Nokea
Which assessment finding will most likely influence the treatment regimen selected by a client with endometriosis?
- A. Presence of pain
- B. Family planning
- C. Dysmenorrhea
- D. Presence of chocolate cyst
Correct Answer: B
Rationale: Selection of a more conservative option may be indicated to preserve the possibility for future childbearing. Pain, dysmenorrhea, and chocolate cysts are all symptoms associated with endometriosis and can influence decision for treatment.
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The nurse is caring for a client with polycystic ovarian syndrome. On which associated problem(s) will the nurse focus teaching? Select all that apply.
- A. Hypertension
- B. Hyperlippiedemia
- C. Infertility
- D. Absence of body hair
- E. Weight loss
- F. Decreased Insulin
Correct Answer: A,B,C
Rationale: Polycystic ovarian syndrome is associated with multiple endocrine abnormalities such as abnormal lipid levels, hypertension, and difficulty with conceaving due to interference of ovulation. Other symptoms include excessive body hair, weight gain, and overproduction and inefficient use of insulin.
A client with extensive endometriosis is scheduled for a panhysterectomy. Which statement by the client indicates a need for further teaching?
- A. I will be having my uterus, tubes, and ovaries removed.
- B. I am finished having children.
- C. I will not have to deal with symptoms of menopause.
- D. I will now have a greater risk for stroke and heart disease.
Correct Answer: C
Rationale: Surgical menopause causes a sudden drop in estrogen and progesterone levels resulting in varied symptoms in clients. The risks of heart disease and stroke increase with estrogen reduction. A panhysterectomy is the removal of the uterus, both tubes and ovaries and will result in the inability to conceive children.
The nurse is caring for a young adult client who reports excessive menstrual flow with menses lasting 10 days each month. Which treatment option does the nurse anticipate the physician will order for symptomatic relief for this client?
- A. Dilation and curettage (D and C)
- B. Hormonal contraceptives
- C. Endometrial ablation
- D. Uterine balloon therapy
Correct Answer: B
Rationale: When combination hormonal contraceptives are administered, they produce a light menstrual period and are helpful in the management of menorrhagia. Dilation and curettage can provide symptomatic relief, however, the effectiveness is limited. Endometrial ablation and uterine balloon therapy cause the endometrium to slough and are cost-effective but are only used after childbearing has completed.
A client is admitted to the hospital with the diagnosis of sepsis secondary to pelvic inflammatory disease. Which transmission-based precaution will be initiated by the nurse?
- A. Standard precautions
- B. Protective precautions
- C. Contact precautions
- D. Droplet precautions
Correct Answer: C
Rationale: Contact isolation is a category of transmission-based precautions for controlling the spread of infectious microorganisms found in body fluids. Standard precautions are used in the care of all clients in the prevention of HIV and hepatitis. Protective precautions are instituted when a client is immune compromised and needs protected from others. Droper precautions are not indicated with PID.
Culture of client's vaginal discharge reveals Gardnerella vaginalis. Which of the following would the nurse expect to assess?
- A. Foul foamy discharge
- B. Thick curry white discharge
- C. Fisy smelling watery discharge
- D. Yellowish white discharge
Correct Answer: C
Rationale: Gardnerella vaginalis is associated with a gray white, watery, fisy smelling vaginal discharge. The discharge associated with a Candida infection is curry white and thick, and has a strong odor. Discharge due to trichomonas vaginalis is yellow white, foamy, and has a foul odor.