Nokea
The nurse is providing care to a 35-year-old female patient who complains of low back pain, pain with defecation, pelvic pressure, and premenstrual spotting. The health care provider has prescribed the hormonal therapy Lupron for this condition. What is the goal of this prescription?
- A. To prevent pregnancy at this time to promote healing
- B. To suppress menstruation and further growth of the tissue
- C. To prevent retrograde menstruation outside the uterine cavity
- D. To increase blood flow to decrease the endometrial lining
Correct Answer: B
Rationale: The goal of prescribing Lupron for this patient is to suppress menstruation and further growth of the tissue. Lupron is a hormonal therapy that works by suppressing the production of certain hormones that stimulate the growth of endometrial tissue. In conditions like endometriosis, where the endometrial tissue grows outside the uterus, suppressing menstruation can help alleviate symptoms such as pelvic pain, back pain, and pelvic pressure. By halting the growth of the tissue, Lupron can help manage the symptoms associated with endometriosis and improve the patient's quality of life.
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When reviewing a new patient’s birth plan, the nurse notices that the patient will be bringing a doula to the hospital during labor. What does the nurse think that this means?
- A. The patient will have her grandmother as a support person.
- B. The patient will bring a paid, trained labor support person with her during labor.
- C. The patient will have a special video she will play during labor to assist with relaxation.
- D. The patient will have a bag that contains all the approved equipment that may help with the labor process.
Correct Answer: B
Rationale: A doula is a trained labor support person who provides physical, emotional, and informational support to the mother before, during, and after childbirth. They are not typically a family member like a grandmother (option A) and do not involve playing a special video (option C) or bringing a bag of equipment (option D). The presence of a doula can help improve birth outcomes, provide continuous support, and enhance the birthing experience for the mother.
What medication would the nurse include when teaching a patient about aromatase inhibitors?
- A. anastrozole (Arimidex)
- B. fulvestrant (Faslodex)
- C. tamoxifen (Novaldex)
- D. pembrolizumab (Keytruda)
Correct Answer: A
Rationale: Aromatase inhibitors, such as anastrozole (Arimidex), are commonly used in hormone receptor-positive breast cancer treatment. They work by blocking the enzyme aromatase, which helps in the production of estrogen in postmenopausal women. By reducing estrogen levels, aromatase inhibitors help in slowing down or stopping the growth of hormone receptor-positive breast cancer cells. Therefore, when teaching a patient about aromatase inhibitors, the nurse would include information about anastrozole as it is a pertinent medication in the management of hormone receptor-positive breast cancer. Fulvestrant, tamoxifen, and pembrolizumab are not aromatase inhibitors; they work through different mechanisms in breast cancer treatment.
A nurse is admitting a patient to the labor and birth unit in early labor that was sent to the facility following a checkup with her health care provider in the office. The patient is a gravida 1, para 0, and is at term. No health issues are discerned from the initial assessment, and the nurse prepares to initiate physician orders based on standard procedures. Which action by the nurse manager is warranted in this situation?
- A. No action is indicated because the nurse is acting within the scope of practice.
- B. The nurse manager should intervene and ask the nurse to clarify admission orders directly with the physician.
- C. The nurse manager should review standard procedures with the nurse to validate that orders are being carried out accurately.
- D. The nurse manger should review the admission procedure with the nurse.
Correct Answer: B
Rationale: In this scenario, the nurse is admitting a patient based on orders initiated by the physician during an office visit. Given that the patient is in early labor and has no discernible health issues, the nurse manager should intervene and ask the nurse to clarify the admission orders directly with the physician. It is important to ensure clarity and accuracy when carrying out physician orders, especially in situations where there may be ambiguity or room for misinterpretation. By verifying the orders with the physician, the nurse can help prevent any potential errors or miscommunications that may impact the patient's care.
In some Middle Eastern and African cultures, female genital mutilation (female cutting) is a prerequisite for marriage. Women who now live in North America need care from nurses who are knowledgeable about the procedure and comfortable with the abnormal appearance of their genitalia. When caring for this patient, the nurse can formulate a diagnosis with the understanding that the patient may be at risk for which of the following? (Select all that apply.)
- A. Infection
- B. Laceration
- C. Hemorrhage
- D. Obstructed labor
Correct Answer: A
Rationale: Female genital mutilation (FGM) can lead to various short-term and long-term complications, putting the woman at risk for infection (such as urinary tract infections and pelvic infections due to poor healing and scar tissue), hemorrhage (excessive bleeding during or after the procedure or in subsequent sexual encounters), and obstructed labor (due to scarring and narrowing of the birth canal, which can lead to prolonged labor, tears, and even fistula formation). These risks highlight the importance of providing appropriate care, support, and education for women who have undergone FGM.
Which issue is a major concern among members of lower socioeconomic groups?
- A. Practicing preventive health care
- B. Meeting health needs as they occur
- C. Maintaining an optimistic view of life
- D. Maintaining group health insurance for their families
Correct Answer: B
Rationale: Members of lower socioeconomic groups often struggle to access and afford healthcare services. Unlike those in higher socioeconomic classes who can afford preventive care, individuals in lower socioeconomic groups typically wait to seek medical care until they have significant health issues or emergencies. Factors such as cost barriers, lack of health insurance, transportation issues, and limited access to healthcare facilities contribute to this problem. As a result, the major concern among individuals in lower socioeconomic groups is the ability to meet their health needs as they occur rather than focusing on preventive healthcare practices. This issue can lead to poorer health outcomes and increased healthcare costs in the long run.