Nokea
A patient calls the clinic and tells the nurse she has thick white, curd-like discharge from her vagina. How should the nurse best interpret this preliminary data?
- A. The drainage is physiologic and normal.
- B. The patient may have a Candida species infection.
- C. The patient needs a Pap smear as soon as possible.
- D. The patient may have a Trichomonas infection.
Correct Answer: B
Rationale: Drainage caused by Candida is typically curd-like and white, matching the patient's description. Trichomonas infections usually cause copious, frothy yellowish-green discharge. A Pap smear is not indicated as the primary response, as malignancy is unlikely. The discharge is not physiologic or normal.
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A 21-year-old woman has sought care because of heavy periods and has subsequently been diagnosed with menorrhagia. The nurse should recognize which of the following as the most likely cause of the patients health problem?
- A. Hormonal disturbances
- B. Cervical or uterine cancer
- C. Pelvic inflammatory disease
- D. A sexually transmitted infection (STI)
Correct Answer: A
Rationale: Menorrhagia in young women is most commonly caused by hormonal disturbances, which disrupt normal menstrual regulation. Cervical or uterine cancer, pelvic inflammatory disease, and STIs are less likely causes in this age group.
A couple with a diagnosis of ovarian failure discusses their infertility options with their physician. The nurse should recognize which of the following as the treatment of choice for a patient with ovarian failure?
- A. Intracytoplasmic sperm injection
- B. Artificial insemination
- C. Gamete intrafallopian transfer
- D. In vitro fertilization
Correct Answer: C
Rationale: Gamete intrafallopian transfer (GIFT), a variation of IVF, is the treatment of choice for ovarian failure, as it addresses the lack of functional ovaries. Intracytoplasmic sperm injection is used for male factor infertility, and artificial insemination and standard IVF are less specific to ovarian failure.
A womans current health complaints are suggestive of a diagnosis of premenstrual dysphoric disorder (PMDD). The nurse should first do which of the following?
- A. Assess the patients understanding of HT.
- B. Assess the patient for risk of suicide.
- C. Assure the patient that the problem is self-limiting.
- D. Suggest the use of St. Johns wort.
Correct Answer: B
Rationale: Severe PMDD can lead to suicidal or violent behavior, so assessing suicide risk is the priority to ensure patient safety. HT is not relevant, PMDD is not self-limiting, and suggesting herbal remedies like St. John's wort requires provider input.
A 17-year-old girl has come to the free clinic for her annual examination. She tells the nurse she uses tampons and asks how long she may safely leave her tampon in place. What is the nurses best response?
- A. You may leave the tampon in overnight.
- B. The tampon should be changed at least twice per day.
- C. Tampons are dangerous and, ideally, you should not be using them.
- D. Tampons need to be changed every 4 to 6 hours.
Correct Answer: D
Rationale: Tampons should not be used for more than 4 to 6 hours, nor should super-absorbent tampons be used because of the association with toxic shock syndrome. If used appropriately, it is acceptable and safe for the patient to use tampons. Changing twice daily or leaving overnight may exceed safe duration.
A 51-year-old woman is experiencing perimenopausal symptoms and expresses confusion around the possible use of hormone therapy (HT). She explains that her mother and aunts used HT and she is unsure why few of her peers have been prescribed this treatment. What should the nurse explain to the patient?
- A. Large, long-term health studies have revealed that HT is minimally effective.
- B. HT has been largely replaced by other nonpharmacologic interventions.
- C. Research has shown that significant health risks are associated with HT.
- D. HT has been shown to exacerbate symptoms of menopause in a minority of women.
Correct Answer: C
Rationale: Research, such as the Women's Health Initiative, has shown significant health risks (e.g., breast cancer, cardiovascular events) associated with HT, leading to reduced use. HT remains effective for symptom relief, has not been replaced by nonpharmacologic options, and does not exacerbate symptoms.