Nokea
A womans current health complaints are suggestive of a diagnosis of premenstrual dysphoric disorder (PMDD). The nurse should first do which of the following?
- A. Assess the patients understanding of HT.
- B. Assess the patient for risk of suicide.
- C. Assure the patient that the problem is self-limiting.
- D. Suggest the use of St. Johns wort.
Correct Answer: B
Rationale: Severe PMDD can lead to suicidal or violent behavior, so assessing suicide risk is the priority to ensure patient safety. HT is not relevant, PMDD is not self-limiting, and suggesting herbal remedies like St. John's wort requires provider input.
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A 51-year-old woman has come to the OB/GYN clinic for her annual physical. She tells the nurse that she has been experiencing severe hot flashes, but that she is reluctant to begin hormone therapy (HT). What potential solution should the nurse discuss with the patient?
- A. Sodium restriction
- B. Adopting a vegan diet
- C. Massage therapy
- D. Vitamin supplements
Correct Answer: D
Rationale: For some women, vitamins B6 and E have proven beneficial for the treatment of hot flashes, making this a viable option to discuss. Sodium restriction, a vegan diet, and massage therapy have not been noted to relieve hot flashes in perimenopause.
A 17-year-old girl has come to the free clinic for her annual examination. She tells the nurse she uses tampons and asks how long she may safely leave her tampon in place. What is the nurses best response?
- A. You may leave the tampon in overnight.
- B. The tampon should be changed at least twice per day.
- C. Tampons are dangerous and, ideally, you should not be using them.
- D. Tampons need to be changed every 4 to 6 hours.
Correct Answer: D
Rationale: Tampons should not be used for more than 4 to 6 hours, nor should super-absorbent tampons be used because of the association with toxic shock syndrome. If used appropriately, it is acceptable and safe for the patient to use tampons. Changing twice daily or leaving overnight may exceed safe duration.
A clinic nurse is meeting with a 38-year-old patient who states that she would like to resume using oral contraceptives, which she used for several years during her twenties. What assessment question is most likely to reveal a potential contraindication to oral contraceptive use?
- A. Have you ever had surgery?
- B. Have you ever had a sexually transmitted infection?
- C. When did you last have your blood sugar levels checked?
- D. Do you smoke?
Correct Answer: D
Rationale: Women who smoke and who are 35 years of age or older should not take oral contraceptives because of an increased risk for cardiac problems. Previous surgeries or STIs do not necessarily contraindicate use, and while blood sugar monitoring is relevant for diabetes management, smoking is the most significant risk factor in this context.
The nurse is working with a couple who is being evaluated for infertility. What nursing intervention would be most appropriate for this couples likely needs?
- A. Educating them about parenting techniques in order to foster hope
- B. Educating them about the benefits of child-free living
- C. Choosing the most appropriate reproductive technology
- D. Referring them to appropriate community resources
Correct Answer: D
Rationale: Referring the couple to appropriate resources, such as support groups or specialists, addresses their emotional and informational needs during infertility evaluation. Discussing parenting or child-free living may be insensitive, and choosing reproductive technology is outside the nurse's scope.
A female patient with cognitive and physical disabilities has come into the clinic for a routine checkup. When planning this patients assessment, what action should the nurse take?
- A. Ensure that a chaperone is available to be present during the assessment.
- B. Limit the length and scope of the health assessment.
- C. Avoid health promotion or disease prevention education.
- D. Avoid equating the patient with her disabilities.
Correct Answer: D
Rationale: When working with women who have disabilities, it is important that the nurse avoid equating the woman with her disability; the nurse must make an effort to understand that the patient and the disability are not synonymous. This ensures respectful and individualized care. A chaperone may not be required unless requested or indicated by policy. Limiting the assessment or avoiding education may compromise care quality and is not appropriate.