Nokea
The nurse is caring for a client with polycystic ovarian syndrome. On which associated problem(s) will the nurse focus teaching? Select all that apply.
- A. Hypertension
- B. Hyperlippiedemia
- C. Infertility
- D. Absence of body hair
- E. Weight loss
- F. Decreased Insulin
Correct Answer: A,B,C
Rationale: Polycystic ovarian syndrome is associated with multiple endocrine abnormalities such as abnormal lipid levels, hypertension, and difficulty with conceaving due to interference of ovulation. Other symptoms include excessive body hair, weight gain, and overproduction and inefficient use of insulin.
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While obtaining the history, the nurse learns the client's mother's was treated with diethylstilbestrol (DES) during her pregnancy. The nurse determines that this client is at risk for which of the following?
- A. Vulvar cancer
- B. Breast cancer
- C. Vaginal cancer
- D. Endometrial cancer
Correct Answer: C
Rationale: Vaginal cancer is associated with the risk factor of being born to mothers treated with DES during their pregnancy. The upper posterior third of the vagina is the most common site of vaginal cancer. Metastatic lesions may occur in the cervix or adjacent areas such as the vulva, uterus, or rectum. DES is not a risk factor associated with vulvar or breast cancers. Endometrial cancer occurs in women who take estrogens without the addition of progesterone for 5 or more years during and after menopause.
The nurse is caring for a young adult client who reports excessive menstrual flow with menses lasting 10 days each month. Which treatment option does the nurse anticipate the physician will order for symptomatic relief for this client?
- A. Dilation and curettage (D and C)
- B. Hormonal contraceptives
- C. Endometrial ablation
- D. Uterine balloon therapy
Correct Answer: B
Rationale: When combination hormonal contraceptives are administered, they produce a light menstrual period and are helpful in the management of menorrhagia. Dilation and curettage can provide symptomatic relief, however, the effectiveness is limited. Endometrial ablation and uterine balloon therapy cause the endometrium to slough and are cost-effective but are only used after childbearing has completed.
The nurse is caring for a client who has just been diagnosed with o endometriosis. The client has been hoping to have children with her partner. Which statement by the nurse is most appropriate to provide the client with support and guidance about treatment options?
- A. Treatment is essential, so you really need to make a decision pretty quickly.
- B. If it was me, I would probably choose the medication options.
- C. If might help to include your partner in any of the discussion about options.
- D. The test results are clear and another physician would tell you the same thing.
Correct Answer: C
Rationale: The nurse assists the client through the decision-making process as it applies to family planning and medical or surgical treatment. Suggesting that the client include a partner or significant other in the discussion of options would be most helpful and therapeutic. The client does not need to make a decision immediately. The nurse should not give advice or offer personal opinions to influence the client's choice. The nurse should support the client's option of seeking a second opinion.
Which of the following is an early symptom of vulvar cancer?
- A. Pruritus with genital burning
- B. Fever accompanied by chills
- C. Severe abdominal pain
- D. Dyspareunia
Correct Answer: A
Rationale: Pruritus and genital burning are the most frequent early symptoms of vulvar cancer, followed by a bloody discharge from the vagina. Abdominal pain can be a result of formation of cysts in the ovary. Dyspareunia and fever accompanied by chills are not the early symptoms of vulvar cancer.
A client is admitted to the hospital with the diagnosis of sepsis secondary to pelvic inflammatory disease. Which transmission-based precaution will be initiated by the nurse?
- A. Standard precautions
- B. Protective precautions
- C. Contact precautions
- D. Droplet precautions
Correct Answer: C
Rationale: Contact isolation is a category of transmission-based precautions for controlling the spread of infectious microorganisms found in body fluids. Standard precautions are used in the care of all clients in the prevention of HIV and hepatitis. Protective precautions are instituted when a client is immune compromised and needs protected from others. Droper precautions are not indicated with PID.