Nokea
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.
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The nurse is caring for a patient with a diagnosis of vulvar cancer who has returned from the PACU after undergoing a wide excision of the vulva. How should this patients analgesic regimen be best managed?
- A. Analgesia should be withheld unless the patients pain becomes unbearable.
- B. Scheduled analgesia should be administered around-the-clock to prevent pain.
- C. All analgesics should be given on a PRN, rather than scheduled, basis.
- D. Opioid analgesics should be avoided and NSAIDs exclusively provided.
Correct Answer: B
Rationale: Scheduled analgesia prevents severe pain post-vulvar excision, enhancing comfort. PRN dosing may be inadequate, and opioids are often necessary rather than relying solely on NSAIDs.
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 patient comes to the clinic complaining of a tender, inflamed vulva. Testing does not reveal the presence of any known causative microorganism. What aspect of this patients current health status may account for the patients symptoms of vulvitis?
- A. The patient is morbidly obese.
- B. The patient has type 1 diabetes.
- C. The patient has chronic kidney disease.
- D. The patient has numerous allergies.
Correct Answer: B
Rationale: Vulvitis, an inflammation of the vulva, may result from disorders like diabetes, which can predispose to inflammation due to altered immune response or glucose levels. Obesity, kidney disease, and allergies are less likely causes.
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.
The nurse is teaching a patient preventative measures regarding vaginal infections. The nurse should include which of the following as an important risk factor?
- A. High estrogen levels
- B. Late menarche
- C. Nonpregnant state
- D. Frequent douching
Correct Answer: D
Rationale: Risk factors associated with vulvovaginal infections include pregnancy, premenarche, low estrogen levels, and frequent douching. Frequent douching disrupts the normal vaginal flora, increasing infection risk.