Nokea
A patient states that PMS that is significantly disrupting her quality of life and that conservative management has failed to produce relief. What pharmacologic treatment may benefit this patient?
- A. An opioid analgesic
- B. A calcium channel blocker
- C. A monoamine oxidase inhibitor (MAOI)
- D. A selective serotonin reuptake inhibitor (SSRI)
Correct Answer: D
Rationale: Selective serotonin reuptake inhibitors (SSRIs) are effective pharmacologic treatments for severe PMS, addressing mood-related symptoms. Opioids, calcium channel blockers, and MAOIs are not indicated for PMS management.
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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.
The nurse is assessing a 53-year-old woman who has been experiencing dysmenorrhea. What questions should the nurse include in an assessment of the patients menstrual history? Select all that apply.
- A. Do you ever experience bleeding after intercourse?
- B. How long is your typical cycle?
- C. Did you have any sexually transmitted infections in early adulthood?
- D. When did your mother and sisters get their first periods?
- E. Do you experience cramps or pain during your cycle?
Correct Answer: A,B,E
Rationale: Menstrual history assessment includes questions about cycle length, presence of cramps or pain, and bleeding after intercourse, which are relevant to dysmenorrhea. Family menarche history and past STIs are less directly related to current menstrual symptoms.
The nurse is assessing a patient who believes that she has recently begun menopause. What principle should inform the nurses interactions with this patient?
- A. The nurse should express empathy for the patients difficult health situation.
- B. The nurse should begin by assuring the patient that her health will be much better in a few years.
- C. The nurse must carefully assess the patients feelings and beliefs surrounding menopause.
- D. The nurse should encourage the patient to celebrate this life milestone and its accompanying benefits.
Correct Answer: C
Rationale: Women have widely varying views on menopause, and the nurse must assess the patient's feelings and beliefs to provide individualized care. Presuming a positive or negative view, or assuring future health improvements, risks misaligning with the patient's perspective.
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 48-year-old woman presenting for care is seeking information about hormone therapy (HT) for the treatment of her perimenopausal symptoms. The patients need for relief from hot flashes and other symptoms will be weighed carefully against the increased risks of what complications of HT? Select all that apply.
- A. Anaphylaxis
- B. Osteoporosis
- C. Breast cancer
- D. Cardiovascular disease
- E. Venous thromboembolism
Correct Answer: C,D,E
Rationale: HT increases the risk of breast cancer, cardiovascular disease (e.g., heart attack, stroke), and venous thromboembolism, which must be considered against benefits like hot flash relief. HT reduces osteoporosis risk, and anaphylaxis is not a significant concern.