Nokea
The nurse is caring for a female patient in the health clinic who is diagnosed with genital warts. Which of the following information should the nurse include in the teaching plan?
- A. The need for regular Pap tests
- B. Increased risk for endometrial cancer
- C. Appropriate use of oral contraceptives
- D. Symptoms of pelvic inflammatory disease
Correct Answer: A
Rationale: Genital warts are caused by the human papilloma virus (HPV) and increase the risk for cervical cancer. There is no indication that the patient needs teaching about PID, oral contraceptives, or endometrial cancer.
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A patient who is 58-years-old calls the health clinic and tells the nurse that she has a moderate amount of vaginal bleeding after 6 years of menopause. Which of the following procedures should the nurse anticipate teaching the patient about?
- A. Endometrial biopsy
- B. Uterine balloon therapy
- C. Laser endometrial ablation
- D. Dilation and curettage (D&C)
Correct Answer: A
Rationale: A postmenopausal woman with vaginal bleeding should be evaluated for endometrial cancer, and endometrial biopsy is the primary test for endometrial cancer. D&C will be needed only if the biopsy does not provide sufficient information to make a diagnosis. Endometrial ablation and balloon therapy are used to treat menorrhagia, which is unlikely in this patient.
A 33-year-old female patient who uses oral contraceptives tells the nurse, 'I want to have children in a few years.' Which of the following responses by the nurse is best?
- A. You may have more difficulty becoming pregnant after about age 35.
- B. You have many years of fertility left, so there is no rush to have children.
- C. You should plan to stop taking oral contraceptives several years before you want to become pregnant.
- D. If you do not have children within the next few years, it will be very difficult for you to become pregnant.
Correct Answer: A
Rationale: The probability of successfully becoming pregnant decreases after age 35 although some patients may have no difficulty in becoming pregnant, this probability further decreases after age 40. Oral contraceptives do not need to be withdrawn for several years for a woman to become pregnant. Although the patient may be fertile for many years, it would be inaccurate to indicate that there is no concern about infertility as she becomes older. Although the risk for infertility increases after age 35, not all patients have difficulty in conceiving.
A couple is considering the possibility of in vitro fertilization (IVF). The woman tells the nurse that they cannot afford IVF on her husband's salary, and the husband replies that if the wife would get a job, they would have enough money. Which of the following nursing diagnoses is appropriate?
- A. Decisional conflict related to insufficient support system (financial resources)
- B. Ineffective sexuality pattern related to impaired relationship with significant other
- C. Defensive coping related to uncertainty (lack of concern)
- D. Ineffective denial related to insufficient sense of control (continued infertility)
Correct Answer: C
Rationale: IVF treatments are very costly. The statements made by the couple are consistent with the diagnosis of defensive coping. No data indicate that ineffective sexuality and ineffective denial are problems. Although the couple is quarrelling about finances, the data do not provide information indicating that the finances are inadequate.
A patient tells the nurse that she needs something to control the negative mood associated with premenstrual dysphoric disorder (PMDD). Which of the following medications should the nurse anticipate administering to the patient?
- A. Potassium supplement
- B. Vitamin B6
- C. Folic acid
- D. Ibuprofen
Correct Answer: B
Rationale: To improve negative mood, vitamin B6 supplementation (50 mg daily) may be used. Calcium (not potassium) and magnesium supplementation may also be effective in alleviating psychological and physiological symptoms. For anxiety, buspirone taken during the luteal phase has helped some women. Women with PMDD may benefit from antidepressants, including fluoxetine HCl (Prozac) and tricyclic antidepressants (e.g., amitriptyline). Folic acid is not given for PMDD. NSAIDs will not have an effect on negative moods.
The nurse is admitting a patient with multiple uterine leiomyomas for an abdominal hysterectomy. Which of the following topics should the nurse include in patient teaching?
- A. Leg exercises and the purpose of frequent ambulation
- B. Temporary decrease in vaginal sensation after surgery
- C. Adverse effects of systemic chemotherapy or radiation
- D. Symptoms caused by the sudden drop in estrogen level
Correct Answer: A
Rationale: Venous thromboembolism (VTE) is a potential complication after the surgery, and the nurse will instruct the patient about ways to prevent it. Vaginal sensation is decreased after a vaginal hysterectomy but not after abdominal hysterectomy. Leiomyomas are benign tumours, so chemotherapy and radiation will not be prescribed. Because the patient will still have her ovaries, the estrogen level will not decrease.