Nokea
A couple is considering the possibility of in vitro fertilization (IVF). The woman tells the nurse that they cannot afford IVF on her husband's salary, and the husband replies that if the wife would get a job, they would have enough money. Which of the following nursing diagnoses is appropriate?
- A. Decisional conflict related to insufficient support system (financial resources)
- B. Ineffective sexuality pattern related to impaired relationship with significant other
- C. Defensive coping related to uncertainty (lack of concern)
- D. Ineffective denial related to insufficient sense of control (continued infertility)
Correct Answer: C
Rationale: IVF treatments are very costly. The statements made by the couple are consistent with the diagnosis of defensive coping. No data indicate that ineffective sexuality and ineffective denial are problems. Although the couple is quarrelling about finances, the data do not provide information indicating that the finances are inadequate.
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A patient who is scheduled for a Pap test tells the nurse that she has had intercourse during the last year with several men. Which of the following information should the nurse teach to the patient?
- A. Contraceptive use
- B. Antibiotic therapy
- C. Chlamydia testing
- D. Pregnancy testing
Correct Answer: C
Rationale: Chlamydia testing is recommended annually for women with multiple sex partners. There is no indication that the patient needs teaching about contraceptives, pregnancy testing, or antibiotic therapy.
The nurse is conducting a health history for a patient who is pregnant requesting pharmacological therapy to induce a medical abortion. Which of the following responses would be accurate regarding the timeframes to use this drug therapy to induce abortion?
- A. 14 days gestation
- B. 35 days gestation
- C. 49 days gestation
- D. 90 days gestation
Correct Answer: C
Rationale: Drug therapy is another method to induce abortion (medical abortion) early in pregnancy. These agents must be given within the first 49 days of pregnancy (day 1 being the first day of the last menstrual period).
A patient who is 45 years of age tells the nurse that she has not had a menstrual period for 3 months and asks whether she is going into menopause. Which of the following responses is best by the nurse?
- A. Have you thought about using hormone therapy?
- B. Most women feel a little depressed about entering menopause
- C. What was your menstrual pattern before your periods stopped?
- D. Since you are in your mid-40s, it is likely that you are menopausal.
Correct Answer: C
Rationale: The initial response by the nurse should be to assess the patient's baseline menstrual pattern. Although many women do enter menopause in the mid-40s, more information about this patient is needed before telling her that it is likely she is menopausal. Although hormone therapy (HT) may be prescribed, further assessment of the patient is needed before discussing therapies for menopause. Because the response to menopause is very individual, the nurse should not assume that the patient is experiencing any adverse emotional reactions.
The nurse is caring for a female patient in the health clinic who is diagnosed with genital warts. Which of the following information should the nurse include in the teaching plan?
- A. The need for regular Pap tests
- B. Increased risk for endometrial cancer
- C. Appropriate use of oral contraceptives
- D. Symptoms of pelvic inflammatory disease
Correct Answer: A
Rationale: Genital warts are caused by the human papilloma virus (HPV) and increase the risk for cervical cancer. There is no indication that the patient needs teaching about PID, oral contraceptives, or endometrial cancer.
The nurse is caring for a patient who tells the nurse that she has noticed increasing headaches with dizziness, abdominal bloating, and unexplained anxiety occurring before her menstrual periods. Which of the following actions is best for the nurse to take at this time?
- A. Ask the patient to write down her symptoms in a diary for 3 months.
- B. Suggest that the patient try aerobic exercise to decrease her symptoms.
- C. Teach the patient about appropriate lifestyle changes to reduce premenstrual syndrome (PMS) symptoms.
- D. Advise the patient to use nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to control symptoms.
Correct Answer: A
Rationale: The patient's symptoms indicate possible PMS, but they may also be associated with other diagnoses. Having the patient keep a symptom diary for 2 or 3 months will help in confirming a diagnosis of PMS. The nurse should not implement interventions for PMS until a diagnosis is made.