Nokea
A nurse is caring for a pregnant patient with active herpes. The teaching plan for this patient should include which of the following?
- A. Babies delivered vaginally may become infected with the virus.
- B. Recommended treatment is excision of the herpes lesions.
- C. Pain generally does not occur with a herpes outbreak during pregnancy.
- D. Pregnancy may exacerbate the mothers symptoms, but poses no risk to the infant.
Correct Answer: A
Rationale: In pregnant women with active herpes, babies delivered vaginally may become infected with the virus, posing a risk for fetal morbidity and mortality. Lesions are not controlled with excision. Itching and pain often accompany outbreaks. Pregnancy can exacerbate symptoms and poses risks to the infant if the virus is active during delivery.
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A patient comes to the free clinic complaining of a gray-white discharge that clings to her external vulva and vaginal walls. A nurse practitioner assesses the patient and diagnoses Gardnerella vaginalis. What would be the most appropriate nursing action at this time?
- A. Advise the patient that this is an overgrowth of normal vaginal flora.
- B. Discuss the effect of this diagnosis on the patients fertility.
- C. Document the vaginal discharge as normal.
- D. Administer acyclovir as ordered.
Correct Answer: A
Rationale: Gray-white discharge that clings to the external vulva and vaginal walls is indicative of an overgrowth of Gardnerella vaginalis. The patients discharge is not a normal assessment finding. Antiviral medications are ineffective because of the bacterial etiology. This diagnosis is unlikely to have a long-term bearing on the patients fertility.
While taking a health history on a 20-year-old female patient, the nurse ascertains that this patient is taking miconazole (Monistat). The nurse is justified in presuming that this patient has what medical condition?
- A. Bacterial vaginosis
- B. Human papillomavirus (HPV)
- C. Candidiasis
- D. Toxic shock syndrome (TSS)
Correct Answer: C
Rationale: Candidiasis is a fungal or yeast infection caused by strains of Candida. Miconazole (Monistat) is an antifungal medication used in the treatment of candidiasis. This agent is inserted into the vagina with an applicator at bedtime and may be applied to the vulvar area for pruritus. HPV, bacterial vaginosis, and TSS are not treated by Monistat.
A patient with a genital herpes exacerbation has a nursing diagnosis of acute pain related to the genital lesions. What nursing intervention best addresses this diagnosis?
- A. Cover the lesions with a topical antibiotic.
- B. Keep the lesions clean and dry.
- C. Apply a topical NSAID to the lesions.
- D. Remain on bed rest until the lesions resolve.
Correct Answer: B
Rationale: Keeping herpes lesions clean and dry reduces pain and promotes healing. Antibiotics are ineffective for viral infections, and topical NSAIDs are not standard. Bed rest is unnecessary unless pain is severe.
A nurse practitioner is examining a patient who presented at the free clinic with vulvar pruritus. For which assessment finding would the practitioner look that may indicate the patient has an infection caused by Candida albicans?
- A. Cottage cheese-like discharge
- B. Yellow-green discharge
- C. Gray-white discharge
- D. Watery discharge with a fishy odor
Correct Answer: A
Rationale: Candida albicans infection is characterized by itching and a scant white, cottage cheese-like discharge. Yellow-green discharge indicates Trichomonas vaginalis. Gray-white discharge and a fishy odor are signs of Gardnerella vaginalis.
A patient has been diagnosed with endometriosis. When planning this patients care, the nurse should prioritize what nursing diagnosis?
- A. Anxiety related to risk of transmission
- B. Acute pain related to misplaced endometrial tissue
- C. Ineffective tissue perfusion related to hemorrhage
- D. Excess fluid volume related to abdominal distention
Correct Answer: B
Rationale: Endometriosis causes pain due to misplaced endometrial tissue, making acute pain a priority nursing diagnosis. It is not transmissible, so anxiety about transmission is irrelevant. Hemorrhage and fluid volume excess are not typical.