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Ati maternal newborn exam 1

Total Questions : 33

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Question 1:

A nurse is providing teaching about expected gestational changes to a client who is at 12 weeks of gestation. Which of the following statements by the client indicates a need for further teaching?

Explanation

Choice A reason: Reducing stress level is a good practice for a pregnant client, as it can lower the risk of complications such as preterm labor, hypertension, and low birth weight. Therefore, this statement does not indicate a need for further teaching.

Choice B reason: Using only nonprescription medications while pregnant is a dangerous and incorrect practice, as some over-the-counter drugs can harm the fetus or cause birth defects. The client should always consult with their doctor before taking any medication, whether prescription or nonprescription. Therefore, this statement indicates a need for further teaching.

Choice C reason: Monitoring weight gain during pregnancy is a recommended practice, as it can help the client and the doctor assess the health and growth of the fetus. The client should follow the guidelines for appropriate weight gain based on their pre-pregnancy body mass index (BMI). Therefore, this statement does not indicate a need for further teaching.

Choice D reason: Telling the doctor before using home remedies for nausea is a prudent practice, as some herbal or natural remedies can interact with medications or cause adverse effects on the fetus. The client should also avoid self-medication and seek medical advice for persistent or severe nausea. Therefore, this statement does not indicate a need for further teaching.


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Question 2:

To lower your risk of getting an STD, you should:

Explanation

Choice A reason: Using male condoms is one of the most effective ways to prevent the transmission of STDs, especially those caused by viruses or bacteria. However, condoms are not 100% foolproof and may not protect against some STDs that can be spread by skin-to-skin contact, such as herpes or HPV.

Choice B reason: Having multiple sex partners increases the risk of getting an STD, as it exposes the person to more potential sources of infection. The more partners a person has, the more likely they are to encounter someone who has an STD or does not know their status.

Choice C reason: Delaying sexual relations as long as possible is another way to lower the risk of getting an STD, as it reduces the number of sexual exposures and the chances of encountering an infected partner. Young people are especially vulnerable to STDs, as they may have less knowledge, experience, or access to preventive measures.

Choice D reason: All of the above choices are valid ways to lower the risk of getting an STD, but none of them are sufficient on their own. The best way to prevent STDs is to practice abstinence or be in a mutually monogamous relationship with a tested and uninfected partner. Additionally, regular testing, screening, and treatment are essential for detecting and curing STDs before they cause serious complications.


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Question 3:

A nurse is caring for a client who is at 22 weeks of gestation and has been unable to control her gestational diabetes mellitus with diet and exercise. The nurse should anticipate a prescription from the provider for which of the following medications for the client?

Explanation

Choice A reason: Insulin is the preferred medication for gestational diabetes mellitus, as it does not cross the placenta and has no adverse effects on the fetus. It can be administered subcutaneously or intravenously, depending on the blood glucose level and the type of insulin.

Choice B reason: Glipizide is an oral antidiabetic agent that belongs to the sulfonylurea class. It stimulates the pancreas to secrete more insulin and lowers the blood glucose level. However, it is not recommended for gestational diabetes mellitus, as it can cross the placenta and cause hypoglycemia, macrosomia, or teratogenic effects on the fetus.

Choice C reason: Acarbose is an oral antidiabetic agent that belongs to the alpha-glucosidase inhibitor class. It delays the absorption of carbohydrates from the intestine and reduces the postprandial blood glucose level. However, it is not recommended for gestational diabetes mellitus, as it can cause gastrointestinal side effects, such as flatulence, diarrhea, or abdominal pain, and may interfere with the absorption of other nutrients.

Choice D reason: Repaglinide is an oral antidiabetic agent that belongs to the meglitinide class. It stimulates the pancreas to secrete more insulin and lowers the blood glucose level. However, it is not recommended for gestational diabetes mellitus, as it can cross the placenta and cause hypoglycemia, macrosomia, or teratogenic effects on the fetus.


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Question 4:

When teaching a group of students about chlamydia, which of the following points is most important for the healthcare provider to emphasize?

Explanation

Choice A reason: Chlamydia is not the least common of all the major sexually transmitted diseases. In fact, it is the most common bacterial STD in the world, affecting about 131 million people each year. ¹ Therefore, this statement is false and does not need to be emphasized.

Choice B reason: Good handwashing technique is not the best way to prevent chlamydial infections. Chlamydia is spread through sexual contact, not through casual contact or hygiene. The best way to prevent chlamydial infections is to practice safe sex, such as using condoms, limiting the number of partners, and getting tested regularly. Therefore, this statement is misleading and does not need to be emphasized.

Choice C reason: Most people infected with chlamydia are unaware that they are infected. This is because chlamydia often has no symptoms, or the symptoms are mild and easily ignored. This can lead to serious complications, such as pelvic inflammatory disease, infertility, ectopic pregnancy, and increased risk of HIV. Therefore, this statement is true and needs to be emphasized.

Choice D reason: Burning and pain with urination is a frequent symptom of chlamydial infections. However, this symptom is not specific to chlamydia, as it can also occur with other STDs or urinary tract infections. Moreover, not all people with chlamydia experience this symptom, especially women. Therefore, this statement is not very informative and does not need to be emphasized.


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Question 5:

Caused by a virus that's related to the virus that causes chickenpox, this infection spreads through any form of unprotected sex, and can be spread even when someone has no signs of having it. It has no cure but medications can help control outbreaks. Which of the following infections is being described?

Explanation

Choice A reason: Syphilis is not caused by a virus, but by a bacterium called Treponema pallidum. It can also be spread through unprotected sex, but it has different stages and symptoms than herpes. Syphilis can be cured with antibiotics if detected early.

Choice B reason: HIV/AIDS is caused by a virus, but not one that is related to the virus that causes chickenpox. HIV stands for human immunodeficiency virus, which attacks the immune system and can lead to AIDS (acquired immunodeficiency syndrome). HIV can be spread through unprotected sex, but also through other means such as blood transfusion or sharing needles. HIV cannot be cured, but antiretroviral therapy can help control the infection and prevent AIDS.

Choice C reason: Gonorrhea is not caused by a virus, but by a bacterium called Neisseria gonorrhoeae. It can be spread through unprotected sex, but it usually causes symptoms such as discharge, burning, or pain in the genitals, anus, or throat. Gonorrhea can be cured with antibiotics, but some strains are resistant to treatment.

Choice D reason: Herpes simplex virus is caused by a virus that is related to the virus that causes chickenpox. There are two types of herpes simplex virus: HSV-1 and HSV-2. HSV-1 usually causes oral herpes (cold sores), while HSV-2 usually causes genital herpes. However, both types can infect either area. Herpes can be spread through any form of unprotected sex, and can be transmitted even when there are no visible sores. Herpes has no cure, but antiviral medications can help reduce the frequency and severity of outbreaks.


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Question 6:

A patient asks the healthcare provider about the benefits of receiving the human papillomavirus (HPV) vaccine. Which statement is the most appropriate response by the healthcare provider?

Explanation

Choice A reason: The HPV vaccine can help prevent cervical cancer, as it protects against the most common types of HPV that cause cervical cancer. HPV is a sexually transmitted infection that can infect the cervix and cause abnormal cell changes that may lead to cancer. The HPV vaccine is recommended for both males and females between the ages of 9 and 26.

Choice B reason: The HPV vaccine will not protect you from all types of the virus, as there are more than 100 types of HPV, and the vaccine only covers 9 of them. However, these 9 types are responsible for about 90% of cervical cancers and 80% of anal cancers. The vaccine also does not protect against other sexually transmitted infections, such as chlamydia, gonorrhea, or HIV.

Choice C reason: You will not need to have a booster vaccination each year, as the HPV vaccine is given in a series of 2 or 3 doses, depending on the age of the person. The vaccine provides long-lasting protection, and no additional doses are needed after completing the series.

Choice D reason: You will still need to get a routine cervical exam, as the HPV vaccine does not eliminate the risk of cervical cancer completely. The vaccine does not protect against all types of HPV, and some people may already be infected with HPV before getting the vaccine. Therefore, regular screening with a Pap test and/or an HPV test is still recommended for women aged 21 to 65 to detect any abnormal cells or HPV infection in the cervix.


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Question 7:

A nurse in a provider's office is caring for a client who is at 36 weeks of gestation and scheduled for an amniocentesis. The client asks why she is having an ultrasound prior to the procedure. Which of the following is an appropriate response by the nurse?

Explanation

Choice A reason: This is not an appropriate response by the nurse, as an ultrasound is not a screening tool for spina bifida. Spina bifida is a birth defect that occurs when the spine and spinal cord do not form properly. It can be detected by a blood test that measures the level of alpha-fetoprotein (AFP) or by a detailed ultrasound that shows the spine and the brain.

Choice B reason: This is not an appropriate response by the nurse, as an ultrasound is not necessary to determine if there is more than one fetus. Multiple fetuses can be detected by other methods, such as listening to the fetal heartbeats, measuring the fundal height, or feeling the fetal movements.

Choice C reason: This is an appropriate response by the nurse, as an ultrasound assists in identifying the location of the placenta and fetus. This is important for an amniocentesis, which is a procedure that involves inserting a needle through the abdomen and the uterus to collect a sample of amniotic fluid. The ultrasound helps to guide the needle and avoid injuring the placenta or the fetus.

Choice D reason: This is not an appropriate response by the nurse, as an ultrasound is not useful for estimating fetal age at 36 weeks of gestation. Fetal age can be estimated by an ultrasound in the first trimester, when the fetus is growing at a predictable rate and has distinct features. However, in the third trimester, the fetus grows at different rates and has more variations in size and shape. Therefore, an ultrasound is less accurate and reliable for estimating fetal age at this stage.


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Question 8:

A nurse is teaching a client who is at 23 weeks of gestation about immunizations. Which of the following statements should the nurse include in the teaching?

Explanation

Choice A reason: You can receive an influenza vaccination during pregnancy, as it is safe and recommended for pregnant women. The flu vaccine can protect you and your baby from serious complications of influenza, such as pneumonia, preterm labor, and low birth weight. The flu vaccine can also provide some immunity to your baby for the first few months of life. ¹

Choice B reason: You can receive the Tdap vaccine during pregnancy, as it is safe and recommended for pregnant women. The Tdap vaccine can protect you and your baby from tetanus, diphtheria, and pertussis (whooping cough). Pertussis can be very dangerous for newborns, as it can cause severe coughing, breathing problems, and even death. The Tdap vaccine can also provide some immunity to your baby for the first few months of life.

Choice C reason: You should not receive a varicella vaccine before you deliver, as it is not recommended for pregnant women. The varicella vaccine can protect you and your baby from chickenpox, which can cause serious complications such as skin infections, pneumonia, and birth defects. However, the varicella vaccine is a live vaccine, which means it contains a weakened form of the virus that can cause infection in some people. Therefore, it is not safe for pregnant women or their babies.

Choice D reason: You should not receive the rubella vaccine while breastfeeding, as it is not recommended for breastfeeding women. The rubella vaccine can protect you and your baby from rubella, which can cause serious complications such as miscarriage, stillbirth, and birth defects. However, the rubella vaccine is a live vaccine, which means it contains a weakened form of the virus that can cause infection in some people. Therefore, it is not safe for breastfeeding women or their babies.


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Question 9:

The overall number of cases of STIs is:

Explanation

Choice A reason: None of the above is incorrect because the other choices are not true statements about the overall number of cases of STIs.

Choice B reason: Staying about the same is incorrect because the overall number of cases of STIs is not constant. According to the World Health Organization, more than 1 million STIs are acquired every day worldwide.

Choice C reason: Going down is incorrect because the overall number of cases of STIs is not decreasing. On the contrary, some STIs such as syphilis, gonorrhea, and chlamydia are resurging in many regions due to factors such as antimicrobial resistance, lack of access to prevention and treatment services, and stigma.

Choice D reason: Rising is correct because the overall number of cases of STIs is increasing globally. The World Health Organization estimates that there were 376 million new cases of four curable STIs (chlamydia, gonorrhea, syphilis, and trichomoniasis) in 2016, up from 357 million in 2012. Additionally, there are millions of cases of incurable STIs such as herpes, HPV, and HIV that affect the health and well-being of people worldwide.


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Question 10:

The nurse providing care in a women's health care setting must be aware of which sexually transmitted infection that can be successfully treated and cured?

Explanation

Choice A reason: HIV/AIDS is incorrect because it is not a curable infection. It is a chronic condition that requires lifelong antiretroviral therapy to suppress the virus and prevent complications.

Choice B reason: Chlamydia is correct because it is a curable infection. It is caused by a bacterium that can be eliminated with antibiotics. However, it can cause serious complications such as pelvic inflammatory disease, infertility, and ectopic pregnancy if left untreated.

Choice C reason: Human papillomavirus is incorrect because it is not a curable infection. It is a virus that can cause genital warts and cervical cancer. There is no specific treatment for HPV, but the symptoms can be managed and the risk of cancer can be reduced with regular screening and vaccination.

Choice D reason: Herpes simplex virus is incorrect because it is not a curable infection. It is a virus that can cause painful blisters and sores in the genital area. There is no cure for herpes, but antiviral medications can help reduce the frequency and severity of outbreaks.


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Question 11:

Your patient has gestational diabetes and she is currently on insulin 24 units in the morning and at night. She is worried about her baby and what will happen after the baby is born. In your education of the patient, you explain what will occur after the baby is born. Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother?

Explanation

Choice A reason: Hyperbilirubinemia is incorrect because it is not a major complication of infants of diabetic mothers. It is a condition where the baby has high levels of bilirubin in the blood, which can cause jaundice. It can occur in any newborn, but it is more common in premature babies, babies with blood type incompatibility, or babies with infections.

Choice B reason: Hypoglycemia is correct because it is a major complication of infants of diabetic mothers. It is a condition where the baby has low blood sugar levels, which can cause seizures, lethargy, or poor feeding. It can occur because the baby's pancreas produces too much insulin in response to the mother's high blood sugar levels during pregnancy.

Choice C reason: Hypoinsulinemia is incorrect because it is not a major complication of infants of diabetic mothers. It is a condition where the body does not produce enough insulin, which can cause high blood sugar levels. It can occur in children or adults with type 1 diabetes, but not in newborns of diabetic mothers.

Choice D reason: Hypercalcemia is incorrect because it is not a major complication of infants of diabetic mothers. It is a condition where the baby has high levels of calcium in the blood, which can cause muscle weakness, vomiting, or kidney stones. It can occur in babies with certain genetic disorders, such as Williams syndrome, or babies with hyperparathyroidism, but not in infants of diabetic mothers.


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Question 12:

A nurse is caring for an antepartum client who has iron deficiency anemia. When teaching the client about nutrition, the nurse should emphasize the need for an increased intake of which of the following foods?

Explanation

Choice A reason: Fresh fruits are incorrect because they are not rich sources of iron. They are good sources of vitamin C, which can enhance iron absorption, but they do not provide enough iron by themselves.

Choice B reason: Milk and cheese are incorrect because they are not rich sources of iron. They are good sources of calcium, which is important for bone health, but they can interfere with iron absorption if consumed in excess.

Choice C reason: Whole grain breads are incorrect because they are not rich sources of iron. They are good sources of complex carbohydrates, which provide energy and fiber, but they contain phytates, which can inhibit iron absorption.

Choice D reason: Red meat and organ meats are correct because they are rich sources of iron. They contain heme iron, which is more easily absorbed by the body than non-heme iron from plant sources. They also provide protein, which is essential for tissue growth and repair.


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Question 13:

Iron deficiency anemia often occurs during pregnancy as a result of

Explanation

Choice A: Decreased production of erythrocytes

This is not the primary cause of iron deficiency anemia during pregnancy. While erythrocyte production may be affected in certain conditions, it is not directly linked to iron deficiency anemia in pregnancy¹.

Choice B: Inadequate intake of iron

This is the correct answer. During pregnancy, the body needs more iron to make hemoglobin for the increased volume of blood. If the intake of iron is not sufficient, it could lead to iron deficiency anemia¹.

Choice C: Dilution of hemoglobin concentration

While it's true that the blood volume increases during pregnancy, leading to a relative dilution of hemoglobin, this is not the primary cause of iron deficiency anemia. The main issue is the lack of sufficient iron intake¹.

Choice D: The fetus establishing iron stores

While the fetus does require iron, which it gets from the mother, this is not the primary cause of iron deficiency anemia during pregnancy. The main issue is still the mother's inadequate intake of iron¹.


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Question 14:

Which viral sexually transmitted infection is characterized by a primary infection followed by recurrent episodes?

Explanation

Choice A reason: Human immunodeficiency virus (HIV) is incorrect because it is not characterized by recurrent episodes. It is a chronic infection that progressively damages the immune system and can lead to acquired immunodeficiency syndrome (AIDS).

Choice B reason: Herpes simplex virus (HSV) 2 is correct because it is characterized by recurrent episodes. It is a viral infection that causes genital herpes, which is marked by painful blisters and sores in the genital area. The virus remains dormant in the nerve cells and can reactivate periodically, causing outbreaks.

Choice C reason: Human papillomavirus (HPV) is incorrect because it is not characterized by recurrent episodes. It is a viral infection that causes genital warts and cervical cancer. The virus can persist in the body for a long time, but it does not cause repeated symptoms.

Choice D reason: Cytomegalovirus (CMV) is incorrect because it is not characterized by recurrent episodes. It is a viral infection that usually causes mild or no symptoms in healthy people, but can be serious in people with weakened immune systems or unborn babies. The virus can remain latent in the body, but it does not cause flare-ups.


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Question 15:

Iron deficiency anemia often occurs during pregnancy as a result of

Explanation

Choice A reason: This is incorrect. Decreased production of erythrocytes (red blood cells) is a consequence, not a cause, of iron deficiency anemia. Iron is needed to make hemoglobin, the protein that carries oxygen in the red blood cells. Without enough iron, the body cannot produce enough hemoglobin or red blood cells¹.

Choice B reason: This is correct. Inadequate intake of iron is the most common cause of iron deficiency anemia during pregnancy. Pregnant women need more iron than nonpregnant women to support the increased blood volume and the fetal growth. If the dietary intake of iron is not sufficient, the body will use up its iron stores, leading to iron deficiency anemia.

Choice C reason: This is incorrect. Dilution of hemoglobin concentration is a normal physiological change during pregnancy, not a cause of iron deficiency anemia. The blood volume increases by 20% to 30% during pregnancy, while the red blood cell mass increases by only 15% to 20%. This results in a lower concentration of hemoglobin in the blood, but not necessarily a lower amount of hemoglobin or iron³.

Choice D reason: This is incorrect. The fetus establishing iron stores is not a cause of iron deficiency anemia during pregnancy, although it can contribute to it. The fetus needs iron for its own development and growth, and it obtains iron from the mother through the placenta. The fetal iron demand increases in the second and third trimesters, when the fetus accumulates iron in its liver and other tissues. This can deplete the maternal iron stores, especially if the mother does not consume enough iron.


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Question 16:

Which of the following sexually transmitted infections is caused by a bacterium called Neisseria gonorrhoeae, often produces no symptoms, but can be treated with antibiotics? If symptoms occur, they may include painful urination and discharge from the penis or vagina. If left untreated, the infection can result in more serious long-term problems, including infertility, pain, and joint problems.

Explanation

Choice A reason: Human papillomavirus is incorrect because it is not caused by a bacterium, but by a virus. It can cause genital warts and cervical cancer, but it cannot be cured with antibiotics.

Choice B reason: Gonorrhea is correct because it is caused by a bacterium called Neisseria gonorrhoeae, often produces no symptoms, but can be treated with antibiotics. If symptoms occur, they may include painful urination and discharge from the penis or vagina. If left untreated, the infection can result in more serious long-term problems, including infertility, pain, and joint problems.

Choice C reason: Herpes simplex virus is incorrect because it is not caused by a bacterium, but by a virus. It can cause genital herpes, which is marked by painful blisters and sores in the genital area. It cannot be cured with antibiotics, but antiviral medications can help reduce the frequency and severity of outbreaks.

Choice D reason: Cytomegalovirus is incorrect because it is not caused by a bacterium, but by a virus. It usually causes mild or no symptoms in healthy people, but can be serious in people with weakened immune systems or unborn babies. It cannot be cured with antibiotics, but antiviral medications can help treat the symptoms.


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Question 17:

The drug of choice for syphilis treatment is

Explanation

Choice A reason: Ceftriaxone is incorrect because it is not the drug of choice for syphilis treatment. It is a cephalosporin antibiotic that can be used for other bacterial infections, such as gonorrhea, meningitis, or pneumonia.

Choice B reason: Penicillin G is correct because it is the drug of choice for syphilis treatment. It is a penicillin antibiotic that can effectively cure syphilis at any stage, except for neurosyphilis, which requires intravenous administration.

Choice C reason: Acyclovir is incorrect because it is not the drug of choice for syphilis treatment. It is an antiviral medication that can be used for viral infections, such as herpes simplex virus, varicella-zoster virus, or cytomegalovirus.

Choice D reason: Tetracycline is incorrect because it is not the drug of choice for syphilis treatment. It is a tetracycline antibiotic that can be used for other bacterial infections, such as chlamydia, acne, or Lyme disease.


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Question 18:

A nurse is caring for a client who is to undergo an amniotomy. Which of the following is the priority nursing action following this procedure?

Explanation

Choice A reason: Assessing the fetal heart rate pattern is the priority nursing action following an amniotomy because it can indicate the well-being of the fetus and the presence of any complications, such as cord compression, prolapse, or infection.

Choice B reason: Observing the color and consistency of fluid is an important nursing action following an amniotomy, but it is not the priority. It can provide information about the gestational age, the presence of meconium, or the risk of infection.

Choice C reason: Assessing the client's temperature is an important nursing action following an amniotomy, but it is not the priority. It can help detect signs of infection, such as chorioamnionitis, which can affect both the mother and the fetus.

Choice D reason: Evaluating the client for the presence of chills and increased tenderness using palpation is an important nursing action following an amniotomy, but it is not the priority. It can also help detect signs of infection, such as chorioamnionitis, which can cause fever, abdominal pain, and uterine contractions.


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Question 19:

Safe sex practices include avoiding the exchange of body fluids. The most essential component of counseling related to the prevention of sexually transmitted infections and human immunodeficiency virus is discussion of condom use. Nurses can help motivate clients to use condoms by initiating a discussion about which of the following?

Explanation

Choice A reason: Strategies to enhance condom use is correct because it is the most effective way to motivate clients to use condoms consistently and correctly. Some of these strategies include providing education, demonstrating skills, addressing barriers, and promoting communication.

Choice B reason: Places to carry condoms safely is incorrect because it is not the most essential component of counseling related to the prevention of sexually transmitted infections and human immunodeficiency virus. It is a practical aspect of condom use, but it does not address the underlying attitudes, beliefs, and behaviors that influence condom use.

Choice C reason: Leaving the decision up to the male partner is incorrect because it is not a way to motivate clients to use condoms. It is a passive and disempowering approach that can increase the risk of infection and unwanted pregnancy. Clients should be encouraged to take an active role in their sexual health and negotiate condom use with their partners.

Choice D reason: Choice of colors and special features is incorrect because it is not the most essential component of counseling related to the prevention of sexually transmitted infections and human immunodeficiency virus. It is a superficial aspect of condom use, but it does not address the underlying attitudes, beliefs, and behaviors that influence condom use.


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Question 20:

Which of the following is a bacterial infection that spreads through any form of unprotected sex and by skin contact? Typically, it has stages of increasingly serious symptoms. If untreated, it may affect the heart, eyes, and brain. It can be treated with antibiotics.

Explanation

Choice A reason: Gonorrhea is incorrect because it is not the infection described in the question. It is a bacterial infection that spreads through any form of unprotected sex, but it does not have stages of symptoms or affect the heart, eyes, and brain. It can cause pain, discharge, and inflammation in the genitals, anus, or throat. It can be treated with antibiotics.

Choice B reason: Syphilis is correct because it is the infection described in the question. It is a bacterial infection that spreads through any form of unprotected sex and by skin contact. It has stages of symptoms, such as sores, rashes, fever, and fatigue. If untreated, it can affect the heart, eyes, and brain, causing serious complications. It can be treated with antibiotics.

Choice C reason: Chlamydia is incorrect because it is not the infection described in the question. It is a bacterial infection that spreads through any form of unprotected sex, but it does not have stages of symptoms or affect the heart, eyes, and brain. It often causes no symptoms, but it can cause pain, discharge, and bleeding in the genitals or rectum. It can be treated with antibiotics.

Choice D reason: Trichomoniasis is incorrect because it is not the infection described in the question. It is a parasitic infection that spreads through any form of unprotected sex, but it does not have stages of symptoms or affect the heart, eyes, and brain. It can cause itching, burning, and odor in the genitals. It can be treated with antiparasitic drugs.


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Question 21:

Which of the following is transmitted through direct contact with the blood or body fluid of someone who is infected (usually through unprotected sex, sharing needles, or passed from a mother to a baby at birth)? Symptoms may take 10 years or more to show. Once they appear, the person is susceptible to life-threatening infections.

Explanation

Choice A reason: Herpes simplex virus is incorrect because it is not the infection described in the question. It is transmitted through direct contact with the skin or mucous membranes of someone who is infected, usually through oral or genital sex. Symptoms include painful blisters and sores in the mouth or genitals. It does not cause life-threatening infections, but it can increase the risk of other sexually transmitted infections.

Choice B reason: Human papillomavirus is incorrect because it is not the infection described in the question. It is transmitted through direct contact with the skin or mucous membranes of someone who is infected, usually through genital sex. Symptoms include genital warts and cervical cancer. It does not cause life-threatening infections, but it can increase the risk of other cancers.

Choice C reason: Human immunodeficiency virus is correct because it is the infection described in the question. It is transmitted through direct contact with the blood or body fluid of someone who is infected, usually through unprotected sex, sharing needles, or passed from a mother to a baby at birth. Symptoms may take 10 years or more to show. Once they appear, the person is susceptible to life-threatening infections, such as pneumonia, tuberculosis, or cancer. This condition is also known as acquired immunodeficiency syndrome (AIDS).

Choice D reason: Cytomegalovirus is incorrect because it is not the infection described in the question. It is transmitted through direct contact with the saliva, urine, or breast milk of someone who is infected, usually through kissing, sexual contact, or breastfeeding. Symptoms are usually mild or absent in healthy people, but they can be serious in people with weakened immune systems or unborn babies. It does not cause life-threatening infections, but it can cause birth defects, hearing loss, or vision problems.


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Question 22:

A nurse is caring for a client who has a new prescription for ferrous sulfate tablets twice daily for iron deficiency anemia. The client asks the nurse why the provider instructed that she take the ferrous sulfate between meals. Which of the following responses should the nurse make?

Explanation

Choice A reason: Taking the medication between meals will help you avoid becoming constipated is incorrect because it is not the reason why the provider instructed that she take the ferrous sulfate between meals. It is a possible benefit of taking the medication between meals, but it is not the main purpose. Iron supplements can cause constipation, but this can be prevented by drinking plenty of fluids, eating high-fiber foods, and exercising regularly.

Choice B reason: The medication can cause nausea if taken with food is incorrect because it is not the reason why the provider instructed that she take the ferrous sulfate between meals. It is a possible side effect of taking the medication with or without food, but it is not the main reason. Iron supplements can cause nausea, but this can be reduced by taking the medication with a small amount of food, such as crackers, or by taking an antiemetic medication.

Choice C reason: Taking the medication between meals will help you absorb the medication more efficiently is correct because it is the reason why the provider instructed that she take the ferrous sulfate between meals. It is the main purpose of taking the medication between meals, as iron absorption is enhanced when the stomach is empty and the pH is low. Iron supplements can interact with food components, such as calcium, phytates, and tannins, and reduce the amount of iron that is absorbed by the body.

Choice D reason: Taking the medication with food increases the risk of esophagitis is incorrect because it is not the reason why the provider instructed that she take the ferrous sulfate between meals. It is a possible complication of taking the medication without enough water, but it is not the main reason. Iron supplements can cause esophagitis, which is inflammation of the esophagus, if they are not swallowed properly or if they get stuck in the throat. This can be prevented by taking the medication with a full glass of water, sitting upright, and not lying down for at least 30 minutes after taking the medication.


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Question 23:

Intrauterine growth restriction (IUGR) is associated with numerous pregnancy-related risk factors except:

Explanation

Choice A reason: Poor maternal weight gain is a risk factor for IUGR, as it indicates inadequate nutrition and fetal growth.

Choice B reason: Premature rupture of membranes is not a risk factor for IUGR, as it does not affect the placental function or blood flow. It is a complication of pregnancy that can lead to infection, preterm labor, or cord prolapse.

Choice C reason: Smoking is a risk factor for IUGR, as it reduces the oxygen and nutrient delivery to the fetus and causes vasoconstriction of the placental vessels.

Choice D reason: Gestational hypertension is a risk factor for IUGR, as it impairs the placental perfusion and causes fetal hypoxia and acidosis.


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Question 24:

What age group has the highest rates of STD infection?

Explanation

Choice A reason: According to the CDC, nearly half (46%) of all new STDs occur among people between the ages of 15-24¹. This age group also has the highest rates of chlamydia, gonorrhea, and syphilis infections compared to other age groups. Some factors that contribute to this high burden of STDs among young people are biological, behavioral, and social.

Choice B reason: This is incorrect. The age group of 51-60 years old has lower rates of STD infection than the age group of 15-24 years old. According to the CDC, the reported rates of chlamydia, gonorrhea, and syphilis among 51-60 year olds in 2020 were 59.8, 54.7, and 12.4 per 100,000 population, respectively. These rates are much lower than the rates among 15-24 year olds, which were 1,583.3, 1,021.9, and 45.5 per 100,000 population, respectively.

Choice C reason: This is incorrect. The age group of 25-35 years old has lower rates of STD infection than the age group of 15-24 years old. According to the CDC, the reported rates of chlamydia, gonorrhea, and syphilis among 25-35 year olds in 2020 were 1,017.9, 1,015.6, and 66.9 per 100,000 population, respectively. These rates are lower than the rates among 15-24 year olds, which were 1,583.3, 1,021.9, and 45.5 per 100,000 population, respectively.

Choice D reason: This is incorrect. The age group of 36-50 years old has lower rates of STD infection than the age group of 15-24 years old. According to the CDC, the reported rates of chlamydia, gonorrhea, and syphilis among 36-50 year olds in 2020 were 316.6, 337.9, and 27.9 per 100,000 population, respectively. These rates are lower than the rates among 15-24 year olds, which were 1,583.3, 1,021.9, and 45.5 per 100,000 population, respectively.


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Question 25:

A 25-year-old single woman comes to the gynecologist's office for a follow-up visit related to her abnormal Papanicolaou (Pap) smear. The test revealed that the patient has human papillomavirus (HPV). The patient asks, "What is that? Can you get rid of it?" Your best response is:

Explanation

Choice A reason: This is a misleading and dismissive response that does not explain what HPV is or how it can affect the patient's health. It also implies that the patient's condition is trivial and easily resolved, which is not true.

Choice B reason: This is a judgmental and accusatory response that does not answer the patient's question. It also assumes that the patient's current partner is the source of the infection, which may not be the case. HPV can remain dormant for years and be transmitted by previous partners.

Choice C reason: This is a false and alarming response that does not provide accurate information about HPV or HIV. It also scares the patient unnecessarily and does not offer any hope or support.

Choice D reason: This is the best response as it provides a clear and factual explanation of what HPV is and how it can affect the patient's health. It also acknowledges that there is no cure for the infection but that the symptoms can be managed with proper treatment.


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