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":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"B"}}

Explanation

Priority concerns:

Liver function tests: The client has elevated ALT (75 U/L), AST (78 U/L), alkaline phosphatase (184 U/L), and LDH (250 U/L), which are consistent with liver involvement in preeclampsia with severe features. This suggests hepatic dysfunction and possible progression to HELLP syndrome.

Blood pressure: The client’s BP is 168/100 mmHg, which meets the criteria for severe preeclampsia (≥160/110 mmHg). Uncontrolled hypertension increases the risk of stroke, placental abruption, and progression to eclampsia.

Headache: The persistent headache could indicate severe preeclampsia with neurological involvement due to cerebral vasospasm and increased risk of stroke or seizure. A headache that does not resolve with usual measures is a warning sign, and magnesium sulfate should be considered for seizure prophylaxis.

Not a Priority Concern

Heartburn is a common symptom in pregnancy due to gastric reflux and increased progesterone levels, which relax the lower esophageal sphincter. While it can be uncomfortable, it is not immediately life-threatening.

Gestational age: The client is at 37 weeks’ gestation, which is considered early term but not preterm. While gestational age is important for delivery planning, it is not the most immediate concern compared to the client’s hypertensive crisis.

Cardiac assessment: The apical pulse is 77 bpm, regular, and lungs are clear, indicating that there is no immediate cardiac or respiratory compromise.

A. Fetal movement felt by provider B. Positive pregnancy test C. Hegar's sign D. Breast tenderness and nausea

Correct Answer is A

Explanation

A. Fetal movement felt by provider
This is correct because fetal movement confirmed by a healthcare provider is a positive sign of pregnancy, as it directly confirms fetal presence.

B. Positive pregnancy test
This is incorrect because a positive pregnancy test is a probable sign, not a positive sign. It detects hCG, which can also be produced in conditions like gestational trophoblastic disease (molar pregnancy).

C. Hegar’s sign
This is incorrect because Hegar’s sign (softening of the lower uterus) is a probable sign, not a positive sign, as it can occur due to other physiological changes.

D. Breast tenderness and nausea
This is incorrect because breast tenderness and nausea are presumptive signs of pregnancy, meaning they are subjective symptoms that could be caused by other conditions (e.g., PMS, stress, illness).

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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) Identify which of the following findings is a priority concern or not for the patient.

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

Explanation

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?

Correct Answer is A

Explanation

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

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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.

The nurse is reviewing fetal and maternal circulation with a group of nursing students. Which statement by a student demonstrates a need for further clarification?