Nokea
A 48-year-old woman has just had a hysterectomy for endometrial cancer. Which statement alerts the nurse that further teaching is needed?
- A. I can't wait to go on the cruise that I have planned for this summer.
- B. I know that the surgery saved my life, but I will miss having sexual intercourse with my husband.
- C. I have asked my daughter to come and stay with me next week after I am discharged from the hospital.
- D. Well, I don't have to worry about getting pregnant anymore.
Correct Answer: B
Rationale: Stating that she will miss having sexual intercourse with her husband indicates that further teaching is needed for this client regarding sexual activities after a hysterectomy. Although intercourse may be initially uncomfortable, the use of water-soluble lubricants, relaxation exercises, and changes in position may be helpful.
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The nurse is providing care to the adult female patient who presents to the emergency department with a suspected myocardial infarction (MI). Which symptom indicates a possible MI for the female patient?
- A. Chest pain that radiates to the right arm and jaw
- B. Episodic nausea/indigestion and palpitations
- C. Sudden onset of trouble walking, and loss of balance
- D. Swelling of the feet and shortness of breath
Correct Answer: B
Rationale: For female patients, the classic symptom of a myocardial infarction (MI) is often different from that in male patients. While chest pain that radiates to the right arm and jaw is a common symptom in male patients, female patients may present with more subtle symptoms. Episodic nausea/indigestion and palpitations are more commonly seen in female patients experiencing a myocardial infarction. It is important for healthcare providers to recognize and consider these atypical symptoms in female patients to ensure timely diagnosis and treatment.
The nurse should be cognizant of which postpartum physiologic alteration?
- A. Cardiac output, pulse rate, and stroke volume all return to prepregnancy normal values within 48 hours of childbirth.
- B. Respiratory function returns to nonpregnant levels by 6 to 8 weeks after childbirth.
- C. Lowered white blood cell count after pregnancy can lead to false-positive results on tests for infections.
- D. Hypercoagulable state protects the new mother from thromboembolism, especially after a cesarean birth.
Correct Answer: B
Rationale: Respiratory function returns to nonpregnant levels by 6 to 8 weeks after childbirth.
Which condition would leuprolide acetate (Lupron) be prescribed for?
- A. Anovulatory cycles
- B. Uterine fibroids
- C. Polycystic ovary disease (PCOD)
- D. Luteal phase inadequacy
Correct Answer: B
Rationale: Leuprolide acetate is used to treat endometriosis and uterine fibroids, not anovulatory cycles or PCOD.
Which viral sexually transmitted infection is characterized by a primary infection followed by recurrent episodes?
- A. Herpes simplex virus 2 (HSV-2)
- B. HPV
- C. HIV
- D. CMV
Correct Answer: A
Rationale: HSV-2 causes genital herpes with initial painful lesions and recurrent outbreaks that are usually milder.
The nurse is providing care to a patient who was just admitted to the labor and birth unit in active labor at term. The patient informed the nurse, “I have not received any prenatal care because I cannot afford to go to the doctor. And, this is my third baby, so I know what to expect.” What is the nurse’s primary concern when developing the patient’s plan of care?
- A. Low birth weight
- B. Oligohydramnios
- C. Gestational diabetes
- D. Gestational hypertension
Correct Answer: A
Rationale: The nurse's primary concern when developing the plan of care for a patient who has not received prenatal care and is now in active labor is the risk of low birth weight for the baby. Prenatal care plays a crucial role in monitoring the health of the pregnant woman and her baby, ensuring appropriate growth and development, and identifying any potential issues early on. Without prenatal care, important factors such as maternal nutritional status, appropriate weight gain, screening for conditions that can affect the baby's growth, and management of any complications during pregnancy may not have been addressed. As a result, the baby is at increased risk for being born with a low birth weight, which can lead to various health problems and complications both immediately after birth and in the long term. Therefore, the nurse should prioritize monitoring and addressing the risk of low birth weight in this situation.