Nokea
The nurse is caring for a patient who has just been told that her ovarian cancer is terminal and that no curative options remain. What would be the priority nursing care for this patient at this time?
- A. Provide emotional support to the patient and her family.
- B. Implement distraction and relaxation techniques.
- C. Offer to inform the patients family of this diagnosis.
- D. Teach the patient about the importance of maintaining a positive attitude.
Correct Answer: A
Rationale: Emotional support is critical for a patient with a terminal diagnosis to help cope with the prognosis. Informing the family is not the nurses role unless requested. Distraction and positive attitude focus may be inappropriate at this stage.
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A nurse practitioner is examining a patient who presented at the free clinic with vulvar pruritus. For which assessment finding would the practitioner look that may indicate the patient has an infection caused by Candida albicans?
- A. Cottage cheese-like discharge
- B. Yellow-green discharge
- C. Gray-white discharge
- D. Watery discharge with a fishy odor
Correct Answer: A
Rationale: Candida albicans infection is characterized by itching and a scant white, cottage cheese-like discharge. Yellow-green discharge indicates Trichomonas vaginalis. Gray-white discharge and a fishy odor are signs of Gardnerella vaginalis.
A patient has returned from a hysterectomy to the post-surgical unit. The patient's care plan addresses the a risk of hemorrhage. How should the nurses best monitor the patient's postoperative blood loss?
- A. Have patients void and have regular bowel movements using a commode rather than a toilet.
- B. Count and inspect each perineal pad used daily.
- C. Swab the patient's perineum for blood presence at least once per shift.
- D. Leave the patient's perineal area open to air to facilitate inspection.
Correct Answer: B
Rationale: Counting and inspecting perineal pads monitors blood loss accurately. Swabbing is insufficient, toilet use is unnecessary, and leaving the perineum open is not standard practice.
The nurse is caring for a patient with a diagnosis of vulvar cancer who has returned from the PACU after undergoing a wide excision of the vulva. How should this patients analgesic regimen be best managed?
- A. Analgesia should be withheld unless the patients pain becomes unbearable.
- B. Scheduled analgesia should be administered around-the-clock to prevent pain.
- C. All analgesics should be given on a PRN, rather than scheduled, basis.
- D. Opioid analgesics should be avoided and NSAIDs exclusively provided.
Correct Answer: B
Rationale: Scheduled analgesia prevents severe pain post-vulvar excision, enhancing comfort. PRN dosing may be inadequate, and opioids are often necessary rather than relying solely on NSAIDs.
The nurse notes that a patient has a history of fibroids and is aware that this term refers to a benign tumor of the uterus. What is a more appropriate term for a fibroid?
- A. Bartholins cyst
- B. Dermoid cyst
- C. Hydatidiform mole
- D. Leiomyoma
Correct Answer: D
Rationale: A leiomyoma is a benign tumor of the uterus, commonly referred to as a fibroid. Bartholins cyst is a cyst in a vestibular gland in the vulva. A dermoid cyst is a benign ovarian tumor. A hydatidiform mole is a gestational neoplasm.
A female patient with HIV has just been diagnosed with condylomata acuminata (genital warts). What information is most appropriate for the nurse to tell this patient?
- A. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually.
- B. The most common treatment is metronidazole (Flagylastin), which should eradicate the problem within 7 to 10 days.
- C. The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse.
- D. The human papillomavirus (HPV), which causes condylomata acuminata, cannot be transmitted during oral sex.
Correct Answer: A
Rationale: HIV-positive women have a higher rate of HPV. Infections with HPV and HIV together increase the risk of malignant transformation and cervical cancer. Thus, women with HIV infection should have frequent Pap smears. Because condylomata acuminata is a virus, there is no permanent cure. Condoms reduce but do not eliminate transmission risk. HPV can be transmitted to other parts of the body, including during oral sex.