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A client who had a hysterectomy has a 200-mg dose of ciprofloxacin (Cipro) ordered to infuse in 30 minutes. At what rate should the nurse infuse the medication if the pharmacy provides 200 mg in a 100-mL bag of normal saline? (Record your answer using a whole number) mL/hr
- A. 200 mL/hr
- B. 100 mL/hr
- C. 150 mL/hr
- D. 250 mL/hr
Correct Answer: A
Rationale: To calculate the infusion rate: The pharmacy provides 200 mg in a 100-mL bag, to be infused over 30 minutes. Infusion rate (mL/hr) = Total volume (mL) ÷ Time (hr). Here, 100 mL ÷ 0.5 hr = 200 mL/hr.
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A client has undergone a vaginal hysterectomy with a bilateral salpingo-oophorectomy. She is concerned about a loss of libido. What intervention by the nurse would be best?
- A. Suggest increasing vitamins and supplements daily.
- B. Discuss the value of a balanced diet and exercise.
- C. Reinforce that weight gain may be inevitable.
- D. Teach that estrogen cream inserted vaginally may help.
Correct Answer: D
Rationale: Use of vaginal estrogen cream and gentle dilation can help with vaginal changes and loss of libido. Weight gain and masculinization are misperceptions after a vaginal hysterectomy. Vitamins, supplements, a balanced diet, and exercise are helpful for healthy living, but are not necessarily going to increase libido.
A client is scheduled to start external beam radiation therapy (EBRT) for her endometrial cancer. Which teaching by the nurse is accurate? (Select all that apply.)
- A. You will need to be hospitalized during this therapy.
- B. Your skin needs to be inspected daily for any breakdown.
- C. It is not wise to stay out in the sun for long periods of time.
- D. The technician applies new site markings before each treatment.
Correct Answer: B,C,D
Rationale: EBRT is usually performed in ambulatory care and does not require hospitalization. The client needs to know to evaluate the skin, especially in the perineal area, for any breakdown, and avoid sunbathing. The client needs to avoid washing off the markings that indicate the treatment site.
Which action would the nurse teach to help the client prevent vulvovaginitis?
- A. Wipe back front after urination.
- B. Cleanse the inner labial mucosa with soap and water.
- C. Use feminine hygiene sprays to avoid odor.
- D. Wear loose cotton underwear.
Correct Answer: D
Rationale: To prevent vulvovaginitis, the client should wear cotton underwear. The client should wipe front to back after urination, not back to front. The client should cleanse the inner labial mucosa with water only, and avoid using feminine hygiene sprays.
The nurse is educating a client on the prevention of toxic shock syndrome (TSS). Which statement by the client indicates a lack of understanding?
- A. I need to change the tampon every 3 hours during the day.
- B. At night, I should use a feminine pad rather than a tampon.
- C. If I don't use tampons, I should not get TSS.
- D. I should wash my hands before inserting the tampon.
Correct Answer: A
Rationale: Tampons need to be changed every 3 to 6 hours to avoid infection by such organisms as Staphylococcus aureus. All of the other responses are correct: using feminine pads only, not using tampons at all, and washing hands before tampon insertion are all strategies to prevent TSS.
A postmenopausal client is experiencing low back and pelvic pain, fatigue, and bloody vaginal discharge. What laboratory tests would the nurse expect to see ordered for this client if endometrial cancer is suspected? (Select all that apply.)
- A. Cancer antigens (CA-125)
- B. White blood cell (WBC) count
- C. Hemoglobin and hematocrit (H&H)
- D. Prothrombin time (PT)
Correct Answer: A,C
Rationale: Serum tumor markers such as CA-125 assess for metastasis, especially if elevated. H&H would evaluate the possibility of anemia, a common finding with postmenopausal bleeding with endometrial cancer. WBC count is not indicated since there are no signs of infection. The INR and PT are coagulation tests to measure the time it takes for a fibrin clot to form, used to evaluate coagulation in clients receiving oral warfarin.