Nokea
A client tells the nurse that she is struggling with symptoms of irritability and 'feeling crazy' around the same time each month. Which assessment data would provide the most important information needed in the development of a treatment plan for this client?
- A. Reproductive history
- B. Menstrual diary
- C. Vital signs
- D. Dietary assessment
Correct Answer: B
Rationale: Diagnosis of premenstrual disorder and/or premenstrual dysphoric disorder is based on data recorded in a menstrual diary over the time period lasting at least 2 months or more. Symptoms are absent during the period between onset of menstruation and ovulation as recorded in the diary. Reproductive history, vital signs, and dietary assessment are not significant in the diagnosis of the PMS or PMIDD.
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The nurse is caring for a client who has just been diagnosed with o endometriosis. The client has been hoping to have children with her partner. Which statement by the nurse is most appropriate to provide the client with support and guidance about treatment options?
- A. Treatment is essential, so you really need to make a decision pretty quickly.
- B. If it was me, I would probably choose the medication options.
- C. If might help to include your partner in any of the discussion about options.
- D. The test results are clear and another physician would tell you the same thing.
Correct Answer: C
Rationale: The nurse assists the client through the decision-making process as it applies to family planning and medical or surgical treatment. Suggesting that the client include a partner or significant other in the discussion of options would be most helpful and therapeutic. The client does not need to make a decision immediately. The nurse should not give advice or offer personal opinions to influence the client's choice. The nurse should support the client's option of seeking a second opinion.
Culture of client's vaginal discharge reveals Gardnerella vaginalis. Which of the following would the nurse expect to assess?
- A. Foul foamy discharge
- B. Thick curry white discharge
- C. Fisy smelling watery discharge
- D. Yellowish white discharge
Correct Answer: C
Rationale: Gardnerella vaginalis is associated with a gray white, watery, fisy smelling vaginal discharge. The discharge associated with a Candida infection is curry white and thick, and has a strong odor. Discharge due to trichomonas vaginalis is yellow white, foamy, and has a foul odor.
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.
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.
Following a colopsopsy, the confirmation of in situ carcinoma of the cervix has been determined. Which comment by the client indicates an appropriate understanding of the diagnosis?
- A. I will not need any further treatment.
- B. The cancer has not spread.
- C. I will need surgery and chemotherapy to increase my odds, for survival.
- D. I can wait until I have finished having babies to seek treatment.
Correct Answer: B
Rationale: Carcinoma in situ means the cancer has not left the original site and therefore has not invaded other tissues. Further treatment is required, which usually consists of cryossurgery or hysterectomy. Surgery with adjuvant chemotherapy is usually reserved for cancers that are more advanced. Even though cervical cancers tend to be slower growing, treatment should not be delayed.