What would the nurse expect to find when taking the health history of a woman admitted for repair of cystocele and rectocele, who has nine living children?

Sporadic vaginal bleeding accompanied by chronic pelvic pain

Heavy leukorrhea with vulvar pruritus

Menstrual irregularities and hirsutism on the chin

Stress incontinence with a feeling of low abdominal pressure .

Answer and Explanation

The Correct Answer is D

Choice A rationale
Sporadic vaginal bleeding accompanied by chronic pelvic pain is not typically associated with a woman who has had multiple pregnancies and is admitted for repair of cystocele and rectocele.
Choice B rationale
Heavy leukorrhea with vulvar pruritus is not typically associated with a woman who has had multiple pregnancies and is admitted for repair of cystocele and rectocele.
Choice C rationale
Menstrual irregularities and hirsutism on the chin are not typically associated with a woman who has had multiple pregnancies and is admitted for repair of cystocele and rectocele.
Choice D rationale
Stress incontinence with a feeling of low abdominal pressure is a common symptom in women who have had multiple pregnancies and are admitted for repair of cystocele and rectocele. Multiple pregnancies can weaken the pelvic floor muscles, leading to conditions like cystocele and rectocele. Stress incontinence, where urine leaks out with increased abdominal pressure (such as when coughing, sneezing, or lifting), is a common symptom of these conditions.

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Correct Answer is B

Explanation

Choice A rationale
A negative pregnancy test is not the priority in this case. While it’s important to rule out pregnancy as a cause of abnormal uterine bleeding (AUB), it’s not the most critical finding.

Choice B rationale
A prothrombin time of 40 seconds is significantly prolonged, indicating a potential coagulation disorder. This could explain the abnormal uterine bleeding and should be prioritized due to the risk of significant blood loss.
Choice C rationale
A hemoglobin level of 10.1 g/dl is slightly low but within acceptable limits for many individuals. While it could indicate some degree of anemia possibly due to chronic blood loss, it’s not as immediately concerning as a coagulation disorder.
Choice D rationale
A serum cholesterol level of 140 mg/dl is within the normal range and is not directly related to AUB1.

A. Prepare for a vaginal delivery:. B. Administer antiviral medication. C. Prepare for a cesarean delivery. D. Discharge the patient:

Correct Answer is C

Explanation

Choice A (Prepare for a vaginal delivery) is incorrect. Vaginal delivery is generally not recommended for women with active genital herpes lesions present during labor due to the high risk of transmitting the virus to the newborn. This risk is especially high when the mother experiences a primary infection (first outbreak) during the third trimester or has visible lesions at the time of delivery.
Choice B (Administer antiviral medication) is partially correct. While antiviral medications can be helpful in managing and potentially shortening outbreaks, they alone are not enough to prevent transmission during delivery. Antiviral medication can be used in combination with cesarean delivery to further reduce the risk of transmission.
Choice C (Prepare for a cesarean delivery) is correct. A cesarean delivery is the preferred method of delivery for women with active genital herpes lesions present during labor because it significantly reduces the risk of the virus being transmitted to the newborn. This risk can be as high as 50% during vaginal delivery with active lesions, while the risk with cesarean delivery is significantly lower, typically around 1% or less.
Choice D (Discharge the patient) is incorrect. Discharging a patient in active labor with active genital herpes lesions is not a safe or appropriate course of action. The patient needs to be carefully monitored and managed in a healthcare setting to minimize the risk of transmission to the newborn and ensure the safety of both mother and baby.

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What would the nurse expect to find when taking the health history of a woman admitted for repair of cystocele and rectocele, who has nine living children?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing the laboratory test results of a client with abnormal uterine bleeding (AUB). Which finding should the nurse prioritize?

Correct Answer is B

Explanation

The labor nurse is admitting a patient in active labor who has a history of genital herpes. The patient reports a recent outbreak, and the nurse verifies lesions on the perineum. What action should the nurse take in anticipating the plan of care for this patient?

Correct Answer is C

Explanation

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