Current Issues in Maternal Newborn Nursing

Current Issues in Maternal Newborn Nursing Related

Review Current Issues in Maternal Newborn Nursing related questions and content

A 32-year-old female patient arrives to the emergency department with heavy uterine bleeding. The nurse finds that the patient had a positive pregnancy test 1 month prior to the visit. What is the potential medical management for this patient's issue?

  • A. Endometrial biopsy
  • B. Dilation and curettage
  • C. Colposcopy
  • D. Laparoscopy
Correct Answer: B

Rationale: The correct answer is B: Dilation and curettage. This procedure is indicated for heavy uterine bleeding in the setting of a positive pregnancy test to diagnose and treat conditions such as incomplete miscarriage or ectopic pregnancy. Dilation and curettage involves dilating the cervix and scraping the uterine lining to remove any remaining products of conception. It is important in this case to rule out any potential sources of bleeding that could be life-threatening.

A: Endometrial biopsy is not the appropriate initial management in this scenario as it is primarily used to assess endometrial pathology such as cancer.
C: Colposcopy is a procedure used to examine the cervix and vagina for abnormalities, not typically indicated for heavy uterine bleeding in the setting of a positive pregnancy test.
D: Laparoscopy is a minimally invasive surgical procedure used to view the abdominal organs, not typically indicated for uterine bleeding related to a positive pregnancy test.

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A nurse is caring for a client who is pregnant for the fourth time. The client delivered two full-term newborns and had one spontaneous abortion at 10 weeks of gestation. The nurse should document the client's obstetrical history as which of the following?

  • A. Gravida 3, Para 2
  • B. Gravida 3, Para 3
  • C. Gravida 4, Para 2
  • D. Gravida 4, Para 3
Correct Answer: C

Rationale: Gravida refers to total pregnancies (4), and Para refers to births after 20 weeks (2 full-term deliveries). The spontaneous abortion does not count in para.

Which condition is inappropriate to treat with exogenous progesterone?

  • A. Thyroid dysfunction
  • B. Recent miscarriage
  • C. PCOD
  • D. Oocyte retrieval
Correct Answer: A

Rationale: Thyroid dysfunction is treated with Synthroid for anovulation, not with progesterone.

Which actions by the nurse indicate compliance with the Health Insurance Portability and Accountability Act (HIPAA)? (Select all that apply.)

  • A. The nurse posts an update about a patient on Facebook.
  • B. The nurse gives the report to the oncoming nurse in a private area.
  • C. The nurse gives information about the patient’s status over the phone to the patient’s friend.
  • D. The nurse logs off any computer screen showing patient data before leaving the computer unattended.
Correct Answer: B

Rationale: The correct answer is B because giving the report to the oncoming nurse in a private area ensures patient information is shared securely, maintaining patient confidentiality as required by HIPAA. Posting patient updates on social media (A) violates patient privacy. Sharing patient information with a friend (C) breaches confidentiality. Leaving computer screens unattended with patient data visible (D) risks unauthorized access. B is the only choice that aligns with HIPAA regulations by prioritizing patient privacy and security.

Which contraceptive method best protects against STIs and the HIV?

  • A. Periodic abstinence
  • B. Barrier methods
  • C. Hormonal methods
  • D. Same protection with all methods
Correct Answer: B

Rationale: Barrier methods, such as condoms, protect against STIs and HIV the best of all contraceptive methods. Periodic abstinence and hormonal methods do not offer protection against STIs or HIV.

The nurse is assessing a 25-year-old female patient when the patient becomes tearful. The patient states that she has thin milky discharge from her nipples and two small masses on her left breast. She has lost over 40 pounds in the past year due to intensive exercises and finds that she needs to wear a sports bra during her sessions. The patient states that she is afraid that she will become the first member of her family to have breast cancer. Besides a negative mammogram, what other symptoms would correlate with this being a benign finding? Select all that apply.

  • A. Milky discharge from nipples
  • B. Extensive weight loss
  • C. Painful masses
  • D. Mood swings
Correct Answer: A

Rationale: The correct answer is A: Milky discharge from nipples. Milky discharge from nipples in a young female with no other concerning symptoms can be indicative of benign conditions such as hormonal imbalances or medication side effects. In this case, the patient's age, weight loss due to exercise, and negative mammogram are all factors that suggest a low likelihood of breast cancer. Extensive weight loss (choice B) is likely attributed to the intensive exercises mentioned and not directly correlated with breast cancer. Painful masses (choice C) could indicate an inflammatory or infection process but are not necessarily indicative of malignancy. Mood swings (choice D) are unrelated to the breast symptomatology described.

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