Nokea
A student nurse is caring for a patient who has undergone a wide excision of the vulva. The student should know that what action is contraindicated in the immediate postoperative period?
- A. Placing patient in low Fowlers position
- B. Application of compression stockings
- C. Ambulation to a chair
- D. Provision of a low-residue diet
Correct Answer: C
Rationale: Sitting in a chair would place too much tension on the incision site and is contraindicated immediately post-surgery. Low Fowlers position reduces tension on the incision. Compression stockings prevent deep vein thrombosis, and a low-residue diet prevents straining during defecation.
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A patient has been diagnosed with endometriosis. When planning this patients care, the nurse should prioritize what nursing diagnosis?
- A. Anxiety related to risk of transmission
- B. Acute pain related to misplaced endometrial tissue
- C. Ineffective tissue perfusion related to hemorrhage
- D. Excess fluid volume related to abdominal distention
Correct Answer: B
Rationale: Endometriosis causes pain due to misplaced endometrial tissue, making acute pain a priority nursing diagnosis. It is not transmissible, so anxiety about transmission is irrelevant. Hemorrhage and fluid volume excess are not typical.
A 14-year-old is brought to the clinic by her mother. The mother explains to the nurse that her daughter has just started using tampons, but is not yet sexually active. The mother states I am very concerned because my daughter is having a lot of stabbing pain and burning. What might the nurse suspect is the problem with the 14-year-old?
- A. Vulvitis
- B. Vulvodynia
- C. Vaginitis
- D. Bartholins cyst
Correct Answer: B
Rationale: Vulvodynia is a chronic vulvar pain syndrome with symptoms like burning and stabbing pain, often triggered by initial tampon use. Vulvitis is typically infectious. Vaginitis involves vaginal inflammation, and Bartholins cyst involves a blocked gland.
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.
A female patient tells the nurse that she thinks she has a vaginal infection because she has noted inflammation of her vulva and the presence of a frothy, yellow-green discharge. The nurse recognizes that the clinical manifestations described are typical of what vaginal infection?
- A. Trichomonas vaginalis
- B. Candidiasis
- C. Gardnerella
- D. Gonorrhea
Correct Answer: A
Rationale: The clinical manifestations indicate Trichomonas vaginalis, characterized by frothy, yellow-green discharge and vulvar inflammation, treated with metronidazole. Candidiasis produces a white, cheese-like discharge. Gardnerella is characterized by gray-white discharge. Gonorrhea often produces no symptoms.
A patient diagnosed with cervical cancer will soon begin round of radiation therapy. When planning the patient's subsequent care plan, the nurse should prioritize actions with what goal?
- A. Preventing hemorrhage from bleeding
- B. Ensuring the patient knows the treatment is palliative, not curative
- C. Protecting the safety of patient, family, and staff
- D. Ensuring that patient adheres to dietary restrictions during treatment
Correct Answer: C
Rationale: Safety during radiation therapy is critical to protect patients, family, and staff from exposure. Hemorrhage is not a common risk, and the treatment may be curative. Dietary restrictions are not typically required.