Nokea
Which of the following assessment findings in a patient who is taking premarin is most important for the nurse to report to the health care provider?
- A. Breast tenderness
- B. Weight gain of 1.4 kg
- C. Intermittent spotting
- D. Unilateral calf swelling
Correct Answer: D
Rationale: The patient taking premarin (estrogen) has an increased risk for stroke and emboli therefore unilateral calf swelling should be reported to the health care provider. The adverse effects of estrogen include nausea, fluid retention, headache, and breast enlargement. Breast tenderness, weight gain, and intermittent spotting do not indicate a need to report these findings to the health care provider.
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The nurse is counselling a couple who are interested in intrauterine insemination (IUI) with sperm from a donor and ask the nurse how long the procedure will take. Which of the following time frames is the basis for the nurses' response?
- A. About 1 hour
- B. 2-4 hours
- C. At least a full day
- D. 2-3 days
Correct Answer: D
Rationale: The option is intrauterine insemination (IUI) with sperm from the partner or a donor and takes 2-3 days for the complete procedure.
The nurse is caring for a patient who tells the nurse that she has noticed increasing headaches with dizziness, abdominal bloating, and unexplained anxiety occurring before her menstrual periods. Which of the following actions is best for the nurse to take at this time?
- A. Ask the patient to write down her symptoms in a diary for 3 months.
- B. Suggest that the patient try aerobic exercise to decrease her symptoms.
- C. Teach the patient about appropriate lifestyle changes to reduce premenstrual syndrome (PMS) symptoms.
- D. Advise the patient to use nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to control symptoms.
Correct Answer: A
Rationale: The patient's symptoms indicate possible PMS, but they may also be associated with other diagnoses. Having the patient keep a symptom diary for 2 or 3 months will help in confirming a diagnosis of PMS. The nurse should not implement interventions for PMS until a diagnosis is made.
Which of the following information should the nurse include when developing a teaching plan for a patient who is premenopausal with symptoms of uterine bleeding caused by a leiomyoma?
- A. Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to control mild to moderate pain.
- B. The tumour size is likely to increase throughout the patient's lifetime.
- C. The symptoms may decrease after the patient undergoes menopause.
- D. The patient will need frequent monitoring to detect any malignant changes.
Correct Answer: C
Rationale: Leiomyomas appear to depend on ovarian hormones and will atrophy after menopause, leading to a decrease in symptoms. Aspirin use is discouraged because the antiplatelet effects may lead to heavier uterine bleeding. The size of the tumour will shrink after menopause. Leiomyomas are benign tumours that do not undergo malignant changes.
A patient is scheduled for an induced abortion using methotrexate with misoprostol. Before the procedure, which of the following information should the nurse discuss with the patient?
- A. Several trips to the health care provider will be required.
- B. There is a possibility that the patient may deliver a live fetus.
- C. The patient will require a general anaesthetic for the procedure.
- D. The procedure may be unsuccessful in terminating the pregnancy.
Correct Answer: A
Rationale: Takes place over 5-7 days, or longer and involves several trips to the health care provider. Risk of incomplete abortion, surgical abortion may be necessary. General anaesthesia is not needed for this procedure. It is used in patients that are 7 weeks gestation or less (within the period of the embryo), so there is no chance of delivering a live fetus. Using methotrexate with misoprostol for an induced abortion is both safe and effective.
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.