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The nurse is being trained to perform assessment screenings for abuse on patients who come into the walk-in clinic where the nurse works. Which of the following assessment questions is most appropriate?
- A. Would you describe your relationship as healthy and functional?
- B. Have you ever been forced into sexual activity?
- C. Do you make your husband uncontrollably angry?
- D. How is conflict usually handled in your home?
Correct Answer: B
Rationale: Asking about abuse directly, such as inquiring about forced sexual activity, is effective in identifying the presence of abuse and should be included in the health history of the patients. Oblique questions that relate to the character of the relationship or conflict resolution are less useful clinically. Asking about making a partner angry is inappropriate as it implies blame and does not directly screen for abuse.
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A patient calls the clinic and tells the nurse she has thick white, curd-like discharge from her vagina. How should the nurse best interpret this preliminary data?
- A. The drainage is physiologic and normal.
- B. The patient may have a Candida species infection.
- C. The patient needs a Pap smear as soon as possible.
- D. The patient may have a Trichomonas infection.
Correct Answer: B
Rationale: Drainage caused by Candida is typically curd-like and white, matching the patient's description. Trichomonas infections usually cause copious, frothy yellowish-green discharge. A Pap smear is not indicated as the primary response, as malignancy is unlikely. The discharge is not physiologic or normal.
The nurse is assessing a patient who believes that she has recently begun menopause. What principle should inform the nurses interactions with this patient?
- A. The nurse should express empathy for the patients difficult health situation.
- B. The nurse should begin by assuring the patient that her health will be much better in a few years.
- C. The nurse must carefully assess the patients feelings and beliefs surrounding menopause.
- D. The nurse should encourage the patient to celebrate this life milestone and its accompanying benefits.
Correct Answer: C
Rationale: Women have widely varying views on menopause, and the nurse must assess the patient's feelings and beliefs to provide individualized care. Presuming a positive or negative view, or assuring future health improvements, risks misaligning with the patient's perspective.
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 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.
A 15-year-old girl is brought to the clinic by her mother to see her primary care provider. The mother states that her daughter has not started to develop sexually. The physical examination shows that the patient has no indication of secondary sexual characteristics. What diagnosis should the nurse suspect?
- A. Primary amenorrhea
- B. Dyspareunia
- C. Vaginal atrophy
- D. Secondary dysmenorrhea
Correct Answer: A
Rationale: Primary amenorrhea is suspected when a young woman over 14 years has not begun menstruating and shows no secondary sexual characteristics, as described. Dyspareunia is painful intercourse, vaginal atrophy is unrelated to puberty onset, and secondary dysmenorrhea involves painful periods due to pathology, none of which fit the scenario.