Nokea
The nurse is assessing a patient who has amenorrhea with a weight of 41 kg. The patient makes all of the following statements. Which one indicates a need for immediate teaching by the nurse?
- A. I have not been able to eat much at all for the past three months.
- B. I drink at least three glasses of nonfat milk daily.
- C. I am not sexually active but currently have a boyfriend.
- D. I was recently treated for a sexually transmitted infection.
Correct Answer: A
Rationale: Not being able to eat much at all for the past three months indicates that the patient may be experiencing anorexia. Anorexia can cause amenorrhea. The other statements by the patient do not suggest any urgent teaching needs.
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The nurse is assessing a patient in the Sexual Health Clinic who has a positive Venereal Disease Research Laboratory (VDRL) test, but no chancre is noted. The nurse should plan to send the specimens for which of the following tests?
- A. Gram stain
- B. Cytological studies
- C. Rapid plasma reagin (RPR) agglutination
- D. Fluorescent treponemal antibody absorption (FTA-ABS)
Correct Answer: D
Rationale: Since false positives are common with VDRL and RPR testing, FTA-ABS testing is recommended to confirm a diagnosis of syphilis. Gram staining is used for other sexually transmitted infections (STIs) such as gonorrhea and chlamydia, and cytological studies are used to detect abnormal cells (such as neoplastic cells).
The nurse is providing teaching a patient who has been treated for pelvic inflammatory disease. Which of the following information should the nurse teach the patient about?
- A. Irregularities in the menstrual cycle
- B. Changes in secondary sex characteristics
- C. Possible difficulty with becoming pregnant
- D. Use of hormone replacement therapy (HRT)
Correct Answer: C
Rationale: Pelvic inflammatory disease may cause scarring of the fallopian tubes and result in difficulty in fertilization or implantation of the fertilized egg. Because ovarian function is not affected, the patient will not require HRT, have irregular menstrual cycles, or experience changes in secondary sex characteristics.
The nurse is preparing a patient for colposcopy with a cervical biopsy. Which of the following information should the nurse explain to the patient about the procedure?
- A. It involves dilation of the cervix and biopsy of the tissue lining the uterus.
- B. It will take place in a same-day-surgery centre so that local anesthesia can be used.
- C. It requires that the patient have nothing to eat or drink for 6 hours before the procedure.
- D. It is similar to a speculum examination of the cervix and should result in little or no pain.
Correct Answer: D
Rationale: Colposcopy involves visualization of the cervix with a binocular microscope and is similar to a speculum examination. A cervical biopsy may cause a minimal amount of pain.
The nurse is assessing the sexual-reproductive functional health pattern for a patient. Which of the following questions is most useful in determining the patient's sexual orientation and risk factors?
- A. Do you have sex with men, women, or both?
- B. Which gender do you prefer to have sex with?
- C. What types of sexual activities do you prefer?
- D. Are you heterosexual, homosexual, or bisexual?
Correct Answer: A
Rationale: This question is the most simply stated and will increase the likelihood of obtaining the relevant information about sexual orientation and possible risk factors associated with sexual activity. A patient who prefers intercourse with women may also have intercourse at times with men. The types of sexual activities engaged in may not indicate sexual orientation. Many patients who have intercourse with both men and women do not identify themselves as homosexual or bisexual.
Which information about a female patient who wants to start using oral contraceptives is most important to report to the health care provider?
- A. The patient quit smoking 6 months previously.
- B. The patient's blood pressure is 164/90 mm Hg.
- C. The patient has a history of migraines.
- D. The patient is 35 years old.
Correct Answer: B
Rationale: Since hypertension increases the risk for morbidity and mortality in women taking oral contraceptives, the patient's blood pressure should be controlled before oral contraceptives are prescribed. The other information will also be reported but will not affect the choice of contraceptive.