NCLEX : Causes and Treatments of OB/GYN Conditions

Study concepts, example questions & explanations for NCLEX

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Example Questions

Example Question #1043 : Nclex

A nurse working in labor and delivery is caring for a client that has been diagnosed with an incompetent cervix. The client has been informed by the physician she is now at risk for a spontaneous abortion. The client asks the nurse about possible interventions. 

The nurse is aware the procedure performed for an incompetent cervix is called __________.

Possible Answers:

colporrhaphy

McReynold's procedure

dilation and curettage

a Shirodkar procedure

tubal ligation

Correct answer:

a Shirodkar procedure

Explanation:

A Shirodkar procedure involves sewing a suture in and around the cervix to hold it closed. This is usually performed within the first trimester and later removed when the risk of miscarriage has lessened. 

Example Question #1044 : Nclex

A pregnant woman at 43 weeks gestation is having labor augmented with oxytocin infusion. Which of the following best categorizes this particular drug?

Possible Answers:

Erythropoietin

Anti-diuretic hormone

Prolactin

Thyroid-stimulating hormone

Growth hormone

Correct answer:

Anti-diuretic hormone

Explanation:

Oxytocin is often used to help augment labor by inducing contractions. This hormone is naturally made in the body and works as an anti-diuretic hormone (thus promotes the excretion of water). In labor, this hormone also works to stimulate uterine contractiity.

Example Question #241 : Conditions And Treatments

You are the nurse taking care of a 76-year old female who complains of vaginal dryness that is occasionally painful during intercourse. She is diagnosed with vulvovaginal atrophy. Which of the following is the best initial treatment?

Possible Answers:

Systemic estrogen

Oxybutinin

Propranolol

Topical estrogen

Diphenhydramine

Correct answer:

Topical estrogen

Explanation:

The correct answer is "Topical estrogen." 

In a patient with atrophic vulvovaginitis, a condition that causes thinning of the vaginal and vulvar tissue, resulting in inflammation, diminished lubrication, and subsequent pain, the best initial treatment option if the condition is distressing to the patient is application of topical estrogen. Atrophic vulvovaginitis is a common condition in post-menopausal women as the level of circulating estrogen decreases, and therefore estrogen-mediated effects on female tissues are diminished. With the significant decrease in estrogen to the vagina and vulva, inflammatory and painful symptoms may occur, as in this patient. By applying a topical estrogen cream to the affected tissues, this allows the patient to supplement the estrogen that was lost following menopause, while not exposing the patient to the potentially negative effects (e.g. cardiovascular) of systemic estrogen supplementation.

Propranolol is a beta-adrenergic antagonist and has no role in the treatment of atrophic vulvovaginitis. 

Oxybutinin is an anti-cholinergic medication that is used to treat spastic bladder, among other conditions. It has no role in the treatment of atrophic vulvovaginitis. 

Diphenhydramine is an anti-histamine medication that has a wide variety of uses, but none known to treat atrophic vulvovaginitis.

Example Question #1045 : Nclex

You are the nurse taking care of a 28-year old G3P2 who is at 33 weeks gestation. She goes into labor, and the physician orders administration of a tocolytic medication. Which of the following medications is a tocolytic?

Possible Answers:

Furosemide

Terbutaline

Sertraline

Lisinopril

Terbinafine

Correct answer:

Terbutaline

Explanation:

The correct answer is "Terbutaline." This is the correct answer, as terbutaline, a beta-2-adrenergic agonist, is the only medication listed that has tocolytic, or labor-repressing (anti-contraction) properties. It is one of the most common medications used for tocolysis in pregnant women. Another commonly used tocolytic agent is nifedipine, a calcium-channel blocker.

The other choices are incorrect. Lisinopril is an angiotensin-converting enzyme inhibitor (ACE-I) that is commonly used to treat hypertension, among other conditions. It has no reported use as a tocolytic. Furosemide is a loop diuretic that is commonly used in the treatment of hypertension. It has no reported tocolytic properties. Sertraline is a selective serotonin reuptake inhibitor medication used to treat a number of conditions including major depressive disorder and generalized anxiety disorder, among others. Terbinafine is an allylamine anti-fungal medication used to treat conditions such as tinea corporis or tinea cruris. 

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