Which finding would lead the nurse to suspect toxic shock syndrome related to tampon use?

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Diffuse rash with fever. Toxic shock syndrome (TSS) is a rare but serious condition associated with tampon use. The presence of a diffuse rash, especially on the palms and soles, along with a high fever, is a classic sign of TSS. This combination of symptoms should immediately raise suspicion for TSS in a patient using tampons. Option B) Angina is not typically associated with TSS. Angina is chest pain or discomfort caused by reduced blood flow to the heart muscle, usually due to coronary artery disease. Option C) Hypertension is not a typical finding in TSS. TSS is more commonly associated with hypotension (low blood pressure) due to the systemic inflammatory response it triggers. Option D) Thrombocytopenia with pallor is not a hallmark sign of TSS. Thrombocytopenia refers to a low platelet count and pallor indicates paleness, neither of which are specific to TSS. Educationally, it is crucial for nurses to recognize the signs and symptoms of TSS related to tampon use as early intervention is vital in managing this life-threatening condition. Understanding these specific manifestations can lead to prompt identification and appropriate treatment, ultimately improving patient outcomes.

Correct Answer: B

Rationale: In a woman diagnosed with primary syphilis, the nurse would expect to see a pain-free lesion, which is the correct answer (B). This lesion, known as a chancre, is typically firm, round, and painless. It is usually located at the site of infection, often on the genitals or mouth. Option A, a cluster of vesicles, is more indicative of conditions like herpes simplex virus, not syphilis. Option C, a macular rash, is more commonly associated with secondary syphilis, not the primary stage. Option D, foul-smelling discharge, is not a typical finding in primary syphilis. Educationally, understanding the physical findings associated with primary syphilis is crucial for nurses to provide appropriate care and education to patients. Recognizing the characteristic painless lesion can prompt timely diagnosis and treatment, preventing the progression of the disease to more severe stages. Nurses play a vital role in educating individuals about sexually transmitted infections, including syphilis, to promote prevention and early intervention.

Correct Answer: C

Rationale: The correct answer is option C: "Since my partner and I are both HIV positive, we use a condom." Explanation: Option C demonstrates an understanding of HIV transmission prevention. In cases where both partners are HIV positive, consistent condom use is still crucial to prevent reinfection with different strains of the virus and to reduce the risk of other sexually transmitted infections. This approach aligns with current guidelines to promote safer sexual practices and protect individuals' health. Why the other options are incorrect: A) Option A is incorrect because with appropriate medical care, including antiretroviral therapy during pregnancy and delivery, the risk of mother-to-child transmission can be significantly reduced to as low as 1% or less. B) Option B is incorrect because checking viral load and antibody levels every day is unnecessary and not a standard recommendation. Regular monitoring as per healthcare provider's guidance is important, but daily monitoring is not practical or indicated. D) Option D is incorrect because while oral sex carries a lower risk of HIV transmission compared to unprotected vaginal or anal sex, there is still a risk involved. Using condoms consistently and correctly is recommended for all types of sexual activity. Educational context: Understanding the nuances of HIV care and prevention is crucial in maternal newborn nursing. Educating individuals about safe sexual practices, adherence to antiretroviral therapy, and regular medical monitoring are essential components of care for women living with HIV during pregnancy and beyond. Promoting accurate information and dispelling myths about HIV transmission are key aspects of providing comprehensive care to this population.

Correct Answer: C

Rationale: In counseling about Gardasil, the correct answer is C) The most common side effect from the vaccine is pain at the injection site. This information is crucial to prepare individuals for a common, expected reaction to the vaccine. Understanding this common side effect can alleviate fears and misconceptions about the vaccine's safety and effectiveness. Option A is incorrect because Gardasil is recommended for women regardless of their sexual activity status, as it can still provide protection against HPV strains they may not have been exposed to. Option B is incorrect because Gardasil protects against specific strains of HPV, not all strains. It is important to clarify this to ensure accurate information is provided during counseling. Option D is incorrect because being allergic to eggs is not a contraindication for receiving the Gardasil vaccine. This misconception could prevent individuals from getting vaccinated unnecessarily. In an educational context, it is essential for healthcare professionals to provide accurate and comprehensive information about vaccines to empower individuals to make informed decisions about their health. Counseling on vaccines like Gardasil should include details on common side effects, efficacy, target population, and any contraindications to ensure individuals have a clear understanding of the benefits and risks associated with vaccination.

Correct Answer: B

Rationale: In teaching an uncircumcised male to use a condom, it is crucial to include the instruction to pull back the foreskin before applying the condom. This is the correct answer because failure to retract the foreskin can lead to discomfort, constriction, and possible tearing of the foreskin during intercourse. By pulling back the foreskin, the condom can be properly placed on the penis, ensuring a comfortable fit and effective protection. Option A, applying mineral oil to the shaft of the penis after applying the condom, is incorrect because it is unnecessary and may actually compromise the integrity of the condom, increasing the risk of breakage. Option C, creating a reservoir at the tip of the condom after putting it on, is incorrect because this step is important for circumcised males to allow space for ejaculate, but it is not necessary for uncircumcised males as the foreskin already provides this function. Option D, waiting five minutes after ejaculating before removing the condom, is incorrect as it does not pertain to the correct method of applying a condom for an uncircumcised male. In an educational context, it is important to emphasize the proper technique of using a condom for uncircumcised males to ensure both effective contraception and protection against sexually transmitted infections. Clear and accurate instruction can empower individuals to take control of their sexual health and well-being.