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A nurse in the ambulatory surgery center is providing discharge teaching to a client who had a dilation and curettage (D&C) following a spontaneous miscarriage. Which of the following should be included in the teaching?
- A. Vaginal intercourse can be resumed after 2 weeks.
- B. Products of conception will be present in vaginal bleeding.
- C. Increased intake of zinc-rich foods is recommended.
- D. Aspirin may be taken for cramps.
- G. A
Correct Answer: After a D&C, vaginal intercourse should be avoided for about 2 weeks to allow healing and reduce infection risk. Products of conception are removed during the procedure, so bleeding should not contain them. There's no specific need for zinc-rich foods post-D&C, and aspirin is avoided due to bleeding risk; NSAIDs like ibuprofen are preferred.
Rationale:
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A nurse is reinforcing teaching about self-care with a client who has pelvic inflammatory disease. The client does not speak English. Which of the following actions by the nurse is appropriate?
- A. Ask the client's English-speaking family member to translate.
- B. Use a translation dictionary to reinforce the teaching.
- C. Seek assistance from a facility-approved interpreter.
- D. Ask an assistive personnel (AP) who speaks the client's language to serve as an interpreter.
- G. C
Correct Answer: A facility-approved interpreter ensures accurate and confidential communication. Family members may lack medical knowledge, dictionaries are inefficient, and APs may not be qualified or authorized to interpret.
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A nurse is reading a journal article about the care of a woman with pelvic organ prolapse. The nurse would expect to find information related to which disorder? Select all that apply.
- A. Fecal incontinence
- B. Rectocele
- C. Urinary incontinence
- D. Cystocele
- E. Enterocele
- G. B,C,D,E
Correct Answer: Pelvic organ prolapse includes rectocele, urinary incontinence, cystocele, and enterocele due to weakened pelvic support. Fecal incontinence is unrelated to organ displacement.
Rationale:
A woman is admitted for repair of cystocele and rectocele. She has nine living children. In taking her health history, what would the nurse expect to find?
- A. Sporadic vaginal bleeding accompanied by chronic pelvic pain
- B. Menstrual irregularities and hirsutism on the chin
- C. Heavy leukorrhea with vulvar pruritus
- D. Stress incontinence with feeling of low abdominal pressure
- G. D
Correct Answer: Cystocele and rectocele, caused by weakened pelvic support, commonly lead to stress incontinence (urine leakage during pressure) and a feeling of low abdominal pressure due to organ protrusion. Other options suggest unrelated conditions like endometriosis or infections.
Rationale:
When describing the menstrual cycle to a group of young women, the nurse explains that estrogen levels are highest during which phase of the endometrial cycle?
- A. Menstrual
- B. Ischemic
- C. Secretory
- D. Proliferative
- G. D
Correct Answer: Estrogen peaks during the proliferative phase, stimulating endometrial regeneration. Menstrual phase has low estrogen, ischemic phase sees declining levels, and secretory phase is dominated by progesterone.
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A client with trichomoniasis is to receive metronidazole. What should the nurse instruct the client to avoid while taking this drug?
- A. Caffeine
- B. Chocolate
- C. Nicotine
- D. Alcohol
- G. D
Correct Answer: Alcohol can cause a severe reaction with metronidazole, leading to nausea, vomiting, and other symptoms. Caffeine, chocolate, and nicotine do not interact with metronidazole.
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