A 56-year-old menopausal woman reports to the registered nurse that she has been experiencing vaginal itching, burning, and an increase in vaginal infections over the past 3 years.
What important factor should the nurse consider before responding to the client's concerns?
The client's vaginal pH may increase during menopause.
The client's dietary habits and fluid intake.
The client's history of sexually transmitted infections.
The client's genitourinary disorder will be alleviated over time.
The Correct Answer is A
Choice A rationale
During menopause, estrogen levels significantly decline. Estrogen plays a crucial role in maintaining the acidic environment of the vagina, which inhibits the growth of pathogenic bacteria and yeast. A decrease in estrogen leads to a rise in vaginal pH (normal premenopausal pH is 3.8 to 4.5), making the vaginal environment less acidic and more susceptible to infections, including bacterial vaginosis and yeast infections, thus explaining the client's symptoms.
Choice B rationale
While dietary habits and fluid intake can influence overall health, they are not the primary factors directly causing the increased risk of vaginal itching, burning, and infections in a menopausal woman. Hormonal changes are the most significant contributing factor.
Choice C rationale
A history of sexually transmitted infections (STIs) is important to consider, but the onset of these symptoms three years into menopause suggests that hormonal changes related to estrogen deficiency are a more likely primary cause for the recurrent vaginal issues. While past STIs can sometimes have long-term effects, the timing aligns with menopausal changes.
Choice D rationale
The client's genitourinary disorder (specifically, the vaginal changes due to estrogen deficiency) will not alleviate over time without intervention. The decrease in estrogen is a permanent physiological change associated with menopause, and the associated symptoms often persist or worsen without treatment such as hormone therapy or other local treatments to restore vaginal health.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Observing an area of redness on the breast of a client who is 1 day postpartum requires the assessment and clinical judgment of a registered nurse. This observation could indicate mastitis or other complications that need professional evaluation.
Choice B rationale
Providing a sitz bath to a stable postpartum client with a fourth-degree laceration is a comfort measure that can be safely delegated to assistive personnel. The procedure is routine and does not require the specialized assessment skills of a registered nurse.
Choice C rationale
Monitoring vital signs during the admission of a client with gestational hypertension requires the assessment skills of a registered nurse. Baseline vital signs and the client's overall condition need to be evaluated by the nurse upon admission, especially in a client with a potentially unstable condition like gestational hypertension. Normal blood pressure is typically less than 140/90 mmHg in gestational hypertension, but admission monitoring requires professional nursing judgment.
Choice D rationale
Changing the initial perineal pad of a client who just transferred from labor and delivery involves assessing the amount and type of bleeding, which is a nursing assessment. This initial assessment is crucial to monitor for postpartum hemorrhage and should be performed by the registered nurse. .
Correct Answer is A
Explanation
Choice A rationale
A pre-pregnancy BMI of 23.5 falls within the normal weight range (18.5 to 24.9 kg/m²). For individuals with a normal pre-pregnancy BMI, the recommended total weight gain during pregnancy is 25 to 35 pounds (11.3 to 15.9 kg). This range supports optimal fetal growth without significantly increasing the risk of maternal or fetal complications associated with excessive weight gain.
Choice B rationale
While a gradual weight gain is generally recommended, stating "about 1 pound per week" is an oversimplification and doesn't account for the varying rates of weight gain throughout pregnancy. The rate of weight gain is typically lower in the first trimester and higher in the second and third trimesters. Focusing solely on a weekly gain might cause unnecessary anxiety if the client's weight gain fluctuates slightly.
Choice C rationale
A recommended weight gain of 15 to 25 pounds is appropriate for individuals with an overweight pre-pregnancy BMI (25 to 29.9 kg/m²), not a normal BMI. Recommending this lower range to a client with a normal BMI could lead to inadequate weight gain and potentially compromise fetal development due to insufficient nutrient supply.
Choice D rationale
A recommended weight gain of 11 to 20 pounds is typically advised for individuals with an obese pre-pregnancy BMI (30 kg/m² or higher). Suggesting this lower range to a client with a normal BMI could restrict necessary weight gain for a healthy pregnancy and fetal growth.
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