Nokea
A nurse presenting an educational event for a local community group is addressing premenstrual syndrome (PMS). What treatment guideline should the nurse teach this group?
- A. Avoid excessive fluid intake.
- B. Increase the frequency and intensity of exercise.
- C. Limit psychosocial stressors in order to reduce symptoms.
- D. Take opioid analgesics as ordered.
Correct Answer: B
Rationale: In general, the patient is encouraged to increase or initiate an exercise program to help relieve symptoms of PMS. Increased fluid intake is recommended, not avoidance. Opioids are not used to treat PMS, and while stress reduction has general benefits, it is not specifically noted to alleviate PMS symptoms.
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A 36-year-old woman comes to the clinic complaining of premenstrual syndrome (PMS) that is disrupting her quality of life. What signs and symptoms are associated with this health problem? Select all that apply.
- A. Loss of appetite
- B. Breast tenderness
- C. Depression
- D. Fluid retention
- E. Headache
Correct Answer: B,C,D,E
Rationale: Physiologic symptoms of PMS include headache, breast tenderness, and fluid retention, along with affective symptoms like depression. Loss of appetite is not a common symptom of PMS.
A community health nurse is leading a health education session addressing menopause and other aspects of womens health. What dietary supplements should the nurse recommend to prevent morbidity associated with osteoporotic fractures?
- A. Vitamin B12 and vitamin C
- B. Vitamin A and potassium
- C. Vitamin B6 and phosphorus
- D. Calcium and vitamin D
Correct Answer: D
Rationale: Calcium and vitamin D supplementation are recommended to reduce bone loss and prevent osteoporotic fractures, a key concern in menopause. Other listed supplements do not address bone health effectively.
A premenopausal patient is complaining of vaginal spotting and sharp, colicky lower abdominal pain. She informs the nurse that her period is 2 weeks late. The nurse should recognize a need for this patient to be investigated for what health problem?
- A. Trichomonas vaginalis
- B. Ectopic pregnancy
- C. Cervical cancer
- D. Fibromyalgia
Correct Answer: B
Rationale: Clinical symptoms of an ectopic pregnancy include delay in menstruation of 1 to 2 weeks, vaginal spotting, and sharp, colicky pain. These symptoms align with the patient's presentation, warranting investigation for this condition. Trichomonas vaginalis causes vaginal infection, typically with discharge, not typically associated with delayed menstruation or colicky pain. Cervical cancer may cause abnormal bleeding but is less likely to present with acute colicky pain and delayed menstruation. Fibromyalgia is unrelated to menstrual irregularities or vaginal spotting.
A 27-year-old primipara presents to the ED with vaginal bleeding and suspected contractions. The woman relates that she is 14 weeks pregnant and she thinks she is losing her baby. Diagnostic testing confirms a spontaneous abortion. What nursing action would be a priority at this time?
- A. Leave the patient alone so she can grieve in private.
- B. Teach the patient that this will not affect her future chance of conception.
- C. Take the patient off the obstetric floor so she will not hear a baby cry.
- D. Provide opportunities for the patient to talk and express her emotions.
Correct Answer: D
Rationale: Providing opportunities for the patient to talk and express emotions is a priority, as it supports grieving and informs further care. Assuming the patient prefers solitude, discussing future pregnancies, or moving her off the unit may not address her immediate emotional needs.
A patient who is in the first trimester of pregnancy has experienced an incomplete abortion. The obstetric nurse should prepare the patient for what possible intervention?
- A. Dilation and evacuation
- B. Several days of bed rest
- C. Administration of hydromorphone
- D. IV administration of clomiphene
Correct Answer: A
Rationale: If only some of the tissue is passed, the abortion is referred to as incomplete. An emptying or evacuation procedure (D&C, or dilation and evacuation [D&E]) or administration of oral misoprostol (Cytotec) is usually required to remove the remaining tissue. Bed rest will not necessarily result in the passing of all the tissue. Clomiphene is used for ovulation induction, not abortion management, and hydromorphone is for pain relief, not a primary intervention.