Nokea
A patient with trichomoniasis comes to the walk-in clinic. In developing a care plan for this patient the nurse would know to include what as an important aspect of treating this patient?
- A. Both partners will be treated with metronidazole (Flagyl).
- B. Constipation and menstrual difficulties may occur.
- C. The patient should perform Kegel exercises 30 to 80 times daily.
- D. Care will involve hormone therapy to control the pain.
Correct Answer: A
Rationale: The most effective treatment for trichomoniasis is metronidazole (Flagyl). Both partners receive a one-time loading dose or a smaller dose three times a day for 1 week. In pelvic inflammatory disease, menstrual difficulties and constipation may occur. Kegel exercises are prescribed to help strengthen weakened muscles associated with cystocele and other structural deficits. Hormone therapy does not address the etiology of trichomoniasis.
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The nurse is teaching a patient preventative measures regarding vaginal infections. The nurse should include which of the following as an important risk factor?
- A. High estrogen levels
- B. Late menarche
- C. Nonpregnant state
- D. Frequent douching
Correct Answer: D
Rationale: Risk factors associated with vulvovaginal infections include pregnancy, premenarche, low estrogen levels, and frequent douching. Frequent douching disrupts the normal vaginal flora, increasing infection risk.
A patient has returned to the post-surgical unit after vulvar surgery. What intervention should the nurse prioritize during the initial postoperative period?
- A. Placing the patient in high Fowlers position
- B. Administering sitz baths every 4 hours
- C. Monitoring the integrity of the surgical site
- D. Avoiding analgesics unless the patients pain is unbearable
Correct Answer: C
Rationale: An important intervention for the patient who has undergone vulvar surgery is to monitor closely for signs of infection in the surgical site, such as redness, purulent drainage, and fever. The patient should be placed in low Fowlers position to reduce pain by relieving tension on the incision. Sitz baths are discouraged after wide excision of the vulva because of the risk of infection. Analgesics should be administered preventively on a scheduled basis to relieve pain and increase the patients comfort level.
A patient has been diagnosed with polycystic ovary syndrome (PCOS). The nurse should encourage what health promotion activity to address the patients hormone imbalance and infertility?
- A. Kegel exercises
- B. Increased fluid intake
- C. Weight loss
- D. Topical antibiotics as ordered
Correct Answer: C
Rationale: Weight loss, even as little as 5% of body weight, can improve hormone imbalance and infertility in PCOS. Kegel exercises and fluid intake do not address PCOS. Antibiotics are irrelevant as PCOS is not infectious.
The nurse is caring for a patient with a diagnosis of vulvar cancer who has returned from the PACU after undergoing a wide excision of the vulva. How should this patients analgesic regimen be best managed?
- A. Analgesia should be withheld unless the patients pain becomes unbearable.
- B. Scheduled analgesia should be administered around-the-clock to prevent pain.
- C. All analgesics should be given on a PRN, rather than scheduled, basis.
- D. Opioid analgesics should be avoided and NSAIDs exclusively provided.
Correct Answer: B
Rationale: Scheduled analgesia prevents severe pain post-vulvar excision, enhancing comfort. PRN dosing may be inadequate, and opioids are often necessary rather than relying solely on NSAIDs.
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.