Nokea
The nurse is assessing a 42-year-old patient who presents to the gynecology office with complaints of pelvic pressure, backaches, menorrhagia, and urinary frequency. The health care provider has diagnosed the patient with leiomyoma of the uterus. What are the treatment options for this condition? Select all that apply.
- A. Routine pelvic examinations to assess rate of disease process
- B. Oral contraceptives to control the bleeding and pain
- C. Myomectomy for women who desire pregnancy
- D. Hysterectomy for women who do not desire pregnancy
Correct Answer: B
Rationale: - Oral contraceptives are a common treatment option for leiomyoma of the uterus to help control the bleeding and pain associated with the condition.
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A woman has chosen the calendar method of conception control. Which is the most important action the nurse should perform during the assessment process?
- A. Obtain a history of the woman's menstrual cycle lengths for the past 6 to 12 months.
- B. Determine the client's weight gain and loss pattern for the previous year.
- C. Examine skin pigmentation and hair texture for hormonal changes.
- D. Explore the client's previous experiences with conception control.
Correct Answer: A
Rationale: The calendar method of conception control is based on the number of days in each cycle, counting from the first day of menses. The fertile period is determined after the lengths of menstrual cycles have been accurately recorded for 6 months.
The nurse is assessing a 33-year-old female patient who comes to the family practice clinic with complaints of excessive menstrual bleeding with bleeding between periods for the past 6 months. The health care provider has performed an endometrial biopsy and has discontinued the patient's oral contraceptives. What is the rationale for this treatment?
- A. This condition is often associated with use of oral contraceptives and may subside upon discontinuation.
- B. This condition is often associated with type 2 diabetes and must be controlled with a different type of birth control.
- C. This condition is often associated with hyperplasia of the endometrial tissue, which is exacerbated with oral contraceptives.
- D. This condition is often associated with ovarian cysts, which are exacerbated with the use of oral contraceptives.
Correct Answer: C
Rationale: The correct rationale for discontinuing the oral contraceptives in a patient with excessive menstrual bleeding and bleeding between periods is that this condition is often associated with hyperplasia of the endometrial tissue, which can be exacerbated with the use of oral contraceptives. Endometrial hyperplasia is a condition characterized by the abnormal thickening of the lining of the uterus, which can lead to heavy or prolonged menstrual bleeding. Estrogen contained in oral contraceptives can contribute to this thickening of the endometrial tissue, potentially worsening the patient's symptoms. By discontinuing the oral contraceptives, the provider aims to reduce the estrogen levels in the body, which may help alleviate the symptoms associated with endometrial hyperplasia. An endometrial biopsy is also important in this case to further investigate the underlying cause of the abnormal bleeding.
Which female reproductive organ(s) is(are) responsible for cyclic menstruation?
- A. Uterus
- B. Ovaries
- C. Vaginal vestibule
- D. Urethra
Correct Answer: A
Rationale: The uterus is responsible for cyclic menstruation as it responds to hormonal changes during the menstrual cycle.
The nurse is assessing a 64-year-old female patient. The patient states that she is able to reduce the risk of urinary tract infections (UTIs) by drinking a quart of cranberry juice a day. Which health condition, if present in this patient, contraindicates the use of cranberry juice?
- A. Hypertension, managed with lisinopril
- B. Diabetes type 1, managed with insulin
- C. Atrial fibrillation, managed with warfarin
- D. COPD, managed with inhaled steroids
Correct Answer: C
Rationale: Cranberry juice has the potential to interact with warfarin, a common blood thinner prescribed for conditions such as atrial fibrillation. Cranberry juice contains components that can inhibit the metabolism of warfarin in the body, leading to an increased risk of bleeding. Therefore, patients taking warfarin should avoid or limit their intake of cranberry juice to prevent potential negative interactions. In this case, the patient's use of warfarin to manage atrial fibrillation contraindicates the consumption of cranberry juice in large quantities. It is essential to consult a healthcare provider before making any changes to the diet, especially when taking medications that may interact with certain foods or beverages.
A charge nurse is working on a postpartum unit and discovers that one of the patients did not receive AM care during her shift assessment. The charge nurse questions the nurse assigned to provide care and finds out that the nurse thought “the patient should just do it by herself because she will have to do this at home.” On further questioning of the nurse, it is determined that the rest of her assigned patients were provided AM care. The assigned nurse has violated which ethical principle?
- A. Justice
- B. Truth
- C. Confidentiality
- D. Autonomy
Correct Answer: A
Rationale: Justice in healthcare ethics refers to the fair and equal distribution of resources, care, and treatment. In this scenario, the nurse's decision to not provide AM care to the specific patient, while providing care to other patients, violates the principle of justice. It is unfair and unjust to selectively provide care based on personal assumptions rather than patients' needs. All patients should be treated equally and receive appropriate care regardless of individual beliefs or assumptions.