Nokea
A 23 y.o. woman is seen at an outpatient clinic for a routine Pap smear. When questioned, she states she is deciding whether to engage in sexual activity with a man she is just getting to know. She asks how she can tell if he has an STD. Which response by the nurse is best?
- A. "If the man appears clean and has been conscientious about using condoms, he is likely infection free."
- B. "Look carefully for signs of lesions before engaging in sexual activity."
- C. "Be sure to use either a male or female condom to protect against possible transmission of infection."
- D. "An examination by a physician with diagnostic testing is the only way to know if he is infection free."
Correct Answer: D
Rationale: The best response by the nurse is to recommend an examination by a physician with diagnostic testing as the only way to know if the potential partner is infection free. Simply relying on the appearance of cleanliness or condom use may not be sufficient to determine the presence of sexually transmitted infections (STIs) such as HPV, chlamydia, or herpes, which may not have visible symptoms. Encouraging regular testing and open communication about sexual health with partners is crucial in preventing the spread of STIs.
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Which of the ff is a reason for providing early discharge instructions and making arrangements for home care for clients undergoing mastectomy?
- A. The adverse effect of mastectomy are immediate
- B. The wound of the surgery is highly contagious and the client should exercise isolation precautions immediately after the procedure
- C. Most clients are not hospitalized long after a mastectomy
- D. The suicidal tendencies in the women undergoing a mastectomy are high
Correct Answer: C
Rationale: Most clients are not hospitalized long after a mastectomy. This is a key reason for providing early discharge instructions and making arrangements for home care for clients undergoing mastectomy. Typically, clients undergoing mastectomy have shorter hospital stays, often as part of the trend toward faster postoperative recovery and reduced healthcare costs. By ensuring that clients have appropriate home care arrangements and understand postoperative instructions early on, healthcare providers can support a smooth transition from the hospital to the home environment, promoting optimal recovery and outcomes for the client.
While caring for a patient who is hospitalized for acute gastroenteritis and dehydration, the pediatric nurse notes that the patient's parent keeps packets of herbs by the patient's bedside. Suspecting that the parent may be administering the herbs to the patient, the nurse's first action is to:
- A. ask the parent in a nonjudgmental manner about the herbs.
- B. coordinate a nursing care conference to discuss the patient's plan of care.
- C. discuss the risks of using alternative therapies with the parent.
- D. refer the family to a social worker for possible nonadherence with the healthcare regimen.
Correct Answer: A
Rationale: A nonjudgmental approach encourages open communication and allows the nurse to assess the situation appropriately.
The majority of lumbar disc herniations occur at the level of:
- A. L1 - L2
- B. L4-L5
- C. L3-L4
- D. S1-S2
Correct Answer: B
Rationale: The majority of lumbar disc herniations occur at the level of L4-L5. This is because the L4-L5 disc segment bears the highest amount of stress and load in the lumbar spine due to its location and mechanics. The intervertebral disc between the fourth (L4) and fifth (L5) lumbar vertebrae is subject to repetitive movements and mechanical stress, making it more susceptible to herniation compared to other levels in the lumbar spine. Additionally, the anatomy of the L4-L5 disc makes it more prone to degeneration and herniation, leading to a higher prevalence of herniated discs at this level.
A 2-year-old child is being evaluated for a right flank mass; radiological appearance is consistent with rupture of Wilms tumor. The BEST therapeutic approach for this child is
- A. radiotherapy
- B. concomitant chemotherapy-radiotherapy
- C. another surgery
- D. observation
Correct Answer: B
Rationale: Concomitant chemotherapy and radiotherapy are essential to manage ruptured Wilms tumor and reduce the risk of dissemination.
A 2-year-old child is being evaluated for a right flank mass; radiological appearance is consistent with rupture of Wilms tumor. The BEST therapeutic approach for this child is
- A. radiotherapy
- B. concomitant chemotherapy-radiotherapy
- C. another surgery
- D. observation
Correct Answer: B
Rationale: Concomitant chemotherapy and radiotherapy are essential to manage ruptured Wilms tumor and reduce the risk of dissemination.