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 genitourinary disorder will be alleviated over time

The client's history of sexually transmitted infections

Answer and Explanation

The Correct Answer is A

A. The client's vaginal pH may increase during menopause – During menopause, estrogen levels decrease, leading to a higher vaginal pH. This disrupts the normal vaginal flora, making the client more susceptible to infections and irritation.

B. The client's dietary habits and fluid intake – While nutrition and hydration affect overall health, they are not the primary cause of menopausal vaginal symptoms and infections.

C. The client's genitourinary disorder will be alleviated over time – Without treatment (e.g., vaginal estrogen therapy or lubricants), menopausal atrophic changes usually persist or worsen, rather than resolve over time.

D. The client's history of sexually transmitted infections – While STIs can cause vaginal discomfort, the client’s symptoms are more likely due to menopausal changes rather than a past history of STIs.

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Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"C"}}

Explanation

Preeclampsia:

Blood pressure of 150/96 mmHg: A BP of ≥140/90 mmHg on two occasions at least 4 hours apart after 20 weeks of gestation in a previously normotensive client is diagnostic of preeclampsia.

Preeclampsia with Severe Features:

Blood pressure of 162/112 mmHg: Severe hypertension is ≥160/110 mmHg on two occasions at least 4 hours apart. This is a criterion for severe preeclampsia, requiring immediate intervention to prevent complications like eclampsia or stroke.

Elevated liver enzymes (ALT/AST > 2x the upper limit of normal) are indicative of severe preeclampsia due to hepatic involvement. This can progress to HELLP syndrome, increasing the risk of liver rupture and disseminated intravascular coagulation (DIC).

Neither:

Negative for protein on a urine dipstick: Preeclampsia is typically diagnosed with proteinuria (≥300 mg in 24 hours or protein/creatinine ratio ≥0.3). A negative urine dipstick means proteinuria is absent, making preeclampsia unlikely. However, preeclampsia can also be diagnosed without proteinuria if other systemic features (e.g., thrombocytopenia, renal dysfunction) are present.

Seizures in a client with preeclampsia indicate eclampsia, which is a medical emergency requiring magnesium sulfate to prevent further seizures. If the client had no preeclampsia, the seizures could be due to another cause (e.g., epilepsy, metabolic disturbance).

A. "There is an increased risk of introducing infection." B. "There is an increased risk of rupture of the membranes." C. "This could result in profound bleeding." D. "This could initiate preterm labor."

Correct Answer is C

Explanation

A. "There is an increased risk of introducing infection." – While infections can occur, the primary concern with internal examinations in placenta previa is hemorrhage rather than infection.

B. "There is an increased risk of rupture of the membranes." – While membrane rupture is a risk with any vaginal examination, it is not the primary concern in placenta previa.

C. "This could result in profound bleeding." – With placenta previa, the placenta partially or completely covers the cervix. Digital or speculum exams can disrupt the placenta, causing significant hemorrhage, which is why they are contraindicated.

D. "This could initiate preterm labor." – While stimulation of the cervix could lead to contractions, the primary risk with an internal exam in placenta previa is significant bleeding, not preterm labor.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

G1P1, 37 weeks' gestation patient with a scheduled nonstress test (NST) As the nurse, you can identify whether the following findings are indicative of preeclampsia, preeclampsia with severe features, or neither. Select at least one answer in each row.

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"C"}}

Explanation

A nurse is caring for a client who is at 37 weeks of gestation and has placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?

Correct Answer is C

Explanation

A client is admitted with a threatened abortion. Which assessment findings would the nurse expect? Select all that apply. (Select All that Apply.)

A nurse is preparing to administer magnesium sulfate IV to a client who is experiencing preterm labor. Which of the following is the priority nursing assessment for this client?

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?

A nurse is assessing a postpartum client for signs of postpartum depression. Which of the following symptoms is most indicative of postpartum depression rather than normal postpartum adjustment?

Which assessment findings might raise the nurse's suspicion of endometriosis in the client they are evaluating?

A nurse is reviewing the different signs of pregnancy with a client who is in her first trimester. Which of the following symptoms should the nurse classify as a positive sign of pregnancy?

Exhibits Select a condition, the assessment cues, and anticipated solutions for this client.

A male client reports to the nurse that he took sildenafil for erectile dysfunction but did not achieve an erection. Which of the following considerations should the nurse evaluate to determine possible reasons for the lack of response?