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A client is being treated for gonorrhea. Which medication combination should the nurse expect to be prescribed?
- A. Ceftriaxone and azithromycin
- B. Penicillin and ceftriaxone
- C. Tetracycline and azithromycin
- D. Levofloxacin and azithromycin
Correct Answer: A
Rationale: The correct answer is A: Ceftriaxone and azithromycin. Ceftriaxone is the first-line treatment for gonorrhea due to increasing resistance to other antibiotics. Azithromycin is often prescribed in combination to treat possible co-infection with chlamydia. Penicillin (B) is not effective against gonorrhea. Tetracycline (C) is not recommended due to resistance issues. Levofloxacin (D) is no longer recommended due to resistance concerns. The combination of ceftriaxone and azithromycin covers both gonorrhea and possible chlamydia co-infection effectively.
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A woman has been diagnosed with single intraductal papilloma and has nipple discharge. Which diagnostic tests will most likely be required?
- A. MRI
- B. Mammogram
- C. Core needle biopsy
- D. Ductogram
Correct Answer: D
Rationale: The correct answer is D: Ductogram. In a patient with single intraductal papilloma and nipple discharge, a ductogram is the most appropriate diagnostic test to visualize the ductal system for any abnormalities. A ductogram involves injecting contrast dye into the affected duct to identify any blockages or abnormalities. This test helps in determining the extent of the papilloma and planning appropriate treatment.
Rationale for incorrect choices:
A: MRI - While MRI can provide detailed images, it is not the primary test for evaluating intraductal papilloma and nipple discharge.
B: Mammogram - Mammogram is used for breast imaging but may not provide detailed visualization of the ductal system.
C: Core needle biopsy - While a biopsy may be needed to confirm the papilloma, it does not directly assess the ductal system for other abnormalities.
When bathing an infant, what sign does the nurse recognize as a sign of developmental hip dysplasia?
- A. Hypotonicity of the leg muscles
- B. One leg is shorter than the other
- C. Broadening and flattening of the buttocks
- D. Two skinfolds on the back of each thigh
Correct Answer: B
Rationale: The correct answer is B: One leg is shorter than the other. This is a key sign of developmental hip dysplasia in infants. It indicates an imbalance in the hip joint, leading to unequal leg lengths. This can be detected during routine physical examinations by the nurse.
Incorrect choices:
A: Hypotonicity of the leg muscles - While muscle tone abnormalities can be associated with hip dysplasia, it is not a specific sign that is easily recognizable during bathing.
C: Broadening and flattening of the buttocks - This may be a sign of hip dysplasia in older children but is not a typical indicator in infants.
D: Two skinfolds on the back of each thigh - Although skinfolds can sometimes be present in infants with hip dysplasia, it is not a reliable or specific sign compared to the leg length discrepancy.
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.
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.
The client receives zidovudine (Retrovir) for treatment of HIV infection. Which assessment data indicates an adverse reaction to the drug?
- A. Cough
- B. Enlarged lymph nodes
- C. Decreased WBC count
- D. Fever
Correct Answer: C
Rationale: The correct answer is C: Decreased WBC count. Zidovudine is known to cause bone marrow suppression which can lead to a decrease in white blood cell count. This is an adverse reaction as it increases the risk of infections.
A: Cough is not a common adverse reaction to zidovudine.
B: Enlarged lymph nodes are not directly associated with zidovudine adverse reactions.
D: Fever is a non-specific symptom and can occur due to various reasons, not specifically related to zidovudine.
Therefore, the most concerning and relevant assessment data indicating an adverse reaction to zidovudine is a decreased white blood cell count.