Nokea
A 28-year-old primigravida admitted to antepartum unit with a diagnosis of hyperemesis gravidarum. Nursing care is based on which of the following?
- A. Assess for dehydration and starvation
- B. Isolated from family
- C. This condition is caused by psychogenic factor
- D. Similar to morning sickness
Correct Answer: A
Rationale: Rationale for Correct Answer (A): Assessing for dehydration and starvation is crucial in managing hyperemesis gravidarum, as it can lead to serious complications for both the mother and the fetus. Dehydration can result from persistent vomiting and may require intravenous fluids. Starvation can occur due to poor nutrient intake. Monitoring these factors helps in providing appropriate treatment and preventing further health issues.
Summary of Incorrect Choices:
B: Isolating the patient from family is not necessary and can have negative psychological impacts. Support from family is crucial in managing hyperemesis gravidarum.
C: Hyperemesis gravidarum is a physical condition related to pregnancy, not a psychogenic factor.
D: Hyperemesis gravidarum is more severe and persistent than morning sickness, requiring different management strategies.
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The nurse provides education to the person undergoing a surgical abortion. What response by the person shows an understanding of the education?
- A. “It’s good I won’t have any pain after the procedure.â€
- B. “I think I’m sure about my decision.â€
- C. “I should call if I soak a pad in 2 hours.â€
- D. “I should follow up for contraception counseling at my annual exam in 6 months.â€
Correct Answer: C
Rationale: The correct answer is C because soaking a pad in 2 hours could indicate excessive bleeding, a potential complication after a surgical abortion. This response shows understanding of the education provided by the nurse about when to seek immediate medical attention.
Choice A is incorrect because it is not true that there will be no pain after a surgical abortion; pain is a common experience post-procedure. Choice B is incorrect because it does not demonstrate an understanding of the key information provided during education. Choice D is incorrect because contraception counseling should be addressed sooner than 6 months post-abortion to prevent unintended pregnancies.
What must instructions for use of nonoxynol-9 spermicide include?
- A. Nononxynol-9 used with barrier methods increases their efficacy.
- B. When spermicide is used with condoms, it will further decrease the risk of STIs.
- C. Remove excess spermicide from the vagina within 6 hours to reduce vaginal irritation.
- D. Place the spermicide close to the opening of the vagina for maximal effectiveness.
Correct Answer: C
Rationale: The correct answer, C, states that excess spermicide should be removed from the vagina within 6 hours to reduce vaginal irritation. This is important as leaving excess spermicide can lead to discomfort and irritation. It is a crucial instruction to ensure the user's comfort and safety.
Choice A is incorrect as nonoxynol-9 does not necessarily increase efficacy when used with barrier methods.
Choice B is incorrect because while using spermicide with condoms can reduce the risk of STIs, the statement does not specifically address the instructions for use.
Choice D is incorrect as placing the spermicide close to the vagina's opening does not guarantee maximal effectiveness and is not a critical instruction for safe use.
Which herbs would you counsel a lactating client to use to stimulate blood flow to the breast glands, stimulate milk production, and enrich milk flow?
- A. Milk thistle
- B. Cabbage juice
- C. Lanolin
- D. Aloe vera
Correct Answer: B
Rationale: The correct answer is B: Cabbage juice. Cabbage juice contains phytoestrogens that help stimulate blood flow to the breast glands and promote milk production. It is used traditionally to increase milk supply in lactating women. Milk thistle (A) is more commonly used for liver health and not specifically for lactation. Lanolin (C) is a topical ointment for sore nipples, not for milk production. Aloe vera (D) is not recommended for internal use during lactation due to potential laxative effects. In summary, cabbage juice is the best choice as it directly supports milk production and flow in lactating clients.
A patient has just been admitted to labor and delivery. She is having mild contractions lasting 30 seconds every 15 minutes. The patient wants to have a mediation free birth. When discussing medication alternatives, the nurse should be sure the patient understands that:
- A. maternal pain and stress can have a more adverse effect on the fetus than a small amount of analgesia
- B. In order to respect her wishes no pain medication will be given
- C. the use of medication allows the patient to rest and be less fatigued
- D. pain relief will allow a more enjoyable birth experience
Correct Answer: A
Rationale: The correct answer is A because maternal pain and stress can lead to increased levels of stress hormones, which can negatively affect the fetus. By providing a small amount of analgesia, the patient can experience relief from pain and stress without compromising the well-being of the fetus.
Option B is incorrect because it disregards the potential benefits of providing some pain relief to the patient while still respecting her desire for a medication-free birth.
Option C is incorrect because while medication may provide some rest and alleviate fatigue, the primary concern in this scenario is the impact on the fetus rather than the patient's comfort.
Option D is incorrect because the main focus should be on ensuring the safety and well-being of both the mother and the fetus, rather than solely on the mother's enjoyment of the birth experience.
A couple comes in for an infertility workup, having attempted to get pregnant for 2 years. The woman, 37, has always had irregular menstrual cycles but is otherwise healthy. The man has fathered two children from a previous marriage and had a vasectomy reversal 2 years ago. The man has had two normal semen analyses, but the sperm seem to be clumped together. What additional test is needed?
- A. FSH level
- B. Antisperm antibodies
- C. Testicular biopsy
- D. Test of testicular infection
Correct Answer: B
Rationale: The correct answer is B: Antisperm antibodies. In this case, the man's history of vasectomy reversal and normal semen analyses with clumped sperm suggest a possible presence of antisperm antibodies. These antibodies can cause sperm agglutination, affecting fertility. Testing for antisperm antibodies can provide valuable information on potential immune-related infertility issues.
A: FSH level is not the most appropriate test in this scenario as the man's semen analyses were normal, indicating potential issues with sperm-egg interaction rather than hormonal imbalances.
C: Testicular biopsy is invasive and not necessary at this stage when the issue seems to be related to sperm clumping rather than a structural problem within the testes.
D: Test of testicular infection is unlikely as the man's semen analyses were normal, and there are no indications of infection based on the information provided.