Nokea
The nurse is planning an educational session at a local community centre related to health promotion during menopause. Which of the following information should the nurse include related to management of hot flashes?
- A. Limit daily calcium intake
- B. Vitamin E daily supplement
- C. Have a glass of wine before bedtime
- D. Daily rigorous exercise in the evening
Correct Answer: B
Rationale: Daily intake of vitamin E in doses up to 800 IU may help reduce hot flashes in some women. Changing sleep patterns may be helped by avoiding alcohol and controlling hot flashes. A regular moderate program (three to four times per week) of aerobic and weight-bearing exercises is appropriate but it has no effect on hot flashes.
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Which of the following statements by a patient who has just been instructed in the treatment for a Chlamydia trachomatis vaginal infection indicates that the nurse's teaching has been effective?
- A. I can purchase an over-the-counter medication to treat this infection.
- B. The symptoms are due to the overgrowth of normal vaginal bacteria.
- C. The medication will need to be inserted once daily with an applicator.
- D. Both my partner and I will need to take the medication for a full week.
Correct Answer: D
Rationale: Chlamydia is a sexually transmitted bacterial infection that requires treatment of both partners with antibiotics for 7 days. The other statements are true for the treatment of Candida albicans infection.
The nurse is admitting a patient with increasing abdominal pain who is diagnosed with an ectopic pregnancy. The patient begins to cry and asks the nurse to leave her alone to grieve. Which of the following actions should the nurse take next?
- A. Stay with the patient and encourage her to discuss her feelings.
- B. Explain the reason for taking vital signs every 15-30 minutes.
- C. Close the door to the patient's room and minimize disturbances.
- D. Provide teaching about options for termination of the pregnancy.
Correct Answer: B
Rationale: Because the patient is at risk for rupture of the fallopian tube and hemorrhage, frequent monitoring of vital signs is needed. The patient has asked to be left alone, so staying with her and encouraging her to discuss her feelings are inappropriate actions. Minimizing contact with her and closing the door of the room is unsafe because of the risk for hemorrhage. Since the patient has requested time to grieve, it would be inappropriate to provide teaching about options for pregnancy termination.
A patient with pelvic inflammatory disease (PID) is treated on an outpatient basis with oral antibiotics. Which of the following instructions should be included in patient teaching?
- A. Return for a follow-up appointment in 2 days.
- B. Abdominal pain may persist for several weeks.
- C. Sexual intercourse should be avoided for 1 week.
- D. Nonsteroidal anti-inflammatory drug (NSAID) use may prevent scarring of pelvic organs.
Correct Answer: A
Rationale: The patient is instructed to return for follow-up in 48-72 hours. The patient should abstain from intercourse for 3 weeks. Abdominal pain should subside with effective antibiotic therapy. Corticosteroids may help prevent inflammation and scarring, but NSAIDs will not decrease scarring.
The nurse is caring for a patient with pelvic inflammatory disease (PID) requiring hospitalization. Which of the following nursing interventions should be included in the plan of care?
- A. Monitor liver function tests.
- B. Use cold packs PRN for pelvic pain.
- C. Teach the patient how to perform Kegel exercises.
- D. Elevate the head of the bed to at least 30 degrees.
Correct Answer: D
Rationale: The head of the bed should be elevated to at least 30 degrees to promote drainage of the pelvic cavity and prevent abscess formation higher in the abdomen. Although a possible complication of PID is acute perihepatitis, liver function tests will remain normal. There is no indication for increased fluid intake. Application of heat is used to reduce pain. Kegel exercises are not helpful in PID.
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).