A nurse is providing teaching to a client about the manifestations of uterine prolapse. Which of the following statements by the client should indicate to the nurse a need for further teaching?

"The symptoms can get worse with penile penetration during intercourse."

"A sensation of pressure in the pelvis can occur."

"Low back pain can occur frequently."

"Feces can be present in the vagina."

Answer and Explanation

The Correct Answer is D

Choice A reason:
The statement that symptoms can worsen with penile penetration during intercourse is partially correct. While sexual activity may exacerbate feelings of bulging or discomfort associated with uterine prolapse, it does not typically worsen the prolapse itself⁹. Painful intercourse, known as dyspareunia, is a common symptom of pelvic organ prolapse, which includes uterine prolapse.

Choice B reason:
Feeling a sensation of pressure in the pelvis is a classic symptom of uterine prolapse. As the uterus descends into the vaginal canal, it can create a sensation of fullness or pressure that is often noticeable and uncomfortable for the patient.

Choice C reason:
Low back pain is indeed a symptom that can be associated with uterine prolapse. The weakening of pelvic floor muscles and ligaments that leads to prolapse can also contribute to discomfort in the lower back.

Choice D reason:
The presence of feces in the vagina would not be a direct symptom of uterine prolapse. However, a related condition called rectocele, where the rectum bulges into the vagina, could cause such a symptom. This condition is different from uterine prolapse and would require separate management.

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Correct Answer is C

Explanation

Choice A reason:

Lightheadedness is generally not an indication of effective treatment for dehydration. It is often a symptom of dehydration itself, as it can result from decreased blood volume and reduced blood flow to the brain. Effective rehydration should alleviate symptoms like lightheadedness, not present as an indication of it.

Choice B reason:

Decreased pulse pressure may indicate a drop in the volume of blood circulating through the body, which is not a sign of effective rehydration. Pulse pressure is the difference between systolic and diastolic blood pressure readings, and a narrow pulse pressure can be a sign of hypovolemia, or low blood volume, often due to dehydration.

Choice C reason:

Urine output of 75 mL in 1 hr can be considered within the normal range of urine output for an adult, which is typically about 0.5 to 1 mL/kg/hr⁵. This indicates that the kidneys are functioning and the body is excreting waste, suggesting effective rehydration.

Choice D reason:

A urine specific gravity of 1.038 is higher than the normal range of 1.005 to 1.030[^10^]. This indicates concentrated urine, which is commonly seen in dehydration as the body attempts to conserve water. Therefore, this is not an indication of effective treatment for dehydration.

A. Dosage of the medication will be reduced during pregnancy. B. Dietary modifications occur during pregnancy when taking this medication. C. The client can breastfeed when taking this medication. D. The medication should be discontinued 3 months prior to a planned pregnancy.

Correct Answer is D

Explanation

Choice A reason:
Reducing the dosage of methotrexate during pregnancy is not a safe option because methotrexate is contraindicated during pregnancy due to its potential to cause birth defects and other adverse pregnancy outcomes.

Choice B reason:
While dietary modifications may be necessary during pregnancy, this is not specifically related to the use of methotrexate. The primary concern with methotrexate and pregnancy is the risk it poses to the developing fetus, not dietary interactions.

Choice C reason:
Breastfeeding while taking methotrexate is not recommended. Methotrexate can be excreted in breast milk and may harm a nursing infant.

Choice D reason:
Methotrexate should indeed be discontinued at least 3 months prior to a planned pregnancy. This is to ensure that the drug is completely cleared from the body, as it can cause serious birth defects and other pregnancy-related complications.

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A nurse is providing teaching to a client about the manifestations of uterine prolapse. Which of the following statements by the client should indicate to the nurse a need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a 68-kg (150-lb) client who has dehydration. Which of the following manifestations is an indication of effective treatment?

Correct Answer is C

Explanation

A nurse is caring for a female client who has rheumatoid arthritis and a new prescription for methotrexate. The client tells the nurse she is planning a pregnancy. Which of the following instructions should the nurse give the client?

Correct Answer is D

Explanation

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