Nokea
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.
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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 27-year-old female patient is diagnosed with invasive cervical cancer and is told she needs to have a hysterectomy. One of the nursing diagnoses for this patient is disturbed body image related to perception of femininity. What intervention would be most appropriate for this patient?
- A. Reassure the patient that she will still be able to have children.
- B. Reassure the patient that she does not have to have sex to be feminine.
- C. Reassure the patient that you know how she is feeling and that you feel her anxiety and pain.
- D. Reassure the patient that she will still be able to have intercourse with sexual satisfaction and orgasm.
Correct Answer: D
Rationale: Reassuring the patient that sexual intercourse is possible post-hysterectomy with satisfaction and orgasm addresses body image concerns related to femininity. The patient cannot have children after hysterectomy, and assuming her feelings is inappropriate.
A female patient tells the nurse that she thinks she has a vaginal infection because she has noted inflammation of her vulva and the presence of a frothy, yellow-green discharge. The nurse recognizes that the clinical manifestations described are typical of what vaginal infection?
- A. Trichomonas vaginalis
- B. Candidiasis
- C. Gardnerella
- D. Gonorrhea
Correct Answer: A
Rationale: The clinical manifestations indicate Trichomonas vaginalis, characterized by frothy, yellow-green discharge and vulvar inflammation, treated with metronidazole. Candidiasis produces a white, cheese-like discharge. Gardnerella is characterized by gray-white discharge. Gonorrhea often produces no symptoms.
A patient is post-operative day 1 following a vaginal hysterectomy. The nurse has notes an increase in the patient's abdominal girth and the patient complains of bloating. What is not the nurses most appropriate action?
- A. Provide the patient an with an unsweetened, carbonated beverage.
- B. Apply a warm compress to the patient's lower abdomen.
- C. Provide an ice pack to apply to the patient's perineum and suprapubic region.
- D. Assist the patient into a prone position.
Correct Answer: B
Rationale: Applying a warm compress to the abdomen can relieve bloating and flatus post-hysterectomy. Carbonated beverages and ice packs are not recommended, and prone positioning may be uncomfortable.
A 14-year-old is brought to the clinic by her mother. The mother explains to the nurse that her daughter has just started using tampons, but is not yet sexually active. The mother states I am very concerned because my daughter is having a lot of stabbing pain and burning. What might the nurse suspect is the problem with the 14-year-old?
- A. Vulvitis
- B. Vulvodynia
- C. Vaginitis
- D. Bartholins cyst
Correct Answer: B
Rationale: Vulvodynia is a chronic vulvar pain syndrome with symptoms like burning and stabbing pain, often triggered by initial tampon use. Vulvitis is typically infectious. Vaginitis involves vaginal inflammation, and Bartholins cyst involves a blocked gland.