Nokea
A patient tells the nurse that she needs something to control the negative mood associated with premenstrual dysphoric disorder (PMDD). Which of the following medications should the nurse anticipate administering to the patient?
- A. Potassium supplement
- B. Vitamin B6
- C. Folic acid
- D. Ibuprofen
Correct Answer: B
Rationale: To improve negative mood, vitamin B6 supplementation (50 mg daily) may be used. Calcium (not potassium) and magnesium supplementation may also be effective in alleviating psychological and physiological symptoms. For anxiety, buspirone taken during the luteal phase has helped some women. Women with PMDD may benefit from antidepressants, including fluoxetine HCl (Prozac) and tricyclic antidepressants (e.g., amitriptyline). Folic acid is not given for PMDD. NSAIDs will not have an effect on negative moods.
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The nurse is teaching a patient about ways to prevent primary dysmenorrhea. Which of the following information should the nurse provide to the patient?
- A. Avoid aerobic exercise during her menstrual period.
- B. Use cold packs on the abdomen and back for pain relief.
- C. Talk with health care provider about antidepressant therapy.
- D. Start taking nonsteroidal anti-inflammatory drugs (NSAIDs) regularly when menstrual period starts.
Correct Answer: D
Rationale: NSAIDs should be started as soon as the menstrual period begins and taken at regular intervals (every 4-8 hours) during the usual time frame in which pain occurs. Aerobic exercise may help reduce symptoms. Heat therapy, such as warm packs, is recommended for relief of pain. Antidepressant therapy is not a typical treatment for dysmenorrhea.
A 33-year-old female patient who uses oral contraceptives tells the nurse, 'I want to have children in a few years.' Which of the following responses by the nurse is best?
- A. You may have more difficulty becoming pregnant after about age 35.
- B. You have many years of fertility left, so there is no rush to have children.
- C. You should plan to stop taking oral contraceptives several years before you want to become pregnant.
- D. If you do not have children within the next few years, it will be very difficult for you to become pregnant.
Correct Answer: A
Rationale: The probability of successfully becoming pregnant decreases after age 35 although some patients may have no difficulty in becoming pregnant, this probability further decreases after age 40. Oral contraceptives do not need to be withdrawn for several years for a woman to become pregnant. Although the patient may be fertile for many years, it would be inaccurate to indicate that there is no concern about infertility as she becomes older. Although the risk for infertility increases after age 35, not all patients have difficulty in conceiving.
The nurse is assessing a patient who is on the surgical unit after a radical abdominal hysterectomy. Which of the following findings is most important to report to the health care provider?
- A. Decreased bowel sounds in all four abdominal quadrants.
- B. Urine output of 100 mL in the first 8 hours after surgery.
- C. Symptom of pain at the incision site with coughing
- D. One inch increased abdominal girth
Correct Answer: B
Rationale: The decreased urine output indicates possible low blood volume and further assessment is needed to assess for possible internal bleeding. The other findings are not unusual after this surgery.
The nurse is conducting a health history for a patient who is pregnant requesting pharmacological therapy to induce a medical abortion. Which of the following responses would be accurate regarding the timeframes to use this drug therapy to induce abortion?
- A. 14 days gestation
- B. 35 days gestation
- C. 49 days gestation
- D. 90 days gestation
Correct Answer: C
Rationale: Drug therapy is another method to induce abortion (medical abortion) early in pregnancy. These agents must be given within the first 49 days of pregnancy (day 1 being the first day of the last menstrual period).
An 18-year-old visits the health clinic for a routine check-up. To determine whether a Pap test is needed, which of the following questions should the nurse ask?
- A. Do you use any illegal substances?
- B. Have you ever had sexual intercourse?
- C. How old were you when your menstrual periods started?
- D. Do you have any cramping with your menstrual periods?
Correct Answer: B
Rationale: The current Canadian Cancer Society recommendation is that a Pap test be done every 1-3 years, for women between age 21 and 69 years. The information about menstrual periods and substance abuse will not help to determine whether the patient requires a Pap test.