A nurse in a gynecology office is caring for a client who reports vaginal itching and discharge in the last week.
The discharge is described as thick and “smelly.”. The client reports pain with urination and sexual intercourse.
The discharge became worse after their menstrual period this month.
The client has been treated for STIs in the past and is currently sexually active in a new relationship.
The provider has been notified, and a vaginal swab for culture and nucleic acid amplification testing (NAAT) has been performed.
Based on the information found in the client’s medical record, which of the following prescriptions should the nurse anticipate receiving from the provider?

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

Administer metronidazole 2 g PO x 1 dose.

Perform an oatmeal sitz bath.

Have the client douche every morning and night.

Recommend the client’s partner receive treatment.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Instructing the client to avoid alcohol for 72 hr after treatment is a common instruction given when a client is prescribed certain medications, such as metronidazole, due to the potential for a disulfiram-like reaction. However, this choice does not directly address the client’s symptoms of vaginal itching and discharge.

Choice B rationale

The client’s symptoms are indicative of Bacterial Vaginosis (BV), a common vaginal infection in women of reproductive age. Metronidazole is a medication commonly used to treat this infection. A single dose of 2 g orally is a typical treatment regimen.

Choice C rationale

An oatmeal sitz bath can help soothe irritated skin and reduce inflammation, but it does not treat the underlying cause of the client’s symptoms.

Choice D rationale

Douching is generally not recommended as it can disrupt the normal balance of bacteria in the vagina and can lead to further complications.

Choice E rationale

Recommending the client’s partner receive treatment is important in cases of sexually transmitted infections to prevent reinfection. However, this choice does not directly address the client’s immediate need for treatment.

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Correct Answer is C

Explanation

Choice A rationale

A negative rubella titer indicates that the client does not have immunity to the rubella virus. Therefore, the statement that the client is immune to the rubella virus is incorrect.

Choice B rationale

While it is true that a person with a negative rubella titer needs a rubella vaccination, it is not recommended to administer the vaccine immediately during pregnancy due to the potential risks to the fetus. Therefore, this statement is not correct in this context.

Choice C rationale

The correct interpretation of a negative rubella titer in an antepartum client is that the client should receive a rubella immunization post-delivery. This is because rubella can cause serious complications if contracted during pregnancy, including congenital rubella syndrome in the newborn. Vaccination post-delivery will protect the client in future pregnancies.

Choice D rationale

A negative rubella titer does not provide information about whether the client is currently infected with the rubella virus. It only indicates that the client does not have immunity to the virus. Therefore, this statement is not a correct interpretation of the data.

A. A client who is at 38 weeks of gestation and reports a cough and fever. B. A client who is at 14 weeks of gestation and reports nausea and vomiting. C. A client who is at 28 weeks of gestation and reports painless vaginal bleeding. D. A client who has missed a period and reports vaginal spotting.

Correct Answer is C

Explanation

Choice A rationale

A cough and fever in a client at 38 weeks of gestation could indicate an infection, which should be addressed promptly. However, it is not as immediately life-threatening as painless vaginal bleeding at 28 weeks of gestation, which could indicate a serious complication such as placental abruption.

Choice B rationale

Nausea and vomiting at 14 weeks of gestation are common symptoms of early pregnancy and, while uncomfortable, are not usually a sign of a serious problem. This client should be seen, but not before a client with a potentially life-threatening condition like painless vaginal bleeding.

Choice C rationale

Painless vaginal bleeding at 28 weeks of gestation is a serious symptom that could indicate placental abruption, a condition where the placenta detaches from the uterus, which can be life-threatening for both the mother and the baby. This client should be seen first.

Choice D rationale

Vaginal spotting in a client who has missed a period could indicate early pregnancy or a number of other conditions. While this client should be seen to confirm the cause of the spotting, it is not as immediately urgent as painless vaginal bleeding at 28 weeks of gestation.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is attending to an antepartum client whose lab results show a negative rubella titer.What is the correct interpretation of this data?

Correct Answer is C

Explanation

A nurse in an antepartum unit is triaging clients.Which of the following clients should the nurse see first?

Correct Answer is C

Explanation

A nurse is caring for a client during the first trimester of pregnancy.After reviewing the client’s blood work, the nurse notices she does not have immunity to rubella.When is the recommended time for rubella immunization?

A nurse in a prenatal clinic overhears a newly licensed nurse discussing conception with a client.Which of the following statements by the newly licensed nurse requires intervention by the nurse?

A nurse is teaching about fetal development to a group of clients in the antenatal clinic. Which of the following statements should the nurse include in the teaching?

A nurse is attending to a client.The nurse notes the following vital signs: Heart rate 88/min, Temperature 38.2 C (100.9" F), Respiratory rate 20/min, Blood pressure 122/58 mm Hg. Based on the client’s medical record, what provider prescription should the nurse anticipate?

A nurse is formulating a care plan for a patient who is 10 weeks pregnant and reports abdominal pain and moderate vaginal bleeding.The preliminary diagnosis is an inevitable abortion.Which nursing interventions should be included in the care plan?