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A client reports loss of interest in sexual relations and discomfort during intercourse. Which is the best response by the nurse?
- A. Don't worry, every woman goes through this.
- B. These are normal, manageable symptoms of menopause.
- C. You need to discuss this with your spouse.
- D. Hormome replacement therapy can resolve your symptoms.
Correct Answer: B
Rationale: Diminished libido and/or dyspareunia are common symptoms associated with perimenopause. Explaining that this can be a normal finding may help to alleviate worries for the client and provide hope for management of the symptoms. The nurse should avoid telling a client 'not to worry' or 'talk to someone else' because these can negate client feelings and shut down communication. HRT may not be recommended for this client.
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The nurse is caring for a client hospitalized for pelvic inflammatory disease (PID) who is discovered to have a ruptured pelvic abscess. Which nursing action is the priority at this time?
- A. Prepare the client for surgery.
- B. Administer antibiotic therapy as prescribed.
- C. Provide intravenous fluid replacement.
- D. Encourage bed rest.
Correct Answer: A
Rationale: A ruptured pelvic abscess requires emergency surgery. Administering antibiotic therapy as prescribed, providing intravenous fluid replacement, and encouraging bed rest are all appropriate actions, but they are lower priority for a client with a ruptured pelvic abscess.
The client asks the nurse if there is a pill that can be ordered to control the symptoms of menopause. Which assessment finding is most important in determining nursing care in association with hormone replacement therapy?
- A. Presence of kyphosis
- B. Symptoms of hot flashes
- C. Family history of breast cancer
- D. History of osteoporosis
Correct Answer: C
Rationale: The risk of endometrial or breast cancer in women prescribed HRT may outweigh the benefits of relieving symptoms of menopause and preventing kyphosis or hip fractures associated with osteoporosis.
A client who wishes to preserve childbearing ability asks the nurse to explain how taking oral contraceptives will work in the management of endometriosis. Which is the best response by the nurse?
- A. Symptoms of endometriosis are increased during normal menstrual cycle.
- B. Conraceptives will allow blood to be diverted to the peritoneal cavity.
- C. Trapping blood causes less pain and discomfort for clients with endometriosis.
- D. Endometriosis is usually cured with surgical menopause.
Correct Answer: A
Rationale: The use of estrogen-progestin contraceptives keeps the client in a non-bleeding phase of the menstrual cycle, therefore decreasing ectopic tissue from shedding and causing extra uterine bleeding. Blood that is trapped in the peritoneal cavity causes more pain or adhesions form. Endometriosis is cured by natural or surgical menopause but can be medically instituted for periods of time with the use of oral contraceptives.
The nurse is caring for a young adult client who reports excessive menstrual flow with menses lasting 10 days each month. Which treatment option does the nurse anticipate the physician will order for symptomatic relief for this client?
- A. Dilation and curettage (D and C)
- B. Hormonal contraceptives
- C. Endometrial ablation
- D. Uterine balloon therapy
Correct Answer: B
Rationale: When combination hormonal contraceptives are administered, they produce a light menstrual period and are helpful in the management of menorrhagia. Dilation and curettage can provide symptomatic relief, however, the effectiveness is limited. Endometrial ablation and uterine balloon therapy cause the endometrium to slough and are cost-effective but are only used after childbearing has completed.
A young client has just completed the 6-month series of Gardasil vaccine. Which comment by the client would alert the nurse that is other teaching is needed?
- A. This vaccine lowers my risk for cervical cancer.
- B. Will still time need to the routine time need for cervical cancer.
- C. I am at lower risk for developing cervical warts.
- D. This vaccine will prevent human papilloma virus (HPV) from occurring.
Correct Answer: D
Rationale: Gardasil is a vaccine that protects against four types of HPV, which cause 90% of cervical cancers and 90% of cervical warts but does not protect against other strains of HPV and pre vaccination infections. Routine cervical cancer screening is recommended regardless of vaccine use.