Nokea
A nurse is caring for a patient who states she is experiencing a thin vaginal discharge with a strong fishy odor. What test does the nurse prepare?
- A. whiff test
- B. vaginal culture
- C. urine culture
- D. blood test
Correct Answer: A
Rationale: A nurse caring for a patient who presents with a thin vaginal discharge with a strong fishy odor should prepare for performing a whiff test. The whiff test, also known as the amine or sniff test, is used to aid in the diagnosis of bacterial vaginosis (BV). BV is a common vaginal infection characterized by an overgrowth of harmful bacteria in the vagina and can cause symptoms like thin, grayish-white discharge with a strong fishy odor.
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Which client should the nurse refer for further testing?
- A. Left breast slightly smaller than right breast
- B. Eversion (elevation) of both nipples
- C. Faintly visible bilateral symmetry of venous network
- D. Small dimple located in the upper outer quadrant of the right breast
Correct Answer: D
Rationale: A small dimple in the breast is a concerning sign and should be referred for further testing as it can indicate breast cancer.
Which response by the nurse is the most therapeutic when the patient states, “I’m so afraid to N R I G B.C M U S N T O have a cesarean birth”?
- A. “Everything will be OK.”
- B. “Don’t worry about it. It will be over soon.”
- C. “What concerns you most about a cesarean birth?”
- D. “The physician will be in later and you can talk to him.”
Correct Answer: C
Rationale: The most therapeutic response by the nurse when the patient expresses fear about having a cesarean birth is to offer an open-ended question that explores the patient's concerns further. By asking, "What concerns you most about a cesarean birth?" the nurse acknowledges the patient's fears, encourages communication, and allows the patient to express her feelings and fears in more detail. This response shows empathy and enables the nurse to better address the specific worries and anxieties the patient may have about the procedure. The other options do not effectively address the patient's fears and do not promote therapeutic communication.
The nurse is assessing a 33-year-old female patient who comes to the family practice clinic with complaints of excessive menstrual bleeding with bleeding between periods for the past 6 months. The health care provider has performed an endometrial biopsy and has discontinued the patient's oral contraceptives. What is the rationale for this treatment?
- A. This condition is often associated with use of oral contraceptives and may subside upon discontinuation.
- B. This condition is often associated with type 2 diabetes and must be controlled with a different type of birth control.
- C. This condition is often associated with hyperplasia of the endometrial tissue, which is exacerbated with oral contraceptives.
- D. This condition is often associated with ovarian cysts, which are exacerbated with the use of oral contraceptives.
Correct Answer: C
Rationale: The correct rationale for discontinuing the oral contraceptives in a patient with excessive menstrual bleeding and bleeding between periods is that this condition is often associated with hyperplasia of the endometrial tissue, which can be exacerbated with the use of oral contraceptives. Endometrial hyperplasia is a condition characterized by the abnormal thickening of the lining of the uterus, which can lead to heavy or prolonged menstrual bleeding. Estrogen contained in oral contraceptives can contribute to this thickening of the endometrial tissue, potentially worsening the patient's symptoms. By discontinuing the oral contraceptives, the provider aims to reduce the estrogen levels in the body, which may help alleviate the symptoms associated with endometrial hyperplasia. An endometrial biopsy is also important in this case to further investigate the underlying cause of the abnormal bleeding.
During the childbearing experience, which behavior might the nurse expect from an African-American client?
- A. Seeking prenatal care early in her pregnancy
- B. Avoiding self-treatment of pregnancy-related discomfort
- C. Requesting liver in the postpartum period to prevent anemia
- D. Arriving at the hospital in advanced labor
Correct Answer: D
Rationale: African-American women often arrive at the hospital in far-advanced labor due to viewing pregnancy as a state of wellness, which contributes to delayed prenatal care. Many practice self-treatment for discomfort and may request liver postpartum for anemia prevention.
Which statement is the most complete and accurate description of medical abortions?
- A. Medical abortions are performed only for maternal health.
- B. They can be achieved through surgical procedures or with drugs.
- C. Medical abortions are mostly performed in the second trimester.
- D. They can be either elective or therapeutic.
Correct Answer: D
Rationale: Medical abortions can be either elective (the woman's choice) or therapeutic (for maternal or fetal health). They are typically performed in the first trimester using medication.