Nokea
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.
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The nurse is caring for a patient who had an anterior and posterior (A&P) colporrhaphy for repair of a cystocele and rectocele. Which of the following nursing actions should be included in the postoperative care plan?
- A. Teach the patient correct pessary use.
- B. Perform in-dwelling catheter care daily.
- C. Repack the vaginal wound daily with gauze.
- D. Provide patient teaching about a high fibre diet.
Correct Answer: B
Rationale: The patient will have an in-dwelling catheter for several days after surgery to keep the bladder empty and decrease strain on the suture. A pessary will not be needed after the surgery. Vaginal wound packing is not usually used after an A&P repair. A low-residue diet will be ordered after posterior colporrhaphy.
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.
A patient who is scheduled for a Pap test tells the nurse that she has had intercourse during the last year with several men. Which of the following information should the nurse teach to the patient?
- A. Contraceptive use
- B. Antibiotic therapy
- C. Chlamydia testing
- D. Pregnancy testing
Correct Answer: C
Rationale: Chlamydia testing is recommended annually for women with multiple sex partners. There is no indication that the patient needs teaching about contraceptives, pregnancy testing, or antibiotic therapy.
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.