A postmenopausal woman with uterine prolapse is being fitted with a pessary. The nurse would be most alert for which side effect?
Increased vaginal discharge
Urinary tract infection
Vaginitis
Vaginal ulceration
The Correct Answer is D
Choice A reason: Increased vaginal discharge is a normal and expected outcome of using a pessary, as it helps to lubricate and cleanse the vagina.
Choice B reason: Urinary tract infection is not a common side effect of using a pessary, as it does not interfere with urination or introduce bacteria into the urinary tract.
Choice C reason: Vaginitis is not a common side effect of using a pessary, as it does not cause inflammation or infection of the vagina. However, the client should maintain good hygiene and use vaginal cream or gel as prescribed to prevent irritation.
Choice D reason: Vaginal ulceration is a serious and possible side effect of using a pessary, as it can cause pressure necrosis and erosion of the vaginal mucosa. The client should report any bleeding, pain, or foul-smelling discharge to the provider and have the pessary removed and replaced regularly.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A: The social worker is not the correct answer because they are not legally responsible for obtaining informed consent for an invasive procedure. The social worker is a professional who provides psychosocial support and advocacy for clients and families, such as counseling, referrals, or discharge planning.
Choice B: The nurse is not the correct answer because they are not legally responsible for obtaining informed consent for an invasive procedure. The nurse is a professional who provides direct care and education for clients and families, such as assessment, medication administration, or teaching. However, the nurse can assist the physician in obtaining informed consent by witnessing the client's signature, verifying the client's understanding, or documenting the process.
Choice C: The physician is the correct answer because they are legally responsible for obtaining informed consent for an invasive procedure. The physician is a professional who diagnoses and treats clients and families, such as performing surgery, prescribing medication, or ordering tests. The physician must explain the purpose, benefits, risks, alternatives, and consequences of the procedure to the client and obtain their voluntary agreement before proceeding.
Choice D: The unit secretary is not the correct answer because they are not legally responsible for obtaining informed consent for an invasive procedure. The unit secretary is a staff member who performs clerical and administrative tasks for the unit, such as answering phones, filing records, or scheduling appointments.

Correct Answer is B
Explanation
Choice A: Protrusion of the posterior bladder wall downward through the anterior vaginal wall is not the correct answer because it describes a different condition called cystocele. A cystocele occurs when the bladder pushes into the vagina due to weakened pelvic support structures.
Choice B: Bulging of the small intestine through the posterior vaginal wall is the correct answer because it describes an enterocele. Enterocele occurs when the small intestine slides into a pouch between the rectum and vagina due to weakened pelvic support structures.
Choice C: Descent of the uterus through the pelvic floor into the vagina is not the correct answer because it describes a different condition called uterine prolapse. Uterine prolapse occurs when the uterus drops down into or out of the vagina due to weakened pelvic support structures.
Choice D: Sagging of the rectum with the pressure exerted against the posterior vaginal wall is not the correct answer because it describes a different condition called rectocele. Rectocele occurs when the rectum bulges into or out of the vagina due to weakened pelvic support structures.
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