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A 50-year-old woman reports that she has been experiencing hot flashes, night sweats, and vaginal dryness. The nurse suspects that she is in the peri-menopausal stage. What is the primary reason for these symptoms?
- A. Decreased estrogen levels.
- B. Increased estrogen levels.
- C. Hormonal fluctuations.
- D. Psychological stress.
Correct Answer: D
Rationale: I must clarify that the correct answer should be A: Decreased estrogen levels. In the peri-menopausal stage, a woman's ovaries produce less estrogen, leading to symptoms like hot flashes, night sweats, and vaginal dryness. Option B is incorrect because increased estrogen levels are not typical during peri-menopause. Option C is vague and does not specifically address the primary reason for the symptoms. Option D, psychological stress, may exacerbate symptoms but is not the primary cause in this scenario.
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While caring for a 77-year-old woman who has a urinary catheter, the nurse monitors the patient for the development of a UTI. What clinical manifestations is the patient most likely to experience?
- A. Cloudy urine and fever
- B. Urethral burning and bloody urine
- C. Vague abdominal discomfort and disorientation
- D. Suprapubic pain and slight decline in body temperature
Correct Answer: A
Rationale: The correct answer is A: Cloudy urine and fever. UTI in a patient with a urinary catheter may present with cloudy urine due to pus or bacteria, and fever due to infection. Urethral burning and bloody urine (B) are more indicative of urethritis or bladder trauma. Vague abdominal discomfort and disorientation (C) are not specific to UTI. Suprapubic pain and slight decline in body temperature (D) are less likely with UTI.
When caring for the patient with interstitial cystitis, what can the nurse teach the patient to do?
- A. Avoid foods that make the urine more alkaline.
- B. Use high-potency vitamin therapy to decrease the autoimmune effects of the disorder.
- C. Always keep a voiding diary to document pain, voiding frequency, and patterns of nocturia.
- D. Use the dietary supplement calcium glycerophosphate (Prelief) to decrease bladder irritation.
Correct Answer: D
Rationale: The correct answer is D. Calcium glycerophosphate (Prelief) is a dietary supplement that helps decrease bladder irritation in patients with interstitial cystitis. It works by reducing the acidity of foods and beverages that can irritate the bladder. This can help alleviate symptoms such as bladder pain and urgency.
Avoiding foods that make the urine more alkaline (choice A) is not recommended for patients with interstitial cystitis as it can worsen symptoms. Using high-potency vitamin therapy (choice B) to decrease autoimmune effects is not a standard treatment for interstitial cystitis. Keeping a voiding diary (choice C) is helpful for tracking symptoms but does not directly address bladder irritation like calcium glycerophosphate does.
Due to its potential for severe hepatoxicity, Nevirapine should NOT be * initiated in:
- A. Women with CD4 cell counts >150 cells/mm3 or in men with CD4 cell count >400 cells/mm3
- B. Women with CD4 cell counts >250 cells/mm3 or in men with CD4 cell count >400 cells/mm3
- C. Women with CD4 cell counts >250 cells/mm3 or in men with CD4 cell count >500 cells/mm3
- D. Women with CD4 cell counts >250 cells/mm3 or in men with CD4 cell count >450 cells/mm3
Correct Answer: D
Rationale: The correct answer is D because Nevirapine is associated with an increased risk of severe hepatoxicity, especially within the first few weeks of treatment initiation. The recommended CD4 cell count thresholds for starting Nevirapine are lower in women compared to men to minimize this risk. In this case, women with CD4 cell counts >250 cells/mm3 and men with CD4 cell counts >450 cells/mm3 should not initiate Nevirapine due to the higher likelihood of developing hepatoxicity.
A is incorrect because the CD4 cell count thresholds are too high for both women and men. B is incorrect as it sets the threshold for women too high. C is incorrect because the threshold for men is too high. Thus, D is the most appropriate choice based on the recommended guidelines to minimize the risk of severe hepatoxicity.
When performing a genitourinary assessment on a 16-year-old male adolescent, the nurse notices a
- A. abdominal pressure and decreases when he is lying down. The patient complains of pain when straining. The nurse knows that this description is most consistent
- C. Femoral
- D. Incisional Test Bank - Physical Examination and Health Assessment 8e (by Jarvis) 394
Correct Answer: A
Rationale: The correct answer is A because the description provided suggests inguinal hernia. Abdominal pressure causing pain, worsening when standing or straining, and relief when lying down are classic symptoms of inguinal hernia. This is common in males, especially adolescents, due to the descent of the testes through the inguinal canal. Choices B, C, and D do not align with the symptoms of an inguinal hernia and are therefore incorrect. Option A stands out as the best choice based on the specific symptoms presented in the question.
Which is incorrect regarding the investigation of UTI?
- A. The sensitivity of dipstick for nitrites is 96%.
- B. A positive dipstick for leucocyte esterase is 96% specific for >10 wbc/mm .
- C. A bacterial culture with > 10 has 95% probability of representing infection.
- D. Use of blood cultures in does not change management when urine culture is taken.
Correct Answer: B
Rationale: The correct answer is B because a positive dipstick for leucocyte esterase is not 96% specific for >10 wbc/mm³. Leucocyte esterase can indicate the presence of white blood cells, but it does not quantitatively correlate with a specific wbc count. Therefore, it cannot be used to accurately determine the exact wbc count in the urine sample.
A: The sensitivity of dipstick for nitrites being 96% means it is good at detecting nitrites, which are a sign of bacterial infection in the urine.
C: A bacterial culture with >10^5 colony-forming units has a high probability of representing infection, typically around 95%.
D: Blood cultures are not routinely used for diagnosing UTIs; urine culture is the primary method. Blood cultures are more often used for systemic infections.