A client with superficiаl urinаry blаdder cancer receives intravesical Bacillus Calmette-Guérin (BCG) therapy. The client is surprised tо learn that a live attenuated bacterium related tо the оrganism causing tuberculosis is intentionally introduced into the bladder. The nurse explains that this therapy uses the immune response to target cancerous cells. Which mechanism best describes its therapeutic effect?
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InstructiоnsReаd eаch questiоn cаrefully.Answer each questiоn by bubbling your answer on the Scantron answer sheet.After you have finished answering all questions, select TRUE.Click Finish Attempt at the bottom of the page.On the next page, click Submit All and Finish.If a confirmation message appears, click Submit All and Finish again to complete your submission.Once your assessment has been submitted successfully, notify your proctor that you are finished. Please wait for the proctor's instructions before proceeding to the next step.Chapters 1-6 Key/Variation C____ 1. At what age do current guidelines recommend that cervical cancer screening with Pap tests should begin for women? a. Cervical cancer screening with Pap tests should begin when women become sexually active regardless of their chronological age c. Cervical cancer screening with Pap tests should begin at 21 years of age according to current screening guidelines b. Cervical cancer screening with Pap tests should begin at 18 years of age regardless of sexual activity status or risk factors d. Cervical cancer screening with Pap tests should begin at 25 years of age to align with peak incidence of cervical abnormalities ____ 2. What percentage of American women experience substance abuse as a health problem according to current estimates? a. Substance abuse affects approximately 5.6% of American women across all ages, races, ethnic groups, and socioeconomic levels c. Substance abuse affects approximately 15.2% of American women with higher prevalence among lower socioeconomic groups b. Substance abuse affects approximately 58.5% of American women primarily in the reproductive age group d. Substance abuse affects approximately 31.0% of American women with significant disparities based on race and ethnicity ____ 3. What biochemical mechanism underlies the pathophysiology of primary dysmenorrhea in women with ovulatory cycles? a. Elevated progesterone secretion causing prolonged endometrial proliferation with associated pelvic congestion and inflammatory mediator release c. Excessive prostaglandin F2-alpha release increasing uterine contraction amplitude and frequency while causing arteriolar vasospasm and ischemia b. Decreased estrogen levels during the luteal phase resulting in inadequate endometrial development and subsequent irregular uterine contractions d. Insufficient luteinizing hormone production leading to incomplete corpus luteum formation with resultant hormonal imbalance and cramping ____ 4. What characteristic vaginal discharge finding distinguishes trichomoniasis from other common vaginal infections? a. Minimal clear mucoid discharge with associated vulvar erythema and excoriations from scratching without characteristic odor c. Thick white lumpy cottage cheese-like discharge found in patches on vaginal walls with associated yeasty odor b. Yellowish-to-greenish frothy mucopurulent copious malodorous discharge that often worsens during and after menstruation d. Thin grayish-white discharge with fishy odor that intensifies after intercourse and demonstrates elevated vaginal pH ____ 5. What gestational week marks the completion of placental structure development? a. Placental structure is complete by the 20th week of gestation when the placenta covers half of the uterine surface c. Placental structure is complete by the 8th week of gestation when genetic testing can be performed on chorionic villi b. Placental structure is complete by the 12th week of gestation and continues to grow wider until 20 weeks d. Placental structure is complete by the 5th month of gestation when only the syncytium layer remains ____ 6. What factor contributes to the increasing maternal mortality rate in the United States? a. Increased prevalence of chronic medical conditions such as heart disease, diabetes, and obesity among pregnant women c. Decreased utilization of preconception counseling services and first-trimester prenatal care among all racial groups b. Decreased access to electronic fetal monitoring technology and point-of-care testing equipment in hospital labor and delivery units d. Reduced availability of neonatal intensive care units and specialized perinatal services in regional health care centers ____ 7. What volume of amniotic fluid indicates oligohydramnios during pregnancy? a. Less than 300 mL of amniotic fluid indicates oligohydramnios and is associated with fetal renal abnormalities c. Less than 700 mL of amniotic fluid indicates oligohydramnios and is associated with fetal renal abnormalities b. Less than 100 mL of amniotic fluid indicates oligohydramnios and is associated with fetal renal abnormalities d. Less than 500 mL of amniotic fluid indicates oligohydramnios and is associated with fetal renal abnormalities ____ 8. What reproductive alternative involves fertilization of a donor egg with the male partner's sperm followed by transfer to the recipient woman's uterus? a. Surrogate motherhood with insemination of the surrogate using sperm from the infertile woman's partner and subsequent adoption c. Therapeutic donor insemination with intrauterine placement of screened donor sperm into the recipient woman's uterus during ovulation b. Oocyte donation with laboratory fertilization of donor eggs and hormonal preparation of the recipient woman for embryo transfer d. Intracytoplasmic sperm injection with micromanipulation technique introducing sperm directly into the woman's own retrieved eggs ____ 9. What infection control principle must nurses apply when providing care to maternal and pediatric patients in the home setting? a. Universal Precautions must replace Standard Precautions in home settings because barrier protection is limited in non-hospital environments c. Transmission-Based Precautions must be used universally for all home care patients because the home environment cannot be adequately controlled b. Body substance isolation must be the primary approach in home care since families cannot maintain the sterile techniques required in hospitals d. Standard Precautions must be implemented for all patients to reduce transmission risk from blood, body fluids, nonintact skin, and mucous membranes ____ 10. What concept describes the professional interaction with families that maintains family control over their lives while fostering their strengths and abilities? a. Collaboration describes the partnership between nurses and families in planning, implementing, and evaluating care for the child and family c. Empowerment describes interactions that help families maintain or acquire control over family life and acknowledge positive changes from helping behaviors b. Advocacy describes the nurse's role in representing family interests and ensuring families receive appropriate resources and support services d. Enabling describes creating opportunities for families to display current competencies and acquire new ones to meet child and family needs ____ 11. What structures develop from the endoderm primary germ layer during embryonic development? a. The endoderm gives rise to the skeletal muscles, dermis and connective tissue, and spleen c. The endoderm gives rise to the bones and teeth, cardiovascular system, and urogenital system b. The endoderm gives rise to the liver and pancreas, respiratory tract epithelium, and bladder d. The endoderm gives rise to the epidermis, central nervous system, and lens of the eye ____ 12. What communication approach demonstrates appropriate nursing practice when conducting a history and physical examination for a woman with hearing impairment? a. Addressing the woman directly with slow, clear enunciation in full view while avoiding the temptation to speak primarily with the interpreter c. Relying primarily on family members and significant others to communicate assessment questions and provide detailed explanations of examination procedures b. Speaking directly to the interpreter while maintaining professional distance to ensure accurate translation of all medical terminology and assessment findings d. Positioning oneself behind the woman during the interview to minimize distractions and allow the interpreter to maintain the woman's full attention ____ 13. What percentage of infertility cases involves male factors either alone or in combination with female factors? a. Approximately 50% of infertility cases are attributed to male factors alone or combined male and female factors c. Approximately 30% of infertility cases are attributed to male factors alone or combined male and female factors b. Approximately 20% of infertility cases are attributed to male factors alone or combined male and female factors d. Approximately 40% of infertility cases are attributed to male factors alone or combined male and female factors ____ 14. What percentage represents the reported reduction in mother-to-child HIV transmission when pregnant women receive triple-drug antiretroviral therapy during pregnancy? a. Mother-to-child HIV transmission decreases to approximately 10% to 15% when pregnant women receive triple-drug ART throughout pregnancy c. Mother-to-child HIV transmission decreases to approximately 5% to 8% when pregnant women receive triple-drug ART throughout pregnancy b. Mother-to-child HIV transmission decreases to approximately 1% to 2% when pregnant women receive triple-drug ART throughout pregnancy d. Mother-to-child HIV transmission decreases to approximately 3% to 5% when pregnant women receive triple-drug ART throughout pregnancy ____ 15. What assessment framework does the CDC recommend for identifying risky behaviors during sexually transmitted infection prevention counseling? a. The PLISSIT model evaluating permission, limited information, specific suggestions, and intensive therapy for sexual health concerns c. The ABCDE approach addressing abstinence, barrier methods, contraception, disease screening, and education about transmission risks b. The HEADSS assessment examining home, education, activities, drugs, sexuality, and suicide risk factors in reproductive health d. The "five Ps" framework assessing partners, practices, prevention of pregnancy, protection from STIs, and past history of STIs ____ 16. What term describes the comprehensive time period that includes preconception, pregnancy, labor and birth, and the postpartum period? a. The antepartum period encompasses all phases of care from preconception counseling through the first weeks following birth c. The perinatal period encompasses all stages including preconception, pregnancy, labor and birth, and the postpartum period b. The intrapartum period encompasses all stages from pregnancy planning through labor, birth, and postpartum recovery d. The postpartum period encompasses all care provided from the beginning of pregnancy through six weeks after birth ____ 17. What period represents the time of greatest susceptibility to teratogenic effects during prenatal development? a. The period from 8 weeks through the second trimester when fetal organs undergo functional maturation c. The period from 8 weeks through the second trimester when fetal organs undergo functional maturation b. The period from days 15 to 60 when both cell number and size are increasing during organogenesis d. The period from fertilization through the first 2 weeks when teratogens cause either no effect or miscarriage ____ 18. What legal concept defines the level of practice expected of a perinatal nurse when determining negligence? a. The standard of care represents the average level of practice demonstrated by all nurses working in perinatal settings nationwide c. The standard of care represents that level of practice a reasonably prudent nurse would provide in the same or similar circumstances b. The standard of care represents the minimum level of practice required by state nursing licensure boards for all registered nurses d. The standard of care represents the ideal level of practice described in nursing textbooks and academic literature for expert practitioners ____ 19. What service represents a component of the nurse's role in linking maternity patients throughout the perinatal continuum of care? a. Establishing hospital admission criteria and determining appropriate length of stay for all maternity patients during labor c. Performing comprehensive physical examinations and diagnostic testing to identify complications requiring immediate hospital readmission b. Coordinating insurance authorization processes and managing billing documentation for all perinatal services provided to families d. Conducting specialized education programs and parent support groups to provide information and emotional support during the perinatal period ____ 20. What timeframe does the perinatal continuum of care encompass in maternal nursing practice? a. The perinatal continuum includes care during the prenatal period, labor and birth, and the first six weeks following delivery c. The perinatal continuum includes care from conception through the first year of the infant's life and postpartum recovery b. The perinatal continuum includes care before pregnancy, during pregnancy and birth, and the days immediately afterward d. The perinatal continuum includes care during the three trimesters of pregnancy and the immediate recovery period after birth ____ 21. What characteristic distinguishes fibroadenoma from fibrocystic changes in terms of response to the menstrual cycle? a. Fibroadenomas exhibit increased tenderness during menstruation but maintain consistent size while fibrocystic changes vary in both c. Fibroadenomas remain stable in size throughout the menstrual cycle while fibrocystic changes typically show cyclical fluctuations b. Fibroadenomas demonstrate cyclical size variations with enlargement before menses and regression after menses similar to simple cysts d. Fibroadenomas decrease in size during the luteal phase due to progesterone effects while fibrocystic changes increase in size ____ 22. What infection control practice represents the standard of care during labor and birth to prevent transmission of bloodborne pathogens? a. Implementing contact precautions with gown and glove use only when caring for patients with known HIV or hepatitis B diagnosis c. Restricting barrier protection use to procedures involving visible blood contamination to minimize unnecessary personal protective equipment waste b. Performing hand hygiene before and after patient contact while applying standard precautions to all maternal and newborn assessments d. Establishing airborne precautions with negative pressure rooms for all women in active labor due to aerosolized body fluid risk ____ 23. What developmental milestone occurs during the embryonic stage of development? a. The embryo experiences rapid brain growth that results in the brain reaching one-half of adult size c. The embryo develops sufficient pulmonary surfactant in the alveoli to support extrauterine respiratory function b. The embryo develops mature alveolar cells and terminal bronchioles that enable adequate gas exchange d. The embryo undergoes organogenesis with formation of all organ systems and external structures by 8 weeks ____ 24. What breast assessment finding during the initial prenatal physical examination suggests potential concerns with adequate milk production for breastfeeding? a. Presence of colostrum expression from the nipples and darkening of the areola observed during the second trimester c. Presence of Montgomery tubercles on the areola and increased breast tenderness reported during the first trimester examination b. Asymmetry of the breasts or tubular-shaped breasts indicating a lack of glandular tissue necessary for milk production d. Slight increase in breast size and visible superficial venous patterns noted bilaterally during the prenatal assessment ____ 25. What telephonic nursing service provides new parents with support, encouragement, and basic parenting education as a community service? a. Warm lines provide telephone support offered as a community service to give new parents encouragement, support, and basic parenting education c. Nurse advice lines provide toll-free consultation services supported by third-party payers to answer medical questions and guide callers through urgent situations b. Telehealth services provide interactive and responsive communication to address immediate health care questions about specific health care needs using technology d. Telephonic nursing assessments provide nurse consultation and health education during telephone conversations added to the nursing care plan with skilled visits ____ 26. What maternal population requires nurses to plan additional supportive counseling during the postpartum period according to evidence-based practice? a. Multiparous mothers with previous successful breastfeeding experiences who demonstrate confidence in infant care and feeding techniques c. First-time mothers inexperienced in child care and women whose careers had provided outside stimulation before childbirth b. Mothers who delivered vaginally without complications and have established social networks within their residential communities d. Mothers with strong extended family support systems who have multiple relatives available to assist with household tasks and childcare ____ 27. What overarching goal of Healthy People 2030 addresses the reduction of maternal and infant mortality disparities? a. Attain healthy, thriving lives and well-being, free of preventable disease, disability, injury, and premature death across all populations c. Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all b. Create social, physical, and economic environments that promote attaining full potential for health and well-being for all d. Promote healthy development, healthy behaviors, and well-being across all life stages from preconception through older adulthood ____ 28. What average cost should nurses inform couples to expect for one cycle of in vitro fertilization with embryo transfer? a. One cycle of IVF-ET averages approximately $15,000 with significant regional variation across the United States c. One cycle of IVF-ET averages approximately $20,000 with significant regional variation across the United States b. One cycle of IVF-ET averages approximately $10,000 with significant regional variation across the United States d. One cycle of IVF-ET averages approximately $5,000 with significant regional variation across the United States ____ 29. What expected outcome demonstrates effective contraceptive counseling by the nurse? a. The woman verbalizes understanding of appropriate contraceptive methods and uses the chosen method correctly and consistently c. The woman describes normal menstrual cycle physiology and recognizes deviations from her typical menstruation pattern b. The woman identifies signs and symptoms of sexually transmitted infections and agrees to notify all partners if infected d. The woman demonstrates ability to perform monthly breast self-examination and schedules annual gynecologic examination appointments ____ 30. What systemic factor serves as a root cause of maternal mortality disparities between Black women and White women in the United States? a. Genetic predisposition and inherited biological differences that increase pregnancy complications among women of different racial backgrounds c. Educational attainment levels and lack of health literacy that prevent Black women from understanding prenatal care recommendations b. Geographic location and rural residence patterns that limit Black women's proximity to tertiary care hospitals and specialty providers d. Structural racism perpetuated through societal systems that creates inequities in health care access and social determinants of health ____ 31. What characteristic describes LGBTQIA families in contemporary family structures? a. LGBTQIA families are considered alternative family forms because they represent a deviation from traditional nuclear family norms and structures c. LGBTQIA families represent another form of family structure that may include same-sex couples, single parents, or multiple parenting figures b. LGBTQIA families consist exclusively of same-sex couples who have adopted children from previous heterosexual unions or foster care systems d. LGBTQIA families are limited to married same-sex couples with children conceived through assisted reproductive technology or surrogacy arrangements ____ 32. What professional development process must nurses engage in throughout their careers to provide culturally competent care to diverse maternal and pediatric populations? a. Continually developing and refining attitudes and behaviors that acknowledge, respect, and appreciate ethnic, cultural, and linguistic diversity c. Adopting standardized communication protocols that eliminate language barriers and ensure consistent care across all cultural groups b. Completing mandatory annual cultural competency training modules that cover basic information about major ethnic groups and their healthcare practices d. Memorizing specific cultural practices and traditions of all ethnic groups to ensure appropriate care delivery for every patient encounter ____ 33. What nursing approach best supports family health by building on inherent family capabilities? a. Recognizing family strengths and unique functioning styles to provide individualized support that enhances existing family resources effectively c. Implementing standardized family care protocols that ensure consistent nursing interventions across all family types and structures uniformly b. Identifying family weaknesses and vulnerabilities to develop comprehensive intervention plans that address all identified deficits systematically d. Establishing nurse-directed family goals and outcomes that align with evidence-based practice guidelines for optimal family functioning ____ 34. What typical failure rate do fertility awareness methods demonstrate during the first year of use? a. Fertility awareness methods have a typical failure rate of 18% during the first year of use c. Fertility awareness methods have a typical failure rate of 24% during the first year of use b. Fertility awareness methods have a typical failure rate of 12% during the first year of use d. Fertility awareness methods have a typical failure rate of 29% during the first year of use ____ 35. What diagnostic method represents the definitive test for confirming the presence of human papillomavirus infection? a. HPV-DNA testing performed in combination with abnormal Pap test results to screen for oncogenic viral types c. Viral screening and typing for HPV combined with cytologic evaluation using the Papanicolaou test for women over 25 years b. Histologic evaluation of a biopsy specimen obtained from suspected lesions to confirm viral presence d. Physical inspection of vulvar, vaginal, and cervical lesions combined with characteristic appearance of genital warts during speculum examination ____ 36. What nursing perspective recognizes that behaviors of childbearing women from different cultures are based on systems of logic different from the biomedical model? a. Transcultural nursing recognizes that all cultures should conform to evidence-based biomedical approaches to ensure safe maternal and infant outcomes c. Ethnocentrism recognizes that Western health care standards provide the foundation for evaluating culturally diverse childbearing practices and beliefs b. Cultural competence recognizes that nurses must accept and adopt the beliefs and values of every culture encountered in clinical practice d. Cultural relativism recognizes that people from different cultural backgrounds perceive and comprehend childbearing objects and situations differently based on their culture ____ 37. What major life stressor represents a priority care need for couples undergoing fertility treatment according to evidence-based nursing practice? a. Psychological support to address effects on self-esteem, relationships, life goals, and emotional distress throughout the treatment process c. Financial planning assistance to manage the considerable expense of medical investigation requiring at least three to four months b. Nutritional counseling to optimize body weight and dietary factors that may contribute to improved fertility outcomes in both partners d. Genetic counseling to identify hereditary conditions that may affect conception success rates and future offspring health status ____ 38. What ethical consideration arises from the use of reproductive technologies such as in vitro fertilization and induced ovulation in perinatal care? a. The allocation of scarce health care resources and third-party payer coverage for reproductive technology services and multiple pregnancy outcomes c. The prohibition of reproductive technology use in women over age 35 due to increased maternal and fetal risks b. The mandatory reporting of all assisted reproduction procedures to state health departments for epidemiological surveillance and tracking d. The requirement for all women of childbearing age to undergo genetic screening before attempting conception with assisted reproduction ____ 39. What challenge represents a disadvantage of providing postpartum home visits to mothers and newborns? a. Home visits limit teaching effectiveness because nurses cannot tailor education to actual home conditions or include other family members in instruction c. Home visits require approximately 2.5 to 3 hours of nursing time per visit when including travel and documentation for a 60- to 90-minute visit b. Home visits increase healthcare costs significantly because they are more expensive than providing equivalent care during a full day of hospitalization d. Home visits prevent comprehensive family assessment because the artificial hospital environment cannot be replicated in the home setting for evaluation ____ 40. What timeframe during the menstrual cycle represents the optimal period for women to perform breast self-examination? a. Immediately before menstruation begins when proliferative breast tissue changes reach their peak activity level for detection c. During the premenstrual phase when breast tissue demonstrates maximum hormonal stimulation and nodular changes are most apparent b. Between 5 to 7 days after menstruation stops when physiologic alterations in breast size and activity reach minimum levels d. During the mid-luteal phase approximately 14 days after ovulation when progesterone effects on breast tissue are stabilized