Nokea
The nurse is providing preoperative education for a patient diagnosed with endometriosis. A hysterectomy has been scheduled. What education topic should the nurse be sure to include for this patient?
- A. Menstrual periods will continue to occur for several months, some of them heavy.
- B. Normal activity will be permitted within 48 hours following surgery.
- C. After a hysterectomy, hormone levels remain largely unaffected.
- D. The bladder must be emptied prior to surgery and a catheter may be placed during surgery.
Correct Answer: D
Rationale: The intestinal tract and the bladder need to be empty before the patient is taken to the OR to prevent contamination and injury to the bladder or intestinal tract. The patient is informed that her periods are now over, but she may have a slightly bloody discharge for a few days. The patient is instructed to avoid straining, lifting, or driving until her surgeon permits her to resume these activities. The patients hormonal balance is upset, which usually occurs in reproductive system disturbances.
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A middle-aged female patient has been offered testing for HIV/AIDS upon admission to the hospital for an unrelated health problem. The nurse observes that the patient is visibly surprised and embarrassed by this offer. How should the nurse best respond?
- A. Most women with HIV dont know they have the disease. If you have it, its important we catch it early.
- B. This testing is offered to every adolescent and adult regardless of their lifestyle, appearance or history.
- C. The rationale for this testing is so that you can begin treatment as soon as testing comes back, if its positive.
- D. Youre being offered this testing because you are actually in the prime demographic for HIV infection.
Correct Answer: B
Rationale: Routine HIV screening is offered to all individuals aged 13 to 64 in healthcare settings to reduce stigma and encourage testing. This approach avoids assumptions about risk and alleviates patient anxiety.
A 45-year-old woman has just undergone a radical hysterectomy for invasive cervical cancer. Prior to the surgery the physician explained to the patient that after the surgery a source of radiation would be placed near the tumor site to aid in reducing recurrence. What is the placement of the source of radiation called?
- A. Internal beam radiation
- B. Trachelectomy
- C. Brachytherapy
- D. External radiation
Correct Answer: C
Rationale: Brachytherapy involves placing a radiation source near the tumor to reduce recurrence. Internal beam radiation is not a standard term, and trachelectomy is a surgical procedure.
A patient with trichomoniasis comes to the walk-in clinic. In developing a care plan for this patient the nurse would know to include what as an important aspect of treating this patient?
- A. Both partners will be treated with metronidazole (Flagyl).
- B. Constipation and menstrual difficulties may occur.
- C. The patient should perform Kegel exercises 30 to 80 times daily.
- D. Care will involve hormone therapy to control the pain.
Correct Answer: A
Rationale: The most effective treatment for trichomoniasis is metronidazole (Flagyl). Both partners receive a one-time loading dose or a smaller dose three times a day for 1 week. In pelvic inflammatory disease, menstrual difficulties and constipation may occur. Kegel exercises are prescribed to help strengthen weakened muscles associated with cystocele and other structural deficits. Hormone therapy does not address the etiology of trichomoniasis.
A patient has been diagnosed with endometriosis. When planning this patients care, the nurse should prioritize what nursing diagnosis?
- A. Anxiety related to risk of transmission
- B. Acute pain related to misplaced endometrial tissue
- C. Ineffective tissue perfusion related to hemorrhage
- D. Excess fluid volume related to abdominal distention
Correct Answer: B
Rationale: Endometriosis causes pain due to misplaced endometrial tissue, making acute pain a priority nursing diagnosis. It is not transmissible, so anxiety about transmission is irrelevant. Hemorrhage and fluid volume excess are not typical.
A female patient with HIV has just been diagnosed with condylomata acuminata (genital warts). What information is most appropriate for the nurse to tell this patient?
- A. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually.
- B. The most common treatment is metronidazole (Flagylastin), which should eradicate the problem within 7 to 10 days.
- C. The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse.
- D. The human papillomavirus (HPV), which causes condylomata acuminata, cannot be transmitted during oral sex.
Correct Answer: A
Rationale: HIV-positive women have a higher rate of HPV. Infections with HPV and HIV together increase the risk of malignant transformation and cervical cancer. Thus, women with HIV infection should have frequent Pap smears. Because condylomata acuminata is a virus, there is no permanent cure. Condoms reduce but do not eliminate transmission risk. HPV can be transmitted to other parts of the body, including during oral sex.