Lewis Test Bank Chapter 53 (Female reproductive problems) medical surgical nursing in Canada 11th edition Q & A 2023 ATESTED

The nurse in the women's health clinic has four patients who are waiting to be seen. Which patient should the nurse see FIRST? correct answers a. 22-year-old with persistent red-brown vaginal drainage 3 days after having balloon thermotherapy b. 42-year-old with secondary amenorrhea who says that her last menstrual cycle was 3 months ago c. 35-year-old with heavy spotting after having a progestin-containing IUD (Mirena) inserted a month ago D. 19-year-old with menorrhagia who has been using superabsorbent tampons and has fever with weakness Rational: The patients history and clinical manifestations suggest possible toxic shock syndrome, which will require rapid intervention. The symptoms for the other patients are consistent with their diagnoses and do not indicate life-threatening complications. A healthy 28-year-old who has been vaccinated against human papillomavirus (HPV) has a normal Pap test. Which information will the nurse include in patient teaching when calling the patient with the results of the Pap test? correct answers Pap testing is recommended every 3 years for women your age. To prevent pregnancy in a patient who has been sexually assaulted, the nurse in the emergency department will plan to teach the patient about the use of correct answers levonorgestrel (Plan-B One-Step). Rational: Plan B One-Step reduces the risk of pregnancy when taken within 72 hours of intercourse. The other methods are used for therapeutic abortion, but not for pregnancy prevention after unprotected intercourse. A 22-year-old tells the nurse that she has not had a menstrual period for the last 2 months. Which action is MOST important for the nurse to take? correct answers A. Obtain a urine specimen for a pregnancy test. b. Ask about any recent stressful lifestyle changes. c. Measure the patients current height and weight. d. Question the patient about prescribed medications. Rational: Pregnancy should always be considered a possible cause of amenorrhea in women of childbearing age. The other actions are also appropriate, but it is important to check for pregnancy in this patient because pregnancy will require rapid implementation of actions to promote normal fetal development such as changes in lifestyle, folic acid intake, etc. Which information will the nurse include when teaching a patient who has developed a small vesicovaginal fistula 2 weeks into the postpartum period? correct answers a. Take stool softeners to prevent fecal contamination of the vagina. b. Limit oral fluid intake to minimize the quantity of urinary drainage. C. Change the perineal pad frequently to prevent perineal skin breakdown. d. Call the health care provider immediately if urine drains from the vagina. Rational: Because urine will leak from the bladder, the patient should plan to use perineal pads and change them frequently. A high fluid intake is recommended to decrease the risk for urinary tract infections. Drainage of urine from the vagina is expected with vesicovaginal fistulas. Fecal contamination is not a concern with vesicovaginal fistulas. The nurse has just received change-of-shift report about the following four patients. Which patient should be assessed FIRST? correct answers a. A patient with a cervical radium implant in place who is crying in her room b. A patient who is complaining of 5/10 pain after an abdominal hysterectomy C. A patient with a possible ectopic pregnancy who is complaining of shoulder pain d. A patient in the fifteenth week of gestation who has uterine cramping and spotting Rational: 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