Nokea
A pregnant woman at 30 weeks gestation discovers she is HPV positive at her prenatal visit. Upon examination, her provider detects genital warts. Which treatment is not recommended in this case?
- A. Carbon dioxide laser surgery
- B. Electrocautery
- C. Surgical excision
- D. Podophyllin
Correct Answer: D
Rationale: The correct answer is D: Podophyllin. It is contraindicated in pregnancy due to its potential teratogenic effects. Carbon dioxide laser surgery, electrocautery, and surgical excision can be considered safer options for treating genital warts during pregnancy. Podophyllin should be avoided to prevent harm to the developing fetus.
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A client has an HSV-2 infection. The nurse recognizes that which of the following should be included in teaching the patient?
- A. The virus causes cold sores of the lips.
- B. Treatment is focused on relieving symptoms.
- C. The virus is cured with antibiotics.
- D. The virus is transmitted only when visible lesions are present.
Correct Answer: B
Rationale: The correct answer is B because HSV-2 is a sexually transmitted infection that causes genital herpes. Treatment focuses on managing symptoms like antiviral medications, not curing the virus. Explanation of other choices: A is incorrect because HSV-2 causes genital sores, not cold sores on the lips. C is incorrect because antibiotics do not cure viral infections. D is incorrect because HSV-2 can be transmitted even when there are no visible lesions through asymptomatic shedding.
A nurse working in a community clinic is teaching a client about chlamydia. Which statement made by the client would indicate a need for further instruction?
- A. Treatment is also required for individuals who are asymptomatic.
- B. Individuals can only spread the infection if symptomatic.
- C. All pregnant women should be screened for chlamydia.
- D. Any sexually active individuals can be infected with chlamydia.
Correct Answer: B
Rationale: The correct answer is B because it is incorrect. Chlamydia can be spread by individuals who are asymptomatic, so the statement that individuals can only spread it if symptomatic is inaccurate. Asymptomatic individuals can still transmit the infection to others. Therefore, this statement indicates a need for further instruction. Choices A, C, and D are all correct statements. Treatment is necessary for asymptomatic individuals to prevent complications, pregnant women should be screened for chlamydia to prevent transmission to the baby, and any sexually active individuals can indeed be infected with chlamydia.
A 32-week-gestation client was last seen in the prenatal clinic at 28 weeks' gestation. Which of the following changes should the nurse bring to the attention of the certified nurse midwife?
- A. Weight change from 128 pounds to 138 pounds.'
- B. Pulse rate change from 88 bpm to 92 bpm.'
- C. Blood pressure change from 120/80 to 118/78.'
- D. Respiratory rate change from 16 rpm to 20 rpm.'
Correct Answer: A
Rationale: The correct answer is A because a weight gain of 10 pounds in 4 weeks for a 32-week-gestation client is excessive and may indicate a potential issue such as gestational diabetes or preeclampsia.
B: The pulse rate change is within a normal range for pregnancy.
C: The blood pressure change is minimal and still within normal limits.
D: The respiratory rate change is also within normal limits for pregnancy.
During the physical assessment of a female client with HPV, which should the nurse expect to find?
- A. Purulent vaginal discharge
- B. Condylomata
- C. Malodorous vaginal discharge
- D. No clinical manifestation
Correct Answer: B
Rationale: The correct answer is B: Condylomata. HPV can manifest as genital warts or condylomata acuminata. These are flesh-colored growths that appear on the genital area. The presence of condylomata indicates an active HPV infection. Choices A and C are incorrect as purulent or malodorous discharge is not typically associated with HPV. Choice D is incorrect as HPV often presents with visible symptoms like condylomata.
Which statement by the woman indicates that she does not understand the teaching provided about postmastectomy breast reconstruction home care?
- A. I will avoid trauma to my breasts.
- B. I will need to wear a tight bra immediately.
- C. I have to empty my drains every 8 hours.
- D. I must notify the doctor if I notice any skin ulceration or changes in breast color such as redness.
Correct Answer: B
Rationale: The correct answer is B because wearing a tight bra immediately after postmastectomy breast reconstruction is not recommended as it can restrict blood flow and cause discomfort. A is correct because avoiding trauma is important. C is correct because draining is necessary. D is correct because skin changes should be reported.