TEST BANK WOMENS HEALTH AND PRIMARY CARE CLINICAL GUIDE 5TH EDITION YOUNGKIN SCHADEWALD PRITHAMTable ofContents Chapter 1 Access to Women’s Health Care
... [Show More] in the United States: Affordability, Equity, Rights... 2 Chapter 2 Women’s Development into the 21st Century ................................ . 6 Chapter 3 Epidemiology, Diagnostic Methods, and Procedures for Women’s Health .......... 9 Chapter 4 Assessing Adolescent Women’s Health Renee Sieving, Sarah Stoddard, Deborah A. Raines................................ ................................ ........... 13 Chapter 5 Assessing Adult Women’s Health Diane Marie Schadewald, Catherine Juve, Ellis Quinn Youngkin, Marcia Szmania Davis ................................ .................... 18 Chapter 6 Assessing Older Women’s Health Debra Hain................................ . 22 Chapter 7 Women and Sexuality Catherine Ingram Fogel, Diane Marie Schadewald.......... 26 Chapter 8 Health Needs of Lesbian, Bisexual, and Transgender Populations ................ 31 Chapter 9 Health Needs of Women with Disabilities Michele Davidson..................... 34 Chapter 10 Integrating Wellness: Complementary Therapies and Women’s Health J o Lynne W. Robins................................ ................................ ........... 37 Chapter 11 Menstruation and Related Problems and Concerns Kristine Alswager, Christine Durler, Deborah Griswold................................ ........................... 41 Chapter 12 Contraceptive Management and Family Planning Beth Walcker, Coralie Pederson, Kathryn A. Caufield................................ ................................ 47 Chapter 13 Infertility Michelle Valentine, Jennifer R. Gardella ............................ 57 Chapter 14 Vaginitis and Sexually Transmitted Diseases Susan D. Schaffer, Jane Houston ..... 60 Chapter 15 Women and HIV Dina Treloar, Susan D. Schaffer............................. 70 Chapter 16 Common Gynecologic Pelvic Disorders Jennifer M. Laubach, Reena P. Lorntson, Donna E. Forrest................................ ................................ .. 74 Chapter 17 Breast Health Linda Christinsen-Rengel ................................ .... 83 Chapter 18 The Menopausal Transition Catherine Juve, Valerie T. Cotter, Ellis Quinn Youngkin88 Chapter 19 Promotion of Women’s Health Care During Pregnancy ....................... 93 Chapter 20 Maternal Conditions Impacting Risk in Pregnancy Debbie Ringdahl, Melissa Frisvold, Joan Corder-Mabe ................................ ................................ . 96 Chapter 21 Assessing Fetal Well-Being Michele Davidson, Marion Herndon Fuqua ......... 101 Chapter 22 Postpartum and Lactation Diane Schadewald, Cheri Friedrich, Kathleen M. Akridge ................................ ................................ ............... 105
Chapter 23 Common Medical Problems: Cardiovascular through Hematological Disorders Mary Benbenek, Mary Dierich, Elaine Ferrary, Rita A. Seeger Jablonski ......................... 115 Chapter 24 Common Medical Problems: Musculoskeletal Injuries through Urinary Tract Disorders Gwen Short, Rita A. Seeger Jablonski, Elaine Ferrary........................... 120 Chapter 25 Psychosocial Health Concerns Ann Bateman,Eugenia Zelanko ................. 125 Chapter 26 Substance Use Disorders and Women ................................ .... 130
1 | P a g eChapter 1 Access to Women’s Health Care in the United States: Affordability, Equity,
Rights
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
2 | P a g eD. 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
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%
3 | P a g eC. 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
4 | P a g eD. Paramedics
Answer: A
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 andstrives to do her best. Often, she maintains a cheerful, caring, and kind demeanor on
the outside whilefeeling exhausted and frustrated on the inside. The effort it takes to maintain this
front before her patientsresults 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
5 | P a g eChapter 2 Women’s Development into the 21st Century
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 andgender
Answer: B, D, E
6 | P a g e4. 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 thanmen
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
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 HealthResearch:
Progress, Pitfalls,
and Promise,” which was published by the Office of Research on Women’s Health in 2010?
(Select all that
apply.)
7 | P a g eA. 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 ofgender 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 rightchoices
Answer: A, B, D, E
10. Which of the following best describes the new model for health care for women?
8 | P a g eA. Physician-centered
B. Authoritarian
C. Pluralistic
D. Disease-oriented
Answer: C
Chapter 3 Epidemiology, Diagnostic Methods, and Procedures for Women’s Health
1:A 46-year-old patient is referred for the biopsy of a vaginal lesion. Vaginal biopsy typically
requires what
type of anesthesia?
a:General
b:Caudal
c:None
d:Conscious sedation
e:Pudendal
2:A 36-year-old patient is to undergo removal of her uterus for benign disease. Which of the
following is
an advantage of abdominal hysterectomy over vaginal hysterectomy?
a:
Repair of rectocele more readily accessible
b:
Fewer incisional complications
c:
Ability to deal with smaller uterine sizes
d:
Ability to visualize associated pelvic pathology e:
Shorter recovery period
3:She undergoes removal of only her uterus. Which term refers to the surgical removal of only the
uterine
corpus?
a:Complete hysterectomy
b:Vaginal hysterectomy
cTotal hysterectomy
d:Subtotal hysterectomy
e:Radical hysterectomy
4:A 53-year-old is referred to you for the evaluation of an adnexal mass found at the time of annual
9 | P a g ephysical examination. In the initial evaluation of a possible adnexal mass, the most appropriate
imaging
technique is
a:computed axial tomography scanning
b:ultrasonography
c:flat plate of the abdomen
d:magnetic resonance imaging
e:positron emission tomography (PET) imaging
5:What is the most appropriate biopsy location for a 45-year-old woman with abnormal vaginal
bleedingfor 5 days and a normal physical examination?
a:Vulva
b:No biopsy indicated if less than 7 days
c:Endometrium
d:Vagina
e:Cervix
6:
A 25-year-old patient had an IUD inserted last year, but no longer feels the string. Which of the
following
is the most appropriate next step in management?
a:
Dilation and curettage
b:
MRI
c:
Hysteroscopy
d:
"Flat-plate" X-ray of the lowerabdomen
e:
Ultrasonography
7:
A 35-year-old patient does not recall why she had a laparoscopy 3 years ago. Which of the
following
conditions is most likely to be associated with a laparoscopy for evaluation?
a:
Pelvic pain
b:
Abnormal Pap smear
c:
Abnormal bleeding
d:
Recurrent cystitis
8:
A 32-year-old patient recovering from a gynecologic procedure complains of shoulder pain. The
procedure she had was most likely a(n)
a:
LEEP
b:
cervical biopsy
10 | P a g ec:
endometrial ablation
d:
dilation and curettage
e:
laparoscopy
9:
What is the most appropriate initial imaging study in an asymptomatic patient with 18-week-size
fibroids?
a:
Positron emission tomography (PET)
b:
computed tomography (CT)
c:
Transabdominal ultrasonography
d:
Sonohysterography
e:
Magnetic resonance imaging (MRI) 10:
A 20-year-old patient at 6 weeks of gestation is suspected of having an ovarian neoplasm. The
most
appropriate initial imaging technique is
a:
Computed tomography (CT)
b:
Positron emission tomography (PET)
c:
transvaginal ultrasonography
d:
transabdominal ultrasonography
e:
Magnetic resonance imaging (MRI) 11:
A healthy, asymptomatic, nulliparous 36-year-old woman requests your advice because she has been
unsuccessful at achieving pregnancy over the last 13 months, despite regular menses. Performing
an
initial physical examination, you detect a firm, non-tender, multinodular uterus whose size
corresponds
to that at approximately 8 to 10 weeks of pregnancy, which is consistent with leiomyomata uteri.
The
remainder of the medical history and physical examination is within normal limits, as is her
husband's
semen analysis. Normal ovulatory status has been documented by basal body temperature
monitoring
and luteal-phase progesterone measurement. Your next best step is to recommend
a:
normal pelvic ultrasonography
b:
hysterosalpingogram (HSG)
c:
in vitro fertilization - embryo transfer (IVF-ET)
d:
11 | P a g emyomectomy
e:
arterial embolization of the fibroids
12:
A 36-year-old woman with regular, monthly, 5-day menstrual cycles presents with a 2-year history
of
severe right-sided pelvic pain. Pelvic examination reveals no abnormalities. She reports insomnia,
loss of
appetite, and decreased libido. The patient once considered evaluation for infertility but now does
not
desire childbearing. She has had three laparoscopic procedures in the last 18 months that showed
minmal peritoneal adhesions, with no change in the pain. Appropriate management of this includes
a:
repeat diagnostic laparoscopy
b:
barium enema, intravenous pyelography, and plevic ultrasonography
c:
presacral neurectomy
d:
transabdominal hysterectomy and bilateral salpingo-oophorectomy
e:
psychological counseling with antidepressant therapy
13:
A 63-year-old woman with 6 months of early satiety and increased abdominal girth has an
abdominal
fluid wave and a palpable 12 cm nodular right adnexal mass. The next BEST step would be for her to
obtain
a:
a diagnostic laparoscopy
b:
a staging laparotomy and debulking for her presumed ovarian cancer
c:
a CT scan to get the exact dimensions of the mass
d:
chemotherapy
e:
an ultrasonography to determine if the mass is cystic or solid
14:
A 42-year-old woman, G2P2, who had a laparoscopic tubal fulguration 7 years ago, has abnormal
uterine
bleeding. Her menstrual cycle has been 28-30 days with a menstrual flow of 5-6 days. During the
last 6
months, the interval has varied from 14 to 35 days and the menstrual flow has lasted from 1 to 14
days.
The uterus is irregular and firm and consistent in size with an 8-week gestation. Both ovaries are
palpably normal in size. Urine pregnancy test is negative. The most appropriate next step in
management is
a:
endometrial sampling
b:
laparoscopy
12 | P a g ec:
transabdominal ultrasonography
d:
pelvic CT e:
hysteroscopy
15:
A 19-year-old primigravid woman is seen because of vaginal bleeding. Her LMP was about 11
weeks ago;
the vagina contains a small amount of dark blood and the cervix is long and closed. The uterus is
enlarged and not tender. A pelvic ultrasonography demonstrates an intrauterine gestational sac but
no
fetal pole is identified. The patient is distraught but declines surgical management. Of the
following, the
most appropriate management of this patient's condition is
a:
combination oral contraceptive pills
b:
methotrexate intramuscular injection
c: depot medroxyprogesterone acetate
d: oral broad-spectrum antibiotic thearpy
e:
mifepristone pills and vaginal misoprostol
ANS: [cddbc eaecc beaae]
Chapter 4 Assessing Adolescent Women’s Health Renee Sieving, Sarah Stoddard,
Deborah A. Raines
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%
13 | P a g eAnswer: 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 ofpuberty
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
14 | P a g eAnswer: D
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
15 | P a g e9. 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%
16 | P a g eAnswer: 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 ofnoncompliance
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. Amammogram
Answer: C
14. In a 2013 survey of the Youth Risk Behavior Surveillance System, what percentage ofhigh
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
17 | P a g ethe nurse use?
A. Tanner staging
B. CRAFFT screening
C. Motivational interviewing
D. Mini-Cog assessment
Answer: A
Chapter 5 Assessing Adult Women’s Health Diane Marie Schadewald, Catherine Juve,
Ellis Quinn Youngkin, Marcia Szmania Davis
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 ofage
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?
18 | P a g eA. 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 ofmenses, 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
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
19 | P a g eC. Back pain
D. Depressedmood
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
20 | P a g eB. 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 161mg/dL
Answer: A, C, E
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?
21 | P a g eA. None—she is already maintaining her [Show Less]