Nokea
A woman is admitted for repair of cystocele and rectocele. She has nine living children. In taking her health history, what would the nurse expect to find?
- A. Sporadic vaginal bleeding accompanied by chronic pelvic pain
- B. Menstrual irregularities and hirsutism on the chin
- C. Heavy leukorrhea with vulvar pruritus
- D. Stress incontinence with feeling of low abdominal pressure
- G. D
Correct Answer: Cystocele and rectocele, caused by weakened pelvic support, commonly lead to stress incontinence (urine leakage during pressure) and a feeling of low abdominal pressure due to organ protrusion. Other options suggest unrelated conditions like endometriosis or infections.
Rationale:
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A client is diagnosed with an enterocele. The nurse interprets this condition as:
- A. Protrusion of the posterior bladder wall downward through the anterior vaginal wall
- B. Bulging of the small intestine through the posterior vaginal wall
- C. Descent of the uterus through the pelvic floor into the vagina
- D. Sagging of the rectum with pressure exerted against the posterior vaginal wall
- G. B
Correct Answer: Enterocele involves the small intestine bulging into the vagina due to weakened pelvic support. Other options describe cystocele, uterine prolapse, and rectocele.
Rationale:
When describing the menstrual cycle to a group of young women, the nurse explains that estrogen levels are highest during which phase of the endometrial cycle?
- A. Menstrual
- B. Ischemic
- C. Secretory
- D. Proliferative
- G. D
Correct Answer: Estrogen peaks during the proliferative phase, stimulating endometrial regeneration. Menstrual phase has low estrogen, ischemic phase sees declining levels, and secretory phase is dominated by progesterone.
Rationale:
A nurse is reading a journal article about the care of a woman with pelvic organ prolapse. The nurse would expect to find information related to which disorder? Select all that apply.
- A. Fecal incontinence
- B. Rectocele
- C. Urinary incontinence
- D. Cystocele
- E. Enterocele
- G. B,C,D,E
Correct Answer: Pelvic organ prolapse includes rectocele, urinary incontinence, cystocele, and enterocele due to weakened pelvic support. Fecal incontinence is unrelated to organ displacement.
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:
A nurse is reviewing contraception options for four clients. The nurse should identify which of the following clients has a contraindication for receiving oral contraceptives.
- A. A 26-year-old client who has migraine headaches at the start of each menstrual cycle
- B. A 28-year-old client who has a history of pelvic inflammatory disease
- C. A 32-year-old client who has benign breast disease
- D. A 38-year-old client who reports smoking one pack of cigarettes every day
- G. D
Correct Answer: Smoking, especially over age 35, increases cardiovascular risks with oral contraceptives, making it a contraindication. Migraines, PID history, and benign breast disease are not absolute contraindications.
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