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A school nurse is presenting information on human development and sexuality. When describing the role of hormones in sexual development, which hormone does the nurse teach the class is the most important one for developing and maintaining the female reproductive organs?
- A. Estrogen
- B. Progesterone
- C. Androgens
- D. Follicle-stimulating hormone
Correct Answer: A
Rationale: Estrogens are responsible for developing and maintaining the female reproductive organs. Progesterone is the most important hormone for conditioning the endometrium in preparation for implantation of the fertilized ovum. Androgens, secreted by the ovaries in small amounts, are involved in the early development of the follicle and affect the female libido. Follicle-stimulating hormone is responsible for stimulating the ovaries to secrete estrogen.
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A 36-year-old woman comes to the clinic complaining of premenstrual syndrome (PMS) that is disrupting her quality of life. What signs and symptoms are associated with this health problem? Select all that apply.
- A. Loss of appetite
- B. Breast tenderness
- C. Depression
- D. Fluid retention
- E. Headache
Correct Answer: B,C,D,E
Rationale: Physiologic symptoms of PMS include headache, breast tenderness, and fluid retention, along with affective symptoms like depression. Loss of appetite is not a common symptom of PMS.
A patient calls the clinic and tells the nurse she has thick white, curd-like discharge from her vagina. How should the nurse best interpret this preliminary data?
- A. The drainage is physiologic and normal.
- B. The patient may have a Candida species infection.
- C. The patient needs a Pap smear as soon as possible.
- D. The patient may have a Trichomonas infection.
Correct Answer: B
Rationale: Drainage caused by Candida is typically curd-like and white, matching the patient's description. Trichomonas infections usually cause copious, frothy yellowish-green discharge. A Pap smear is not indicated as the primary response, as malignancy is unlikely. The discharge is not physiologic or normal.
By initiating an assessment about sexual concerns what does the nurse convey to the patient? Select all that apply.
- A. That sexual issues are valid health issues
- B. That it is safe to talk about sexual issues
- C. That sexual issues are only a minor aspect a persons identity
- D. That changes or problems in sexual functioning should be discussed
- E. That changes or problems in sexual functioning are highly atypical
Correct Answer: A,B,D
Rationale: By initiating an assessment about sexual concerns, the nurse communicates that issues about changes or problems in sexual functioning are valid and significant health issues, that it is safe to discuss them, and that they should be addressed. Sexual issues are not portrayed as minor or highly atypical.
A patient who is in the first trimester of pregnancy has experienced an incomplete abortion. The obstetric nurse should prepare the patient for what possible intervention?
- A. Dilation and evacuation
- B. Several days of bed rest
- C. Administration of hydromorphone
- D. IV administration of clomiphene
Correct Answer: A
Rationale: If only some of the tissue is passed, the abortion is referred to as incomplete. An emptying or evacuation procedure (D&C, or dilation and evacuation [D&E]) or administration of oral misoprostol (Cytotec) is usually required to remove the remaining tissue. Bed rest will not necessarily result in the passing of all the tissue. Clomiphene is used for ovulation induction, not abortion management, and hydromorphone is for pain relief, not a primary intervention.
The nurse is being trained to perform assessment screenings for abuse on patients who come into the walk-in clinic where the nurse works. Which of the following assessment questions is most appropriate?
- A. Would you describe your relationship as healthy and functional?
- B. Have you ever been forced into sexual activity?
- C. Do you make your husband uncontrollably angry?
- D. How is conflict usually handled in your home?
Correct Answer: B
Rationale: Asking about abuse directly, such as inquiring about forced sexual activity, is effective in identifying the presence of abuse and should be included in the health history of the patients. Oblique questions that relate to the character of the relationship or conflict resolution are less useful clinically. Asking about making a partner angry is inappropriate as it implies blame and does not directly screen for abuse.