When providing care to a young single woman just diagnosed with acute pelvic inflammatory disease, the nurse should:
point out that inappropriate sexual behavior caused the infection.
position the woman in a semi-Fowler position.
tell her that antibiotics need to be taken until pelvic pain is relieved.
explain to the woman that infertility is a likely outcome of this type of infection.
The Correct Answer is B
Choice A reason: Pointing out that inappropriate sexual behavior caused the infection is not helpful, as it may make the woman feel guilty, ashamed, or defensive. The nurse should avoid blaming or judging the woman and focus on providing education and support.
Choice B reason: Positioning the patient in a semi-Fowler position (head of the bed elevated 30–45 degrees) helps promote drainage of pelvic exudate and reduces the risk of abscess formation or further spread of infection. This is a key nursing intervention for patients with acute pelvic inflammatory disease (PID).
Choice C reason: Telling her that antibiotics need to be taken until pelvic pain is relieved is incorrect, as it may lead to incomplete treatment and recurrence of the infection. The nurse should instruct the woman to take the full course of antibiotics as prescribed, regardless of the symptoms.
Choice D reason: While infertility is a potential complication of PID, it is not a guaranteed outcome. The nurse should provide accurate information about risks but avoid causing unnecessary alarm. The focus should be on prompt treatment and prevention of complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is: B. 3-1-1-0-3.
Choice A reason:
This option suggests the woman has been pregnant four times, which is incorrect. She has had three pregnancies: one set of twins (counted as one pregnancy) and two singletons.
Choice B reason:
This is the correct option. The woman has had three pregnancies (Gravida = 3), one full-term delivery (Term = 1), one preterm delivery (the twins, Preterm = 1), no abortions (Abortions = 0), and three living children (Living = 3).
Choice C reason:
This option incorrectly suggests two preterm deliveries and one abortion, neither of which is indicated in the woman's history.
Choice D reason:
This option incorrectly suggests two preterm deliveries (the twins are counted as one preterm delivery) and does not accurately reflect the woman's history.
GTPAL stands for Gravida (total number of pregnancies), Term births (deliveries after 37 weeks), Preterm births (deliveries between 20-36 weeks), Abortions (losses before 20 weeks), and Living children. Normal ranges: Term (≥37 weeks), Preterm (20-36 weeks)
Correct Answer is C
Explanation
Choice A reason: Anxiety due to hospitalization is not a likely cause of the signs reported by the patient. Anxiety can cause some symptoms, such as headache, palpitations, or sweating, but it does not cause visual changes or epigastric pain. Anxiety is also not a common complication of pregnancy-induced hypertension, which is a condition characterized by high blood pressure and protein in the urine.
Choice B reason: Effects of magnesium sulfate are not a likely cause of the signs reported by the patient. Magnesium sulfate is a medication used to prevent seizures and lower blood pressure in patients with pregnancy-induced hypertension. It can cause some side effects, such as flushing, nausea, or drowsiness, but it does not cause headache, visual changes, or epigastric pain. In fact, magnesium sulfate can help relieve these symptoms by reducing the cerebral edema and vasospasm caused by pregnancy-induced hypertension.
Choice C reason: Worsening disease and impending convulsion are the most likely cause of the signs reported by the patient. These signs indicate that the patient is developing severe preeclampsia or eclampsia, which are life-threatening complications of pregnancy-induced hypertension. Preeclampsia is characterized by high blood pressure, protein in the urine, and signs of organ damage, such as headache, visual changes, epigastric pain, or decreased urine output. Eclampsia is the occurrence of seizures in a patient with preeclampsia. These conditions can lead to stroke, bleeding, placental abruption, or fetal distress, and require immediate medical attention.
Choice D reason: Gastrointestinal upset is not a likely cause of the signs reported by the patient. Gastrointestinal upset can cause some symptoms, such as nausea, vomiting, or abdominal pain, but it does not cause headache, visual changes, or epigastric pain. Gastrointestinal upset is also not a common complication of pregnancy-induced hypertension, which is a condition that affects the blood vessels and organs, not the digestive system.
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