The nurse in the women's health clinic has four patients who are waiting to be seen. Which patient should the nurse see first?
A 42-yr-old patient with secondary amenorrhea who says that her last menstrual cycle was 3 months ago
A 19-yr-old patient with menorrhagia who has been using superabsorbent tampons and has fever with weakness
A 22-yr-old patient with persistent red-brown vaginal drainage 3 days after having balloon thermotherapy
A 35-yr-old patient with heavy spotting after having a progestin-containing IUD (Mirena) inserted a month ago
The Correct Answer is B
Choice A rationale: The 42-yr-old patient with secondary amenorrhea may have menopause, pregnancy, or a hormonal disorder. This is less urgent compared to the 19- year old patient.
Choice B rationale: This patient may have toxic shock syndrome, which is a life- threatening complication of tampon use that can cause organ failure and shock. The nurse should assess the patient's vital signs, remove the tampon, and initiate fluid resuscitation and antibiotic therapy.
Choice C rationale: This patient may have an infection or a complication of the balloon thermotherapy, which is a procedure to destroy the endometrial lining of the uterus and is not an emergency compared to the 19 year old.
Choice D rationale: This patient may have a displacement or perforation of the IUD, which is a contraceptive device that releases progestin into the uterus. However, this is not urgent compared to the 19 year old.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale: Furosemide is a loop diuretic used to increase urine output by blocking the reabsorption of sodium and water. It's not typically associated with hyperkalemia. In fact, it's more common for loop diuretics like furosemide to cause hypokalemia (low potassium) due to increased urinary excretion of potassium.
Choice B rationale: Lovastatin is a statin used to lower cholesterol levels. It is not related to increased cholesterol. Additionally, there is no known direct interaction between lovastatin and furosemide. Furosemide is a diuretic, while selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants, and they do not typically interact in a way that requires discontinuation.
Choice C rationale: Duloxetine is an antidepressant (SNRI), and glipizide is an oral diabetes medication. There's no direct interaction between duloxetine and glipizide that would necessitate discontinuation.
Choice D rationale: Trimethoprim/sulfamethoxazole (Bactrim) is a sulfonamide antibiotic, and glipizide belongs to the sulfonylurea class of medications. Both drugs contain sulfur groups in their chemical structures, and there is a possibility of cross-reactivity or drug interaction. This interaction can potentially reduce the effectiveness of glipizide, leading to compromised blood sugar control. Additionally, sulfonamide antibiotics like trimethoprim/sulfamethoxazole can cause adverse reactions, including skin rashes or hypersensitivity reactions, particularly in individuals sensitive to sulfa medications.
Correct Answer is C
Explanation
Choice A rationale: This is a general description of an imaging test, such as an X-ray, ultrasound, or MRI, which can show the structure of the organs but not the mucosal lining.
Choice B rationale: This is a general description of a blood test, which can show signs of infection, inflammation, or anemia, but not the cause of these problems.
Choice C rationale: This exam is called a colonoscopy, which involves inserting a flexible tube with a camera and light into the anus and advancing it through the colon. A colonoscopy can reveal signs of inflammation, ulcers, bleeding, or narrowing of the intestinal wall that are characteristic of Crohn's disease. A biopsy can also be taken during the procedure to confirm the diagnosis.
Choice D rationale: This is a general description of a urine test, which can show signs of kidney problems, urinary tract infections, or dehydration, but not Crohn's disease.
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