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A woman is admitted for repair of cystocele and rectocele. She has nine living children. In taking her health history, what would the nurse expect to find?
- A. Sporadic vaginal bleeding accompanied by chronic pelvic pain
- B. Menstrual irregularities and hirsutism on the chin
- C. Heavy leukorrhea with vulvar pruritus
- D. Stress incontinence with feeling of low abdominal pressure
- G. D
Correct Answer: Cystocele and rectocele, caused by weakened pelvic support, commonly lead to stress incontinence (urine leakage during pressure) and a feeling of low abdominal pressure due to organ protrusion. Other options suggest unrelated conditions like endometriosis or infections.
Rationale:
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A nurse is working with a woman who has been diagnosed with severe fibrocystic breast disease. After describing the medications that can be used as treatment, the nurse determines that additional teaching is needed when the client identifies which drug as being used?
- A. Danazol
- B. Penicillin
- C. Bromocriptine
- D. Tamoxifen
- G. B
Correct Answer: Penicillin, an antibiotic, has no role in treating fibrocystic breast disease, which involves hormonal changes. Danazol, bromocriptine, and tamoxifen are used to manage symptoms by altering hormone levels.
Rationale:
A nurse is preparing a class discussion on the clinical manifestations of a heart attack observed in women. Which symptoms would the nurse include as key assessment data? Select all that apply.
- A. Sleep disturbances
- B. Syncope
- C. Unusual fatigue
- D. Extreme hunger
- E. Arm pain
- G. A,C,E
Correct Answer: Women may experience sleep disturbances (48%), unusual fatigue (70%), and arm pain (42%) before a heart attack, indicating reduced cardiac function. Syncope (12%) and extreme hunger (4%) are less common.
Rationale:
A nurse is assessing a male client recently diagnosed with genital herpes. Which finding would most likely correlate with this diagnosis?
- A. Reports of itching, tingling, and pain in the genital area
- B. Painful urination with a penile discharge present
- C. Wart-like flesh-colored lesions on the scrotal area
- D. A chancre on the penis
- G. A
Correct Answer: Genital herpes causes itching, tingling, and pain before painful blisters appear. Discharge suggests gonorrhea/chlamydia, warts suggest HPV, and a chancre indicates syphilis.
Rationale:
Which finding would the nurse expect in a client with bacterial vaginosis?
- A. Vaginal pH of 3
- B. Cervical bleeding on contact
- C. Fishy odor of discharge
- D. Yellowish-green discharge
- G. C
Correct Answer: Bacterial vaginosis causes a fishy-smelling, thin, gray-white discharge due to anaerobic bacteria. Vaginal pH rises above 4.5, cervical bleeding suggests other issues, and yellowish-green discharge indicates other infections.
Rationale:
A nurse is providing discharge teaching for a client who is postoperative following a simple mastectomy. The client is to begin outpatient radiation therapy the next day. Which of the following instructions about maintaining skin integrity should the nurse include?
- A. Do not apply heat to the area of irradiation.
- B. Use an antibiotic ointment to treat skin breakdown.
- C. Lubricate the skin with hypoallergenic lotion.
- D. Do not wash the area of irradiation.
- G. A
Correct Answer: Avoiding heat prevents increased inflammation in the irradiated area. Antibiotic ointments and lotions may interfere with therapy, and gentle washing with mild soap is recommended.
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