Nokea
A postmenopausal woman with uterine prolapse is being fitted with a pessary. The nurse would be most alert for which side effect?
- A. Increased vaginal discharge
- B. Urinary tract infection
- C. Vaginitis
- D. Vaginal ulceration
- G. D
Correct Answer: Vaginal ulceration is a serious side effect of pessary use due to potential pressure necrosis and mucosal erosion. Increased vaginal discharge is normal, and UTIs and vaginitis are less common with proper hygiene and care.
Rationale:
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After teaching a group of adolescent girls about female reproductive development, the nurse determines that teaching was successful when the girls state that menarche is defined as a woman's first:
- A. Sexual experience
- B. Menstrual period
- C. Signs of breast development
- G. B
Correct Answer: Menarche is the first menstrual period, marking the onset of fertility. Sexual experience and breast development are unrelated to this definition.
Rationale:
A nurse is preparing to administer hydrocortisone 100 mg IM daily to a client. Available as hydrocortisone 250 mg/2 mL. How many mL should the nurse administer per dose?(Round the answer to the nearest tenth number. Use a leading zero if it applies. Do not use a trailing zero.)
- G. 0.8 mL
Correct Answer: Using the ratio 250 mg/2 mL = 100 mg/x mL, cross-multiply to get 250x = 200, so x = 0.8 mL. This is the correct dose, rounded to the nearest tenth.
Rationale:
A nurse is caring for a male client who has a new diagnosis of genital herpes (HSV 2). Which of the following findings should the nurse expect?
- A. White- or flesh-colored papillary growths in the genital area
- B. Green penile discharge
- C. Influenza-like symptoms
- D. Anuria
- G. C
Correct Answer: Genital herpes can cause flu-like symptoms (fever, aches) during outbreaks. Warts suggest HPV, discharge indicates gonorrhea, and anuria (no urine output) is unrelated.
Rationale:
Assessment of a female client reveals a thick, white vaginal discharge. She also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has:
- A. Trichomoniasis
- B. Genital herpes simplex
- C. Candidiasis
- D. Bacterial vaginosis
- G. C
Correct Answer: Candidiasis (yeast infection) causes thick, white, cottage cheese-like discharge, itching, and painful intercourse. Trichomoniasis causes frothy discharge, herpes causes blisters, and bacterial vaginosis causes thin, fishy-smelling discharge.
Rationale:
To assist the woman in regaining control of the urinary sphincter after bladder surgery, the nurse should teach the client to perform which action?
- A. Limit the intake of fluid.
- B. Void every hour while awake.
- C. Perform Kegel exercises daily.
- D. Take a laxative every night.
- G. C
Correct Answer: Kegel exercises strengthen pelvic floor muscles, improving urinary sphincter control. Limiting fluids risks dehydration, frequent voiding may irritate the bladder, and laxatives address constipation, not sphincter control.
Rationale: