Nokea
The nurse is providing care to the 35-year-old female patient at the family practice clinic who is in the office for her annual physical examination. Which tests should the nurse recommend are the most appropriate for this patient? Select all that apply.
- A. Papanicolaou test every 5 years
- B. Mammogram every 2 years
- C. DEXA screen every 2 years
- D. HPV every 5 years
Correct Answer: A
Rationale: A. Papanicolaou test (Pap smear) every 5 years - This test is recommended for cervical cancer screening in women aged 30-65 years old. It helps in early detection and prevention of cervical cancer.
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Which statement is true regarding the shortage of nurses in the United States?
- A. There are a larger proportion of younger nurses in the workforce as compared with older nurses.
- B. As a result of decreased RN-to-patient ratios, there is a decrease in patient mortality in the clinical setting.
- C. Nursing programs are turning away qualified applicants.
- D. There are adequate classroom and clinical facilities for training RNs.
Correct Answer: C
Rationale: The statement that nursing programs are turning away qualified applicants is true regarding the shortage of nurses in the United States. Despite the growing demand for healthcare services and the critical need for more nurses, nursing schools across the country face challenges in accepting all qualified applicants due to a shortage of nursing faculty, limited clinical space, and budget constraints. This bottleneck in nursing education and training contributes to the shortage of nurses in the workforce. As a result, many potential nursing students who are qualified and interested in pursuing a career in nursing are being turned away from programs, exacerbating the shortage.
Which documentation on a woman's chart on postpartum day 14 indicates a normal involution process?
- A. Moderate bright red lochial flow
- B. Breasts firm and tender
- C. Fundus below the symphysis and nonpalpable
- D. Episiotomy slightly red and puffy
Correct Answer: C
Rationale: By postpartum day 14, the fundus should be below the symphysis and nonpalpable, indicating normal involution.
With regard to an obstetric litigation case, a nurse working in labor and birth is found to be negligent. Which intervention performed by the nurse indicates that a breach of duty has occurred?
- A. The nurse did not document fetal heart tones (FHR) during the second stage of labor.
- B. The patient was only provided ice chips during the labor period, which lasted 8 hours.
- C. The nurse allowed the patient to use the bathroom rather than a bedpan during the first stage of labor.
- D. The nurse asked family members to leave the room when she prepared to do a pelvic exam on the patient.
Correct Answer: A
Rationale: In an obstetric setting, failure to document fetal heart tones (FHR) during the second stage of labor is a critical breach of duty by the nurse. Monitoring FHR is essential to assess fetal well-being and detect any signs of distress or complications during labor. Neglecting to document this important vital sign could result in delayed recognition of fetal distress, potentially leading to adverse outcomes for the baby and the mother. Therefore, this intervention indicates negligence on the part of the nurse in this scenario.
A nurse is conducting an infertility assessment for a newly admitted client. Which of the following factors should the nurse identify as affecting the client's fertility?
- A. Premature ovarian failure
- B. Renal calculi
- C. Dysmenorrhea
- D. Recurrent urinary tract infection
Correct Answer: A
Rationale: Premature ovarian failure leads to decreased estrogen production and lack of ovulation, significantly affecting fertility.
The nurse in labor and birth is caring for a Muslim patient during the active phase of labor. The nurse notes that the patient quickly draws away when touched. Which intervention should the nurse implement?
- A. Ask the charge nurse to reassign you to another patient.
- B. Assume that she does not like you and decrease your time with her.
- C. Continue to touch her as much as you need to while providing care.
- D. Limit touching to a minimum because physical contact may not be acceptable in her culture.
Correct Answer: D
Rationale: The appropriate intervention for the nurse to implement in this situation is to limit touching to a minimum because physical contact may not be acceptable in the patient's culture. In Islam, modesty and privacy are significant aspects of the faith, and physical contact, especially with someone of the opposite gender, may be considered inappropriate or uncomfortable for the patient. Respecting and acknowledging the patient's cultural background and preferences is essential in providing culturally competent care. Therefore, it is important for the nurse to be mindful of the patient's boundaries and minimize any unnecessary physical contact while still providing necessary care and support during labor.