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 C
Explanation
Choice A rationale
Combination oral contraceptives are contraindicated for smokers over 35 due to an increased risk of cardiovascular events such as thromboembolism and myocardial infarction. While the client is younger, her smoking habit is still a significant risk factor, and oral contraceptives do not protect against sexually transmitted infections given her multiple partners.
Choice B rationale
Depo-Provera, an injectable progestin, can cause irregular bleeding and potential weight gain, which might not be ideal given the client's existing irregular menstrual cycles and menorrhagia. Furthermore, it does not offer protection against sexually transmitted infections.
Choice C rationale
Barrier methods such as female condoms, when used consistently and correctly, provide protection against both pregnancy and sexually transmitted infections, which is crucial given the client's multiple partners. While they require proper education and may have a higher failure rate than hormonal methods, they address the STI risk directly.
Choice D rationale
A contraceptive implant is a highly effective long-acting reversible contraceptive. However, it does not protect against sexually transmitted infections. Given the client's multiple partners, STI protection is a primary concern that the implant does not address. .
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