A 56-year-old menopausal woman reports to the registered nurse that she has been experiencing vaginal itching, burning, and an increase in vaginal infections over the past 3 years. What important factor should the nurse consider before responding to the client's concerns?

The client's vaginal pH may increase during menopause

The client's dietary habits and fluid intake

The client's genitourinary disorder will be alleviated over time

The client's history of sexually transmitted infections

Answer and Explanation

The Correct Answer is A

A. The client's vaginal pH may increase during menopause – During menopause, estrogen levels decrease, leading to a higher vaginal pH. This disrupts the normal vaginal flora, making the client more susceptible to infections and irritation.

B. The client's dietary habits and fluid intake – While nutrition and hydration affect overall health, they are not the primary cause of menopausal vaginal symptoms and infections.

C. The client's genitourinary disorder will be alleviated over time – Without treatment (e.g., vaginal estrogen therapy or lubricants), menopausal atrophic changes usually persist or worsen, rather than resolve over time.

D. The client's history of sexually transmitted infections – While STIs can cause vaginal discomfort, the client’s symptoms are more likely due to menopausal changes rather than a past history of STIs.

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Correct Answer is A

Explanation

A. "Swelling and redness in one breast, accompanied by flu-like symptoms."
Mastitis is a bacterial infection in breastfeeding mothers, typically caused by Staphylococcus aureus. It presents with unilateral breast pain, erythema, swelling, fever, and flu-like symptoms.

B. "A white patch on a nipple."
A white patch on the nipple may indicate a blocked milk duct or thrush (Candida infection), not mastitis.

C. "Symmetrical breast swelling with a sudden increase in milk production."
Engorgement occurs when the breasts overfill with milk, leading to bilateral swelling, tenderness, and firmness, but no systemic signs of infection like fever or flu-like symptoms.

D. "Bilateral breast tenderness and engorgement with no fever."
Normal breast engorgement can cause discomfort, but mastitis typically affects one breast and causes fever and systemic symptoms.

A. Observe an area of redness on the breast of a client who is 1 day postpartum. B. Provide a sitz bath to a client who has a fourth-degree laceration and is 2 days postpartum. C. Monitor vital signs during admission of a client who has gestational hypertension. D. Change the initial perineal pad of a client who just transferred from labor and delivery.

Correct Answer is B

Explanation

A. Observe an area of redness on the breast of a client who is 1 day postpartum.
Assessment is outside the scope of practice for an AP. The nurse must assess the redness, as it could indicate mastitis or engorgement requiring further evaluation.

B. Provide a sitz bath to a client who has a fourth-degree laceration and is 2 days postpartum.
Assisting with hygiene and comfort measures, such as a sitz bath, is within the AP’s scope of practice. The nurse should ensure that the client understands proper perineal care and has no contraindications.

C. Monitor vital signs during admission of a client who has gestational hypertension.
Clients with gestational hypertension require close monitoring, and initial admission assessments, including vital signs, must be performed by the nurse to identify signs of preeclampsia or worsening hypertension.

D. Change the initial perineal pad of a client who just transferred from labor and delivery.
The first perineal pad change is an assessment opportunity for the nurse, allowing them to evaluate bleeding amount, presence of clots, and signs of postpartum hemorrhage. The nurse should perform the initial assessment and pad change before delegating routine hygiene tasks to the AP.

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A 56-year-old menopausal woman reports to the registered nurse that she has been experiencing vaginal itching, burning, and an increase in vaginal infections over the past 3 years. What important factor should the nurse consider before responding to the client's concerns?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is 3 days postpartum and is attempting to breastfeed. Which of the following findings indicate mastitis?

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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