Chapter 04- Assessment and Health Promotion
Lowdermilk- Maternity & Women's Health Care,
12th Edition Updated Solved Solution 2022
1. Due to the
... [Show More] effects of cyclic ovarian changes in the breast, when is the best time for
breast self-examination (BSE)?
a. Between 5 and 7 days after menses ceases
b. Day 1 of the endometrial cycle
c. Midmenstrual cycle
d. Any time during a shower or bath - ANS: A
The physiologic alterations in breast size and activity reach their minimal level
approximately 5 to 7 days after menstruation ceases. Therefore, BSE is best performed
during this phase of the menstrual cycle. Day 1 of the endometrial cycle is too early to
perform an accurate BSE. After the midmenstrual cycle, breasts are likely to become
tender and increase in size, which is not the ideal time to perform BSE. Lying down after
a shower or bath with a small towel under the shoulder of the side being examined is
appropriate teaching for BSE. A secondary BSE may be performed while in the shower.
2. Individual irregularities in the ovarian (menstrual) cycle are most often caused by
what?
a. Variations in the follicular (preovulatory) phase
b. Intact hypothalamic-pituitary feedback mechanism
c. Functioning corpus luteum
d. Prolonged ischemic phase - ANS: A
Almost all variations in the length of the ovarian cycle are the result of variations in the
length of the follicular phase. This information discounts the other options as being
correct. An intact hypothalamic-pituitary feedback mechanism would be regular, not
irregular. The luteal phase begins after ovulation. The corpus luteum is dependent on
the ovulatory phase and fertilization. During the ischemic phase, the blood supply to the
functional endometrium is blocked, and necrosis develops. The functional layer
separates from the basal layer, and menstrual bleeding begins
3. How would the physiologic process of the sexual response best be characterized?
a. Coitus, masturbation, and fantasy
b. Myotonia and vasocongestion
c. Erection and orgasm
d. Excitement, plateau, and orgasm - ANS: B
Physiologically, sexual response can be analyzed in terms of two processes:
vasocongestion and myotonia. Coitus, masturbation, and fantasy are forms of
stimulation for the physical manifestation of the sexual response. Erection and orgasm
occur in two of the four phases of the sexual response cycle. Excitement, plateau, and
orgasm are three of the four phases of the sexual response cycle
4. The nurse guides a woman to the examination room and asks her to remove her
clothes and put on an examination gown with the front open. The woman replies, "I
have special undergarments that I do not remove for religious reasons." Which is the
most appropriate response from the nurse?
a. "You can't have an examination without removing all your clothes."
b. "I'll ask the physician to modify the examination."
c. "I'll explain the examination procedure, and then we can discuss how you can
comfortably have your examination."
d. "I have no idea how we can accommodate your beliefs." - ANS: C
Explaining the examination procedure reflects cultural competence by the nurse and
shows respect for the woman's religious practices. The nurse must respect the rich and
unique qualities that cultural diversity brings to individuals. The examination can be
modified to ensure that modesty is maintained. In recognizing the value of cultural
differences, the nurse can modify the plan of care to meet the needs of each woman.
Telling the client that her religious practices are different or strange is inappropriate and
disrespectful to the client.
5. A woman tells the nurse that she thinks she has a vaginal infection, and has been
using an over-the-counter cream for the past 2 days to treat it. How should the nurse
initially respond?
a. Determine when she first noticed the symptoms.
b. Reassure the woman that using vaginal cream is not a problem for the examination.
c. Ask the woman to describe the symptoms that indicate to her that she has a vaginal
infection.
d. Ask the woman to reschedule the appointment for the examination. - ANS: C
An important element of the health history and physical examination is the client's
description of any symptoms she may be experiencing. The best response is for the
nurse to inquire about the symptoms the woman is experiencing. While relevant, when
the symptoms began is not as important as what the symptoms are. Women should not
douche, use vaginal medications, or have sexual intercourse for 24 to 48 hours before
obtaining a Pap test. Although the woman may need to reschedule a visit for her Pap
test, her current symptoms should still be addressed.
6. Preconception and prenatal care have become important components of women's
health. What is the guiding principal of preconception care?
a. Ensure that pregnancy complications do not occur.
b. Identify the woman who should not become pregnant. c. Encourage healthy lifestyles
for families desiring pregnancy.
d. Ensure that women know about prenatal care. - ANS: C
Preconception counseling guides couples in how to avoid unintended pregnancies, how
to identify and manage risk factors in their lives and in their environment, and how to
identify healthy behaviors that promote the well-being of the woman and her potential
fetus. Preconception care does not ensure that pregnancy complications will not occur.
In many cases, problems can be identified and treated and may not recur in subsequent
pregnancies. For many women, counseling can allow behavior modification before any
damage is done, or a woman can make an informed decision about her willingness to.... [Show Less]