Nokea
A nurse teaches a client with vulvodynia about self-care. What statement indicates understanding?
- A. I should use scented soaps.
- B. I should avoid the use of any lubricants.
- C. I should wear tight synthetic underwear.
- D. I should use hot baths frequently.
Correct Answer: B
Rationale: The correct answer is B. Clients with vulvodynia should avoid the use of any lubricants to prevent irritation and exacerbation of symptoms. Lubricants can contain chemicals or fragrances that can further irritate the sensitive skin in the vulvar area. Choosing products specifically designed for sensitive skin or recommended by a healthcare provider is crucial. Using lubricants can worsen symptoms and discomfort.
Avoiding scented soaps (choice A) is important as well because fragrances can also irritate the vulvar area. Wearing tight synthetic underwear (choice C) can trap moisture and heat, leading to increased irritation. Using hot baths frequently (choice D) can also worsen symptoms by further irritating the sensitive skin.
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A nurse is teaching a group of newly licensed nurses on effective techniques for counseling clients about sexually transmitted infections (STIs). Which of the following statements should the nurse include in the teaching?
- A. Ask about the client's exposure to any past or present STIs.
- B. Advise clients not to disclose their sexual history.
- C. Focus only on present symptoms of STIs.
- D. Only ask about high-risk behavior.
Correct Answer: A
Rationale: The correct answer is A because asking about the client's exposure to any past or present STIs is crucial for effective counseling. Understanding the client's history helps in assessing risk factors, determining appropriate interventions, and providing tailored education. It also promotes trust and open communication.
Choice B is incorrect as advising clients not to disclose their sexual history hinders the nurse's ability to provide comprehensive care and support. Choice C is incorrect because focusing only on present symptoms may overlook important information needed for proper assessment and management. Choice D is incorrect as only asking about high-risk behavior limits the scope of the assessment and may miss potential risk factors.
A nurse is caring for an older adult client who has rheumatoid arthritis (RA) and is taking aspirin 650 mg every 4 hours. Which of the following diagnostic tests should the nurse monitor to evaluate the effectiveness of this medication?
- A. C-reactive protein
- B. Erythrocyte sedimentation rate (ESR)
- C. White blood cell count
- D. Hematocrit
Correct Answer: B
Rationale: The correct answer is B: Erythrocyte sedimentation rate (ESR). ESR is a common test used to monitor inflammation levels in rheumatoid arthritis (RA) patients. Aspirin is an anti-inflammatory medication, so monitoring ESR can help assess the effectiveness of the treatment. A decrease in ESR levels indicates a reduction in inflammation, suggesting that the aspirin is working. The other choices (A, C, D) are not specific to monitoring the effectiveness of aspirin in RA. C-reactive protein and white blood cell count are general markers of inflammation and infection, not specific to RA. Hematocrit measures red blood cell levels, which are not directly related to the effectiveness of aspirin in treating RA.
A nurse is teaching a newly licensed nurse about gynecological examination. Which of the following information should the nurse include in the teaching?
- A. The urethral orifice is assessed by separating the labia minora.
- B. The cervix should be palpated first.
- C. The external genitalia should not be inspected.
- D. The perineum should be assessed after the vaginal examination.
Correct Answer: A
Rationale: The correct answer is A because the urethral orifice is located between the clitoris and the vaginal opening, so separating the labia minora allows for proper visualization and assessment. This step ensures accurate examination of the urethral opening for signs of infection or abnormalities. Palpating the cervix first (B) is incorrect as it should be done after inspecting the external genitalia. Choosing not to inspect the external genitalia (C) is incorrect as it is an essential part of the gynecological examination. Assessing the perineum after the vaginal examination (D) is incorrect as the perineum should be assessed before the vaginal examination to evaluate for any abnormalities or injuries.
A nurse in a cardiac care unit is caring for a client with acute right-sided heart failure. Which of the following findings should the nurse expect?
- A. Low blood pressure
- B. Elevated central venous pressure (CVP).
- C. Decreased urine output
- D. Increased lung crackles
Correct Answer: B
Rationale: The correct answer is B: Elevated central venous pressure (CVP). In right-sided heart failure, the right ventricle fails to effectively pump blood to the lungs, causing blood to back up in the systemic circulation. This leads to increased pressure in the venous system, including the central veins. Elevated CVP is a classic sign of right-sided heart failure. Low blood pressure (A) is more commonly associated with left-sided heart failure. Decreased urine output (C) may occur due to poor perfusion but is not specific to right-sided heart failure. Increased lung crackles (D) are typically seen in left-sided heart failure, not right-sided heart failure.
A female middle adult client tells a nurse that she tested positive for a mutant BRCA1 gene. The nurse should recognize that the client is at an increased risk for which of the following situations?
- A. Developing breast cancer
- B. Developing ovarian cancer
- C. Developing uterine cancer
- D. Developing cervical cancer
Correct Answer: A
Rationale: The correct answer is A: Developing breast cancer. The BRCA1 gene mutation is associated with an increased risk of breast cancer in women. The mutation affects the body's ability to repair damaged DNA, leading to a higher likelihood of developing breast cancer. This risk is significantly higher in women with the mutant BRCA1 gene compared to those without it. Choices B, C, and D are incorrect because the BRCA1 gene mutation is not specifically linked to an increased risk of ovarian, uterine, or cervical cancer. Therefore, the client should be counseled and monitored closely for early detection and prevention of breast cancer.