During an initial examination in the labor room, the nurse notes a large amount of yellow-green or gray frothy and bubbly discharge around the vaginal walls with a foul smell.
The nurse suspects the woman has which type of sexually transmitted infection?
Gonorrhea.
Trichomoniasis.
Chlamydia.
Syphilis.
The Correct Answer is B
Choice A rationale
Gonorrhea typically presents with a purulent, often thick, yellow discharge. While it can have a foul odor, the description of frothy and bubbly is less characteristic of gonorrhea. Diagnosis usually involves a cervical culture or nucleic acid amplification testing (NAAT).
Choice B rationale
Trichomoniasis, caused by the protozoan *Trichomonas vaginalis*, is characteristically associated with a large amount of yellow-green or gray, frothy, and bubbly vaginal discharge with a distinct, often foul or fishy odor. Microscopic examination of the discharge reveals the motile trichomonads for definitive diagnosis.
Choice C rationale
Chlamydia often presents with a thin or mucopurulent discharge, which may be yellowish, but it is not typically described as frothy or bubbly. Many women with chlamydia are asymptomatic. Diagnosis is usually made through NAAT of cervical or urine samples.
Choice D rationale
Syphilis in its primary stage presents with a painless chancre. Secondary syphilis can involve a generalized rash and flu-like symptoms. Vaginal discharge is not a primary characteristic of either the primary or secondary stages of syphilis. Diagnosis involves serological testing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E","F"]
Explanation
Choice A rationale
Hourly monitoring of deep tendon reflexes is crucial in clients receiving magnesium sulfate for severe preeclampsia. Magnesium sulfate acts as a central nervous system depressant, and diminished or absent deep tendon reflexes (normal range: 2+ to 4+) can indicate magnesium toxicity, necessitating immediate intervention to prevent serious complications like respiratory depression.
Choice B rationale
A urinary output of less than 30 mL per hour signals potential renal hypoperfusion, which can be exacerbated by severe preeclampsia and magnesium sulfate administration. Reduced kidney function can lead to the accumulation of magnesium, increasing the risk of toxicity. Prompt notification of the physician allows for timely adjustments in the treatment plan.
Choice C rationale
Calcium gluconate is the antidote for magnesium sulfate overdose. Having it readily available is essential in case the client exhibits signs of magnesium toxicity, such as respiratory depression, severe hypotension, or loss of reflexes. Prompt administration of calcium gluconate can reverse the effects of magnesium and prevent life-threatening complications.
Choice E rationale
Hourly monitoring of intake and output is vital to assess fluid balance and renal function in pregnant clients with severe preeclampsia receiving magnesium sulfate. Accurate measurement helps in detecting oliguria, a sign of worsening preeclampsia or magnesium toxicity, allowing for timely interventions to maintain adequate hydration and prevent complications.
Choice F rationale
Severe preeclampsia significantly impacts both renal and cardiac function due to widespread vasoconstriction and endothelial dysfunction. Close monitoring of these systems through laboratory tests (e.g., serum creatinine, BUN, electrolytes, ECG) and clinical assessments is essential to detect and manage potential complications such as acute kidney injury, heart failure, and arrhythmias.
Correct Answer is A
Explanation
Choice A rationale
The latent phase of labor is the longest and often the least intense phase, characterized by mild, infrequent contractions and gradual cervical dilation (0-3 cm). During this time, the woman is typically more receptive to learning and can concentrate better, making it the ideal phase to teach non-pharmacologic pain control methods such as breathing techniques, relaxation exercises, and positioning.
Choice B rationale
The active phase of labor (4-7 cm dilation) is characterized by more frequent and intense contractions, making it harder for the laboring woman to concentrate and learn new pain management techniques. Reinforcement of previously learned techniques is more appropriate at this stage.
Choice C rationale
The transition phase (8-10 cm dilation) is the most intense and shortest phase of the first stage of labor. The woman is likely experiencing significant discomfort and may have difficulty focusing on learning new pain control methods.
Choice D rationale
The second stage of labor begins with complete cervical dilation (10 cm) and ends with the birth of the baby. The focus during this stage is on pushing and delivering the baby, making it an inappropriate time to teach non-pharmacologic pain control methods for labor.
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