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A female patient with cognitive and physical disabilities has come into the clinic for a routine checkup. When planning this patients assessment, what action should the nurse take?
- A. Ensure that a chaperone is available to be present during the assessment.
- B. Limit the length and scope of the health assessment.
- C. Avoid health promotion or disease prevention education.
- D. Avoid equating the patient with her disabilities.
Correct Answer: D
Rationale: When working with women who have disabilities, it is important that the nurse avoid equating the woman with her disability; the nurse must make an effort to understand that the patient and the disability are not synonymous. This ensures respectful and individualized care. A chaperone may not be required unless requested or indicated by policy. Limiting the assessment or avoiding education may compromise care quality and is not appropriate.
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The school nurse is presenting a class on female reproductive health. The nurse should describe what aspect of Pap smears?
- A. The test may be performed at any time during the patients menstrual cycle.
- B. The smear should be done every 2 years.
- C. The test can detect early evidence of cervical cancer.
- D. Falsepositive Pap smear results occur mostly from not douching before the examination.
Correct Answer: C
Rationale: The Pap smear is used to detect early evidence of cervical cancer, which is a key point to emphasize. It should not be performed during menstruation, and douching can cause false-negative results by washing away cells. Annual Pap smears are recommended for most women, not every 2 years.
A 17-year-old girl has come to the free clinic for her annual examination. She tells the nurse she uses tampons and asks how long she may safely leave her tampon in place. What is the nurses best response?
- A. You may leave the tampon in overnight.
- B. The tampon should be changed at least twice per day.
- C. Tampons are dangerous and, ideally, you should not be using them.
- D. Tampons need to be changed every 4 to 6 hours.
Correct Answer: D
Rationale: Tampons should not be used for more than 4 to 6 hours, nor should super-absorbent tampons be used because of the association with toxic shock syndrome. If used appropriately, it is acceptable and safe for the patient to use tampons. Changing twice daily or leaving overnight may exceed safe duration.
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.
The nurse is utilizing the PLISSIT model of sexual health assessment during an interaction with a new patient. According to this model, the nurse should begin with what action?
- A. Conducting a preliminary assessment
- B. Addressing the patients psychosocial status
- C. Asking the patients permission to discuss sexuality
- D. Assessing for physiologic problems
Correct Answer: C
Rationale: The PLISSIT model of sexual assessment begins with permission, where the nurse seeks the patient's consent to discuss sexual health, fostering a safe environment. This is followed by limited information, specific suggestions, and intensive therapy if needed.
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.