Nokea
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.
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The nurse is caring for a patient with pelvic inflammatory disease (PID) requiring hospitalization. Which of the following nursing interventions should be included in the plan of care?
- A. Monitor liver function tests.
- B. Use cold packs PRN for pelvic pain.
- C. Teach the patient how to perform Kegel exercises.
- D. Elevate the head of the bed to at least 30 degrees.
Correct Answer: D
Rationale: The head of the bed should be elevated to at least 30 degrees to promote drainage of the pelvic cavity and prevent abscess formation higher in the abdomen. Although a possible complication of PID is acute perihepatitis, liver function tests will remain normal. There is no indication for increased fluid intake. Application of heat is used to reduce pain. Kegel exercises are not helpful in PID.
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.
The nurse has just received change-of-shift report about the following four patients. Which of the following patients should be assessed first?
- A. A patient with a possible ectopic pregnancy who is complaining of severe shoulder pain
- B. A patient in the fifteenth week of gestation who is experiencing uterine cramping and spotting
- C. A patient who has a radium implant in place to treat cervical cancer and is crying in her room
- D. A patient with ovarian cancer who is complaining of 8/10 pain after an abdominal hysterectomy
Correct Answer: A
Rationale: The patient with the ectopic pregnancy has symptoms consistent with rupture and needs immediate assessment for signs of hemorrhage and possible transfer to surgery. The other patients should also be assessed as quickly as possible but do not have symptoms of life-threatening complications.
The nurse is planning an educational session at a local community centre related to health promotion during menopause. Which of the following information should the nurse include related to management of hot flashes?
- A. Limit daily calcium intake
- B. Vitamin E daily supplement
- C. Have a glass of wine before bedtime
- D. Daily rigorous exercise in the evening
Correct Answer: B
Rationale: Daily intake of vitamin E in doses up to 800 IU may help reduce hot flashes in some women. Changing sleep patterns may be helped by avoiding alcohol and controlling hot flashes. A regular moderate program (three to four times per week) of aerobic and weight-bearing exercises is appropriate but it has no effect on hot flashes.
The nurse is counselling a healthy perimenopausal woman who prefers not to use hormone therapy (HT). Which of the following treatment options should the nurse discuss with the patient? (Select all that apply.)
- A. Reduce coffee intake.
- B. Exercise several times a week.
- C. Take black cohosh supplements.
- D. Have a glass of wine in the evening.
- E. Increase intake of dietary soy products.
Correct Answer: A,B,C,E
Rationale: Reduction in caffeine intake, use of black cohosh, increasing dietary soy intake, and exercising three to four times weekly are recommended to reduce symptoms associated with menopause. Alcohol intake in the evening may increase the sleep problems associated with menopause.