Nokea
A patient who is trying to become pregnant asks the nurse about ways to determine when she is most likely to conceive. Which of the following information is the basis of the nurses' response?
- A. Ovulation prediction kits provide accurate information about ovulation.
- B. Ovulation is difficult to predict unless she has regular menstrual periods.
- C. She will need to bring a specimen of cervical mucus to the clinic for testing.
- D. She should take her body temperature daily and have intercourse when it drops.
Correct Answer: A
Rationale: Ovulation prediction kits indicate when luteinizing hormone (LH) levels first rise. Ovulation occurs about 28-36 hours after the first rise of LH. This information can be used to determine the best time for intercourse. Body temperature rises at ovulation. Postcoital cervical smears are used in infertility testing, but they do not predict the best time for conceiving and are not obtained by the patient. Determination of the time of ovulation can be predicted by basal body temperature charts or ovulation prediction kits and is not dependent on regular menstrual periods.
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The nurse is caring for a patient who has an induced abortion with suction curettage at an ambulatory surgical centre. Which of the following instructions should the nurse include when discharging the patient?
- A. Heavy vaginal bleeding is expected for about 2 weeks.
- B. You should abstain from sexual intercourse for 2 weeks.
- C. Irregular menstrual periods are expected for the next few months.
- D. Use of contraceptives should be avoided until your reexamination.
Correct Answer: B
Rationale: Because infection is a possible complication of this procedure, the patient is advised to avoid intercourse until the reexamination in 2 weeks. Patients may be started on contraceptives on the day of the procedure. The patient should call the doctor if heavy vaginal bleeding occurs. No change in the regularity of the menstrual periods is expected.
The nurse is caring for a patient with endometriosis who is treated with medroxyprogesterone. Which of the following information related to this therapy should the nurse explain to the patient?
- A. Suppresses the menstrual cycle by mimicking pregnancy.
- B. May cause symptoms such as vaginal atrophy and hot flashes.
- C. Is associated with loss of bone density and increased fracture risk.
- D. Will lead to permanent suppression of abnormal endometrial tissues.
Correct Answer: A
Rationale: Depo-Provera induces a pseudopregnancy, which suppresses ovulation and causes shrinkage of endometrial tissue. Vaginal atrophy and hot flashes are caused by synthetic androgens such as danazol or gonadotropin-releasing hormone agonists (GnRH) such as leuprolide. Although hormonal therapies will control endometriosis while the therapy is used, endometriosis will recur once the menstrual cycle is reestablished. Depo-Provera use is not associated with bone loss.
A patient requests a prescription for birth control pills to decrease abdominal cramping and headaches during her menstrual periods. Which of the following actions should the nurse take first?
- A. Determine whether the patient is sexually active.
- B. Suggest that the patient use nonsteroidal anti-inflammatory drugs (NSAIDs) for symptom relief.
- C. Take a personal and family health history from the patient.
- D. Teach the patient about the adverse effects of oral contraceptives.
Correct Answer: C
Rationale: Oral contraceptives may be appropriate to control this patient's symptoms, but the patient's health history may reveal contraindications to oral contraceptive use. Because the patient is requesting contraceptives for management of dysmenorrhea, whether she is sexually active is irrelevant. Since the patient is asking for birth control pills, responding that she should try NSAIDs is nontherapeutic. The patient does not need teaching about oral contraceptive adverse effects at this time.
The nurse is caring for a patient with persistent menorrhagia. Which of the following parameters should the nurse monitor?
- A. Estrogen level
- B. Complete blood count (CBC)
- C. Gonadotropin-releasing hormone (GnRH) level
- D. Serial β-human chorionic gonadotropin (hCG) results
Correct Answer: B
Rationale: Because anemia is a likely complication of menorrhagia, the nurse will need to check the CBC. Estrogen and GnRH levels are checked for patients with other problems, such as infertility. Serial β-hCG levels are monitored in patients who may be pregnant, which is not likely for this patient.
The nurse is caring for a female patient in the health clinic who is diagnosed with genital warts. Which of the following information should the nurse include in the teaching plan?
- A. The need for regular Pap tests
- B. Increased risk for endometrial cancer
- C. Appropriate use of oral contraceptives
- D. Symptoms of pelvic inflammatory disease
Correct Answer: A
Rationale: Genital warts are caused by the human papilloma virus (HPV) and increase the risk for cervical cancer. There is no indication that the patient needs teaching about PID, oral contraceptives, or endometrial cancer.