A nurse practitioner is examining a patient who presented at the free clinic with vulvar pruritus. For which assessment finding would the practitioner look that may indicate the patient has an infection caused by Candida albicans?

Correct Answer: A

Rationale: The correct answer is A: Cottage cheese-like discharge. Candida albicans is a common cause of vulvovaginal candidiasis, characterized by itching and cottage cheese-like discharge. This type of discharge is specific to a yeast infection. Yellow-green discharge (choice B) is indicative of trichomoniasis, gray-white discharge (choice C) is seen in bacterial vaginosis, and watery discharge with a fishy odor (choice D) is characteristic of bacterial vaginosis or trichomoniasis. Therefore, the presence of cottage cheese-like discharge is a key indicator of a Candida albicans infection.

Correct Answer: B

Rationale: The correct answer is B: Refer the woman to her primary care provider to have the medication changed. Rationale: 1. Rash after taking the first dose of an antibiotic suggests a possible allergic reaction. 2. Allergic reactions can range from mild to severe, including anaphylaxis. 3. It is crucial to discontinue the suspected medication to prevent worsening of the reaction. 4. Referring the patient to their primary care provider ensures proper evaluation and management. 5. Changing the medication is necessary to avoid potential harm from continued exposure. Summary: A: Continuing the medication can worsen the allergic reaction and is not recommended. C: Going to the emergency department may be excessive at this point for a mild rash. D: Taking an antihistamine does not address the underlying issue of an allergic reaction.

Correct Answer: A

Rationale: The correct answer is A: Ineffective Airway Clearance. In a patient with AIDS and PCP, maintaining clear airways is crucial to prevent respiratory distress and hypoxia. Pneumocystis pneumonia can cause thick secretions and mucus plugging, leading to difficulty breathing. Ensuring effective airway clearance is a priority to optimize oxygenation and prevent respiratory complications. Impaired oral mucous membranes (B) and imbalanced nutrition (C) are important considerations but not as immediate as airway clearance. Activity intolerance (D) may be a concern for the patient but ensuring adequate oxygenation takes precedence.

Correct Answer: A

Rationale: The correct answer is A: Maintaining a closed urinary drainage system. This action prevents infection by reducing exposure to external pathogens. Step 1: A closed system minimizes the risk of contamination. Step 2: It prevents entry of bacteria into the urinary tract. Step 3: Regularly emptying the drainage bag helps maintain a closed system. Step 4: This action promotes patient safety and reduces infection risk. Summary: Choice B (strict clean technique) may reduce infection risk during catheter insertion but does not prevent infections post-insertion. Choice C (replacing drainage bag once per shift) increases infection risk due to frequent disconnection. Choice D (fully inflating catheter balloon) is unrelated to infection prevention.

Correct Answer: D

Rationale: The correct answer is D: Surgery. Surgery is the most effective treatment modality for severe Peyronie's disease as it can correct the penile curvature and alleviate pain. Physical therapy (A) may not be effective in severe cases. PDE-5 inhibitors (B) are used for erectile dysfunction but do not treat the underlying Peyronie's disease. Intracapsular hydrocortisone injections (C) may be used for less severe cases, but in severe cases, surgery is recommended for optimal outcomes.

Correct Answer: C

Rationale: The correct answer is C because it emphasizes cultural competence and respect for the patient's background. By including racial and ethnic practices with food preferences of the patient, the nurse can provide tailored and relevant nutrition education. This approach promotes inclusivity and acknowledges the importance of cultural traditions in dietary habits. Choices A and B are incorrect as they disregard the patient's cultural background and may lead to cultural insensitivity. Choice D is also incorrect as it focuses on comparison rather than understanding and incorporating the patient's unique cultural context. Overall, choice C aligns with patient-centered care and facilitates effective communication and trust between the nurse and the patient.

Correct Answer: B

Rationale: The correct answer is B: Administration of methotrexate. This is the priority intervention for an intact tubal pregnancy to prevent further growth and potential rupture of the fallopian tube. Methotrexate is a medication used to stop the growth of the pregnancy tissue. Assessment of pain level (A) is important but not the priority as immediate intervention to address the ectopic pregnancy is crucial. Administration of Rh immune globulin (C) is not the priority in this situation, as it is typically given after a miscarriage or abortion to prevent Rh sensitization. Explanation of common side effects (D) is important for patient education, but it is not the immediate priority when dealing with an ectopic pregnancy.

Correct Answer: A

Rationale: The correct answer is A: immediate birth is required. The Kleihauer–Betke test is used to detect fetal-maternal hemorrhage in situations where there is a risk of fetal blood entering the maternal circulation, such as trauma during pregnancy. A positive result indicates a significant fetal-maternal hemorrhage, which can lead to Rh incompatibility and severe fetal anemia. Immediate birth is required to prevent complications and ensure the safety of both the mother and the baby. Choice B is incorrect as transferring the patient to the critical care unit does not address the underlying issue of fetal-maternal hemorrhage. Choice C is incorrect as RhoGAM is typically administered to prevent Rh sensitization in Rh-negative mothers carrying Rh-positive babies, which is not the primary concern in this scenario. Choice D is incorrect as a tetanus shot is not directly related to the positive Kleihauer–Betke test result indicating fetal-maternal hemorrhage.

Correct Answer: A

Rationale: The correct answer is A because babies can become infected with the herpes virus if delivered vaginally. During childbirth, the virus can be passed to the infant, leading to serious health complications. This information is crucial for the patient to understand in order to make informed decisions about delivery options. Choice B is incorrect because excision of herpes lesions is not the recommended treatment during pregnancy. Treatment typically involves antiviral medications to manage symptoms and reduce the risk of transmission to the baby. Choice C is incorrect because herpes outbreaks can indeed be painful during pregnancy due to hormonal changes and a weakened immune system. Pain management strategies should be discussed as part of the teaching plan. Choice D is incorrect because pregnancy can pose a risk to the infant if the mother has active herpes. It is important to manage the condition appropriately to prevent transmission to the baby.