A nurse is obtaining a medication history from a pregnant client with a history of systemic lupus erythematosus (SLE). Which medication(s) would the nurse expect the woman to report to be currently using? Select all that apply.

Ibuprofen

Prednisone

Hydroxychloroquine

Leflunomide

Methotrexate

Answer and Explanation

Correct Answer : B,C

A. Ibuprofen:

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for pain relief and inflammation. However, its use during pregnancy, especially in the third trimester, is generally not recommended due to the potential risks of fetal harm and complications, such as constriction of the fetal ductus arteriosus and premature closure of the fetal ductus arteriosus. Therefore, its use would be concerning in a pregnant woman, particularly one with SLE.

B. Prednisone:

Prednisone is a corticosteroid medication often used to manage inflammation and autoimmune conditions like SLE. While corticosteroids are generally considered safe for use during pregnancy, they may be prescribed cautiously and in the lowest effective dose to minimize potential risks to the fetus. Pregnant women with SLE may be prescribed prednisone to manage their condition.

C. Hydroxychloroquine:

Hydroxychloroquine is an antimalarial medication that is also used to manage autoimmune conditions like SLE. It is considered relatively safe for use during pregnancy and is often continued in pregnant women with SLE to control disease activity and reduce the risk of flares.

D. Leflunomide:

Leflunomide is a disease-modifying antirheumatic drug (DMARD) used to treat autoimmune conditions such as rheumatoid arthritis. Its use is contraindicated during pregnancy due to its potential teratogenic effects, which can cause serious birth defects. Pregnant women should discontinue leflunomide before attempting to conceive or switch to alternative medications.

E. Methotrexate:

Methotrexate is another DMARD used to treat autoimmune conditions, but it is contraindicated during pregnancy due to its high risk of causing birth defects and pregnancy loss. It can interfere with fetal development and should not be used by pregnant women or women planning pregnancy.

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Correct Answer is C

Explanation

A. Have the technician come back later on:

This option suggests delaying the blood draw until a later time when the IV line is removed or after the infusion is completed. While this may seem like a reasonable approach to avoid interfering with the IV line, it could lead to unnecessary delays in obtaining essential laboratory test results.

B. Notify the surgeon to obtain the specimen via a cut-down procedure:

This option involves a more invasive procedure, called a cut-down, which is typically reserved for situations where peripheral venous access is challenging or impossible. It involves making an incision to expose a vein for direct cannulation. This approach is not warranted in this scenario, where obtaining blood from the opposite arm is a standard and less invasive practice.

C. Tell the technician to obtain the specimen from the client's left arm:

This option is the most appropriate response. It instructs the technician to draw blood from the client's left arm, which is free from the IV line. Drawing blood from the opposite arm minimizes the risk of complications associated with interfering with the IV infusion.

D. Stop the technician immediately:

While stopping the technician immediately may prevent them from proceeding with the incorrect approach, it lacks specific guidance on how to proceed correctly. It's essential to provide clear instructions to the technician to draw blood from the opposite arm rather than simply halting the procedure without further direction.

A. candidiasis. B. genital herpes simplex. C. trichomoniasis. D. bacterial vaginosis.

Correct Answer is A

Explanation

A. Candidiasis:

Candidiasis is caused by an overgrowth of the fungus Candida albicans in the vagina. It typically presents with symptoms such as thick, white vaginal discharge (resembling cottage cheese), itching, and discomfort during sexual intercourse (dyspareunia). This option is the most likely diagnosis based on the client's symptoms.

B. Genital herpes simplex:

Genital herpes simplex is caused by the herpes simplex virus (HSV). It presents with symptoms such as painful, fluid-filled blisters or sores in the genital area. While genital herpes can cause vaginal discharge, the discharge is typically clear or cloudy, not thick and white as described in the scenario.

C. Trichomoniasis:

Trichomoniasis is a sexually transmitted infection caused by the parasite Trichomonas vaginalis. It commonly presents with symptoms such as a frothy, yellow-green vaginal discharge, itching, and discomfort during urination or sexual intercourse. The discharge is typically not described as thick and white.

D. Bacterial vaginosis:

Bacterial vaginosis results from an imbalance of bacteria in the vagina, with a decrease in beneficial bacteria and an overgrowth of harmful bacteria. It presents with symptoms such as a thin, grayish-white vaginal discharge with a fishy odor. While bacterial vaginosis can cause vaginal discomfort, the discharge is not typically described as thick and white.

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A nurse is obtaining a medication history from a pregnant client with a history of systemic lupus erythematosus (SLE). Which medication(s) would the nurse expect the woman to report to be currently using? Select all that apply.

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

Assessment of a female client reveals a thick, white vaginal discharge. The client also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has:

Correct Answer is A

Explanation

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