A nurse in a gynecology office is caring for a client.

Nurses' Notes

1000:

Client reports vaginal itching and discharge in the last week. Describes the discharge as thick and "smelly." Reports pain with urination and sexual intercourse. Verbalizes that the discharge became worse after their menstrual period this month. Reports has been treated for STIs in the past and is currently sexually active in a new relationship. Provider notified.

1035:

Vaginal swab for culture and nucleic acid amplification testing (NAAT) performed. Physical Examination

1015:

Labia majora and minora inflamed. Large amount of frothy, yellow-green, malodorous discharge observed.

Based on the information found in the client's medical record, which of the following prescriptions should the nurse anticipate receiving from the provider?

(Select all that apply.)

Have the client douche every morning and night.

Instruct the client to avoid alcohol for 72 hr after treatment.

Administer metronidazole 2 g PO x 1 dose.

Recommend the client's partner receive treatment.

Perform an oatmeal sitz bath.

Answer and Explanation

Correct Answer : B,C,D

A.   Having the client douche every morning and night is not recommended as it can disrupt the natural balance of vaginal flora and exacerbate the condition. It may worsen symptoms and increase the risk of complications.

B.   Instructing the client to avoid alcohol for 72 hours after treatment is not necessary in this scenario. Metronidazole is an antibiotic used to treat bacterial vaginosis and does not typically interact with alcohol.
C.   Metronidazole is the treatment of choice for bacterial vaginosis, which is suggested by the client's symptoms (frothy, yellow-green, malodorous discharge) and the provider's likely diagnosis based on the clinical presentation.
D.   Recommending the client's partner receive treatment is important to prevent reinfection or transmission of the infection. Bacterial vaginosis can be sexually transmitted, and treating both partners helps reduce the risk of recurrence.
E.   Performing an oatmeal sitz bath may provide symptomatic relief for certain conditions, but it is not typically indicated for the treatment of bacterial vaginosis.

Nursing Test Bank

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Correct Answer is D

Explanation

Rationale:

A. Metronidazole: Metronidazole is an antibiotic and does not have significant interactions with sildenafil.

B. Phenytoin: Phenytoin is an anticonvulsant medication and does not have significant interactions with sildenafil.

C. Prednisone: Prednisone is a corticosteroid and does not have significant interactions with sildenafil.

D. Isosorbide: Isosorbide is a nitrate medication used to treat angin

A. Combining sildenafil with nitrate medications can lead to severe hypotension and is contraindicated. Sildenafil potentiates the vasodilatory effects of nitrates, which can result in a dangerous drop in blood pressure.

A. A 10-year-old child who has sickle cell anemia who reports severe chest pain B. A 4-year-old child who has asthma and a PCO2 of 37 mm Hg C. A 7-year-old child who has diabetes insipidus and a urine specific gravity of 1.016 D. A 1-year-old toddler who has roseola and a temperature of 39°C (102.2°F)

Correct Answer is A

Explanation

A. A 10-year-old child who has sickle cell anemia who reports severe chest pain

Rationale:

A. A 10-year-old child who has sickle cell anemia who reports severe chest pain. Chest pain in a child with sickle cell anemia could indicate vaso-occlusive crisis, acute chest syndrome, or other serious complications requiring immediate assessment and intervention.

B. A PCO2 of 37 mm Hg in a 4-year-old child with asthma may indicate respiratory distress, but severe chest pain in a child with sickle cell anemia takes priority.

C. A urine specific gravity of 1.016 in a 7-year-old child with diabetes insipidus may indicate mild dehydration, but it does not require immediate assessment compared to severe chest pain.

D. A temperature of 39°C (102.2°F) in a 1-year-old toddler with roseola is concerning but does not take precedence over severe chest pain in a child with sickle cell anemi

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a provider's clinic is caring for a client who reports erectile dysfunction and requests a prescription for sildenafil. Which of the following medications currently prescribed for the client is a contraindication to taking sildenafil?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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