Current Issues in Maternal-Newborn Nursing

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A 48-year-old female patient presents to the OB/GYN clinic for her annual examination. She states that she has had the following symptoms: mood swings, irregular menstrual cycles, forgetfulness, food cravings, and a decrease in libido. Which of the following does the nurse suspect the patient is experiencing?

  • A. Menopause
  • B. Perimenopause
  • C. Postmenopause
  • D. Pregnancy
Correct Answer: B

Rationale: Perimenopause is the transitional period leading to menopause that usually begins in a woman's 40s but can start earlier. During this phase, women may experience symptoms such as mood swings, irregular menstrual cycles, forgetfulness, food cravings, and a decrease in libido, as described by the patient in this case. These symptoms are caused by hormonal fluctuations as the ovaries start to produce less estrogen in preparation for menopause. Menopause occurs when a woman has not had a menstrual period for 12 consecutive months. Postmenopause, on the other hand, refers to the stage after menopause, where menopausal symptoms have generally subsided. The symptoms described by the patient are more indicative of the perimenopausal stage rather than pregnancy, as they are typical signs of hormonal changes associated with the menopausal transition.

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The telephone triage nurse receives a call from a patient who is 5 days postoperative total
abdominal hysterectomy. The patient states that her pain is not relieved with the medications and
that she has noticed blood in her urine. The nurse instructs the patient to report immediately to the
emergency department. What does the nurse suspect as the surgical complication?

  • A. Possible complication related to the anesthesia
  • B. Possible injury to the ureters or bladder
  • C. Possible hemorrhage from the internal incision
  • D. Possible peritoneal venous thromboembolism
Correct Answer: D

Rationale: In this situation where the patient is 5 days postoperative total abdominal hysterectomy and experiencing pain that is not relieved with medications, the nurse should suspect a possible hemorrhage from the internal incision. Although some pain is expected postoperatively, severe or worsening pain that is not relieved with medications can indicate a complication such as internal bleeding. Immediate medical attention is needed to assess and manage any potential hemorrhage to prevent further complications or adverse outcomes. Other signs of internal bleeding may include symptoms such as increasing abdominal distention, tachycardia, hypotension, and signs of shock.

Which of the following statements highlights the nurse’s role as a researcher?

  • A. Reading peer-reviewed journal articles
  • B. Working as a member of the interdisciplinary team to provide patient care
  • C. Helping patient to obtain home care postdischarge from the hospital
  • D. Delegating tasks to unlicensed personnel to allow for more teaching time with patients
Correct Answer: A

Rationale: Reading peer-reviewed journal articles highlights the nurse's role as a researcher because it involves staying current with the latest evidence-based practices, advancements in healthcare, and research findings. Nurses who engage in reading such articles are able to enhance their knowledge, critical thinking skills, and decision-making abilities, which are crucial aspects of conducting research and applying research findings to patient care. By continuously educating themselves through reviewing peer-reviewed literature, nurses contribute to the advancement of nursing practice and further research in the field.

Which statement best describes the advantage of a labor, birth, recovery, and postpartum (LDRP) room?

  • A. The family is in a familiar environment.
  • B. They are less expensive than traditional hospital rooms.
  • C. The infant is removed to the nursery to allow the mother to rest.
  • D. The woman’s support system is encouraged to stay until discharge.
Correct Answer: A

Rationale: One of the advantages of a labor, birth, recovery, and postpartum (LDRP) room is that the family is in a familiar environment. LDRP rooms are designed to provide a comfortable setting where the mother, baby, and family can stay together throughout the entire childbirth process. This environment allows for better continuity of care, enhances bonding between the baby and the family, and helps reduce stress and anxiety often associated with being in an unfamiliar hospital setting. Being in a familiar environment can also promote a sense of security and control for the mother, which can positively impact her overall birthing experience.

A college-aged female patient states that she understands the risk of sexual assault with overdrinking. She asks the nurse what health risks are associated with excessive alcohol intake for her age. What diseases or conditions should the nurse include in her response? Select all that
apply

  • A. Infertility
  • B. Cancer of mouth
  • C. Hypertension
  • D. Brain shrinkage
Correct Answer: A

Rationale: A. Excessive alcohol intake is a risk factor for developing cancer, particularly cancers of the mouth, throat, esophagus, liver, and breast. Chronic alcohol use can increase the individual's susceptibility to these types of cancers.

Which patient will most likely seek prenatal care?

  • A. A 15-year-old patient who tells her friends, “I just don’t believe that I am pregnant”
  • B. A 28-year-old who is in her second pregnancy and abuses drugs and alcohol
  • C. A 20-year-old who is in her first pregnancy and has access to a free prenatal clinic
  • D. A 30-year-old who is in her fifth pregnancy and delivered her last infant at home with the help of her mother and sister
Correct Answer: C

Rationale: The patient in option C is the most likely to seek prenatal care. This is because she is in her first pregnancy, indicating that she may be more inclined to seek medical guidance and support for the first time experience of pregnancy. Furthermore, the fact that she has access to a free prenatal clinic suggests that she has the resources and opportunity to obtain proper prenatal care, which can significantly benefit her and her baby's health. In contrast, the patients in the other options either demonstrate risky behaviors (such as drug and alcohol abuse in option B) or have previously given birth without professional medical assistance (as indicated in option D), which may indicate lower likelihood of seeking prenatal care. The patient in option A also demonstrates denial of pregnancy, which could delay seeking necessary prenatal care.

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