Nokea
A patient is diagnosed with vaginal candidiasis and an antifungal vaginal cream is prescribed. Which of the following patient statements indicate that the nurse's teaching about the treatment plan has been effective?
- A. I will tell my husband that we cannot have sex for the next month.
- B. I should clean carefully after each urination and bowel movement.
- C. I can douche daily with warm water if the itching continues to bother me.
- D. I will insert the cream using the applicator before I get up in the morning.
Correct Answer: B
Rationale: Cleaning of the perineal area will decrease itching caused by contact of the irritated tissues with urine and reduce the chance of further infection of irritated tissues by bacteria in the stool. Sexual intercourse should be avoided for 1 week. Douching will disrupt normal protective mechanisms in the vagina. The cream should be used at night so that it will remain in the vagina for longer.
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Which of the following statements by a patient who has just been instructed in the treatment for a Chlamydia trachomatis vaginal infection indicates that the nurse's teaching has been effective?
- A. I can purchase an over-the-counter medication to treat this infection.
- B. The symptoms are due to the overgrowth of normal vaginal bacteria.
- C. The medication will need to be inserted once daily with an applicator.
- D. Both my partner and I will need to take the medication for a full week.
Correct Answer: D
Rationale: Chlamydia is a sexually transmitted bacterial infection that requires treatment of both partners with antibiotics for 7 days. The other statements are true for the treatment of Candida albicans infection.
The nurse is caring for a patient who has a large cystocele and has not voided since admission 8 hours previously. Which of the following actions should the nurse take first?
- A. Insert a straight catheter per the PRN order.
- B. Encourage the patient to increase oral fluids.
- C. Notify the health care provider of the inability to void.
- D. Assess for urinary retention.
Correct Answer: D
Rationale: Since urinary retention is common with a large cystocele, the nurse's first action should be to assess for the presence of urine in the bladder. The other actions may be appropriate, depending on the findings of the physical assessment.
A couple is considering the possibility of in vitro fertilization (IVF). The woman tells the nurse that they cannot afford IVF on her husband's salary, and the husband replies that if the wife would get a job, they would have enough money. Which of the following nursing diagnoses is appropriate?
- A. Decisional conflict related to insufficient support system (financial resources)
- B. Ineffective sexuality pattern related to impaired relationship with significant other
- C. Defensive coping related to uncertainty (lack of concern)
- D. Ineffective denial related to insufficient sense of control (continued infertility)
Correct Answer: C
Rationale: IVF treatments are very costly. The statements made by the couple are consistent with the diagnosis of defensive coping. No data indicate that ineffective sexuality and ineffective denial are problems. Although the couple is quarrelling about finances, the data do not provide information indicating that the finances are inadequate.
Which of the following information should the nurse include when developing a teaching plan for a patient who is premenopausal with symptoms of uterine bleeding caused by a leiomyoma?
- A. Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to control mild to moderate pain.
- B. The tumour size is likely to increase throughout the patient's lifetime.
- C. The symptoms may decrease after the patient undergoes menopause.
- D. The patient will need frequent monitoring to detect any malignant changes.
Correct Answer: C
Rationale: Leiomyomas appear to depend on ovarian hormones and will atrophy after menopause, leading to a decrease in symptoms. Aspirin use is discouraged because the antiplatelet effects may lead to heavier uterine bleeding. The size of the tumour will shrink after menopause. Leiomyomas are benign tumours that do not undergo malignant changes.
The nurse is caring for a patient recently diagnosed with polycystic ovary syndrome. Which of the following information is most important for the nurse to teach the patient?
- A. Reasons for a total hysterectomy
- B. How to decrease facial hair growth
- C. Ways to reduce the occurrence of acne
- D. Methods to maintain appropriate weight
Correct Answer: D
Rationale: Obesity exacerbates the problems associated with polycystic ovary syndrome, such as insulin resistance and type 2 diabetes. The nurse will also address the problems of acne and hirsutism, but these symptoms are lower priority because they do not have long-term health consequences. Although some patients do require total hysterectomy, this is usually performed only after other therapies have been unsuccessful.