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

Estrogen is a hormone that plays a crucial role in the menstrual cycle and pregnancy. However, it is not the primary hormone that triggers ovulation.

Choice B rationale

Progesterone is a hormone that prepares the uterus for pregnancy after ovulation. It does not trigger ovulation.

Choice C rationale

Luteinizing Hormone (LH) is the hormone that triggers ovulation. A surge in LH levels causes the mature follicle in the ovary to burst and release an egg.

Choice D rationale

Prostaglandins are hormone-like substances involved in pain and inflammation. They do not trigger ovulation.

A. A 38-year-old client who reports smoking one pack of cigarettes every day. B. A 28-year-old client who has a history of pelvic inflammatory disease. C. A 32-year-old client who has benign breast disease. D. A 26-year-old client who has migraine headaches at the start of each menstrual cycle.

Correct Answer is A

Explanation

Choice A rationale

A 38-year-old client who reports smoking one pack of cigarettes every day. Oral contraceptives are contraindicated in women who are over 35 years old and smoke. This is because the combination of oral contraceptives and smoking increases the risk of serious cardiovascular side effects, such as blood clots, stroke, or heart attack. These risks are even higher in women over 35 years old who smoke. Therefore, this client should not receive oral contraceptives due to the increased risk of these serious side effects.

Choice B rationale

A 28-year-old client who has a history of pelvic inflammatory disease. While pelvic inflammatory disease (PID) can lead to complications such as infertility and ectopic pregnancy, it is not a contraindication for the use of oral contraceptives. In fact, oral contraceptives can provide some protection against PID by causing changes in the cervix that make it more resistant to infection.

Choice C rationale

A 32-year-old client who has benign breast disease. Benign breast disease is not a contraindication for the use of oral contraceptives. While some studies have suggested a slightly increased risk of breast cancer in women who have used oral contraceptives, the risk appears to decrease over time once the contraceptives are stopped.

Choice D rationale

A 26-year-old client who has migraine headaches at the start of each menstrual cycle. While migraines can be a contraindication for the use of oral contraceptives, it generally applies to migraines with aura. Women who have migraines with aura have an increased risk of stroke when using oral contraceptives. However, for women who have migraines without aura, the benefits of using oral contraceptives usually outweigh the risks.

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Naxlex Comprehensive Predictor Exams

When educating a teenager about ovulation, the nurse would include that ovulation is triggered by a surge in which hormone?

Correct Answer is C

Explanation

A nurse is reviewing contraception options for four clients.Which client has a contraindication for receiving oral contraceptives?

Correct Answer is A

Explanation

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