Nokea
A couple with a diagnosis of ovarian failure discusses their infertility options with their physician. The nurse should recognize which of the following as the treatment of choice for a patient with ovarian failure?
- A. Intracytoplasmic sperm injection
- B. Artificial insemination
- C. Gamete intrafallopian transfer
- D. In vitro fertilization
Correct Answer: C
Rationale: Gamete intrafallopian transfer (GIFT), a variation of IVF, is the treatment of choice for ovarian failure, as it addresses the lack of functional ovaries. Intracytoplasmic sperm injection is used for male factor infertility, and artificial insemination and standard IVF are less specific to ovarian failure.
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A womans current health complaints are suggestive of a diagnosis of premenstrual dysphoric disorder (PMDD). The nurse should first do which of the following?
- A. Assess the patients understanding of HT.
- B. Assess the patient for risk of suicide.
- C. Assure the patient that the problem is self-limiting.
- D. Suggest the use of St. Johns wort.
Correct Answer: B
Rationale: Severe PMDD can lead to suicidal or violent behavior, so assessing suicide risk is the priority to ensure patient safety. HT is not relevant, PMDD is not self-limiting, and suggesting herbal remedies like St. John's wort requires provider input.
An adolescent is brought to the clinic by her mother because of abnormal uterine bleeding. The nurse should understand that the most likely cause of this dysfunctional bleeding pattern is what?
- A. Lack of ovulation
- B. Chronic vaginitis
- C. A sexually transmitted infection
- D. Ectopic pregnancy
Correct Answer: A
Rationale: Dysfunctional uterine bleeding is most common in adolescents due to anovulation (lack of ovulation), which disrupts normal hormonal cycles. Vaginitis, STIs, and ectopic pregnancy are less likely causes of abnormal bleeding in this age group.
A patient in her late fifties has expressed to the nurse her desire to explore hormone replacement therapy (HRT). Based on what aspect of the patients health history is HRT contraindicated?
- A. History of vaginal dryness
- B. History of hot flashes and night sweats
- C. History of vascular thrombosis
- D. Family history of osteoporosis
Correct Answer: C
Rationale: The use of HRT is contraindicated in women with a history of vascular thrombosis, active liver disease, some cases of uterine cancer, and undiagnosed vaginal bleeding. HRT is beneficial in women with a risk for osteoporosis and can relieve symptoms like vaginal dryness, hot flashes, and night sweats. A history of vascular thrombosis is a clear contraindication.
A 36-year-old woman comes to the clinic complaining of premenstrual syndrome (PMS) that is disrupting her quality of life. What signs and symptoms are associated with this health problem? Select all that apply.
- A. Loss of appetite
- B. Breast tenderness
- C. Depression
- D. Fluid retention
- E. Headache
Correct Answer: B,C,D,E
Rationale: Physiologic symptoms of PMS include headache, breast tenderness, and fluid retention, along with affective symptoms like depression. Loss of appetite is not a common symptom of PMS.
The nurse is working with a couple who have been unable to conceive despite more than 2 years of trying to get pregnant. The couple has just learned that in vitro fertilization (IVF) was unsuccessful and they are both tearful. What nursing diagnosis is most likely to apply to this couple?
- A. Hopelessness related to failed IVF
- B. Acute confusion related to reasons for failed IVF
- C. Compromised family coping related to unsuccessful IVF
- D. Moral distress related to unsuccessful IVF
Correct Answer: A
Rationale: The couple's tearful response to a failed IVF suggests hopelessness, a likely emotional reaction to the loss of a promising intervention. Acute confusion implies cognitive impairment, compromised coping is less specific, and moral distress is unrelated to the scenario.