Correct Answer: A

Rationale: The correct answer is A: Advise the patient that this is an overgrowth of normal vaginal flora. This is correct because Gardnerella vaginalis is a bacteria associated with bacterial vaginosis, which is an overgrowth of normal vaginal flora. By advising the patient of this, the nurse practitioner can provide education on the condition and treatment options. B: Discussing the effect of this diagnosis on the patient's fertility is incorrect as Gardnerella vaginalis is not typically associated with fertility issues. C: Documenting the vaginal discharge as normal is incorrect as Gardnerella vaginalis is indicative of an abnormal vaginal flora imbalance. D: Administering acyclovir as ordered is incorrect as acyclovir is an antiviral medication used to treat herpes simplex virus infections, not bacterial vaginosis caused by Gardnerella vaginalis.

Correct Answer: C

Rationale: The correct answer is C: Impaired verbal communication. In ALS, motor neurons deteriorate leading to muscle weakness and atrophy, including those involved in speech production. This results in impaired verbal communication. Chronic confusion (A) is not a common manifestation of ALS. Impaired urinary elimination (B) and bowel incontinence (D) are not typically associated with ALS, as it primarily affects motor neurons, not autonomic functions.

Correct Answer: C

Rationale: The correct answer is C: Stop taking aspirin. Aspirin is a blood thinner that can increase the risk of bleeding during and after surgery. By stopping aspirin before surgery, the woman's blood clotting ability will improve, reducing the risk of hemorrhage. A: Limiting intake of green leafy vegetables is not directly related to preventing hemorrhage in the postoperative period. B: Increasing water intake is important for overall health, but it does not specifically address the risk of hemorrhage related to aspirin use. D: Having nothing by mouth for 6 hours before surgery is important for preventing aspiration during anesthesia, but it does not directly address the risk of hemorrhage related to aspirin use.

Correct Answer: A

Rationale: The correct answer is A: Impaired nutritional status. Radiation therapy to the neck can lead to mucositis, dysphagia, and taste changes, which can impair the patient's ability to eat and maintain adequate nutrition. This can lead to weight loss, weakness, and delayed wound healing. Discussing this potential adverse effect with the patient is crucial for proactive management. Choice B: Cognitive changes, and Choice C: Diarrhea are less likely to be direct adverse effects of radiation therapy to the neck. Cognitive changes are more commonly associated with brain radiation, while diarrhea is a more common side effect of abdominal radiation. Choice D: Alopecia is a side effect of chemotherapy, not radiation therapy. Radiation therapy does not typically cause hair loss unless it is in the treatment field. Therefore, discussing alopecia with the patient receiving radiation for a malignant neck tumor is not a priority.

Correct Answer: D

Rationale: The correct answer is D: Use electronic fetal surveillance to determine a baseline fetal heart rate. This is important in assessing the well-being of the fetus during labor, especially in the presence of genital herpes lesions. Monitoring the fetal heart rate helps in detecting any signs of distress or compromise due to maternal infection. A: Asking about the patient's last intake is important but not the immediate priority when managing a patient with active genital herpes lesions in labor. B: Taking a culture of the lesions might be helpful but not the immediate action needed in this situation. C: Asking about unprotected sex is relevant but not as critical as monitoring the fetal well-being during labor in this scenario. Overall, the most critical action is to monitor the fetal heart rate for any signs of distress related to the maternal herpes infection.