Sexuality and Reproduction

The patient with human immunodeficiency virus (HIV) presents with a disseminated rash. The nurse notes purple papules over the trunk, arms, and on mucous membranes. Some are scabbed. The patient’s CD4 count is 64. Although highly active antiretroviral therapy (HAART) has been prescribed, the patient reports being noncompliant because of intolerable side effects. The nurse suspects which infection is most responsible for this new rash? 

The 28-year-old G2P1 patient presents after rupture of membranes 2 hours ago at 39 weeks gestation. She has a history of prior cesarean section for failure to progress but is otherwise healthy; this pregnancy is uncomplicated. Contractions are painful and labor is progressing. Abruptly, the patient complains of extreme abdominal pain; the nurse observes a significant amount of blood coming from her vagina. Which action is most important? 

The 28-year-old G2P1 patient presents after rupture of membranes 2 hours ago at 39 weeks gestation. She has a history of prior cesarean section for failure to progress but is otherwise healthy; this pregnancy is uncomplicated. Contractions are painful and labor is progressing. Abruptly, the patient complains of extreme abdominal pain; the nurse observes a small amount of blood coming from her vagina. Which assessment prompts the nurse to prepare the patient for an emergency cesarean section? 

The 59-year-old female reports vaginal bleeding. She experienced menarche at 12 years of age and menopause at 56. Endometrial carcinoma is found with endometrial biopsy. Further testing reveals no lymph node involvement or metastasis. The nurse prepares the patient for which initial therapy?  

The 24-year-old patient presents with flu-like symptoms and a diffuse maculopapular rash across her chest, trunk, and palms of the hands. Upon palpation, cervical lymph nodes are enlarged. The patient uses intravenous drugs and reports having unprotected sex. The patient’s labs are notable for negative HIV test, positive human chorionic gonadotropin test, and positive rapid plasma reagin test. The patient reports a history of anaphylaxis with penicillin administration. The nurse educates the patient about which treatment? 

The 49-year-old patient presented with a breast lump found during her monthly breast self-exam. This is confirmed on mammogram; the lump was biopsied and found to be an adenocarcinoma that is HER2/neu negative. The patient requests that interventions conserve as much of her breast tissue as possible. The nurse prepares the patient for which next step in management?  

The patient who has a positive human chorionic gonadotropin test tells the nurse, “I don’t understand how this happened! I take my combined hormonal contraceptive (CHC) pill every single day at the exact same time!” The nurse asks the patient which question(s)? Select all that apply.

The neonate is found to have a hemoglobin of 26 g/dL on the first day of life. Which additional findings does the nurse anticipate in this patient? Select all that apply.