Nokea
A client complains of severe abdominal and pelvic pain around the time of menstruation. This pain has become progressively worse over the last 5 years. She also complains of pain during intercourse and has tried unsuccessfully to become pregnant for the past 18 months. To which condition are these symptoms most likely related?
- A. Endometriosis
- B. PMS
- C. Primary dysmenorrhea
- D. Secondary dysmenorrhea
Correct Answer: A
Rationale: Endometriosis can cause severe pelvic pain dysmenorrhea dyspareunia and infertility. These symptoms are most indicative of endometriosis.
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The nurse is assessing a 33-year-old female patient who comes to the family practice clinic with complaints of excessive menstrual bleeding with bleeding between periods for the past 6 months. The health care provider has performed an endometrial biopsy and has discontinued the patient's oral contraceptives. What is the rationale for this treatment?
- A. This condition is often associated with use of oral contraceptives and may subside upon discontinuation.
- B. This condition is often associated with type 2 diabetes and must be controlled with a different type of birth control.
- C. This condition is often associated with hyperplasia of the endometrial tissue, which is exacerbated with oral contraceptives.
- D. This condition is often associated with ovarian cysts, which are exacerbated with the use of oral contraceptives.
Correct Answer: C
Rationale: The correct rationale for discontinuing the oral contraceptives in a patient with excessive menstrual bleeding and bleeding between periods is that this condition is often associated with hyperplasia of the endometrial tissue, which can be exacerbated with the use of oral contraceptives. Endometrial hyperplasia is a condition characterized by the abnormal thickening of the lining of the uterus, which can lead to heavy or prolonged menstrual bleeding. Estrogen contained in oral contraceptives can contribute to this thickening of the endometrial tissue, potentially worsening the patient's symptoms. By discontinuing the oral contraceptives, the provider aims to reduce the estrogen levels in the body, which may help alleviate the symptoms associated with endometrial hyperplasia. An endometrial biopsy is also important in this case to further investigate the underlying cause of the abnormal bleeding.
The nurse is providing care for the 34-year-old patient diagnosed with polycystic ovarian syndrome .Which interventions would correlate to the common symptoms of this syndrome? Select all that apply.
- A. The patient has been unsuccessful with the ability to conceive
- B. The patient has a history of painful and irregular menstrual cycles.
- C. The patient has noticed a drastic weight loss and dry skin.
- D. The patient has chronic back pain and gastrointestinal issues
Correct Answer: A
Rationale: Polycystic ovarian syndrome (PCOS) is a common endocrine disorder in women of reproductive age that can present with a variety of symptoms. Common symptoms of PCOS include irregular menstrual cycles, weight gain, acne, excessive hair growth, and infertility. Therefore, interventions that may correlate with these common symptoms can include lifestyle modifications like weight management, exercise, dietary changes, hormonal medications to regulate menstrual cycles, and fertility treatments if conception is desired. Treating the symptoms can help improve the patient's quality of life and overall health outcomes.
Which client should the nurse refer for further testing?
- A. Left breast slightly smaller than right breast
- B. Eversion (elevation) of both nipples
- C. Faintly visible bilateral symmetry of venous network
- D. Small dimple located in the upper outer quadrant of the right breast
Correct Answer: D
Rationale: A small dimple in the breast is a concerning sign and should be referred for further testing as it can indicate breast cancer.
A maternal-newborn nurse is caring for a mother who just delivered a baby born with Down syndrome. Which nursing diagnosis would be the most essential in caring for the mother of this infant?
- A. Disturbed body image
- B. Interrupted family processes
- C. Anxiety
- D. Risk for injury
Correct Answer: B
Rationale: This mother will likely experience a disruption in the family process related to the birth of a baby with an inherited disorder. Therefore, the probable nursing diagnosis for this family is 'Interrupted family processes.' Women commonly experience 'body image disturbances in the postpartum period'; however, this nursing diagnosis is unrelated to giving birth to a child with Down syndrome. The mother will likely have a mix of emotions that may include anxiety, guilt, and denial, but this nursing diagnosis is not the most essential for this family. 'Risk for injury' is not an applicable nursing diagnosis.
A nurse is caring for a client who is receiving oxytocin to augment labor. The client has an intrauterine pressure catheter and an internal fetal scalp electrode for monitoring. Which of the following is an indication that the nurse should discontinue the infusion?
- A. Contraction frequency every 3 min
- B. Contraction duration of 100 seconds
- C. Fetal heart rate with moderate variability
- D. Fetal heart rate of 118/min
Correct Answer: B
Rationale: Contractions lasting longer than 90 seconds (tachysystole) can lead to fetal distress by reducing uteroplacental blood flow. Oxytocin should be discontinued if contractions become excessive. Moderate variability and normal fetal heart rate do not indicate distress.