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.

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice A rationale

A fetal heart rate of 160 beats per minute is at the upper limit of the normal range (110-160 beats per minute) and could indicate fetal stress or maternal fever. While moderate variability is a positive sign of fetal well-being, the elevated heart rate warrants further investigation and does not solely indicate optimal fetal status.

Choice B rationale

A fetal heart rate consistently below 120 beats per minute indicates bradycardia, which can be a sign of fetal distress or hypoxia. The absence of accelerations, which are transient increases in FHR, further suggests a lack of fetal reserve and is not indicative of well-being.

Choice C rationale

The presence of late decelerations, which are decreases in FHR that begin after the peak of a uterine contraction and return to baseline after the contraction ends, is a pattern associated with uteroplacental insufficiency. This indicates that the fetus is not receiving adequate oxygen during contractions and is a sign of fetal distress, not well-being.

Choice D rationale

Increased fetal movement between contractions is often a reassuring sign of fetal well-being. It indicates that the fetus has adequate oxygenation and is active. While a decrease or absence of fetal movement can be concerning, increased movement suggests the fetus is healthy and responsive.

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"C"}

Explanation

The nurse should be most concerned about preeclampsia, which is a hypertensive disorder of pregnancy that typically occurs after 20 weeks' gestation. Primigravida status (first pregnancy) and being at or near term (like 37 weeks) are known risk factors. Monitoring through a nonstress test is part of evaluating fetal well-being in at-risk pregnancies.

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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?

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Naxlex Comprehensive Predictor Exams

While caring for a client in labor, which assessment finding best indicates fetal well-being to the nurse?

Correct Answer is D

Explanation

A G1P1 patient at 37 weeks' gestation is scheduled for a nonstress test (NST). The nurse's greatest concern is the client's risk of developing related to dropdown and dropdown.

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"C"}

Explanation

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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?