Muslim woman who is shunned by her neighbors because of her religion Answer: A 4. Which of the following are effects of social determinants of health? (Select all that apply.) A. A higher rate of infant mortality in a poor neighborhood compared with wealthier ones B. Increased incidence of boating injuries in a city located on a large lake C. A murder rate five times the national average in an inner-city neighborhood plagued by gang activity D. A man with HIV who goes without treatment because he fears the stigma associated with his condition E. An outbreak of the flu in an area due to rapid changes in the weather Answer: A, C, D 5. Which of the following is the generally accepted view of race by the scientific community? A. Biologically determined B. Established by socioeconomic level C. Determined by the country of one’s birth D. Socially constructed Answer: D 12 6. Mary is a 51-year-old woman with 20 years of experience as an assembly line worker in the automobile industry. She was recently interviewed for a management position in her company but did not get the job. A coworker later tells her, “Don’t feel bad. Archie never hires women for management.” This scenario can best be described as an example of which of the following? A. Prejudice B. Discrimination C. Health inequity D. Social justice Answer: B 7. Jamie is a single mom who, because of her low income, is unable to consistently provide nutritious meals for her children and self. Her food insecurity makes Brittany at a greater risk for which of the following? A. Breast cancer B. Type 1 diabetes C. Type 2 diabetes D. Chronic obstructive pulmonary disease Answer: C 8. Which of the following are challenges that low-income women are more likely to encounter in the workplace than high-income women? (Select all that apply.) A. Discrimination based on gender B. Long commutes C. No paid sick days D. Pressure from a demanding boss E. Lack of health insurance Answer: A, C, E 9. Teresa lives in a town of 3,000 people in Montana, 100 miles away from the nearest city. Which barrier to care is Teresa most likely to face as a result of living in a rural community? A. Lack of a women’s health specialist B. Higher cost of care C. Structural racism D. Social stigma Answer: A 10. What percentage of women in the United States will experience severe physical violence by an intimate partner in their lifetimes? A. 15% B. 25% C. 35% D. 45% Answer: B 11. Which group of women are likely to experience intimate partner violence? A. Lesbians B. Women with disabilities C. Women living in rural communities D. Women who work full time Answer: B 13 12. A nurse is preparing to assess a client for alcohol use. Which clinical tool would be appropriate for this task? A. Cut down, annoyed, guilty, and eye-opener (CAGE) B. Patient Health Questionnaire (PHQ-9) C. Mini-Cog D. Wong-Baker FACES (Wong-Baker FACES Pain Rating Scale) Answer: A 13. A nurse is assisting a client who is food insecure. Which agency should the nurse refer the client to for food assistance? A. Food and Drug Administration (FDA) B. Centers for Disease Control and Prevention (CDC) C. Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) D. World Health Organization (WHO) Answer: C 14. A nurse learns from an older client, Gabby, that Gabby’s landlord is increasing her rent by 100% with only a month’s notice. The nurse refers Gabby to a social worker to explore subsidized housing and follows up a month later to make sure Gabby is okay. The nurse’s behavior is an example of which of the following? A. Discrimination B. Patient advocacy C. Health inequity D. Marginalization Answer: B 14 C H A P T E R 5 Legal Issues in Women’s Health Care 1. The landmark U.S. Supreme Court case Griswold v. Connecticut established which of the following? A. Unmarried women’s right to privacy in contraception B. Women’s right to choose to have an abortion C. The right of women younger than 16 years to receive birth control D. Married couples’ right to privacy in contraception Answer: D 2. The U.S. Supreme Court case Carey v. Population Services established which of the following? A. Unmarried women’s right to privacy in contraception B. Women’s right to choose to have an abortion C. The right of women younger than 16 years to receive birth control D. Married couples’ right to privacy in contraception Answer: C 3. What proportion of pregnancies in the United States are unintended each year? A. One fourth B. One third C. One half D. Two thirds Answer: C 4. By age 45, what proportion of women have had an abortion in their lifetime? A. 1 in 10 B. 2 in 10 C. 3 in 10 D. 4 in 10 Answer: D 5. In the U.S. Supreme Court case in which Hobby Lobby challenged an aspect of the Patient Protection and Affordable Care Act, what was the outcome? A. The Court ruled that the contraception mandate violated religious liberty B. The Court ruled that Hobby Lobby must provide birth control coverage for its employees C. The Court ruled that Hobby Lobby must provide abortion coverage for its employees D. The Court ruled that the individual mandate was unconstitutional Answer: A 6. Before 1880, what was the status of abortion in the United States? A. It was prohibited by federal law B. It was unregulated C. It was outlawed by individual states, with limited exceptions D. It was a right legally protected by federal law Answer: B 15 7. Which of the following were outcomes of the landmark U.S. Supreme Court case Roe v. Wade , 1973? (Select all that apply.) A. Women were granted the right to choose to have an abortion B. Human life was defined as beginning at birth C. States retained the right to restrict and regulate abortion D. States retained the right to outlaw abortion E. Physicians retained the right to make decisions regarding abortion with their patients Answer: A, C, E 8. Which of the following are controversial aspects of in vitro fertilization? (Select all that apply.) A. Allowing parents to select the sex of their child B. Implanting two to three embryos at a time C. Allowing parents to implant an embryo for the purpose of harvesting an organ to be donated to a sick sibling D. Allowing preimplantation genetic testing when a parent has a history of an inheritable genetic disorder E. Allowing parents to select the hair color, eye color, and skin complexion of a child Answer: A, C, E 9. Which U.S. Supreme Court case involved a child custody battle between parents of an embryo that was mistakenly implanted in another woman and the woman who gave birth to this child? A. Griswold v. Connecticut B. Eisenstadt v. Baird C. Rodgers v. Fasano D. Doe v. Doe Answer: C 10. In the case of In re Baby M , 1988, the New Jersey Supreme Court did which of the following? A. Granted permission for the surrogate mother to have an abortion B. Awarded custody of the child to the surrogate mother C. Awarded custody of the child to the father, who was the client and sperm donor D. Awarded custody of the child to the state Answer: B 11. Which state has prosecuted a woman for illegal drug use in pregnancy; allowed drug testing on women in a public hospital without their consent and arrested and incarcerated those who tested positive; and convicted a woman of murder after her child was stillborn as a result of her using cocaine? A. Alabama B. South Carolina C. Georgia D. Texas Answer: B 12. What percentage of women who have experienced domestic violence are diagnosed with an anxiety disorder? A. 26% B. 36% C. 46% D. 56% Answer: C 16 C H A P T E R 6 Feminist Frameworks for Advanced Practice With Women 1. Which of the following is the process of marginalizing groups of people who are not part of a dominant and privileged group of society? A. Critiquing B. Colonializing C. Othering D. Deconstructing Answer: C 2. Which “wave” of feminism was focused on organizing women and using feminism as a resource for seeking equality in social organizations? A. First wave B. Second wave C. Third wave D. Fourth wave Answer: B 3. Which of the following were proponents of liberal feminism? (Select all that apply.) A. Mary Wollstonecraft B. Angela Davis C. John Stuart Mill D. Julia Kristeva E. Shulamith Firestone Answer: A, C 4. Which feminist theory seeks to eradicate sexual oppression by ending women’s economic dependence on men? A. Marxist/socialist feminism B. Liberal feminism C. Radical feminism D. Psychoanalytic feminism Answer: A 5. Which feminist theory strives to eradicate the patriarchal system by replacing the institutions that support hierarchy and dominance? A. Womanist B. Liberal feminism C. Radical feminism D. Psychoanalytic feminism Answer: C 17 6. According to radical feminism, which of the following are sources of women’s oppression? (Select all that apply.) A. Biology B. Gender C. Psyche D. Sexuality E. Language Answer: A, C, D 7. Which feminist theory seeks to reveal how language constructs gender and to use language to deconstruct gender? A. Womanist B. Postmodernist feminism C. Postcolonial feminism D. Liberal feminism Answer: B 8. Which group of feminist theorists is concerned primarily with exploring subjectivity and agency, abjection, and psychosexual identity formation? A. French psychoanalytic feminists B. Early psychoanalytic feminists C. Queer theorists D. Womanists Answer: A 9. Which group of feminist theorists is concerned primarily with pointing out the differences between the lives of women of color and the lives of White women? A. Queer theorists B. Liberal feminists C. Radical feminists D. Womanists Answer: D 10. Who coined the term “womanist”? A. Mary Daly B. Julia Kristeva C. Michel Foucault D. Alice Walker Answer: D 11. Which group of feminist theorists is known for studying sexuality via concepts such as the Oedipus complex and for promoting dual parenting? A. French psychoanalytic feminists B. Early psychoanalytic feminists C. Queer theorists D. Womanists Answer: B 18 12. Which group of feminist theorists describes feminism from lesbian, gay, bisexual, transgendered, and queer (LGBTQ) perspectives and emphasizes “affinity and solidarity over identity”? A. Queer theorists B. Postcolonial feminists C. Radical feminists D. Womanists Answer: A 13. A nurse researcher is interested in studying how the phenomenon of child labor in developing nations, resulting from globalization and the imposition of Western economic principles, has affected the health of girls in these nations. Which feminist theory would be most appropriate to adopt in this case? A. Queer theory B. Postcolonial feminist theory C. Psychoanalytic feminist theory D. Postmodern feminist theory Answer: B 14. A nurse researcher would like to explore how the health outcomes of low-income African American women differ from those of low-income White women. Which feminist theory would be most appropriate to adopt in this case? A. Queer theory B. Marxist feminist theory C. Psychoanalytic feminist theory D. Womanist theory Answer: D 15. Which of the following term denotes the concept that race-, class-, and gender-based oppressions interact and shape one another, resulting in complex, multifactorial results in the lives of women? A. Transnationalism B. Intersectionality C. Poststructuralism D. Subjectivity Answer: B 19 C H A P T E R 7 Women’s Bodies 1. On an average, by how much are women shorter than men? A. 2 inches B. 4 inches C. 6 inches D. 8 inches Answer: C 2. Which of the following characteristics are generally true of women compared with men? (Select all that apply.) A. 42% to 68% less absolute strength B. Thicker skin but thinner subcutaneous tissues C. Lower levels of VO 2 max and cardiovascular fitness D. Higher fat stores in the abdomen E. Smaller lungs and airways Answer: A, C, E 3. A nurse is performing a clinical breast exam on a client. Which of the following signs should the nurse note as a possible indicator of breast cancer? A. Slight asymmetry in breast size B. Brown areolar pigment C. Erect nipples D. An invertednipple Answer: D 4. Which structure of the female anatomy is homologous to the penis of the male? A. Perineum B. Clitoris C. Labia minora D. Vaginal orifice Answer: B 5. Out of the approximately 1 to 2 million germ cells present in the ovary at birth, how many, on an average, will achieve ovulation during a woman’s reproductive life? A. 100 B. 400 C. 800 D. 1,200 Answer: B 20 6. Which three bones compose the innominate bone? (Select all that apply.) A. Sacrum B. Ilium C. Pubis D. Ischium E. Coccyx Answer: B, C, D 7. Which of the following denotes a substance that is produced in one part of the body that enters into the blood circulation, travels to and stimulates target cells, and exerts specific effects? A. Hormone B. Neuron C. Erythrocyte D. Lymph Answer: A 8. Which of the following are steroidal hormones secreted by the ovaries? (Select all that apply.) A. Inhibin B. Estrogen C. Activin D. Progesterone E. Follistatin Answer: B, D 9. Which hormone, secreted by neurons in the hypothalamus, triggers a hormonal cascade of reproductive processes that result in puberty? A. Estrogen B. Follicle-stimulating hormone (FSH) C. Luteinizing hormone (LH) D. Gonadotropin-releasing hormone (GnRH) Answer: D 10. When viewing the ultrasound display of a woman in her 20th week of pregnancy, a nurse notes the presence of labia majora in the fetus. This is a sign of which of the following? A. Gender B. Genetic sex C. Gonadal sex D. Somatic sex Answer: D 11. Which of the following is the phase of the ovarian cycle that occurs following ovulation but before menses? A. Luteal B. Follicular C. Proliferative D. Secretory Answer: A 12. Ovulation typically occurs on which day of the menstrual cycle? A. 1 B. 7 C. 14 D. 21 Answer: C 21 13. The proliferative phase of the endometrial cycle is characterized by which of the following? A. Shedding of the endometrium B. Growth of the endometrium C. Secretion of progesterone D. Growth of the follicle Answer: B 14. The average age for the onset of the perimenopausal period is which of the following? A. 38 years B. 42 years C. 46 years D. 50 years Answer: C 15. Kelly, a woman in her mid-40s, asks the nurse what symptoms she is most likelyto experience once she enters the perimenopausal period. Which of the following should the nurse mention? A. Cessation of menstrual period B. Mood changes C. Hot flashes D. Night sweats E. Nausea Answer: B, C, D 22 C H A P T E R 8 Young Women’s Health 1. The teen birthrate is highest among which major racial or ethnic group? A. Latinos B. African Americans C. Whites D. Asians Answer: A 2. What percentage of the U.S. population was 10 to 19 years old in 2014? A. 14% B. 19% C. 24% D. 29% Answer: A 3. Which of the following are examples of protective factors for adolescents? (Select all that apply.) A. Bonds with friends and family B. Physical inactivity C. A school’s high expectations of students D. Risky sexual behaviors E. Opportunities for youth participation in the community Answer: A, C, E 4. Rachel is a talkative, open 13-year-old who is in for a physical exam today by herself. In talking with Rachel, the nurse should recognize which of the following as characteristics typical of this stage of development? (Select all that apply.) A. Criticism of her parents B. Acceptance of the physical changes of puberty C. Mood swings D. Sexual feelings emerging E. Transition to adulthood Answer: A, C, D 5. Lydia is a teenager who is in the process of researching college programs. She thinks she would like to be a lawyer. She is also searching for a summer job to save up to buy a car. Which stage of development is Lydia most likely in? A. Preadolescence B. Early adolescence C. Middle adolescence D. Late adolescence Answer: D 23 6. Yancy is a 14-year-old with Down syndrome. She, like many teens with disabilities, is at an increased risk of having which chronic condition? A. Epilepsy B. Obesity C. Heart disease D. Arthritis Answer: B 7. Brooke is a 17-year-old who is questioning both her sexual orientation and her gender. She says she has begun exploring these but that her parents do not know. Brooke is at an increased risk of experiencing which of the following? (Select all that apply.) A. Obesity B. Family violence C. Homelessness D. Substance abuse E. Suicidality Answer: B, C, D, E 8. Rose is a 14-year-old refugee from Nigeria who recently came to the United States. Being a foreign born, which of the following is Rose more likely to do than her native-born classmates? A. Exercise B. Succeed academically C. Eat meals with her family D. Develop positive peer relationships Answer: C 9. Destiny is an outgoing, fun-loving 13-year-old who has developed a strong network of friends at school. These positive relationships make it more likely that Destiny will experience which of the following? (Select all that apply.) A. Academic achievement B. A healthy diet C. Reduced substance abuse D. Improved mental health E. Lack of peer conflict Answer: A, C, D 10. During an office visit, Jordan, a 16-year-old patient, asks her nurse if she can share something in confidence. The nurse affirms, but adds that there were a few disclosures that would legally require breaking confidentiality. Which of the following are issues the nurse would be obligated to report? (Select all that apply.) A. Sexual activity B. Intent to self-harm C. Evidence of abuse D. Gender questioning E. Religious doubts Answer: B, C 11. What percentage of adolescents were covered by health insurance in 2013? A. 48% B. 63% C. 78% D. 93% 24 Answer: D 12. A nurse is having trouble communicating with her teenaged client, Enid, who is disengaged and sullen. What approach would most likely be effective in helping the nurse engage with Enid? A. Giving some concrete goals to Enid for her to pursue B. Asking Enid’s mother to join them C. Using motivational interviewing with Enid D. Reminding Enid of the consequences of noncompliance Answer: C 13. Nadia is a 13-year-old who is in for her first reproductive health visit. She reports having no special concerns and appears healthy. Which of the following is most important for the nurse to do in this visit? A. A Pap exam B. An internal pelvic exam C. An assessment of menstrual issues D. A mammogram Answer: C 14. In a 2013 survey of the Youth Risk Behavior Surveillance System, what percentage of high school females reported drinking more than five drinks in a row on at least 1 day in the 30 days before the survey? A. 16.1% B. 21.1% C. 26.1% D. 31.1% Answer: B 15. A nurse needs to assess an adolescent client’s level of sexual development. Which diagnostic tool should the nurse use? A. Tanner staging B. CRAFFT screening C. Motivational interviewing D. Mini-Cog assessment Answer: A 25 C H A P T E R 9 Midlife Women’s Health 1. Midlife is commonly defined by which of the following ways? (Select all that apply.) A. Age B. Proximity to menopause C. Degree of children’s independence D. Level of cognitive function E. Women’s self-perception of age Answer: A, B, C, E 2. Vivian is an 80-year-old patient who is reminiscing about her own midlife with her nurse, who has just entered midlife. Given her age, Vivian is most likely to identify which of the following as having been a primary source of meaning during her midlife? A. Her career B. Her family C. Her friends D. Her artistic accomplishments Answer: B 3. Which of the following is the definition of menopause currently used in the health sciences? A. The date of onset of menopause-related symptoms B. The cessation of menses, defined as the end of the final menstrual period C. The cessation of menses, defined as 1 year after the final menstrual period D. The date of the last menopause-related symptom Answer: C 4. Women of which U.S. ethnic group are most likely to describe menopause as “something you have to go through” and to view it as a time to reorient and restructure their lives? A. African Americans B. Japanese Americans C. European Americans D. Urban Latinas Answer: D 5. Which of the following endocrine changes are typical during the last 2 years before the final menstrual period? (Select all that apply.) A. Increased testosterone levels B. Decreased antral follicle count C. Increased follicle-stimulating hormone levels D. Decreased progesterone levels E. Increased estradiol levels Answer: B, C, D 26 6. Sleep disruption, a common symptom during the menopausal transition, is most often associated with which other perimenopausal symptom? A. Hot flashes B. Decline in memory C. Back pain D. Depressed mood Answer: A 7. Which of the following are common symptoms during the menopausal transition? (Select all that apply.) A. Difficulty concentrating B. Urinary incontinence C. Vaginal dryness D. Increased sexual desire E. Nausea and vomiting Answer: A, B, C 8. Which of the following statements is most accurate concerning symptoms of the menopausal transition? A. Almost all women experience the same set of symptoms, known as menopausal syndrome. B. Almost all women experience hot flashes, but other symptoms are too variable to predict. C. Symptoms experienced appear to vary from culture to culture, and thus may be culture bound. D. Symptoms are completely random, demonstrating no predictable patterns. Answer: C 9. Which of the following accurately describes metabolic changes in bone, muscle, and fat that typically occur in the menopausal transition? A. Increases in bone, muscle, and fat mass B. Decreases in bone, muscle, and fat mass C. Increases in muscle and fat mass but a decrease in bone mass D. Decreases in bone and muscle mass but an increase in fat mass Answer: D 10. Which of the following are characteristics of metabolic syndrome? (Select all that apply.) A. Increased lipid levels B. Insulin resistance C. Decreased inflammatory response D. Increased risk of thrombosis E. Increased blood pressure Answer: A, B, D, E 11. The nurse is reviewing assessment and lab results of a patient at risk for metabolic syndrome. Which of the following findings are consistent with metabolic syndrome? (Select all that apply.) A. Waist circumference of 37 inches B. Body mass index (BMI) of 23 C. Blood pressure of 138/86 mmHg D. Fasting blood glucose level of 99 mg/dL E. Triglycerides level of 161 mg/dL Answer: A, C, E 27 12. Patricia is a 50-year-old woman with a body mass index (BMI) of 31 and elevated lipid levels. Which of the following changes would you recommend to promote Patricia’s health? A. Exercise 60 to 90 minutes per day at moderate intensity, most days B. Limit alcohol intake to no more than two drinks per day C. Take omega-3 fatty acid supplements D. No smoking or use of tobacco E. Reduce waist circumference to less than 40 inches Answer: A, C, D 13. Lorraine is a 46-year-old woman who has a body mass index (BMI) of 21 and who is generally healthy. Based on current recommendations by the National Institutes of Health (NIH), what exercise program would you suggest to Lorraine to maintain her current level of fitness? A. None—she is already maintaining her fitness level B. 20 minutes of light-intensity exercise per day, 3 days per week C. 30 minutes of moderate-intensity exercise per day, 5 days per week D. 60 minutes of heavy-intensity exercise per day, 6 days per week Answer: C 14. Isadora is a 49-year-old woman with a body mass index (BMI) of 18 and a family history of osteoporosis. Which of the following health promotion recommendations specifically related to preventing osteoporosis should the nurse give to Isadora? (Select all that apply.) A. Take aspirin daily B. Include plenty of calcium in the diet C. Consume foods fortified with vitamin D D. Limit sodium intake E. Engage in weight-bearing exercise Answer: B, C, E 15. How much more likely are women to be diagnosed with depression in their lifetime than men? A. 60% B. 70% C. 80% D. 90% Answer: B 28 C H A P T E R 1 0 Older Women’s Health 1. How many people in the United States were 65 years or older in 2010? A. 3.1 million B. 20.5 million C. 40.3 million D. 83.7 million Answer: C 2. What percentage of those 85 years and older in the United States in 2010 were women? A. 47% B. 57% C. 67% D. 77% Answer: C 3. What percentage of women 85 years and older in the United States in 2010 were widowed? A. 35% B. 52% C. 73% D. 91% Answer: C 4. Compared with older men, older women are: (Select all that apply.) A. More prepared to retire B. Less likely to retire at retirement age C. More likely to have a retirement pension from their employer D. Less likely to report being satisfied in retirement E. More likely to live alone Answer: B, D, E 5. In 2030, which of the following is the percentage of the older population (65 years or older) that is projected to be White? A. 47% B. 54% C. 67% D. 74% Answer: A 29 6. Which of the following cognition-related capacities typically decline with normal aging? (Select all that apply.) A. Motivation B. Short- and long-term memory C. Knowledge D. Learning E. Wisdom Answer: A, B, D 7. Daisy, a 77-year-old client, reports a gradual and slight loss of hearing, especially for higher pitched tones. The nurse should recognize this condition as which of the following? A. Presbyopia B. Presbycusis C. Age-related macular degeneration D. Otitis media Answer: B 8. What percentage of cancers are diagnosed at age 55 years or older? A. 55% B. 65% C. 75% D. 85% Answer: C 9. Which of the following is the leading cause of cancer death in women? A. Breast cancer B. Lung cancer C. Colorectal cancer D. Pancreatic cancer Answer: B 10. Mamie is a 76-year-old client who is suspected of having Alzheimer’s disease. To confirm this suspicion, the nurse should look for impairment in which of the following mental functions? (Select all that apply.) A. Visual acuity B. Memory C. Language D. Attention E. Ability to reason Answer: B, C, D, E 11. A phenotype of positive aging that has been described in older women is focused on which of the following? (Select all that apply.) A. Presence of chronic disease B. Physical functioning C. Presence of a disability D. Social functioning E. Emotional functioning Answer: B, D, E 30 12. Which of the following are the benefits associated with weight-bearing aerobic exercise in older women? (Select all that apply.) A. Decreased risk for breast cancer B. Increased bone density C. Reversal of Alzheimer’s disease symptoms D. Improved balance E. Improved insulin resistance Answer: B, D, E 13. Opal, who is 82 years old, would like information on vaccinations recommended for clients of her age. Which of the following should the nurse recommend? (Select all that apply.) A. Annual influenza B. Human papillomavirus C. Onetime pneumococcal D. Hepatitis B E. Herpes zoster Answer: A, C, E 14. What percentage of community-dwelling older adults take at least five prescription medications? A. 29% B. 39% C. 49% D. 59% Answer: A