Nokea
The nurse is conducting a health history for a patient who is pregnant requesting pharmacological therapy to induce a medical abortion. Which of the following responses would be accurate regarding the timeframes to use this drug therapy to induce abortion?
- A. 14 days gestation
- B. 35 days gestation
- C. 49 days gestation
- D. 90 days gestation
Correct Answer: C
Rationale: Drug therapy is another method to induce abortion (medical abortion) early in pregnancy. These agents must be given within the first 49 days of pregnancy (day 1 being the first day of the last menstrual period).
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A patient who is 58-years-old calls the health clinic and tells the nurse that she has a moderate amount of vaginal bleeding after 6 years of menopause. Which of the following procedures should the nurse anticipate teaching the patient about?
- A. Endometrial biopsy
- B. Uterine balloon therapy
- C. Laser endometrial ablation
- D. Dilation and curettage (D&C)
Correct Answer: A
Rationale: A postmenopausal woman with vaginal bleeding should be evaluated for endometrial cancer, and endometrial biopsy is the primary test for endometrial cancer. D&C will be needed only if the biopsy does not provide sufficient information to make a diagnosis. Endometrial ablation and balloon therapy are used to treat menorrhagia, which is unlikely in this patient.
The nurse is caring for a patient with persistent menorrhagia. Which of the following parameters should the nurse monitor?
- A. Estrogen level
- B. Complete blood count (CBC)
- C. Gonadotropin-releasing hormone (GnRH) level
- D. Serial β-human chorionic gonadotropin (hCG) results
Correct Answer: B
Rationale: Because anemia is a likely complication of menorrhagia, the nurse will need to check the CBC. Estrogen and GnRH levels are checked for patients with other problems, such as infertility. Serial β-hCG levels are monitored in patients who may be pregnant, which is not likely for this patient.
A patient requests a prescription for birth control pills to decrease abdominal cramping and headaches during her menstrual periods. Which of the following actions should the nurse take first?
- A. Determine whether the patient is sexually active.
- B. Suggest that the patient use nonsteroidal anti-inflammatory drugs (NSAIDs) for symptom relief.
- C. Take a personal and family health history from the patient.
- D. Teach the patient about the adverse effects of oral contraceptives.
Correct Answer: C
Rationale: Oral contraceptives may be appropriate to control this patient's symptoms, but the patient's health history may reveal contraindications to oral contraceptive use. Because the patient is requesting contraceptives for management of dysmenorrhea, whether she is sexually active is irrelevant. Since the patient is asking for birth control pills, responding that she should try NSAIDs is nontherapeutic. The patient does not need teaching about oral contraceptive adverse effects at this time.
The nurse is caring for a patient who has a radium implant for treatment of cancer of the cervix. Which of the following actions should the nurse implement?
- A. Maintain the patient on complete bed rest.
- B. Use gloves when changing the patient's bed.
- C. Allow extra time for patient discussion of concerns.
- D. Flush the toilet several times after the patient voids.
Correct Answer: A
Rationale: To prevent displacement of the implant, absolute bed rest is required. Wearing of gloves when changing linens and flushing the toilet several times are not necessary because the isotope is confined to the implant. The nurse should spend minimal time in the patient's room to avoid exposure to radiation.
Which of the following information should the nurse include when developing a teaching plan for a patient who is premenopausal with symptoms of uterine bleeding caused by a leiomyoma?
- A. Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to control mild to moderate pain.
- B. The tumour size is likely to increase throughout the patient's lifetime.
- C. The symptoms may decrease after the patient undergoes menopause.
- D. The patient will need frequent monitoring to detect any malignant changes.
Correct Answer: C
Rationale: Leiomyomas appear to depend on ovarian hormones and will atrophy after menopause, leading to a decrease in symptoms. Aspirin use is discouraged because the antiplatelet effects may lead to heavier uterine bleeding. The size of the tumour will shrink after menopause. Leiomyomas are benign tumours that do not undergo malignant changes.