Nokea
The nurse is assessing a client who has a suspected cystocele. Which signs and symptoms should the nurse expect? Select all that apply.
- A. Frequent bladder infections
- B. Sense of fullness in the vaginal area
- C. Leaking of urine
- D. Irregular vaginal bleeding
Correct Answer: D
Rationale: The correct answer is D: Irregular vaginal bleeding. A cystocele is a condition where the bladder protrudes into the vagina. This can cause pressure on surrounding tissues and lead to irregular vaginal bleeding. A, B, and C are incorrect as they are more commonly associated with other conditions such as urinary tract infections (A), pelvic organ prolapse (B), and urinary incontinence (C). Irregular vaginal bleeding is a key sign specific to cystocele due to the physical displacement of organs.
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A 60-year-old client with a palpable mass to the right adnexa and family history of ovarian cancer is seen by the HCP. The nurse anticipates the order for which of the following laboratory results?
- A. CBC
- B. Blood glucose
- C. CA-125
- D. FSH and LH
Correct Answer: C
Rationale: The correct answer is C: CA-125. This tumor marker is used to assess for ovarian cancer in high-risk individuals. The client's age, palpable mass, and family history of ovarian cancer raise suspicion for malignancy. A CBC (choice A) and blood glucose (choice B) are not specific to ovarian cancer evaluation. FSH and LH (choice D) are hormone levels that do not directly assess for ovarian cancer. Therefore, CA-125 is the most appropriate lab test to anticipate in this scenario.
Reduction in congenital rubella is best accomplished by:
- A. Avoiding contact with young children when infections are prevalent
- B. Taking prophylactic antibiotics during the second half of pregnancy
- C. Testing the rubella titer at the first prenatal visit to determine immunity
- D. Immunizing susceptible women at least 28 days before they become pregnant
Correct Answer: D
Rationale: The correct answer is D because immunizing susceptible women at least 28 days before they become pregnant ensures protection against rubella during pregnancy, reducing the risk of congenital rubella syndrome in the fetus. This timing allows for the development of immunity before conception.
Avoiding contact with young children (A) does not directly prevent rubella transmission to pregnant women. Taking prophylactic antibiotics during pregnancy (B) is not recommended for rubella prevention. Testing rubella titer at the first prenatal visit (C) only assesses current immunity status but does not actively prevent congenital rubella.
The client has been taking danazol for endometriosis for 3 years. She tells you that she would like to have a baby and wants to stop taking this medication. She wants to know what will happen when she stops. Which is the nurse’s best response?
- A. Nothing, your endometriosis will not return.
- B. If you stop taking danazol, it could increase your blood pressure.
- C. Once you stop any medication for endometriosis, your symptoms may return in 1 to 5 years.
- D. Once you stop the medication, the growths from endometriosis will return in 2 to 3 months.
Correct Answer: C
Rationale: Rationale for Correct Answer (C): The nurse should explain to the client that once she stops any medication for endometriosis, her symptoms may return in 1 to 5 years. This is the best response because endometriosis is a chronic condition, and stopping the medication can lead to a recurrence of symptoms over time. It is important for the client to be aware of this possibility to make informed decisions about her health and fertility. By mentioning the timeframe of 1 to 5 years, the nurse provides a general idea of when symptoms may return, allowing the client to plan accordingly.
Summary of Incorrect Choices:
A: Nothing, your endometriosis will not return - This is incorrect because endometriosis is a chronic condition that can recur when medication is stopped.
B: If you stop taking danazol, it could increase your blood pressure - This is incorrect as danazol is not typically associated with blood pressure changes upon discontinuation.
D: Once you stop
The nurse is caring for an Rh-negative mother on the postpartum unit. What scenario indicates the need to administer RhoGAM to this patient?
- A. She has had one Rh-negative child and is pregnant with an Rh-negative child.
- B. She has had an Rh-positive infant and is pregnant with an Rh-positive fetus.
- C. She has had an O-negative child and is pregnant with a B-negative child.
- D. She is a primipara with an O-negative child.
Correct Answer: B
Rationale: Rationale:
1. Rh-negative mother with Rh-positive infant: During delivery, fetal blood can mix with maternal blood leading to sensitization.
2. Sensitization can cause the mother's immune system to produce antibodies against Rh antigen.
3. RhoGAM is administered to prevent antibody formation in Rh-negative mothers carrying Rh-positive infants.
Summary:
- A: Incorrect. No risk of sensitization as both child and fetus are Rh-negative.
- B: Correct. Rh-negative mother with Rh-positive infant at risk for sensitization.
- C: Incorrect. Rh factor mismatch between children doesn't require RhoGAM.
- D: Incorrect. Being primipara or child's blood type doesn't warrant RhoGAM administration.
For HIV treatment, the pregnant woman should be expected to receive:
- A. Antibiotics
- B. Protease analogues
- C. Zidovudine
- D. Acyclovir
Correct Answer: C
Rationale: Rationale:
1. Zidovudine (AZT) is recommended for HIV-infected pregnant women to reduce the risk of vertical transmission to the baby.
2. It inhibits viral replication and decreases viral load in the mother, reducing transmission to the fetus.
3. Antibiotics are not effective for HIV treatment. Protease analogues are not typically used in pregnancy due to safety concerns. Acyclovir is used for herpes simplex virus, not HIV.