What diagnosis best fits this description of her examination?

A 42-year-old realtor comes to your clinic, complaining of “growths” in her vulvar area. She is currently undergoing a divorce and is convinced she has a sexually transmitted disease. She denies any vaginal discharge or pain with urination. She has had no fever, malaise, or night sweats. Her past medical history consists of depression and hypothyroidism. She has had two spontaneous vaginal deliveries and one cesarean section. She has had no other surgeries. She denies smoking or drug use. She has two to three drinks weekly. Her mother also has hypothyroidism and her father has high blood pressure and hypercholesterolemia. On examination you see a woman who is anxious but appears otherwise healthy. Her blood pressure, pulse, and temperature are unremarkable. On visualization of the perineum you see two 2- to 3-mm, round, yellow nodules on the left labia. On palpation they are nontender and quite firm.

A) Genital herpes
B) Condylomata acuminata
C) Syphilitic chancre
D) Epidermoid cyst


D) Epidermoid cyst

These cysts are small, firm, round cystic nodules in the labia that are nonpainful. These do not represent a sexually transmitted infection, but rather a blocked sebaceous gland.

Nursing

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A nurse is reviewing the stress response. What does she identify as the most important neurotransmitter involved?

1. GABA 2. Serotonin 3. Dopamine 4. Norepinephrine

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Why is it important to record a complete family history during the assessment of a client's health history?

A) Because allergy to iodine is inherited B) Because endocrine disorders are inherited C) Because it helps determine the client's general status D) Because diet and drug histories are related to the family history

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Which are important considerations when spinal anesthesia is being administered? (Select all that apply.)

a. Encouraging the patient to remain supine after the procedure b. Having epinephrine available in case of adverse effects c. Injecting a local anesthetic into the sacral region d. Placing the agent into the spinal column outside the dura mater e. Using an anesthetic solution from a sin-gle-dose vial

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When a client is admitted to the emergency department with a gunshot wound to the abdomen and is experiencing severe blood loss, the nurse anticipates the initial use of

a. dextran. b. normal saline. c. packed red blood cells. d. whole blood.

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