Nokea
A patient who is 58-years-old calls the health clinic and tells the nurse that she has a moderate amount of vaginal bleeding after 6 years of menopause. Which of the following procedures should the nurse anticipate teaching the patient about?
- A. Endometrial biopsy
- B. Uterine balloon therapy
- C. Laser endometrial ablation
- D. Dilation and curettage (D&C)
Correct Answer: A
Rationale: A postmenopausal woman with vaginal bleeding should be evaluated for endometrial cancer, and endometrial biopsy is the primary test for endometrial cancer. D&C will be needed only if the biopsy does not provide sufficient information to make a diagnosis. Endometrial ablation and balloon therapy are used to treat menorrhagia, which is unlikely in this patient.
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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.
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.
A 32-year-old patient has minor changes on her Pap test. Which of the following actions should the nurse take?
- A. Teach the patient about colposcopy.
- B. Teach the patient about punch biopsy.
- C. Schedule another Pap test in 4 months.
- D. Administer the human papilloma virus (HPV) vaccine.
Correct Answer: C
Rationale: Patients with minor changes on the Pap test can be followed with Pap tests every 4-6 months because these changes may revert to normal. Punch biopsy or colposcopy may be used if the Pap test shows more prominent changes. The HPV vaccine may reduce the risk for cervical cancer, but it is recommended only for ages 9 through 26.
The nurse is admitting a patient with multiple uterine leiomyomas for an abdominal hysterectomy. Which of the following topics should the nurse include in patient teaching?
- A. Leg exercises and the purpose of frequent ambulation
- B. Temporary decrease in vaginal sensation after surgery
- C. Adverse effects of systemic chemotherapy or radiation
- D. Symptoms caused by the sudden drop in estrogen level
Correct Answer: A
Rationale: Venous thromboembolism (VTE) is a potential complication after the surgery, and the nurse will instruct the patient about ways to prevent it. Vaginal sensation is decreased after a vaginal hysterectomy but not after abdominal hysterectomy. Leiomyomas are benign tumours, so chemotherapy and radiation will not be prescribed. Because the patient will still have her ovaries, the estrogen level will not decrease.
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).