Nokea
Which action would the nurse teach to help the client prevent vulvovaginitis?
- A. Wipe back front after urination.
- B. Cleanse the inner labial mucosa with soap and water.
- C. Use feminine hygiene sprays to avoid odor.
- D. Wear loose cotton underwear.
Correct Answer: D
Rationale: To prevent vulvovaginitis, the client should wear cotton underwear. The client should wipe front to back after urination, not back to front. The client should cleanse the inner labial mucosa with water only, and avoid using feminine hygiene sprays.
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A 20-year-old client is interested in protection from the human papilloma virus (HPV) since she may become sexually active. Which response from the nurse is the most accurate?
- A. You are too old to receive an HPV vaccine.
- B. Either Gardasil or Cervarix can provide protection.
- C. You will need to have three injections over a span of 1 year.
- D. The most common side effect of the vaccine is itching at the injection site.
Correct Answer: B
Rationale: Current HPV vaccines are Gardasil and Cervarix, which should be given before the first sexual contact to protect against the highest risk HPV types associated with cervical cancer. The client is not too old since it is recommended that younger women, 19-26 years, should receive an HPV vaccine. The series consists of three injections over 6 months, not 1 year. Local pain and redness surrounding the injection site are very common, but this does not include itching.
The nurse is caring for a postoperative client following an anterior colporrhaphy. What action can be delegated to the unlicensed assistive personnel (UAP)?
- A. Reviewing the hematocrit and hemoglobin results
- B. Reading the hematocrit and hemoglobin results to an old grandson
- C. Assessing the level of pain and any drainage
- D. Drawing a shallow hot bath for comfort measures
Correct Answer: D
Rationale: The UAP is able to provide comfort through a bath. The registered nurse should review any laboratory results, complete any teaching, and assess pain and discharge.
A client has undergone a vaginal hysterectomy with a bilateral salpingo-oophorectomy. She is concerned about a loss of libido. What intervention by the nurse would be best?
- A. Suggest increasing vitamins and supplements daily.
- B. Discuss the value of a balanced diet and exercise.
- C. Reinforce that weight gain may be inevitable.
- D. Teach that estrogen cream inserted vaginally may help.
Correct Answer: D
Rationale: Use of vaginal estrogen cream and gentle dilation can help with vaginal changes and loss of libido. Weight gain and masculinization are misperceptions after a vaginal hysterectomy. Vitamins, supplements, a balanced diet, and exercise are helpful for healthy living, but are not necessarily going to increase libido.
A client has scheduled brachytherapy sessions and states that she feels as though she is not safe around her family. What is the best response by the nurse?
- A. You are only radioactive when the radioactive implant is in place.
- B. To be totally safe, it is a good idea to sleep in a separate room.
- C. It is best to stay a safe distance from friends or family between treatments.
- D. You should use a separate bathroom from the rest of the family.
Correct Answer: A
Rationale: In brachytherapy, the surgeon inserts an applicator into the uterus. After placement is verified, the radioactive isotope is placed in the applicator for several minutes for a single treatment. There are no restrictions for the woman to stay away from her family or the public between treatments.
A client has a recurrent Bartholin cyst. What is the nurse's priority action?
- A. Apply an ice pack to the area.
- B. Administer a prophylactic antibiotic.
- C. Support a fluid transfer to the liver analysis.
- D. Suggest moist heat such as a sitz bath.
Correct Answer: C
Rationale: A major cause of an obstructed duct forming a cyst is infection. The laboratory specimen is a priority since a culture is needed in order to prescribe sensitive antibiotics. Comfort measures can then be used, such as ice packs and moist heat.