Nokea
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.
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The nurse is counselling a healthy perimenopausal woman who prefers not to use hormone therapy (HT). Which of the following treatment options should the nurse discuss with the patient? (Select all that apply.)
- A. Reduce coffee intake.
- B. Exercise several times a week.
- C. Take black cohosh supplements.
- D. Have a glass of wine in the evening.
- E. Increase intake of dietary soy products.
Correct Answer: A,B,C,E
Rationale: Reduction in caffeine intake, use of black cohosh, increasing dietary soy intake, and exercising three to four times weekly are recommended to reduce symptoms associated with menopause. Alcohol intake in the evening may increase the sleep problems associated with menopause.
The nurse is caring for an older-adult patient who is recently diagnosed with stage III ovarian cancer. Which of the following nursing diagnoses is best for this patient?
- A. Sexual dysfunction related to insufficient knowledge about sexual function (loss of vaginal sensation)
- B. Risk for infection as evidenced by immunosuppression
- C. Situational low self-esteem related to unrealistic self-expectations
- D. Anxiety related to threat to current status (cancer diagnosis and need to make treatment decisions)
Correct Answer: D
Rationale: The patient with stage III ovarian cancer is likely to be anxious about the poor prognosis and about the need to make decisions about the multiple treatments that may be used. Decreased vaginal sensation does not occur with ovarian cancer. The patient may develop immune dysfunction when she receives chemotherapy, but she is not currently at risk. It is unlikely that the patient has delayed seeking medical care because the symptoms of ovarian cancer are vague and occur late in the course of the cancer.
The nurse is caring for a patient who has an induced abortion with suction curettage at an ambulatory surgical centre. Which of the following instructions should the nurse include when discharging the patient?
- A. Heavy vaginal bleeding is expected for about 2 weeks.
- B. You should abstain from sexual intercourse for 2 weeks.
- C. Irregular menstrual periods are expected for the next few months.
- D. Use of contraceptives should be avoided until your reexamination.
Correct Answer: B
Rationale: Because infection is a possible complication of this procedure, the patient is advised to avoid intercourse until the reexamination in 2 weeks. Patients may be started on contraceptives on the day of the procedure. The patient should call the doctor if heavy vaginal bleeding occurs. No change in the regularity of the menstrual periods is expected.
An 18-year-old visits the health clinic for a routine check-up. To determine whether a Pap test is needed, which of the following questions should the nurse ask?
- A. Do you use any illegal substances?
- B. Have you ever had sexual intercourse?
- C. How old were you when your menstrual periods started?
- D. Do you have any cramping with your menstrual periods?
Correct Answer: B
Rationale: The current Canadian Cancer Society recommendation is that a Pap test be done every 1-3 years, for women between age 21 and 69 years. The information about menstrual periods and substance abuse will not help to determine whether the patient requires a Pap test.
The nurse is caring for a patient who has undergone a radical vulvectomy for vulvar carcinoma. Which of the following nursing diagnoses is priority at this time?
- A. Bathing self-care deficit related to pain
- B. Risk for infection as evidenced by invasive procedure (contamination of the wound with urine and stool)
- C. Imbalanced nutrition: less than body requirements related to insufficient dietary intake
- D. Risk for ineffective sexual pattern as evidenced by impaired relationship with significant other (disfiguration caused by the surgery)
Correct Answer: B
Rationale: Complex and meticulous wound care is needed to prevent infection and delayed wound healing. The other nursing diagnoses may also be appropriate for the patient but are not the highest priority immediately after surgery.