Nokea
A patient is post-operative day 1 following a vaginal hysterectomy. The nurse has notes an increase in the patient's abdominal girth and the patient complains of bloating. What is not the nurses most appropriate action?
- A. Provide the patient an with an unsweetened, carbonated beverage.
- B. Apply a warm compress to the patient's lower abdomen.
- C. Provide an ice pack to apply to the patient's perineum and suprapubic region.
- D. Assist the patient into a prone position.
Correct Answer: B
Rationale: Applying a warm compress to the abdomen can relieve bloating and flatus post-hysterectomy. Carbonated beverages and ice packs are not recommended, and prone positioning may be uncomfortable.
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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 patient with genital herpes is having an acute exacerbation. What medication would the nurse expect to be ordered to suppress the symptoms and shorten the course of the infection?
- A. Clotrimazole (Gyne-Lotrimin)
- B. Metronidazole (Flagyl)
- C. Podophyllin (Podofin)
- D. Acyclovir (Zovirax)
Correct Answer: D
Rationale: Acyclovir (Zovirax) is an antiviral agent that can suppress the symptoms of genital herpes and shorten the course of the infection. It is effective at reducing the duration of lesions and preventing recurrences. Clotrimazole is used in the treatment of yeast infections. Metronidazole is the most effective treatment for trichomoniasis. Podophyllin is used to treat external genital warts.
The nurse is caring for a 63-year-old patient with ovarian cancer. The patient is to receive chemotherapy consisting of Taxol and Paraplatin. For what adverse effect of this treatment should the nurse monitor the patient?
- A. Leukopenia
- B. Metabolic acidosis
- C. Hyperphosphatemia
- D. Respiratory alkalosis
Correct Answer: A
Rationale: Taxol and Paraplatin commonly cause leukopenia, a manageable toxicity. Acid-base imbalances and hyperphosphatemia are not typical adverse effects of these drugs.
A 45-year-old woman has just undergone a radical hysterectomy for invasive cervical cancer. Prior to the surgery the physician explained to the patient that after the surgery a source of radiation would be placed near the tumor site to aid in reducing recurrence. What is the placement of the source of radiation called?
- A. Internal beam radiation
- B. Trachelectomy
- C. Brachytherapy
- D. External radiation
Correct Answer: C
Rationale: Brachytherapy involves placing a radiation source near the tumor to reduce recurrence. Internal beam radiation is not a standard term, and trachelectomy is a surgical procedure.
A female patient tells the nurse that she thinks she has a vaginal infection because she has noted inflammation of her vulva and the presence of a frothy, yellow-green discharge. The nurse recognizes that the clinical manifestations described are typical of what vaginal infection?
- A. Trichomonas vaginalis
- B. Candidiasis
- C. Gardnerella
- D. Gonorrhea
Correct Answer: A
Rationale: The clinical manifestations indicate Trichomonas vaginalis, characterized by frothy, yellow-green discharge and vulvar inflammation, treated with metronidazole. Candidiasis produces a white, cheese-like discharge. Gardnerella is characterized by gray-white discharge. Gonorrhea often produces no symptoms.