Nokea
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.
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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 comes to the clinic complaining of a tender, inflamed vulva. Testing does not reveal the presence of any known causative microorganism. What aspect of this patients current health status may account for the patients symptoms of vulvitis?
- A. The patient is morbidly obese.
- B. The patient has type 1 diabetes.
- C. The patient has chronic kidney disease.
- D. The patient has numerous allergies.
Correct Answer: B
Rationale: Vulvitis, an inflammation of the vulva, may result from disorders like diabetes, which can predispose to inflammation due to altered immune response or glucose levels. Obesity, kidney disease, and allergies are less likely causes.
A patient is post-operative day 1 following a vaginal hysterectomy. The nurse has notes an increase in the patient's abdominal girth and the patient complains of bloating. What is not the nurses most appropriate action?
- A. Provide the patient an with an unsweetened, carbonated beverage.
- B. Apply a warm compress to the patient's lower abdomen.
- C. Provide an ice pack to apply to the patient's perineum and suprapubic region.
- D. Assist the patient into a prone position.
Correct Answer: B
Rationale: Applying a warm compress to the abdomen can relieve bloating and flatus post-hysterectomy. Carbonated beverages and ice packs are not recommended, and prone positioning may be uncomfortable.
A 45-year-old woman has just undergone a radical hysterectomy for invasive cervical cancer. Prior to the surgery the physician explained to the patient that after the surgery a source of radiation would be placed near the tumor site to aid in reducing recurrence. What is the placement of the source of radiation called?
- A. Internal beam radiation
- B. Trachelectomy
- C. Brachytherapy
- D. External radiation
Correct Answer: C
Rationale: Brachytherapy involves placing a radiation source near the tumor to reduce recurrence. Internal beam radiation is not a standard term, and trachelectomy is a surgical procedure.
A student nurse is caring for a patient who has undergone a wide excision of the vulva. The student should know that what action is contraindicated in the immediate postoperative period?
- A. Placing patient in low Fowlers position
- B. Application of compression stockings
- C. Ambulation to a chair
- D. Provision of a low-residue diet
Correct Answer: C
Rationale: Sitting in a chair would place too much tension on the incision site and is contraindicated immediately post-surgery. Low Fowlers position reduces tension on the incision. Compression stockings prevent deep vein thrombosis, and a low-residue diet prevents straining during defecation.