Scenario:

A nurse is caring for a 32-year-old female client who was recently diagnosed with endometriosis. The client is in the clinic for a follow-up visit after beginning nafarelin treatment.

Setting: Clinic

Exhibits

Which of the following manifestations reported by the client should the nurse identify as a therapeutic effect of the nafarelin? (Select all that apply.)

CNS manifestations

Pain level during sexual intercourse

Nasal mucosa changes

Breast changes

Missed previous month's menstrual cycle

Dermatological manifestations

Answer and Explanation

Correct Answer : B,E

Choice A rationale: CNS manifestations such as headaches are not a therapeutic effect of nafarelin. These are side effects of the medication. Nafarelin, a gonadotropin-releasing hormone (GnRH) agonist, works by reducing the production of estrogen in the body. This can lead to a variety of side effects, including headaches. While these side effects can be bothersome, they do not indicate that the medication is effectively treating the endometriosis.

Choice B rationale: The reduction in pain level during sexual intercourse, or dyspareunia, is a therapeutic effect of nafarelin. Endometriosis can cause painful sexual intercourse, and one of the goals of treatment with nafarelin is to reduce this pain. The client’s report of decreased dyspareunia suggests that the nafarelin is effectively treating the endometriosis.

Choice C rationale: Changes in the nasal mucosa, such as irritation, are not a therapeutic effect of nafarelin. These are side effects of the medication. Nafarelin is administered intranasally, which can lead to irritation of the nasal mucosa. While this side effect can be bothersome, it does not indicate that the medication is effectively treating the endometriosis.

Choice D rationale: Changes in breast size are not a therapeutic effect of nafarelin. These are side effects of the medication. Nafarelin can cause a variety of side effects, including changes in breast size. While this side effect can be bothersome, it does not indicate that the medication is effectively treating the endometriosis.

Choice E rationale: The absence of menstruation, or amenorrhea, is a therapeutic effect of nafarelin. Nafarelin works by reducing the production of estrogen in the body, which can lead to a temporary halt in menstruation. This is a therapeutic effect as it can help to reduce the pain and other symptoms associated with endometriosis.

Choice F rationale: Dermatological manifestations such as increased acne are not a therapeutic effect of nafarelin. These are side effects of the medication. Nafarelin can cause a variety of side effects, including increased acne. While this side effect can be bothersome, it does not indicate that the medication is effectively treating the endometriosis.

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Correct Answer is B

Explanation

Choice A rationale

Petechiae, or small red or purple spots on the skin caused by minor bleeding from broken capillary blood vessels, are an objective finding. They can be seen and evaluated by the nurse during a physical examination.

Choice B rationale

Nausea is a subjective symptom. It is something the patient experiences and reports, but it cannot be directly observed or measured by the nurse.

Choice C rationale

Cyanosis, or bluish discoloration of the skin due to poor circulation or inadequate oxygenation of the blood, is an objective finding. It can be observed by the nurse during a physical examination.

Choice D rationale

Fever is an objective finding. It can be measured by the nurse using a thermometer.

A. The patient with polycystic ovarian syndrome. B. The patient with cancer. C. The patient with Kallmann’s syndrome. D. The patient with Addison’s disease.

Correct Answer is B

Explanation

Choice A rationale

Polycystic ovarian syndrome is a hormonal disorder common among women of reproductive age. While it can lead to several complications, it does not significantly increase the risk of sepsis.

Choice B rationale

Cancer and certain treatments for cancer can weaken the immune system, increasing the risk of infections that could lead to sepsis.

Choice C rationale

Kallmann’s syndrome is a genetic condition that affects the production of a hormone involved in sexual development. It does not significantly increase the risk of sepsis.

Choice D rationale

Addison’s disease affects the adrenal glands and can disrupt the balance of hormones in the body, but it does not significantly increase the risk of sepsis.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is conducting a patient’s history and physical examination. Which information should the nurse consider as subjective data?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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