A student nurse is doing clinical hours at an OB/GYN clinic. The student is helping to develop a plan of care for a patient with gonorrhea who has presented at the clinic. The student should include which of the following in the care plan for this patient?
- A. The patient may benefit from oral contraceptives.
- B. The patient must avoid use of tampons.
- C. The patient is susceptible to urinary incontinence.
- D. The patient should also be treated for chlamydia.
Correct Answer: D
Rationale: Because of the high incidence of coinfection with chlamydia and gonorrhea, the patient should also be treated for chlamydia. Avoiding the use of tampons is part of the self-care management of a patient with possible toxic shock syndrome (TSS). The patient is not susceptible to incontinence and there is no indication for the use of oral contraceptives.
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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 comes to the clinic complaining of a tender, inflamed vulva. Testing does not reveal the presence of any known causative microorganism. What aspect of this patients current health status may account for the patients symptoms of vulvitis?
- A. The patient is morbidly obese.
- B. The patient has type 1 diabetes.
- C. The patient has chronic kidney disease.
- D. The patient has numerous allergies.
Correct Answer: B
Rationale: Vulvitis, an inflammation of the vulva, may result from disorders like diabetes, which can predispose to inflammation due to altered immune response or glucose levels. Obesity, kidney disease, and allergies are less likely causes.
A nurse practitioner is examining a patient who presented at the free clinic with vulvar pruritus. For which assessment finding would the practitioner look that may indicate the patient has an infection caused by Candida albicans?
- A. Cottage cheese-like discharge
- B. Yellow-green discharge
- C. Gray-white discharge
- D. Watery discharge with a fishy odor
Correct Answer: A
Rationale: Candida albicans infection is characterized by itching and a scant white, cottage cheese-like discharge. Yellow-green discharge indicates Trichomonas vaginalis. Gray-white discharge and a fishy odor are signs of Gardnerella vaginalis.
A patient with ovarian cancer is admitted to the hospital for surgery and the nurse is completing the patients health history. What clinical manifestation would the nurse expect to assess?
- A. Fish-like vaginal odor
- B. Increased abdominal girth
- C. Fever and chills
- D. Lower abdominal pelvic pain
Correct Answer: B
Rationale: Clinical manifestations of ovarian cancer include enlargement of the abdomen from an accumulation of fluid. Flatulence and feeling full after a light meal are significant symptoms. A fish-like odor is associated with bacterial vaginosis. Fever, chills, and abdominal pelvic pain are less typical of ovarian cancer.
A public health nurse is participating in a campaign aimed at preventing cervical cancer. What strategies should the nurse include is this campaign? Select all that apply.
- A. Promotion of HPV immunization
- B. Encouraging young women to delay first intercourse
- C. Smoking cessation
- D. Vitamin D and calcium supplementation
- E. Using safer sex practices
Correct Answer: A,B,C,E
Rationale: Cervical cancer prevention includes HPV immunization, delaying first intercourse, smoking cessation, and safer sex practices to reduce HPV risk. Vitamin D and calcium supplementation are not relevant.
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