Nokea
A 17-year-old girl has come to the free clinic for her annual examination. She tells the nurse she uses tampons and asks how long she may safely leave her tampon in place. What is the nurses best response?
- A. You may leave the tampon in overnight.
- B. The tampon should be changed at least twice per day.
- C. Tampons are dangerous and, ideally, you should not be using them.
- D. Tampons need to be changed every 4 to 6 hours.
Correct Answer: D
Rationale: Tampons should not be used for more than 4 to 6 hours, nor should super-absorbent tampons be used because of the association with toxic shock syndrome. If used appropriately, it is acceptable and safe for the patient to use tampons. Changing twice daily or leaving overnight may exceed safe duration.
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The nurse is planning the sexual assessment of a new adolescent patient. The nurse should include what assessment components? Select all that apply.
- A. Physical examination findings
- B. Laboratory results
- C. Health history
- D. Interpersonal skills
- E. Understanding of menopause
Correct Answer: A,B,C
Rationale: A sexual assessment includes both subjective and objective data, such as health and sexual histories, physical examination findings, and laboratory results. Assessing interpersonal skills or understanding of menopause is not relevant to a sexual assessment for an adolescent.
A patient calls the clinic and tells the nurse she has thick white, curd-like discharge from her vagina. How should the nurse best interpret this preliminary data?
- A. The drainage is physiologic and normal.
- B. The patient may have a Candida species infection.
- C. The patient needs a Pap smear as soon as possible.
- D. The patient may have a Trichomonas infection.
Correct Answer: B
Rationale: Drainage caused by Candida is typically curd-like and white, matching the patient's description. Trichomonas infections usually cause copious, frothy yellowish-green discharge. A Pap smear is not indicated as the primary response, as malignancy is unlikely. The discharge is not physiologic or normal.
A 21-year-old woman has sought care because of heavy periods and has subsequently been diagnosed with menorrhagia. The nurse should recognize which of the following as the most likely cause of the patients health problem?
- A. Hormonal disturbances
- B. Cervical or uterine cancer
- C. Pelvic inflammatory disease
- D. A sexually transmitted infection (STI)
Correct Answer: A
Rationale: Menorrhagia in young women is most commonly caused by hormonal disturbances, which disrupt normal menstrual regulation. Cervical or uterine cancer, pelvic inflammatory disease, and STIs are less likely causes in this age group.
A womans current health complaints are suggestive of a diagnosis of premenstrual dysphoric disorder (PMDD). The nurse should first do which of the following?
- A. Assess the patients understanding of HT.
- B. Assess the patient for risk of suicide.
- C. Assure the patient that the problem is self-limiting.
- D. Suggest the use of St. Johns wort.
Correct Answer: B
Rationale: Severe PMDD can lead to suicidal or violent behavior, so assessing suicide risk is the priority to ensure patient safety. HT is not relevant, PMDD is not self-limiting, and suggesting herbal remedies like St. John's wort requires provider input.
A patient who is in the first trimester of pregnancy has experienced an incomplete abortion. The obstetric nurse should prepare the patient for what possible intervention?
- A. Dilation and evacuation
- B. Several days of bed rest
- C. Administration of hydromorphone
- D. IV administration of clomiphene
Correct Answer: A
Rationale: If only some of the tissue is passed, the abortion is referred to as incomplete. An emptying or evacuation procedure (D&C, or dilation and evacuation [D&E]) or administration of oral misoprostol (Cytotec) is usually required to remove the remaining tissue. Bed rest will not necessarily result in the passing of all the tissue. Clomiphene is used for ovulation induction, not abortion management, and hydromorphone is for pain relief, not a primary intervention.