Nokea
The nurse is taking the sexual history of an adolescent who has come into the free clinic. What question best assesses the patients need for further information?
- A. Are you involved in an intimate relationship at this time?
- B. How many patients are you asking this of?
- C. What questions or concerns do you have about your sexual health?
- D. Have you ever been diagnosed with a sexually transmitted infection?
Correct Answer: C
Rationale: An open-ended question related to the patient's need for further information should be included while obtaining a sexual history. This approach encourages the patient to express specific concerns or areas of uncertainty, facilitating targeted education. The other listed questions are not open-ended and do not directly assess the need for further information.
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A premenopausal patient is complaining of vaginal spotting and sharp, colicky lower abdominal pain. She informs the nurse that her period is 2 weeks late. The nurse should recognize a need for this patient to be investigated for what health problem?
- A. Trichomonas vaginalis
- B. Ectopic pregnancy
- C. Cervical cancer
- D. Fibromyalgia
Correct Answer: B
Rationale: Clinical symptoms of an ectopic pregnancy include delay in menstruation of 1 to 2 weeks, vaginal spotting, and sharp, colicky pain. These symptoms align with the patient's presentation, warranting investigation for this condition. Trichomonas vaginalis causes vaginal infection, typically with discharge, not typically associated with delayed menstruation or colicky pain. Cervical cancer may cause abnormal bleeding but is less likely to present with acute colicky pain and delayed menstruation. Fibromyalgia is unrelated to menstrual irregularities or vaginal spotting.
A nurse practitioner is preparing to perform a patients scheduled Pap smear and the patient asks the nurse to ensure that the speculum is well-lubricated. How should the nurse proceed with assessment?
- A. Reassure the patient that ample petroleum jelly will be used.
- B. Reassure that patient that a water-based lubricant will be used.
- C. Explain to the patient that water is the only lubricant that can be used.
- D. Explain to the patient why the speculum must be introduced dry.
Correct Answer: C
Rationale: Because lubricants may obscure cells on a Pap smear, warm water is the only lubricant that can be used to facilitate speculum insertion without compromising test results. Petroleum jelly and water-based lubricants can interfere with cell collection, and a dry speculum may cause discomfort and is not preferred.
A patient who is in the first trimester of pregnancy has experienced an incomplete abortion. The obstetric nurse should prepare the patient for what possible intervention?
- A. Dilation and evacuation
- B. Several days of bed rest
- C. Administration of hydromorphone
- D. IV administration of clomiphene
Correct Answer: A
Rationale: If only some of the tissue is passed, the abortion is referred to as incomplete. An emptying or evacuation procedure (D&C, or dilation and evacuation [D&E]) or administration of oral misoprostol (Cytotec) is usually required to remove the remaining tissue. Bed rest will not necessarily result in the passing of all the tissue. Clomiphene is used for ovulation induction, not abortion management, and hydromorphone is for pain relief, not a primary intervention.
A patient in her late fifties has expressed to the nurse her desire to explore hormone replacement therapy (HRT). Based on what aspect of the patients health history is HRT contraindicated?
- A. History of vaginal dryness
- B. History of hot flashes and night sweats
- C. History of vascular thrombosis
- D. Family history of osteoporosis
Correct Answer: C
Rationale: The use of HRT is contraindicated in women with a history of vascular thrombosis, active liver disease, some cases of uterine cancer, and undiagnosed vaginal bleeding. HRT is beneficial in women with a risk for osteoporosis and can relieve symptoms like vaginal dryness, hot flashes, and night sweats. A history of vascular thrombosis is a clear contraindication.
A school nurse is presenting information on human development and sexuality. When describing the role of hormones in sexual development, which hormone does the nurse teach the class is the most important one for developing and maintaining the female reproductive organs?
- A. Estrogen
- B. Progesterone
- C. Androgens
- D. Follicle-stimulating hormone
Correct Answer: A
Rationale: Estrogens are responsible for developing and maintaining the female reproductive organs. Progesterone is the most important hormone for conditioning the endometrium in preparation for implantation of the fertilized ovum. Androgens, secreted by the ovaries in small amounts, are involved in the early development of the follicle and affect the female libido. Follicle-stimulating hormone is responsible for stimulating the ovaries to secrete estrogen.