Nokea
A patient has returned from a hysterectomy to the post-surgical unit. The patient's care plan addresses the a risk of hemorrhage. How should the nurses best monitor the patient's postoperative blood loss?
- A. Have patients void and have regular bowel movements using a commode rather than a toilet.
- B. Count and inspect each perineal pad used daily.
- C. Swab the patient's perineum for blood presence at least once per shift.
- D. Leave the patient's perineal area open to air to facilitate inspection.
Correct Answer: B
Rationale: Counting and inspecting perineal pads monitors blood loss accurately. Swabbing is insufficient, toilet use is unnecessary, and leaving the perineum open is not standard practice.
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While taking a health history on a 20-year-old female patient, the nurse ascertains that this patient is taking miconazole (Monistat). The nurse is justified in presuming that this patient has what medical condition?
- A. Bacterial vaginosis
- B. Human papillomavirus (HPV)
- C. Candidiasis
- D. Toxic shock syndrome (TSS)
Correct Answer: C
Rationale: Candidiasis is a fungal or yeast infection caused by strains of Candida. Miconazole (Monistat) is an antifungal medication used in the treatment of candidiasis. This agent is inserted into the vagina with an applicator at bedtime and may be applied to the vulvar area for pruritus. HPV, bacterial vaginosis, and TSS are not treated by Monistat.
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.
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.
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 caring for a patient who has just been told that her ovarian cancer is terminal and that no curative options remain. What would be the priority nursing care for this patient at this time?
- A. Provide emotional support to the patient and her family.
- B. Implement distraction and relaxation techniques.
- C. Offer to inform the patients family of this diagnosis.
- D. Teach the patient about the importance of maintaining a positive attitude.
Correct Answer: A
Rationale: Emotional support is critical for a patient with a terminal diagnosis to help cope with the prognosis. Informing the family is not the nurses role unless requested. Distraction and positive attitude focus may be inappropriate at this stage.