A client comes to an outpatient clinic for evaluation. What in the client's blood sample reveals that administration of the hepatitis B vaccine has been effective?
- A. Hepatitis B surface antigen (HBsAg)
- B. anti-HBs
- C. anti-HBc IgM
- D. anti-HBc
Correct Answer: B
Rationale: The correct answer is B: anti-HBs. This antibody indicates successful immunity after hepatitis B vaccination. It is produced in response to the vaccine and signifies protection against the virus. Choice A, HBsAg, is present in acute infection. Choices C and D, anti-HBc IgM and anti-HBc, indicate acute or chronic infection, not vaccine response.
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A 20-year-old college student expresses concern over the recent appearance of genital warts, an assessment finding her primary care provider confirms as attributable to HPV infection. Which client education should be included?
- A. It's important to start treatment as soon as possible, so you will receive a prescription for pills today.
- B. There is a chance that the genital warts will clear up on their own without any treatment.
- C. I recommend receiving an HPV vaccination today.
- D. Unfortunately, this is going to greatly increase your chance of developing pelvic inflammatory disease.
Correct Answer: B
Rationale: The correct answer is B: There is a chance that the genital warts will clear up on their own without any treatment.
Rationale:
1. Genital warts caused by HPV can sometimes resolve spontaneously without treatment.
2. This option emphasizes the possibility of self-resolution, which is a common occurrence.
3. Encouraging observation without immediate treatment aligns with current guidelines for managing HPV-related genital warts.
4. Avoiding unnecessary treatment helps prevent potential side effects and reduces healthcare costs.
Summary of Incorrect Choices:
A: Incorrect because immediate treatment is not always necessary for genital warts caused by HPV.
C: Incorrect because HPV vaccination does not treat existing HPV infections, including genital warts.
D: Incorrect because developing pelvic inflammatory disease is not directly related to the presence of genital warts caused by HPV.
The pregnant woman who becomes infected with chickenpox should be taught to report promptly:
- A. Cough or dyspnea
- B. Severe skin itching
- C. Joint pain
- D. Increased urination
Correct Answer: A
Rationale: The correct answer is A: Cough or dyspnea. Chickenpox can lead to pneumonia in pregnant women, causing cough or dyspnea. Prompt reporting is crucial for timely intervention. B: Severe itching is common in chickenpox but not a critical symptom. C: Joint pain is not a typical complication of chickenpox. D: Increased urination is not directly related to chickenpox complications during pregnancy. It's important for the pregnant woman to be aware of respiratory symptoms as they can indicate a serious complication that requires immediate medical attention.
Which best describes the signs and symptoms of trichomoniasis in women?
- A. Foul, fishy odor and thick clumpy white vaginal discharge
- B. Malodorous, frothy yellow-green vaginal discharge
- C. Dysuria and thin milky-white vaginal discharge
- D. Condition is asymptomatic in women
Correct Answer: B
Rationale: Rationale: Trichomoniasis is characterized by malodorous, frothy yellow-green vaginal discharge due to the presence of Trichomonas vaginalis parasite. This discharge is a hallmark sign of the infection. Other choices are incorrect because:
A: Foul, fishy odor and thick clumpy white discharge are more indicative of bacterial vaginosis or yeast infection.
C: Dysuria and thin milky-white discharge are more suggestive of a urinary tract infection.
D: Trichomoniasis can manifest with symptoms in women such as vaginal discharge, itching, and discomfort.
The nurse is preparing a 51-year-old client for a vaginal examination. The nurse should place the client in which position?
- A. Prone
- B. Lateral Sims’
- C. Lithotomy
- D. High Fowler’s
Correct Answer: C
Rationale: The correct answer is C: Lithotomy position. This position allows for optimal visualization of the vaginal area and easier access for the examination. The client lies on their back with knees flexed and feet in stirrups, providing proper exposure. Prone (A) is face down and not suitable for a vaginal exam. Lateral Sims' (B) is on the side and not ideal for this exam. High Fowler's (D) is sitting upright, which is not appropriate for a vaginal examination.
A 17-year-old client presents to the clinic with concerns that she has not begun menstruating. She states that she is a gymnast and has been competing since she was 9 years old. Based on this history, what does the nurse know the client is most likely experiencing?
- A. Secondary amenorrhea
- B. Polycystic ovary syndrome
- C. Primary amenorrhea
- D. Dysmenorrhea
Correct Answer: C
Rationale: The correct answer is C: Primary amenorrhea. A 17-year-old who has not started menstruating is experiencing primary amenorrhea. This is likely due to her intense physical activity as a gymnast, which can delay the onset of menstruation. Secondary amenorrhea (A) occurs when menstruation stops after it has already begun. Polycystic ovary syndrome (B) is characterized by hormonal imbalances and ovarian cysts, not delayed onset of menstruation. Dysmenorrhea (D) refers to painful menstruation, which is not the issue in this case.