Nokea
A 33-year-old female patient who uses oral contraceptives tells the nurse, 'I want to have children in a few years.' Which of the following responses by the nurse is best?
- A. You may have more difficulty becoming pregnant after about age 35.
- B. You have many years of fertility left, so there is no rush to have children.
- C. You should plan to stop taking oral contraceptives several years before you want to become pregnant.
- D. If you do not have children within the next few years, it will be very difficult for you to become pregnant.
Correct Answer: A
Rationale: The probability of successfully becoming pregnant decreases after age 35 although some patients may have no difficulty in becoming pregnant, this probability further decreases after age 40. Oral contraceptives do not need to be withdrawn for several years for a woman to become pregnant. Although the patient may be fertile for many years, it would be inaccurate to indicate that there is no concern about infertility as she becomes older. Although the risk for infertility increases after age 35, not all patients have difficulty in conceiving.
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The nurse is assessing a patient who is on the surgical unit after a radical abdominal hysterectomy. Which of the following findings is most important to report to the health care provider?
- A. Decreased bowel sounds in all four abdominal quadrants.
- B. Urine output of 100 mL in the first 8 hours after surgery.
- C. Symptom of pain at the incision site with coughing
- D. One inch increased abdominal girth
Correct Answer: B
Rationale: The decreased urine output indicates possible low blood volume and further assessment is needed to assess for possible internal bleeding. The other findings are not unusual after this surgery.
The nurse is caring for a patient who has been hospitalized with endometriosis. Which of the following medications should the nurse anticipate preparing for the patient?
- A. Ganirelix
- B. Cetorelix
- C. hCG
- D. Nafarelin
Correct Answer: D
Rationale: Nafarelin can be used in the treatment of endometriosis. Cetorelix and ganirelix are GnRH antagonists and used to prevent premature LH surges and premature ovulation in patients undergoing ovarian stimulation. hCG is used to stimulate ovulation.
The nurse is caring for an older-adult patient who is recently diagnosed with stage III ovarian cancer. Which of the following nursing diagnoses is best for this patient?
- A. Sexual dysfunction related to insufficient knowledge about sexual function (loss of vaginal sensation)
- B. Risk for infection as evidenced by immunosuppression
- C. Situational low self-esteem related to unrealistic self-expectations
- D. Anxiety related to threat to current status (cancer diagnosis and need to make treatment decisions)
Correct Answer: D
Rationale: The patient with stage III ovarian cancer is likely to be anxious about the poor prognosis and about the need to make decisions about the multiple treatments that may be used. Decreased vaginal sensation does not occur with ovarian cancer. The patient may develop immune dysfunction when she receives chemotherapy, but she is not currently at risk. It is unlikely that the patient has delayed seeking medical care because the symptoms of ovarian cancer are vague and occur late in the course of the cancer.
The nurse is caring for a patient who is diagnosed with stage 0 cervical cancer using a punch biopsy. Which of the following treatments should the nurse include in the teaching plan?
- A. Radiation
- B. Conization
- C. Chemotherapy
- D. Radical hysterectomy
Correct Answer: B
Rationale: Because the carcinoma is in situ, conization can be used for treatment. Radical hysterectomy, chemotherapy, or radiation will not be needed.
The nurse is caring for a patient who has been diagnosed with human papilloma virus (HPV) infection and who smokes cigarettes, uses oral contraceptives, and has a history of candidiasis. Which of the following topics should the nurse include in the teaching plan?
- A. Use of water-soluble lubricants
- B. Antifungal cream administration
- C. Importance of smoking cessation
- D. Possible difficulties with conception
Correct Answer: C
Rationale: Because smoking and HPV infection are both associated with increased cervical cancer risk, the nurse should emphasize the importance of avoiding smoking. An HPV infection does not decrease vaginal lubrication, decrease ability to conceive, or require the use of antifungal creams.