Nokea
A 22-year-old woman presents to the clinic with a complaint of severe menstrual cramps. The nurse suspects dysmenorrhea. Which of the following is the most likely cause of dysmenorrhea?
- A. Uterine contractions.
- B. Endometriosis.
- C. Ovarian cysts.
- D. Polycystic ovary syndrome (PCOS).
Correct Answer: C
Rationale: The correct answer is C: Ovarian cysts. Ovarian cysts can cause dysmenorrhea by disrupting the normal menstrual cycle and causing pain. Endometriosis (B) is another common cause of dysmenorrhea, but it involves the abnormal growth of endometrial tissue outside the uterus. Uterine contractions (A) are a normal part of menstruation and may cause cramping but are not the primary cause of dysmenorrhea. PCOS (D) is a hormonal disorder that can cause irregular periods and pain, but it is not the most likely cause of dysmenorrhea in this case.
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When performing a genital examination on a 25-year-old man, the nurse notices deeply pigmented, wrinkled scrotal skin with large sebaceous follicles. On the basis of this information, the nurse would:
- A. Squeeze the glans to check for the presence of discharg
- C. Consider this finding as normal, and proceed with the examination.
- D. Assess the testicles for the presence of masses or painless lumps.
Correct Answer: C
Rationale: Rationale: Choice C is correct because the description of deeply pigmented, wrinkled scrotal skin with large sebaceous follicles in a 25-year-old man is indicative of normal changes associated with development and aging. The nurse should recognize this as a normal finding and proceed with the examination without any further intervention.
Summary of Incorrect Choices:
A: Squeezing the glans to check for discharge is not indicated based on the information provided. This action is unnecessary and could potentially cause discomfort or harm to the patient.
D: Assessing the testicles for masses or painless lumps is not relevant to the described findings of pigmented, wrinkled scrotal skin with sebaceous follicles. This choice does not align with the presented information and would not be appropriate in this scenario.
A patient has experienced excessive losses of the kidneys
- A. The left kidneys connection to the common bile duct
- B. How will this lost bicarbonate be replaced?
Correct Answer: B
Rationale: The correct answer is B because excessive losses of the kidneys can lead to metabolic acidosis due to bicarbonate loss. Bicarbonate is essential for maintaining acid-base balance in the body. Replacement of lost bicarbonate is crucial to prevent acidosis. Choice A is incorrect as the kidneys are not connected to the common bile duct. Choices C and D are not applicable to the scenario provided.
Superinfections are more common with:
- A. Use of narrow spectrum antibiotics
- B. Short courses of antibiotics
- C. Use of antibiotics that are completely absorbed from the small intestines
- D. Use of antibiotic combinations covering both gram positive and gram negative bacteria
Correct Answer: D
Rationale: The correct answer is D because using antibiotic combinations covering both gram positive and gram negative bacteria can disrupt the balance of normal flora in the body, leading to superinfections. Gram positive and gram negative bacteria have different susceptibility patterns, so using a combination of antibiotics increases the likelihood of killing off a wider range of bacteria, including the beneficial ones. This disruption paves the way for opportunistic pathogens to overgrow and cause superinfections. Choices A, B, and C are incorrect because narrow spectrum antibiotics target specific bacteria, short courses of antibiotics reduce the risk of resistance and overgrowth, and antibiotics completely absorbed from the small intestines have minimal impact on gut flora compared to systemic antibiotics.
The best time for a woman of childbearing age to perform breast self-examination is
- A. during her menstrual period
- B. 2 days before the onset of her menstrual period
- C. 1 week after her menstrual period ends
- D. the day her menstrual period begins
Correct Answer: C
Rationale: The best time for a woman of childbearing age to perform breast self-examination is 1 week after her menstrual period ends. This is because breast tissue tends to be less tender and lumpy during this time, making it easier to detect any abnormalities. Performing the examination at this time allows for a more accurate assessment of the breasts. Additionally, hormonal changes during the menstrual cycle can affect breast tissue, so performing the examination post-menstruation reduces the likelihood of false alarms. Choices A, B, and D are not ideal times as breast tenderness and hormonal fluctuations during the menstrual period can make it challenging to accurately detect abnormalities.
An 11-year-old girl is in the clinic for a sports physical examination. The nurse notices that she has begun to develop breasts, and during the conversation the girl reveals that she is worried about her development. The nurse should use which of these techniques to best assist the young girl in understanding the expected sequence for development? The nurse should:
- A. Use the Tanner scale on the five stages of sexual development.
- B. Describe her development and compare it with that of other girls her age.
- C. Use the Jacobsen table on expected development on the basis of height and weight data.
- D. Reassure her that her development is within normal limits and tell her not to worry about the next step.
Correct Answer: A
Rationale: The correct answer is A: Use the Tanner scale on the five stages of sexual development. The Tanner scale is a standardized tool used to assess the stages of sexual development in children and adolescents. By using this scale, the nurse can provide the girl with a clear and objective understanding of her current stage of development and what to expect in the future. This approach helps the young girl feel informed and reassured about the normal process of puberty.
Choice B is incorrect because comparing the girl's development with other girls her age may lead to unnecessary comparisons and anxiety. Choice C is incorrect as the Jacobsen table based on height and weight data is not relevant for assessing sexual development. Choice D is incorrect as simply reassuring the girl without providing detailed information may not address her concerns effectively.