Maternal and Child Nursing Care 4th Edition London Test Bank

Maternal and Child Nursing Care 4th
Edition London Test Bank

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Question 139317
Id: 139317 Question Title:
Type: MCSA Difficulty Level:
Calculator: false
Question Stem
The nurse is teaching a class to women who were recently diagnosed with benign breast disease (BBD),
commonly known as fibrocystic breast disease. One of the participants reports increased swelling, pain, and
pressure in her breasts just before menstruation. What is the best response by the nurse?
Stimulus
Answer
“Consider asking your nurse practitioner about adding a mild diuretic to your
Choice 1
regimen.”
Treatment of BBD may include taking a mild diuretic during the week prior to
Rationale 1 the onset of menses to counteract fluid retention, relieve pressure in the breast,
and help decrease pain.
Answer 1 true
Choice 2 “The pain may be caused by thinning of the normal breast tissue.”
The pathology of BBD involves fibrosis, which is a thickening of the normal
Rationale 2
breast tissue.
Answer 2 false
“Breast swelling and pressure are expected symptoms, but pain is abnormal
Choice 3
and should be evaluated by your physician.”
Common symptoms associated with BBD include cyclical breast pain,
Rationale 3
tenderness, and swelling.
Answer 3 false
Choice 4 “It's best to make an appointment with an oncologist.”
Cyclical breast pain, swelling, and tenderness are common symptoms
Rationale 4 associated with BBD. Generally fibrocystic changes are not a risk factor for
breast cancer.
Answer 4 false
Global Rationale
Meta 1
Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Implementation
Content Area:
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Sub:
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Reference:
Source Id: Chapter 06_LO 01_Q01
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LO01 - Contrast the contributing factors, signs and symptoms, treatment
Learning Outcome 1: options, and nursing care management of women with common benign breast
disorders.
Learning Outcome 2:
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Question 139318
Calculator: false
Question Stem
The nurse is caring for a patient diagnosed with endometriosis. Which statement by the patient requires
immediate follow-up?
Stimulus
Answer
Choice 1 “I am having many hot flashes since I had the Lupron injection.”
Leuprolide acetate (Lupron) is a GnRH agonist and causes symptoms of a
Rationale 1 hypo-estrogenic state (hot flashes, vaginal dryness, decreased libido, and bone
density loss). Hot flashes are expected and not a complication.
Answer 1 false
Choice 2 “The pain I experience with intercourse is becoming more severe.”
Dyspareunia is a common symptom of endometriosis and therefore is not a
Rationale 2
complication.
Answer 2 false
“My leg has become painful and swollen since I started taking birth control
Choice 3
pills.”
Combination oral contraceptive pills contain estrogen. A painful, swollen
lower extremity can be a sign of deep vein thrombosis, which can cause
Rationale 3
thromboembolus, which is potentially life threatening. This is a complication
and must be addressed immediately.
Answer 3 true
Choice 4 “I’ve noticed my voice is lower since I started taking danazol.”
Danocrine (danazol) is a testosterone derivative that suppresses GnRH and has
Rationale 4 high-androgen and low-estrogen effects. A lowered voice is one side effect of
danazol. This patient is not experiencing a complication.
Answer 4 false
Global Rationale
Meta 1
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Assessment
Content Area:
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Clinical Domain:
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Reference:
Source Id: Chapter 06_LO 02 _Q02
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LO02 - Explain the signs and symptoms, medical therapy, and implications for
Learning Outcome 1:
fertility of endometriosis.
Learning Outcome 2:
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Question 139319
Calculator: false
Question Stem
The nurse is creating a care plan for a patient who is unable to conceive as a consequence of endometriosis.
Which statement accurately reflects a nursing diagnosis that may apply to the care of this patient?
Stimulus
Answer
Choice 1 Acute pain related to dysuria and renal pain secondary to endometriosis
Pelvic pain is a frequent symptom of endometriosis, while dysuria and renal
Rationale 1 pain are more commonly associated with conditions such as upper urinary tract
infections (UTI).
Answer 1 false
Hyperandrogenism related to elevated serum androgen levels secondary to
Choice 2
endometriosis
Hyperandrogenism is a medical diagnosis that pertains to elevated serum
Rationale 2 androgen levels. Hyperandrogenism is associated with polycystic ovarian
syndrome (PCOS).
Answer 2 false
Choice 3 Compromised family coping related to depression secondary to infertility
Infertility may lead to depression and subsequent compromised family coping,
Rationale 3
which is a nursing diagnosis.
Answer 3 true
Infertility related to endometrial inflammation and adhesions secondary to
Choice 4
endometriosis
Although associated with the medical condition of endometriosis, infertility is
Rationale 4
a medical diagnosis.
Answer 4 false
Global Rationale
Meta 1
Client Need: Safe Effective Care Environment
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Diagnosis
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Source Id: Chapter 06_LO02 _Q03
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Learning Outcome 1:
fertility of endometriosis
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Question 139320
Calculator: false
Question Stem
The patient has been diagnosed with endometriosis. She asks the nurse if there are any long-term health risks
associated with this condition. The nurse should include which statement in the patient teaching about
endometriosis?
Stimulus
Answer
Choice 1 “There are no other health risks associated with endometriosis.”
There are long-term health risks associated with endometriosis, including
Rationale 1 increased risk for cancer of the ovary and breast, melanoma, non-Hodgkins
lymphoma, and an increased incidence of fibromyalgia.
Answer 1 false
Choice 2 “Pain with intercourse rarely occurs as a long-term problem.”
Rationale 2 Dyspareunia is a common symptom of endometriosis.
Answer 2 false
Choice 3 “You are at increased risk for ovarian and breast cancer.”
An increased risk for cancer of the ovary and breast is associated with
Rationale 3
endometriosis.
Answer 3 true
Choice 4 “Most women with this condition develop fibromyalgia.”
Rationale 4 There is a risk of increased incidence of fibromyalgia.
Answer 4 false
Global Rationale
Meta 1
Client Need: Physiological Integrity
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Planning
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Question 139321
Calculator: false
Question Stem
A patient diagnosed with polycystic ovarian disease (PCOS) asks her nurse why her treatment regimen includes
spironolactone (Aldactone). How should the nurse respond?
Stimulus
Answer
"Spironolactone may be used to decrease symptoms associated with PCOS,
Choice 1
such as excessive hair growth and acne."
Spironolactone may be used to treat symptoms of hyperandrogenism that are
Rationale 1
secondary to PCOS, including excessive hair growth and acne.
Answer 1 true
"Menstrual irregularities related to polycystic ovarian disease are treated using
Choice 2
spironolactone."
Combined oral contraceptive (COC) or cyclic progesterone are used to treat
Rationale 2
menstrual irregularities associated with PCOS.
Answer 2 false
"Spironolactone is often used to reduce complications associated with PCOS,
Choice 3
including rectocele."
A rectocele, which may develop when the posterior vaginal wall is weakened,
Rationale 3
is associated with pelvic relaxation.
Answer 3 false
"Condylomata acuminata, which are sometimes caused by polycystic ovarian
Choice 4
disease, are treated with spironolactone."
Condylomata acuminata, also called genital or venereal warts, is a sexually
Rationale 4
transmitted condition unrelated to PCOS.
Answer 4 false
Global Rationale
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LO04 - Discuss the signs and symptoms, treatment options, and health
Learning Outcome 1:
implications of polycystic ovarian syndrome (PCOS).
Learning Outcome 2:
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Question 139322
Type: MCMA Difficulty Level:
Calculator: false
Question Stem
The nurse is planning a group session for parents who are beginning infertility evaluation. Which statement
should be included in this session?
Standard Text
Select all that apply.
Stimulus
Answer
Choice 1 “Infertility can be stressful for a marriage.”
Infertility is often stressful on a marriage, as a result of the need to schedule
Rationale 1 intercourse and pay for treatments and the societal expectation to have
children.
Answer 1 true
Choice 2 “The doctor will be able to tell why you have not conceived.”
Rationale 2 Some infertility cannot be explained, despite extensive treatments.
Answer 2 false
Choice 3 “Your insurance will pay for the infertility treatments.”
Rationale 3 Insurance often does not pay for infertility treatment.
Answer 3 false
Choice 4 “Keep communicating with one another through this process.”
Communication is important to help cope with stress. A nurse should always
Rationale 4
encourage patients to ask questions.
Answer 4 true
Choice 5 “Taking a vacation usually results in pregnancy.”
A common myth is that taking a vacation or just relaxing will result in
Rationale 5
conception.
Answer 5 false
Global Rationale
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Cognitive Level: Applying
Client Need Sub:
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Question 139323
Calculator: false
Question Stem
Which patient in the gynecology clinic should the nurse see first?
Stimulus
Answer
Choice 1 22-year-old, using tampons, T=102°F, P=122, BP=70/55
A patient using tampons who is febrile, tachycardic, and hypotensive might
Rationale 1 have toxic shock syndrome. Hypotension is life-threatening; this patient should
be seen immediately.
Answer 1 true
Choice 2 15-year-old, no menses for past four months
Secondary amenorrhea can be caused by pregnancy. Teen pregnancy is a high
Rationale 2 risk, but no indication is given that the patient is exhibiting a life-threatening
condition.
Answer 2 false
Choice 3 18-year-old seeking information on contraception methods
Unplanned pregnancy and sexually transmitted infections can be problematic
Rationale 3 in the future, but this patient exhibits no signs or symptoms of a life-
threatening condition at this time.
Answer 3 false
Choice 4 31-year-old, reports increasing dyspareunia
Although this patient might have endometriosis, dyspareunia is not a life-
Rationale 4
threatening condition.
Answer 4 false
Global Rationale
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LO03 – Summarize the risk factors, treatment options, and nursing interventions
Learning Outcome 1:
for a woman with toxic shock syndrome.
Learning Outcome 2:
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Question 139324
Calculator: false
Question Stem
Which statement indicates that patient teaching has been effective?
Stimulus
Answer
Choice 1 “I should douche weekly to prevent a recurrence of my bacterial vaginosis.”
Douching disrupts normal flora by washing out desirable bacteria; douching is
Rationale 1
not recommended.
Answer 1 false
Choice 2 “I can use this anti-yeast medication weekly to prevent another infection.”
Medication for vaginal yeast infections should be used as treatment, not
Rationale 2 prophylaxis. Using medication as prescribed is important patient education.
Medication should not be saved for future use.
Answer 2 false
Choice 3 “My diabetes is unrelated to the frequency of my vaginal yeast infections.”
Yeast vaginitis is more common in diabetic and pre-diabetic women. Four
Rationale 3 episodes or more per year of yeast vaginitis are an indication to screen a
woman for diabetes.
Answer 3 false
Choice 4 “The fishy vaginal odor I have is caused by a bacterial infection.”
Bacterial vaginosis is characterized by a fishy vaginal odor and greenish
Rationale 4
discharge with a vaginal pH over 4.5.
Answer 4 true
Global Rationale
Meta 1
Client Need Sub:
Nursing/Integrated Concepts: Nursing Process: Evaluation
Content Area:
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LO05 - Compare the causes, signs and symptoms, treatment options, and
Learning Outcome 1: nursing care for women with vulvovaginal candidiasis versus bacterial
vaginosis.
Learning Outcome 2:
Learning Outcome 3:
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Learning Outcome 5:
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Question 139325
Calculator: false
Question Stem
Which patient is at greatest risk for developing Chlamydia trachomatis infection?
Stimulus
Answer
Choice 1 16-year-old, sexually active, using no contraceptive
Teens have the highest incidence of sexually transmitted infections, especially
Rationale 1 Chlamydia. A patient not using contraceptives is not using condoms, which
decrease the risk of contracting a STI.
Answer 1 true
Choice 2 22-year-old mother of two, developed dyspareunia
Dyspareunia sometimes develops with Chlamydia infection, but dyspareunia is
Rationale 2
not a symptom specific to Chlamydia.
Answer 2 false
Choice 3 35-year-old woman on oral contraceptives
There is no correlation between oral contraceptive use and an increased rate of
Rationale 3 Chlamydia infection. Additionally, Chlamydia is more commonly seen in
young women
Answer 3 false
Choice 4 48-year-old woman with hot flashes and night sweats
Rationale 4 This patient is experiencing signs of menopause, not Chlamydia infection.
Answer 4 false
Global Rationale
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Nursing/Integrated Concepts: Nursing Process: Assessment
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LO06 - Compare the common sexually transmitted infections with regard to
Learning Outcome 1:
their etiology, treatment options, nursing care, and methods of prevention.
Learning Outcome 2:
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Learning Outcome 5:
Learning Outcome 6:
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Question 139326
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Question Stem
The physician has prescribed metronidazole (Flagyl) for a woman diagnosed with trichomoniasis. The nurse’s
instructions to the woman should include:
Stimulus
Answer
Choice 1 “Both partners must be treated with the medication.”
Rationale 1 Both partners should be treated with the medication.
Answer 1 true
Choice 2 “Alcohol does not need to be avoided while taking this medication.”
Rationale 2 Alcohol should be avoided.
Answer 2 false
Choice 3 “It will turn your urine orange.”
Rationale 3 Metronidazole does not turn the urine orange.
Answer 3 false
Choice 4 “This medication could produce drowsiness.”
Rationale 4 Metronidazole does not cause drowsiness.
Answer 4 false
Global Rationale
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LO06 – Compare the common sexually transmitted infections with regard to
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Question 139327
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Question Stem
The couple demonstrates understanding of the consequences of not treating Chlamydia when they state:
Standard Text
Stimulus
Answer
Choice 1 “She could become pregnant.”
Rationale 1 Chlamydia does not cause a woman to become pregnant.
Answer 1 false
Choice 2 “She could have severe vaginal itching.”
Rationale 2 Chlamydia does not cause vaginal itching.
Answer 2 false
Choice 3 “He could get an infection in the tube that carries the urine out.”
Rationale 3 Chlamydia is a major cause of nongonococcal urethritis (NGU) in men.
Answer 3 true
Choice 4 “It could cause us to develop rashes.”
Rationale 4 Chlamydia does not cause a rash.
Answer 4 false
Choice 5 “She could develop a worse infection of the uterus and tubes.”
Chlamydia cervicitis can ascend and become pelvic inflammatory disease, or
Rationale 5
infection of the uterus, fallopian tubes, and sometimes ovaries.
Answer 5 true
Global Rationale
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Question 139328
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Question Stem
Which of the following patients should be treated with ceftriaxone (Rocephin) IM and doxycycline (Vibramycin)
orally?
Stimulus
Answer
Choice 1 A pregnant patient with gonorrhea and a yeast infection
Rationale 1 Doxycycline is contraindicated during pregnancy.
Answer 1 false
Choice 2 A non-pregnant patient with gonorrhea and Chlamydia
This combined treatment provides dual treatment for gonorrhea and Chlamydia
Rationale 2
because the two infections frequently occur together.
Answer 2 true
Choice 3 A pregnant patient with syphilis
Rationale 3 Syphilis is treated with penicillin.
Answer 3 false
Choice 4 A non-pregnant patient with Chlamydia and trichomoniasis
Rationale 4 Trichomoniasis is treated with metronidazole.
Answer 4 false
Global Rationale
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Question 139329
Calculator: false
Question Stem
The nurse is preparing a brochure that compares and contrasts cystitis and pyelonephritis. Which information
should be included in the brochure?
Stimulus
Answer
Both conditions usually present with sudden onset of chills, high temperature,
Choice 1
and flank pain.
Acute pyelonephritis has a sudden onset, with chills, high temperature, and
Rationale 1
flank pain (either unilateral or bilateral).
Answer 1 false
Dysuria, especially at the end of urination, is often the initial symptom of both
Choice 2
conditions.
The initial symptom of cystitis is often dysuria, specifically at the end of
Rationale 2
urination.
Answer 2 false
Both conditions are associated with pregnancy complications including
Choice 3
increased risk of preterm birth and of intrauterine growth restriction.
Pyelonephritis during pregnancy is associated with an increased risk of preterm
Rationale 3
birth and intrauterine growth restriction.
Answer 3 false
Choice 4 Urine culture is included in the evaluation of both cystitis and pyelonephritis.
Diagnosis of cystitis is made with a urine culture. Women with acute
Rationale 4 pyelonephritis should have a urine culture and sensitivity done to determine the
appropriate antibiotic.
Answer 4 true
Global Rationale
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Source Id: Chapter 06_LO09 _Q13
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LO09 - Contrast the causes, signs and symptoms, treatment options, and nursing
Learning Outcome 1:
care for women with cystitis versus pyelonephritis.
Learning Outcome 2:
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Question 139330
Calculator: false
Question Stem
The nurse is discharging a patient after hospitalization for pelvic inflammatory disease (PID). Which statements
indicate that teaching was effective?
Standard Text
Stimulus
Answer
Choice 1 “I might have infertility because of this infection.”
Women sometimes become infertile because of scarring in the fallopian tubes
Rationale 1
as a result of the inflammation of PID.
Answer 1 true
Choice 2 “It is important for me to finish my antibiotics.”
Antibiotic therapy should always be completed when a patient is diagnosed
Rationale 2
with any infection.
Answer 2 true
Choice 3 “Tubal pregnancy could occur after PID.”
The tubal scarring that occurs from tubal inflammation during PID can prevent
Rationale 3 a fertilized ovum from passing through the tube into the uterus, causing an
ectopic or tubal pregnancy.
Answer 3 true
Choice 4 “My PID was caused by a yeast infection.”
PID is caused by bacteria, most commonly Chlamydia trachomatis or Neisseria
Rationale 4 gonorrhoeae. Yeast infections do not ascend and become upper reproductive
tract infections.
Answer 4 false
Choice 5 “I am going to have an IUD placed for contraception.”
An intrauterine device (IUD) in place increases the risk of developing PID; a
Rationale 5
patient who has a history of PID is not a good candidate for an IUD.
Answer 5 false
Global Rationale
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LO07 – Summarize the pathology, signs and symptoms, treatment, nursing care,
Learning Outcome 1:
and implications for future fertility of pelvic inflammatory disease.
Learning Outcome 2:
Learning Outcome 3:
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Question 139331
Calculator: false
Question Stem
Which of the following diagnostic tests would the nurse question when ordered for a patient diagnosed with
pelvic inflammatory disease (PID)?
Stimulus
Answer
Choice 1 CBC (complete blood count) with differential
Rationale 1 CBC with differential will give an indication of the severity of the infection.
Answer 1 false
Choice 2 Vaginal culture for Neisseria gonorrhoeae
Rationale 2 Gonorrhea is a common cause of PID, and the patient should be tested for this.
Answer 2 false
Choice 3 Throat culture for Streptococcus A
Rationale 3 Streptococcus of the throat is not associated with PID.
Answer 3 true
Choice 4 RPR (rapid plasma reagin)
Rationale 4 RPR is a test for syphilis, another cause of PID.
Answer 4 false
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LO07 – Summarize the pathology, signs and symptoms, treatment, nursing care,
Learning Outcome 1:
and implications for future fertility of pelvic inflammatory disease.
Learning Outcome 2:
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Question 139332
Calculator: false
Question Stem
The nurse is to tell a patient that her Pap smear result was abnormal. Which statement should the nurse include?
Stimulus
Answer
Choice 1 “The Pap smear is used to diagnose cervical cancer.”
The Pap smear is a screening tool for cervical abnormalities; it is not
Rationale 1
diagnostic.
Answer 1 false
Choice 2 “A loop electrosurgical excision procedure (LEEP) is needed.”
Although LEEP (the removal of the surface tissue of the cervix) might be
Rationale 2 performed to treat cervical dysplasia or carcinoma in situ, this patient has not
had a diagnostic examination yet.
Answer 2 false
Choice 3 “Colposcopy to further examine your cervix is the next step.”
Colposcopy is an examination of the cervix through a magnifying device.
Solutions are often painted onto the cervix and surrounding tissue and
observed for changes secondary to the application of the solution. Biopsy
Rationale 3
samples are taken of suspected abnormal tissue and sent for pathologic
examination and diagnosis. Endocervical canal biopsy is often undertaken with
colposcopy.
Answer 3 true
Choice 4 “Your cervix needs to be treated with cryotherapy.”
Cryotherapy, or freezing of the cervix, is one treatment option for precancerous
Rationale 4 cervical lesions. However, this patient does not yet have a diagnosis; she has
only had an abnormal screening test.
Answer 4 false
Global Rationale
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LO08 – Identify the implications of an abnormal finding during a pelvic
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examination in the provision of nursing care.
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Question 139333
Calculator: false
Question Stem
The nurse is preparing an education session for women on prevention of urinary tract infections (UTIs). Which
statement should be included?
Stimulus
Answer
Choice 1 Lower urinary tract infections rarely occur in women.
About 60% of women will experience an episode of cystitis during their
Rationale 1
lifetime.
Answer 1 false
Choice 2 The most common causative organism of cystitis is E. coli.
Because E. coli is a common bacterium in the bowel and the female urethra is
Rationale 2 short and close to the anus, cross-contamination of bowel bacteria into the
female urinary tract is common.
Answer 2 true
Choice 3 Wiping from back to front after a BM will help prevent a UTI.
Wiping from back to front increases the risk of UTIs because the E. coli of the
Rationale 3 bowel is being drawn towards the urethra. Women should be instructed always
to wipe from front to back.
Answer 3 false
Choice 4 Back pain often develops with a lower urinary tract infection.
Low back or flank pain is a sign of pylonephritis, which is an upper urinary
Rationale 4 tract infection. Signs of a lower UTI include dysuria, urinary frequency, and
urinary urgency.
Answer 4 false
Global Rationale
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LO09 - Contrast the causes, signs and symptoms, treatment options, and nursing
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care for women with cystitis versus pyelonephritis.
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Maternal and Child Nursing Care 4th Edition London Test Bank

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Maternal and Child Nursing Care 4th

Edition London Test Bank

Type: MCSA Difficulty Level:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Pearson Nursing Taxonomy #:

Taxonomy Category Comments:

Source Id: Chapter 06_LO 01_Q01

Source Chapter Number:

Source Chapter Title:

Source Au Title Ed:

Writer First Name: admin

Writer Last Name:

Learning Outcome 10:

Learning Outcome 11:

Learning Outcome 12:

Type: MCSA Difficulty Level:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Pearson Nursing Taxonomy #:

Taxonomy Category Comments:

Source Id: Chapter 06_LO 02 _Q02

Source Chapter Number:

Source Chapter Title:

Source Au Title Ed:

Writer First Name: admin

Writer Last Name:

Learning Outcome 10:

Learning Outcome 11:

Learning Outcome 12:

Type: MCSA Difficulty Level:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Pearson Nursing Taxonomy #:

Taxonomy Category Comments:

Source Id: Chapter 06_LO02 _Q03

Source Chapter Number:

Source Chapter Title:

Source Au Title Ed:

Writer First Name: admin

Writer Last Name:

Learning Outcome 10:

Learning Outcome 11:

Learning Outcome 12:

Type: MCSA Difficulty Level:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Pearson Nursing Taxonomy #:

Taxonomy Category Comments:

Source Id: Chapter 06_LO 02 _Q04

Source Chapter Number:

Source Chapter Title:

Source Au Title Ed:

Writer First Name: admin

Writer Last Name:

Learning Outcome 10:

Learning Outcome 11:

Learning Outcome 12:

Type: MCSA Difficulty Level:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Pearson Nursing Taxonomy #:

Taxonomy Category Comments:

Source Id: Chapter 06_LO 04_Q05