Review Vulvovaginitis

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Vulvovaginitis

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Total Questions : 24

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Question 1:

: A client with gastroenteritis is experiencing severe dehydration. The nurse should anticipate the need for which intervention?

A. Initiation of antibiotic therapy. B. Administration of antidiarrheal agents. C. Oral rehydration therapy (ORT) D. Intravenous fluid therapy (IVF)

Answer and Explanation

Choice A:

Initiation of antibiotic therapy is not the primary intervention for severe dehydration in gastroenteritis. Fluid replacement is crucial to correct the fluid and electrolyte imbalances.

Choice B:

Administration of antidiarrheal agents is contraindicated in cases of severe dehydration. These agents can delay the elimination of the causative agent and further worsen fluid loss.

Choice C:

Oral rehydration therapy (ORT) is effective for mild dehydration but may not be sufficient in cases of severe dehydration where oral intake is limited.

Choice D:

Intravenous fluid therapy (IVF) is the appropriate intervention for severe dehydration. IV fluids rapidly restore fluid balance and correct electrolyte imbalances, ensuring timely rehydration and preventing complications.

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Question 2:

: A nurse is caring for a child with suspected gastroenteritis. Which statement by the child's parent indicates understanding of the treatment plan?

A. "I will give my child loperamide to stop the diarrhea.” B. "I should encourage my child to drink plenty of fluids.” C. "I will avoid giving my child any food until the vomiting stops.” D. "I should give my child aspirin for the fever and abdominal pain.”

Answer and Explanation

Choice A:

Giving loperamide to stop diarrhea is not appropriate for a child with suspected gastroenteritis. Loperamide can slow down bowel movements and may lead to complications, especially in pediatric patients.

Choice B:

Encouraging the child to drink plenty of fluids is crucial to prevent dehydration, a common concern in gastroenteritis. Fluid intake helps replace lost fluids and electrolytes due to vomiting and diarrhea.

Choice C:

Avoiding food until vomiting stops can deprive the child of essential nutrients. Small, frequent, bland meals are recommended during recovery from gastroenteritis.

Choice D:

Giving aspirin to a child with fever is contraindicated due to the risk of Reye's syndrome, a potentially fatal condition. Acetaminophen is the preferred antipyretic.

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Question 3:

: A client with gastroenteritis is prescribed ondansetron for persistent vomiting. Which action should the nurse take before administering the medication?

A. Assess the client's blood glucose level. B. Obtain a stool sample for culture and microscopy. C. Monitor the client's urinary output. D. Check the client's vital signs. .

Answer and Explanation

Choice A:

Assessing blood glucose levels is not directly related to ondansetron administration for vomiting. Ondansetron does not typically affect blood glucose levels.

Choice B:

Obtaining a stool sample for culture and microscopy is important for diagnosing the cause of gastroenteritis, but it is not a necessary step before administering ondansetron.

Choice C:

Monitoring urinary output is not directly associated with the administration of ondansetron. It's important for assessing hydration status, but it's not the immediate concern when administering this antiemetic medication.

Choice D:

Checking vital signs is essential before giving any medication to ensure the client's overall stability and to detect any potential contraindications or adverse reactions.

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Question 4:

A nurse is providing education to a group of postmenopausal women about preventing vulvovaginitis. Which of the following strategies should the nurse include in the teaching?

A. Avoiding sexual intercourse. B. Using scented soaps for cleansing. C. Limiting sexual partners. D. Douching regularly.

Answer and Explanation

Choice A:

Avoiding sexual intercourse is not necessary for preventing vulvovaginitis. Maintaining good hygiene and other preventive measures are more relevant.

Choice B:

Using scented soaps for cleansing can actually increase the risk of vulvovaginal irritation and infections. Unscented, gentle cleansers are recommended.

Choice C:

Limiting sexual partners helps reduce the risk of sexually transmitted infections (STIs) that can lead to vulvovaginitis.

Choice D:

Douching regularly is not advised, as it disrupts the natural balance of vaginal flora and increases the risk of infections and irritation.

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Question 5:

A client with vulvovaginitis presents with a thick, white discharge resembling cottage cheese. Which of the following causative agents is most likely responsible for this presentation?

A. Anaerobic bacteria. B. Fungi. C. Protozoa. D. Low estrogen levels. E. Human papillomavirus.

Answer and Explanation

Choice A:

Anaerobic bacteria are not responsible for the described symptoms. They typically cause foul-smelling discharge with a different consistency.

Choice B:

Fungi, such as Candida species, commonly cause vaginal candidiasis, which presents with thick, white, cottage cheese-like discharge. This matches the client's symptoms.

Choice C:

Protozoa, like Trichomonas vaginalis, usually lead to a frothy, greenish-yellow discharge with a foul odor, which doesn't align with the client's presentation.

Choice D:

Low estrogen levels would not directly cause this type of discharge. They might lead to vaginal dryness and thinning of vaginal walls, but not the specific discharge described.

Choice E:

Human papillomavirus (HPV) doesn't typically cause the described discharge. It's associated with genital warts and cervical changes but not with this type of discharge.

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Question 6:

A nurse is assessing a client with vulvovaginitis who complains of a fishy odor. Which statement by the nurse is appropriate?

A. "This odor is caused by the overgrowth of lactobacilli.” B. "The fishy odor is due to a viral infection.” C. "The fishy odor indicates the presence of protozoa.” D. "The odor is a result of allergic reaction to douches.”

Answer and Explanation

Choice A:

Lactobacilli overgrowth can lead to a fishy odor, particularly in bacterial vaginosis (BV) The overgrowth disrupts the normal vaginal pH.

Choice B:

A viral infection wouldn't cause a fishy odor. Viruses like human papillomavirus (HPV) might cause genital warts but not this specific odor.

Choice C:

Protozoa, such as Trichomonas vaginalis, cause a distinct odor, but it's not typically described as fishy.

Choice D:

Allergic reactions to douches might cause irritation, itching, or redness, but they wouldn't lead to a fishy odor.

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Question 7:

A client with vulvovaginitis reports experiencing dysuria, green-yellow frothy discharge, and foul odor. What should the nurse suspect as the most likely causative agent?

A. Anaerobic bacteria. B. Fungi. C. Protozoa. D. Low estrogen levels.

Answer and Explanation

Choice A:

Anaerobic bacteria typically cause a foul-smelling discharge, which doesn't match the described symptoms.

Choice B:

Fungal infections result in a thick, white, cottage cheese-like discharge, different from the green-yellow frothy discharge mentioned.

Choice C:

Protozoa, specifically Trichomonas vaginalis, cause green-yellow frothy discharge with a foul odor, closely resembling the client's symptoms.

Choice D:

Low estrogen levels would not cause this specific presentation; they're more associated with vaginal dryness and thinning of vaginal walls.

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Question 8:

A nurse is teaching a group of young women about vulvovaginitis prevention. Which of the following measures should the nurse recommend to reduce the risk of vulvovaginitis?

A. Limiting sexual partners. B. Avoiding the use of condoms. C. Using scented detergents for laundry. D. Increasing the intake of sugary foods.

Answer and Explanation

Choice A:

Limiting sexual partners is a crucial preventive measure for vulvovaginitis. This reduces the risk of exposure to potential infections that can lead to vulvovaginitis. Multiple sexual partners can increase the chances of contracting sexually transmitted infections (STIs) and other pathogens.

Choice B:

Avoiding the use of condoms is not a recommended preventive measure. Condoms provide a barrier against STIs and other infectious agents, reducing the risk of vulvovaginitis. Therefore, this choice is not appropriate for prevention.

Choice C:

Using scented detergents for laundry is not advisable. Scented products can disrupt the natural pH balance of the vagina, leading to irritation and an increased risk of vulvovaginitis. Unscented or mild detergents are preferable to maintain vaginal health.

Choice D:

Increasing the intake of sugary foods is not recommended for vulvovaginitis prevention. High sugar consumption can lead to an overgrowth of yeast (Candida albicans) in the vaginal area, potentially causing vulvovaginitis. Therefore, this choice contradicts preventive measures.

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Question 9:

. A client with vulvovaginitis is prescribed antibiotics. The nurse should monitor the client for which potential adverse effect?

A. Vaginal itching. B. Fishy odor. C. Increased vaginal discharge. D. Photosensitivity.

Answer and Explanation

Choice A:

Vaginal itching is a common symptom of vulvovaginitis but not a potential adverse effect of antibiotics. It is more indicative of the condition itself rather than a medication side effect.

Choice B:

A fishy odor is characteristic of bacterial vaginosis (BV), not a common adverse effect of antibiotics. BV is caused by an imbalance in vaginal flora and is not directly related to antibiotic therapy.

Choice C:

Increased vaginal discharge is a potential adverse effect of antibiotics. Antibiotics can disrupt the normal vaginal flora, leading to an overgrowth of yeast or other pathogens, which may result in increased discharge.

Choice D:

Photosensitivity is unrelated to antibiotics or vulvovaginitis. It refers to an increased sensitivity to sunlight or artificial light and is not a relevant consideration in this context.

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Question 10:

. A nurse is caring for a client with vulvovaginitis caused by Candida albicans. Which intervention should the nurse include in the client's care plan?

A. Encouraging the use of vaginal douches. B. Applying a topical corticosteroid cream. C. Using hormonal therapy. D. Promoting good hygiene practices.

Answer and Explanation

Choice A:

Encouraging the use of vaginal douches is not recommended for vulvovaginitis caused by Candida albicans. Douching can disrupt the vaginal pH balance and lead to further irritation or infection.

Choice B:

Applying a topical corticosteroid cream is not a suitable intervention for Candida albicans-related vulvovaginitis. Corticosteroids can suppress the immune response and potentially worsen fungal infections.

Choice C:

Using hormonal therapy is not indicated for treating Candida albicans vulvovaginitis. This condition is primarily fungal in nature and requires antifungal treatment, not hormonal therapy.

Choice D:

Promoting good hygiene practices is essential in managing Candida albicans vulvovaginitis. Proper hygiene helps maintain a healthy vaginal environment and reduces the risk of fungal overgrowth. Emphasizing the importance of gentle cleansing and avoiding irritants is crucial.

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Question 11:

. A client has been diagnosed with vulvovaginitis caused by Trichomonas vaginalis. Which treatments should the nurse anticipate being prescribed for this client? Select all that apply:

A. Antibiotics. B. Antifungals. C. Antiprotozoals. D. Topical creams.

Answer and Explanation

Choice A:

Antibiotics are not typically used to treat Trichomonas vaginalis, as it is a protozoan infection rather than a bacterial infection.

Choice B:

Antifungals are also not appropriate for treating Trichomonas vaginalis, as it is not a fungal infection.

Choice C:

Antiprotozoals are the correct treatment for Trichomonas vaginalis infection. Metronidazole is commonly prescribed to treat this type of vulvovaginitis.

Choice D:

Topical creams may be used for other types of vulvovaginitis, but they are not the primary treatment for Trichomonas vaginalis.

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Question 12:

A nurse is educating a group of clients about vulvovaginitis. Which mode of transmission is associated with bacterial vaginosis (BV)?

A. Endogenous transmission. B. Sexual transmission. C. Vector transmission. D. Contact transmission.

Answer and Explanation

Choice A:

Bacterial vaginosis (BV) is primarily associated with endogenous transmission, meaning it is caused by an overgrowth of normally occurring vaginal bacteria rather than being directly transmitted from another individual.

Choice B:

While sexual transmission can play a role in the development of BV, it is not the primary mode of transmission for this condition.

Choice C:

Vector transmission involves the transfer of pathogens by a vector such as a mosquito or tick and is not relevant to bacterial vaginosis.

Choice D:

Contact transmission typically involves direct physical contact with an infected person or contaminated object, which is not the main mode of transmission for BV.

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Question 13:

A nurse is assessing clients with vulvovaginitis. Which type of vulvovaginitis can be transmitted from mother to child during delivery?

A. Bacterial vaginosis (BV) B. Candidal vulvovaginitis (CV) C. Trichomonas vaginalis (TV) D. Atrophic vaginitis (AV)

Answer and Explanation

Choice A:

Bacterial vaginosis (BV) is not commonly transmitted from mother to child during delivery. It is primarily associated with an imbalance in vaginal bacteria.

Choice B:

Candidal vulvovaginitis (CV), caused by the fungus Candida, can be transmitted from mother to child during delivery as the baby passes through the birth canal.

Choice C:

Trichomonas vaginalis (TV) can also be transmitted from mother to child during delivery, but CV is a more common cause of transmission.

Choice D:

Atrophic vaginitis (AV) is not typically transmitted from mother to child during delivery. It is often associated with hormonal changes during menopause.

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Question 14:

A nurse is caring for a client with candidal vulvovaginitis (CV) Which statement is an appropriate assessment finding for this client?

A. "I have noticed a thin, frothy, green-yellow vaginal discharge.” B. "I experience intense inflammation, itching, and burning in my genital area.” C. "My vaginal discharge is thick, white, and clumpy with no odor.” D. "I have no discharge, and my vaginal pH is greater than 5.0.”

Answer and Explanation

Choice A:

Thin, frothy, green-yellow vaginal discharge is indicative of trichomoniasis, not candidal vulvovaginitis (CV) Trichomoniasis typically presents with a foul-smelling discharge.

Choice B:

While inflammation, itching, and burning are common symptoms of CV, they do not specifically describe the characteristic discharge associated with this condition.

Choice C:

Thick, white, and clumpy vaginal discharge with no odor is a classic presentation of candidal vulvovaginitis (CV) The discharge is often described as resembling cottage cheese.

Choice D:

A vaginal pH greater than 5.0 is suggestive of bacterial vaginosis, not candidal vulvovaginitis. In CV, the vaginal pH is usually normal (around 4-4.5)

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Question 15:

A client reports experiencing vaginal dryness and atrophy. The nurse suspects atrophic vaginitis (AV) Which assessment finding supports this suspicion?

A. Vaginal pH less than 4.5. B. Presence of motile trichomonads on microscopic examination. C. Thin and loss of rugae (folds) of vaginal mucosa on examination. D. Vaginal discharge that is thin, gray-white, or milky.

Answer and Explanation

Choice A:

A vaginal pH less than 4.5 is within the normal acidic range and does not specifically support the suspicion of atrophic vaginitis (AV)

Choice B:

Presence of motile trichomonads indicates trichomoniasis, not atrophic vaginitis (AV)

Choice C:

Thin and loss of rugae (folds) of vaginal mucosa is a characteristic finding in atrophic vaginitis (AV) This condition occurs due to decreased estrogen levels, leading to thinning and drying of vaginal tissues.

Choice D:

A thin, gray-white, or milky vaginal discharge is more suggestive of other infections or conditions and is not a specific sign of atrophic vaginitis (AV)

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Question 16:

A nurse is planning care for a client with vulvovaginitis. Which treatment is appropriate for Trichomonas vaginalis (TV) infection?

A. Oral or intravaginal metronidazole, clindamycin, tinidazole, or secnidazole. B. Oral fluconazole or topical azoles (miconazole, clotrimazole, butoconazole, tioconazole) C. Hormonal therapy with estrogen creams, tablets, or rings. D. Removal of foreign bodies or irritants.

Answer and Explanation

Choice A:

Trichomonas vaginalis (TV) infection is treated with medications that have activity against protozoa, such as metronidazole, clindamycin, tinidazole, or secnidazole. These drugs are effective in eradicating the infection.

Choice B:

Oral fluconazole and topical azoles are used to treat fungal infections, such as candidiasis, not Trichomonas vaginalis (TV) infection.

Choice C:

Hormonal therapy with estrogen creams, tablets, or rings is used for menopausal or postmenopausal symptoms, not for the treatment of Trichomonas vaginalis (TV) infection.

Choice D:

Removal of foreign bodies or irritants is a general management strategy and is not specific to treating Trichomonas vaginalis (TV) infection.

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Question 17:

Which type of vulvovaginitis can occur due to hormonal changes such as menopause or aging?

A. Bacterial vaginosis (BV) B. Candidal vulvovaginitis (CV) C. Trichomonas vaginalis (TV) D. Atrophic vaginitis (AV)

Answer and Explanation

Choice A:

Bacterial vaginosis (BV) is not related to hormonal changes but rather an overgrowth of bacteria causing an imbalance in the vaginal ecosystem.

Choice B:

Candidal vulvovaginitis (CV) is a fungal infection and is not primarily caused by hormonal changes.

Choice C:

Trichomonas vaginalis (TV) is a sexually transmitted infection and is not directly linked to hormonal changes.

Choice D:

Atrophic vaginitis (AV) occurs due to hormonal changes, specifically a decrease in estrogen levels that can lead to thinning and inflammation of vaginal tissues. Estrogen deficiency commonly occurs during menopause or aging, leading to symptoms like vaginal dryness and discomfort.

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Question 18:

A client presents with a thin, frothy, green-yellow vaginal discharge with a foul musty odor. Which condition is most likely to be the cause?

A. Bacterial vaginosis (BV) B. Candidal vulvovaginitis (CV) C. Trichomonas vaginalis (TV) D. Atrophic vaginitis (AV)

Answer and Explanation

Choice A:

Bacterial vaginosis (BV) typically presents with a thin gray or white discharge and is associated with a fishy odor. It is not known for a green-yellow discharge.

Choice B:

Candidal vulvovaginitis (CV) often presents with a white, thick, cottage cheese-like discharge, not a green-yellow discharge.

Choice C:

Trichomonas vaginalis (TV) infection can result in a thin, frothy, green-yellow vaginal discharge with a foul musty odor. This infection is sexually transmitted and may also cause itching and irritation.

Choice D:

Atrophic vaginitis (AV) is not associated with a frothy, green-yellow discharge but rather with symptoms related to estrogen deficiency and vaginal thinning.

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Question 19:

A nurse is educating clients about the modes of transmission for different types of vulvovaginitis. Which type can have various modes of transmission, such as sexual transmission, contact transmission, or vector transmission?

A. Bacterial vaginosis (BV) B. Candidal vulvovaginitis (CV) C. Trichomonas vaginalis (TV) D. Atrophic vaginitis (AV) E. Other types with various modes of transmission.

Answer and Explanation

Choice A:

Bacterial vaginosis (BV) is primarily caused by an imbalance in the vaginal microbiota and is not known for multiple modes of transmission.

Choice B:

Candidal vulvovaginitis (CV) is commonly caused by Candida fungi and is not known for having various modes of transmission.

Choice C:

Trichomonas vaginalis (TV) is primarily transmitted sexually and is not typically associated with contact or vector transmission.

Choice D:

Atrophic vaginitis (AV) is related to hormonal changes and is not transmitted through sexual or contact modes.

Choice E:

Other types of vulvovaginitis, such as certain viral or bacterial infections, could have various modes of transmission, including sexual, contact, or vector transmission. It is important to consider these possibilities when educating clients about modes of transmission.

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Question 20:

A nurse is educating a patient about preventing bacterial vaginosis (BV) Which of the following strategies should the nurse recommend to the patient? (Select all that apply)

A. Avoiding douching. B. Using condoms or other barrier methods during sexual intercourse. C. Limiting sexual partners. D. Treating underlying conditions, such as diabetes mellitus. E. Using hormonal therapy as prescribed.

Answer and Explanation

Choice A:

Avoiding douching is recommended to prevent bacterial vaginosis (BV) as douching can disrupt the natural vaginal flora and increase the risk of BV.

Choice B:

Using condoms or other barrier methods during sexual intercourse helps reduce the risk of BV transmission, as it prevents the introduction of potentially harmful bacteria into the vagina.

Choice C:

Limiting sexual partners can lower the risk of BV, as having multiple sexual partners may increase the likelihood of exposure to different bacteria that can disrupt the vaginal flora.

Choice D:

Treating underlying conditions, such as diabetes mellitus, is important because uncontrolled diabetes can create an environment conducive to BV development due to elevated glucose levels.

Choice E:

Using hormonal therapy as prescribed is not directly related to preventing BV. Hormonal therapy typically pertains to conditions like hormone replacement therapy and is not a preventive measure for BV.

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Question 21:

A nurse is caring for a client diagnosed with vulvovaginal candidiasis (CV) What nursing interventions should the nurse implement for this client? (Select all that apply)

A. Administering oral or intravaginal antibiotics. B. Educating the client on the causes, symptoms, and prevention of CV. C. Providing comfort measures to relieve irritation and discomfort. D. Encouraging the client to avoid sexual intercourse during treatment. E. Advising the client to limit sexual partners.

Answer and Explanation

Choice A:

Administering oral or intravaginal antibiotics is not appropriate for vulvovaginal candidiasis (CV) since it is caused by a fungal infection, not bacterial. Antifungal medications are the primary treatment.

Choice B:

Educating the client on the causes, symptoms, and prevention of CV is essential to ensure the client understands the infection, its symptoms, and how to prevent recurrence.

Choice C:

Providing comfort measures to relieve irritation and discomfort, such as soothing creams and warm sitz baths, helps alleviate the discomfort associated with CV.

Choice D:

Encouraging the client to avoid sexual intercourse during treatment is advised to prevent further irritation and disruption of the vaginal flora.

Choice E:

Advising the client to limit sexual partners is not a specific intervention for CV.

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Question 22:

A nurse is providing patient education to a client with trichomoniasis vaginitis (TV) Which statement by the client indicates a need for further teaching?

A. "I will abstain from sexual contact until both partners are treated and cured.” B. "I should avoid alcohol consumption during treatment with metronidazole.” C. "Using condoms or other barrier methods during sexual intercourse can prevent transmission.” D. "I will continue the hormonal therapy even if I experience abnormal bleeding.”

Answer and Explanation

Choice A:

Abstaining from sexual contact until both partners are treated and cured is an appropriate measure to prevent re-infection and transmission of trichomoniasis vaginitis (TV)

Choice B:

Avoiding alcohol consumption during treatment with metronidazole is necessary, as alcohol can interact with this medication and cause adverse reactions.

Choice C:

Using condoms or other barrier methods during sexual intercourse can prevent transmission of TV and is an accurate statement.

Choice D:

Continuing hormonal therapy despite experiencing abnormal bleeding is concerning, as it may indicate an adverse reaction or need for further evaluation. This statement highlights a need for further teaching.

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Question 23:

A client with atrophic vaginitis (AV) is prescribed hormonal therapy. Which statement by the client indicates an understanding of the treatment plan?

A. "I will use lubricants or moisturizers to relieve dryness and discomfort.” B. "I should avoid irritants or allergens that may worsen my symptoms.” C. "I will report any abnormal bleeding or breast changes to my health care provider.” D. "I will complete the full course of oral antibiotics as prescribed.”

Answer and Explanation

Choice A:

Lubricants and moisturizers are commonly used for symptom relief in atrophic vaginitis (AV), but this choice does not reflect an understanding of hormonal therapy, which is the treatment plan specified.

Choice B:

Avoiding irritants or allergens is important for overall vaginal health, but it does not specifically indicate comprehension of hormonal therapy for AV.

Choice C:

This choice demonstrates understanding of potential side effects and complications associated with hormonal therapy, such as abnormal bleeding and breast changes. Monitoring for such changes is vital.

Choice D:

The mention of completing a course of oral antibiotics is unrelated to the treatment plan for atrophic vaginitis, which involves hormonal therapy.

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Question 24:

A nurse is caring for a patient with vulvovaginitis caused by a foreign body. Which nursing intervention should the nurse prioritize for this patient?

A. Providing patient education on the causes, symptoms, and prevention of foreign body-related vulvovaginitis. B. Administering specific treatment, such as antivirals, antiparasitics, or antibiotics, as prescribed. C. Encouraging the patient to maintain good hygiene and wear cotton underwear. D. Monitoring the patient for signs of complications, such as chronic pain, dyspareunia, or infertility.

Answer and Explanation

Choice A:

Education empowers the patient to prevent recurrence by understanding the causes and symptoms of foreign body-related vulvovaginitis, contributing to long-term management.

Choice B:

Administering specific treatments like antivirals, antiparasitics, or antibiotics addresses the acute phase but does not focus on preventing future occurrences or patient education.

Choice C:

Encouraging good hygiene and cotton underwear is essential, but it is more reactive than providing education for long-term prevention.

Choice D:

Monitoring for complications is important, but the nurse should prioritize patient education to promote proactive management and prevention. Ebola.

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