Nokea
The nurse is caring for a patient who had an anterior and posterior (A&P) colporrhaphy for repair of a cystocele and rectocele. Which of the following nursing actions should be included in the postoperative care plan?
- A. Teach the patient correct pessary use.
- B. Perform in-dwelling catheter care daily.
- C. Repack the vaginal wound daily with gauze.
- D. Provide patient teaching about a high fibre diet.
Correct Answer: B
Rationale: The patient will have an in-dwelling catheter for several days after surgery to keep the bladder empty and decrease strain on the suture. A pessary will not be needed after the surgery. Vaginal wound packing is not usually used after an A&P repair. A low-residue diet will be ordered after posterior colporrhaphy.
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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.
The nurse is caring for a patient who has been hospitalized with endometriosis. Which of the following medications should the nurse anticipate preparing for the patient?
- A. Ganirelix
- B. Cetorelix
- C. hCG
- D. Nafarelin
Correct Answer: D
Rationale: Nafarelin can be used in the treatment of endometriosis. Cetorelix and ganirelix are GnRH antagonists and used to prevent premature LH surges and premature ovulation in patients undergoing ovarian stimulation. hCG is used to stimulate ovulation.
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.
The nurse is planning an educational session at a local community centre related to health promotion during menopause. Which of the following information should the nurse include related to management of hot flashes?
- A. Limit daily calcium intake
- B. Vitamin E daily supplement
- C. Have a glass of wine before bedtime
- D. Daily rigorous exercise in the evening
Correct Answer: B
Rationale: Daily intake of vitamin E in doses up to 800 IU may help reduce hot flashes in some women. Changing sleep patterns may be helped by avoiding alcohol and controlling hot flashes. A regular moderate program (three to four times per week) of aerobic and weight-bearing exercises is appropriate but it has no effect on hot flashes.
The nurse is caring for a patient recently diagnosed with polycystic ovary syndrome. Which of the following information is most important for the nurse to teach the patient?
- A. Reasons for a total hysterectomy
- B. How to decrease facial hair growth
- C. Ways to reduce the occurrence of acne
- D. Methods to maintain appropriate weight
Correct Answer: D
Rationale: Obesity exacerbates the problems associated with polycystic ovary syndrome, such as insulin resistance and type 2 diabetes. The nurse will also address the problems of acne and hirsutism, but these symptoms are lower priority because they do not have long-term health consequences. Although some patients do require total hysterectomy, this is usually performed only after other therapies have been unsuccessful.