Nokea
A 51-year-old woman has come to the OB/GYN clinic for her annual physical. She tells the nurse that she has been experiencing severe hot flashes, but that she is reluctant to begin hormone therapy (HT). What potential solution should the nurse discuss with the patient?
- A. Sodium restriction
- B. Adopting a vegan diet
- C. Massage therapy
- D. Vitamin supplements
Correct Answer: D
Rationale: For some women, vitamins B6 and E have proven beneficial for the treatment of hot flashes, making this a viable option to discuss. Sodium restriction, a vegan diet, and massage therapy have not been noted to relieve hot flashes in perimenopause.
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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 school nurse is presenting information on human development and sexuality. When describing the role of hormones in sexual development, which hormone does the nurse teach the class is the most important one for developing and maintaining the female reproductive organs?
- A. Estrogen
- B. Progesterone
- C. Androgens
- D. Follicle-stimulating hormone
Correct Answer: A
Rationale: Estrogens are responsible for developing and maintaining the female reproductive organs. Progesterone is the most important hormone for conditioning the endometrium in preparation for implantation of the fertilized ovum. Androgens, secreted by the ovaries in small amounts, are involved in the early development of the follicle and affect the female libido. Follicle-stimulating hormone is responsible for stimulating the ovaries to secrete estrogen.
During the nurses assessment of a female patient, the patient reveals that she experienced sexual abuse when she was a young woman. What is the nurses most appropriate response to this disclosure?
- A. Reassure her that this information will be kept a secret.
- B. Begin the process of intensive psychotherapy.
- C. Encourage the patient to phone 911.
- D. Facilitate appropriate resources and referrals.
Correct Answer: D
Rationale: The nurse's primary roles in response to a disclosure of past sexual abuse are to provide empathy and arrange for appropriate resources and referrals, such as counseling or support services. Promising secrecy is inappropriate as confidentiality has limits, psychotherapy is beyond the nurse's scope, and calling 911 is unnecessary for a past event.
A 15-year-old girl is brought to the clinic by her mother to see her primary care provider. The mother states that her daughter has not started to develop sexually. The physical examination shows that the patient has no indication of secondary sexual characteristics. What diagnosis should the nurse suspect?
- A. Primary amenorrhea
- B. Dyspareunia
- C. Vaginal atrophy
- D. Secondary dysmenorrhea
Correct Answer: A
Rationale: Primary amenorrhea is suspected when a young woman over 14 years has not begun menstruating and shows no secondary sexual characteristics, as described. Dyspareunia is painful intercourse, vaginal atrophy is unrelated to puberty onset, and secondary dysmenorrhea involves painful periods due to pathology, none of which fit the scenario.
A woman presents at the ED with sharp, colicky pain in her right abdomen that radiates to her right shoulder. She tells the nurse that she has been spotting lightly for the past few days. The patient is subsequently diagnosed with an ectopic pregnancy. What major nursing diagnosis most likely relates to this patients needs?
- A. Anxiety related to potential treatment options and health outcomes
- B. Chronic sorrow related to spontaneous abortion
- C. Chronic pain related to genitourinary trauma
- D. Impaired tissue integrity related to keloid scarring
Correct Answer: A
Rationale: A diagnosis of ectopic pregnancy is likely to cause significant anxiety due to treatment uncertainties and health risks. Chronic sorrow, chronic pain, and impaired tissue integrity (keloid scarring) are less applicable to the acute presentation of ectopic pregnancy.