Nokea
A clinic nurse is meeting with a 38-year-old patient who states that she would like to resume using oral contraceptives, which she used for several years during her twenties. What assessment question is most likely to reveal a potential contraindication to oral contraceptive use?
- A. Have you ever had surgery?
- B. Have you ever had a sexually transmitted infection?
- C. When did you last have your blood sugar levels checked?
- D. Do you smoke?
Correct Answer: D
Rationale: Women who smoke and who are 35 years of age or older should not take oral contraceptives because of an increased risk for cardiac problems. Previous surgeries or STIs do not necessarily contraindicate use, and while blood sugar monitoring is relevant for diabetes management, smoking is the most significant risk factor in this context.
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A 27-year-old primipara presents to the ED with vaginal bleeding and suspected contractions. The woman relates that she is 14 weeks pregnant and she thinks she is losing her baby. Diagnostic testing confirms a spontaneous abortion. What nursing action would be a priority at this time?
- A. Leave the patient alone so she can grieve in private.
- B. Teach the patient that this will not affect her future chance of conception.
- C. Take the patient off the obstetric floor so she will not hear a baby cry.
- D. Provide opportunities for the patient to talk and express her emotions.
Correct Answer: D
Rationale: Providing opportunities for the patient to talk and express emotions is a priority, as it supports grieving and informs further care. Assuming the patient prefers solitude, discussing future pregnancies, or moving her off the unit may not address her immediate emotional needs.
The nurse is working with a patient who expects to begin menopause in the next few years. What educational topic should the nurse prioritize when caring for a healthy woman approaching menopause?
- A. Patient teaching and counseling regarding healthy lifestyles
- B. Referrals to local support groups
- C. Nutritional counseling regarding osteoporosis prevention
- D. Drug therapy options
Correct Answer: A
Rationale: Fostering healthy lifestyles through patient teaching and counseling is a priority, as it supports overall health and well-being during the menopausal transition. This encompasses specific topics like osteoporosis prevention, support groups, and drug therapy but is broader in scope.
A 15-year-old girl is brought to the clinic by her mother to see her primary care provider. The mother states that her daughter has not started to develop sexually. The physical examination shows that the patient has no indication of secondary sexual characteristics. What diagnosis should the nurse suspect?
- A. Primary amenorrhea
- B. Dyspareunia
- C. Vaginal atrophy
- D. Secondary dysmenorrhea
Correct Answer: A
Rationale: Primary amenorrhea is suspected when a young woman over 14 years has not begun menstruating and shows no secondary sexual characteristics, as described. Dyspareunia is painful intercourse, vaginal atrophy is unrelated to puberty onset, and secondary dysmenorrhea involves painful periods due to pathology, none of which fit the scenario.
The nurse is being trained to perform assessment screenings for abuse on patients who come into the walk-in clinic where the nurse works. Which of the following assessment questions is most appropriate?
- A. Would you describe your relationship as healthy and functional?
- B. Have you ever been forced into sexual activity?
- C. Do you make your husband uncontrollably angry?
- D. How is conflict usually handled in your home?
Correct Answer: B
Rationale: Asking about abuse directly, such as inquiring about forced sexual activity, is effective in identifying the presence of abuse and should be included in the health history of the patients. Oblique questions that relate to the character of the relationship or conflict resolution are less useful clinically. Asking about making a partner angry is inappropriate as it implies blame and does not directly screen for abuse.
A school nurse is presenting information on human development and sexuality. When describing the role of hormones in sexual development, which hormone does the nurse teach the class is the most important one for developing and maintaining the female reproductive organs?
- A. Estrogen
- B. Progesterone
- C. Androgens
- D. Follicle-stimulating hormone
Correct Answer: A
Rationale: Estrogens are responsible for developing and maintaining the female reproductive organs. Progesterone is the most important hormone for conditioning the endometrium in preparation for implantation of the fertilized ovum. Androgens, secreted by the ovaries in small amounts, are involved in the early development of the follicle and affect the female libido. Follicle-stimulating hormone is responsible for stimulating the ovaries to secrete estrogen.