Nokea
The nurse is assessing a 53-year-old woman who has been experiencing dysmenorrhea. What questions should the nurse include in an assessment of the patients menstrual history? Select all that apply.
- A. Do you ever experience bleeding after intercourse?
- B. How long is your typical cycle?
- C. Did you have any sexually transmitted infections in early adulthood?
- D. When did your mother and sisters get their first periods?
- E. Do you experience cramps or pain during your cycle?
Correct Answer: A,B,E
Rationale: Menstrual history assessment includes questions about cycle length, presence of cramps or pain, and bleeding after intercourse, which are relevant to dysmenorrhea. Family menarche history and past STIs are less directly related to current menstrual symptoms.
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A patient states that PMS that is significantly disrupting her quality of life and that conservative management has failed to produce relief. What pharmacologic treatment may benefit this patient?
- A. An opioid analgesic
- B. A calcium channel blocker
- C. A monoamine oxidase inhibitor (MAOI)
- D. A selective serotonin reuptake inhibitor (SSRI)
Correct Answer: D
Rationale: Selective serotonin reuptake inhibitors (SSRIs) are effective pharmacologic treatments for severe PMS, addressing mood-related symptoms. Opioids, calcium channel blockers, and MAOIs are not indicated for PMS management.
A 36-year-old woman comes to the clinic complaining of premenstrual syndrome (PMS) that is disrupting her quality of life. What signs and symptoms are associated with this health problem? Select all that apply.
- A. Loss of appetite
- B. Breast tenderness
- C. Depression
- D. Fluid retention
- E. Headache
Correct Answer: B,C,D,E
Rationale: Physiologic symptoms of PMS include headache, breast tenderness, and fluid retention, along with affective symptoms like depression. Loss of appetite is not a common symptom of PMS.
The nurse is working with a couple who have been unable to conceive despite more than 2 years of trying to get pregnant. The couple has just learned that in vitro fertilization (IVF) was unsuccessful and they are both tearful. What nursing diagnosis is most likely to apply to this couple?
- A. Hopelessness related to failed IVF
- B. Acute confusion related to reasons for failed IVF
- C. Compromised family coping related to unsuccessful IVF
- D. Moral distress related to unsuccessful IVF
Correct Answer: A
Rationale: The couple's tearful response to a failed IVF suggests hopelessness, a likely emotional reaction to the loss of a promising intervention. Acute confusion implies cognitive impairment, compromised coping is less specific, and moral distress is unrelated to the scenario.
The nurse is caring for a couple trying to get pregnant and have not been able to for over a year. The couple asks what kind of problems a man can have that can cause infertility. What should be the nurses response?
- A. Men can have increased prolactin levels that decrease sperm viability.
- B. Men can have problems that increase the temperature around their testicles and decrease the quality of their semen.
- C. Men may inherit the gene that causes low sperm production.
- D. Men may produce sperm that are incompatible with the shape of the egg.
Correct Answer: B
Rationale: Varicoceles, which increase testicular temperature, can decrease semen quality and contribute to male infertility. Increased prolactin is less common, genetic factors are not specifically noted, and sperm-egg shape incompatibility is not a recognized cause.
A 48-year-old woman presenting for care is seeking information about hormone therapy (HT) for the treatment of her perimenopausal symptoms. The patients need for relief from hot flashes and other symptoms will be weighed carefully against the increased risks of what complications of HT? Select all that apply.
- A. Anaphylaxis
- B. Osteoporosis
- C. Breast cancer
- D. Cardiovascular disease
- E. Venous thromboembolism
Correct Answer: C,D,E
Rationale: HT increases the risk of breast cancer, cardiovascular disease (e.g., heart attack, stroke), and venous thromboembolism, which must be considered against benefits like hot flash relief. HT reduces osteoporosis risk, and anaphylaxis is not a significant concern.