Nokea
The nurse is collecting assessment data on a client who is reporting a vaginal discharge that is cottage cheese-like in appearance. Which pathogen is the most likely cause for this symptom?
- A. Gonococci
- B. Candida albicans
- C. Trichomonas vaginalis
- D. Gardnerella vaginalis
Correct Answer: B
Rationale: Candida albicans is a yeast infection that presents with a thick, curdy white discharge. Gonococcus is the organism that causes gonorrhea and presents with a yellow, mucoppuntent discharge. Trichomonas vaginalis presents with a foamy, white foul-smelling discharge and Gardnerella vaginalis is a watery, fishy-smelling discharge.
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Following a colopsopsy, the confirmation of in situ carcinoma of the cervix has been determined. Which comment by the client indicates an appropriate understanding of the diagnosis?
- A. I will not need any further treatment.
- B. The cancer has not spread.
- C. I will need surgery and chemotherapy to increase my odds, for survival.
- D. I can wait until I have finished having babies to seek treatment.
Correct Answer: B
Rationale: Carcinoma in situ means the cancer has not left the original site and therefore has not invaded other tissues. Further treatment is required, which usually consists of cryossurgery or hysterectomy. Surgery with adjuvant chemotherapy is usually reserved for cancers that are more advanced. Even though cervical cancers tend to be slower growing, treatment should not be delayed.
Which risk factor(s) supports the need for ovarian cancer screening? Select all that apply.
- A. Carrying genetic mutation for the disease
- B. Being nulliparous
- C. Family history of lung cancer
- D. Breastfeeding
- E. Use of oral contraceptives for 5 years or more
- F. Multiple full-term pregnancies
Correct Answer: A,B
Rationale: Woman who are nulliparous, have a family history of ovarian cancer, and/or carry a genetic mutation for it tend to develop ovarian cancer more often than others. Preventive measures recommended to lower the risk of ovarian cancer include having at least 2 full-term pregnancies, breastfeeding after pregnancies, and using oral contraceptives for 3 years or more. History of lung cancer is not a risk factor.
The nurse is interviewing a postmenopausal client during an annual gynecologic exam. Which assessment finding presents the greatest concern in the care of this client?
- A. Positive for human papillomavirus (HPV)
- B. Use of pessary
- C. Vaginal bleeding
- D. Urinary stress incontinence
Correct Answer: C
Rationale: Vaginal bleeding in a client after menopause is abnormal and a predominant symptom for vaginal cancers. The incidence of vaginal cancer is higher among woman infected with HPV and those who use a pessary but neglect to remove and clean it. Urinary stress incontinence is not a significant concern.
A client who wishes to preserve childbearing ability asks the nurse to explain how taking oral contraceptives will work in the management of endometriosis. Which is the best response by the nurse?
- A. Symptoms of endometriosis are increased during normal menstrual cycle.
- B. Conraceptives will allow blood to be diverted to the peritoneal cavity.
- C. Trapping blood causes less pain and discomfort for clients with endometriosis.
- D. Endometriosis is usually cured with surgical menopause.
Correct Answer: A
Rationale: The use of estrogen-progestin contraceptives keeps the client in a non-bleeding phase of the menstrual cycle, therefore decreasing ectopic tissue from shedding and causing extra uterine bleeding. Blood that is trapped in the peritoneal cavity causes more pain or adhesions form. Endometriosis is cured by natural or surgical menopause but can be medically instituted for periods of time with the use of oral contraceptives.
The nurse is caring for a client who has experienced repeated episodes of vaginitis. Which assessment finding does the nurse explain is the most likely cause?
- A. Tub baths preferred over shower
- B. Healthy sex life
- C. Occasional use of vinegar douches
- D. Type 2 diabetes mellitus
Correct Answer: D
Rationale: Unregulated blood sugars can result in alteration of the vaginal environment and promote the presence of glycogen in vaginal mucus, which supports the growth of microorganisms. Monitoring and controlling blood sugars would be key in a client with diabetes. Tub baths and participation in a healthy sex life are not associated with vaginitis. Frequent douching should be avoided.