Nokea
The nurse is caring for a 63-year-old patient with ovarian cancer. The patient is to receive chemotherapy consisting of Taxol and Paraplatin. For what adverse effect of this treatment should the nurse monitor the patient?
- A. Leukopenia
- B. Metabolic acidosis
- C. Hyperphosphatemia
- D. Respiratory alkalosis
Correct Answer: A
Rationale: Taxol and Paraplatin commonly cause leukopenia, a manageable toxicity. Acid-base imbalances and hyperphosphatemia are not typical adverse effects of these drugs.
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When teaching patients about the risk factors of cervical cancer, what would the nurse identify as the most important risk factor?
- A. Late childbearing
- B. Human papillomavirus (HPV)
- C. Postmenopausal bleeding
- D. Tobacco use
Correct Answer: B
Rationale: HPV is the most salient risk factor for cervical cancer, exceeding the risks posed by smoking, late childbearing, and postmenopausal bleeding.
A patient comes to the free clinic complaining of a gray-white discharge that clings to her external vulva and vaginal walls. A nurse practitioner assesses the patient and diagnoses Gardnerella vaginalis. What would be the most appropriate nursing action at this time?
- A. Advise the patient that this is an overgrowth of normal vaginal flora.
- B. Discuss the effect of this diagnosis on the patients fertility.
- C. Document the vaginal discharge as normal.
- D. Administer acyclovir as ordered.
Correct Answer: A
Rationale: Gray-white discharge that clings to the external vulva and vaginal walls is indicative of an overgrowth of Gardnerella vaginalis. The patients discharge is not a normal assessment finding. Antiviral medications are ineffective because of the bacterial etiology. This diagnosis is unlikely to have a long-term bearing on the patients fertility.
When reviewing the electronic health record of a female patient, the nurse reads that the patient has a history of adenomyosis. The nurse should be aware that this patient experiences symptoms resulting from what pathophysiologic process?
- A. Loss of muscle tone in the vaginal wall
- B. Excessive synthesis and release of unopposed estrogen
- C. Invasion of the uterine wall by endometrial tissue
- D. Proliferation of tumors in the uterine wall
Correct Answer: C
Rationale: Adenomyosis involves the invasion of endometrial tissue into the uterine wall, causing symptoms. It is not related to vaginal muscle tone, unopposed estrogen, or tumor proliferation.
A 45-year-old woman has just undergone a radical hysterectomy for invasive cervical cancer. Prior to the surgery the physician explained to the patient that after the surgery a source of radiation would be placed near the tumor site to aid in reducing recurrence. What is the placement of the source of radiation called?
- A. Internal beam radiation
- B. Trachelectomy
- C. Brachytherapy
- D. External radiation
Correct Answer: C
Rationale: Brachytherapy involves placing a radiation source near the tumor to reduce recurrence. Internal beam radiation is not a standard term, and trachelectomy is a surgical procedure.
A student nurse is caring for a patient who has undergone a wide excision of the vulva. The student should know that what action is contraindicated in the immediate postoperative period?
- A. Placing patient in low Fowlers position
- B. Application of compression stockings
- C. Ambulation to a chair
- D. Provision of a low-residue diet
Correct Answer: C
Rationale: Sitting in a chair would place too much tension on the incision site and is contraindicated immediately post-surgery. Low Fowlers position reduces tension on the incision. Compression stockings prevent deep vein thrombosis, and a low-residue diet prevents straining during defecation.