Nokea
The nurse is palpating a female patient's adnexa. The findings include a firm, smooth uterine wall; the ovaries are palpable and feel smooth and firm. The fallopian tube is firm and pulsating. The nurse's most appropriate course of action would be to:
- A. Tell the patient that her examination is normal.
- B. Give her an immediate referral to a gynecologist.
- C. Suggest that she return in a month for a recheck to verify the findings.
- D. Tell the patient that she may have an ovarian cyst that should be evaluated further.
Correct Answer: B
Rationale: The correct answer is B because the findings of a firm, smooth uterine wall, palpable ovaries, and a firm, pulsating fallopian tube are concerning for possible gynecological issues such as ovarian cancer or pelvic inflammatory disease. A prompt referral to a gynecologist is necessary for further evaluation, which may include imaging studies or biopsies to rule out serious conditions. Choice A is incorrect as the findings are not normal. Choice C delays necessary evaluation, potentially leading to a progression of any underlying condition. Choice D assumes the presence of an ovarian cyst without further investigation, which is not appropriate given the pulsating fallopian tube and the need for a comprehensive assessment by a specialist.
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When the nurse is performing a genital examination on a male patient, the patient has an erection. The nurses most appropriate action or response is to:
- A. Ask the patient if he would like someone else to examine him.
- B. Continue with the examination as though nothing has happened
- C. reassure the patient that it is normal
- D. Stop the examination, leave the room while stating that the examination will resume at a later tim
Correct Answer: C
Rationale: The correct answer is C: reassure the patient that it is normal. An erection during a genital examination is a normal physiological response and not under the patient's control. By reassuring the patient, the nurse helps alleviate any potential embarrassment or anxiety. Asking for someone else (A) may further embarrass the patient. Continuing as if nothing happened (B) may ignore the patient's emotional well-being. Stopping the examination and leaving (D) without explanation can create confusion and discomfort.
Which of the following viruses is most susceptible to acyclovir?:
- A. Herpes simplex Type 1 virus
- B. Herpes simplex Type 2 virus
- C. Varicella-zoster virus
- D. Epstein-Barr virus
Correct Answer: A
Rationale: Acyclovir is an antiviral medication that specifically targets viruses that belong to the herpes virus family by inhibiting their replication. Herpes simplex Type 1 virus is most susceptible to acyclovir because it has a thymidine kinase enzyme that activates acyclovir into its active form, which then interferes with viral DNA synthesis. Herpes simplex Type 2 virus also has this enzyme, but it is not as effective against acyclovir compared to Type 1. Varicella-zoster virus and Epstein-Barr virus do not have the thymidine kinase enzyme necessary for acyclovir activation, making them less susceptible to the drug.
What is the most common cause of acute pyelonephritis resulting from an ascending infection from the lower urinary tract?
- A. The kidney is scarred and fibrotic.
- B. The organism is resistant to antibiotics.
- C. There is a preexisting abnormality of the urinary tract.
- D. The patient does not take all of the antibiotics for treatment of a UTI.
Correct Answer: C
Rationale: The correct answer is C. The most common cause of acute pyelonephritis from an ascending infection is a preexisting abnormality of the urinary tract. This abnormality can lead to urine stasis, making it easier for bacteria to ascend from the lower urinary tract to the kidneys. Choices A and B are incorrect because scarred kidneys and antibiotic resistance do not typically cause acute pyelonephritis. Choice D is incorrect as non-compliance with antibiotics may contribute to recurrent infections but is not the most common cause of pyelonephritis.
Mrs. T. also complains of hoarseness, which results from
- A. increased capillary permeability
- B. a secondary respiratory infection
- C. a large thyroid tumor pressing on the larynx
- D. a psychologic illness
Correct Answer: C
Rationale: The correct answer is C because hoarseness can be caused by a large thyroid tumor pressing on the larynx, affecting vocal cord function. This physical obstruction directly interferes with the ability of the vocal cords to vibrate properly, leading to hoarseness. Increased capillary permeability (A) would not result in hoarseness. A secondary respiratory infection (B) may cause coughing or throat irritation, but not hoarseness specifically. A psychologic illness (D) would not directly cause hoarseness as it is a physical symptom related to the vocal cords.
A 22-year-old woman with a history of chronic pelvic pain is being examined. The nurse suspects endometriosis. Which of the following is the most common symptom of endometriosis?
- A. Pain during menstruation.
- B. Pelvic pain that worsens during menstruation.
- C. Pain during ovulation.
- D. Heavy bleeding during menstruation.
Correct Answer: B
Rationale: The correct answer is B: Pelvic pain that worsens during menstruation. This is because endometriosis is characterized by the presence of endometrial-like tissue outside the uterus, leading to inflammation and pain in the pelvic region. The pain typically worsens during menstruation due to the shedding of this tissue, causing irritation and further inflammation.
A: Pain during menstruation is a common symptom, but what distinguishes endometriosis is the worsening of pain during menstruation.
C: Pain during ovulation is not a typical symptom of endometriosis. While some individuals may experience pain during ovulation, it is not the most common symptom.
D: Heavy bleeding during menstruation can occur in endometriosis, but it is not the most common symptom. Pelvic pain that worsens during menstruation is the hallmark symptom of endometriosis.