Nokea
A nurse working in a community clinic is teaching a client about chlamydia. Which statement made by the client would indicate a need for further instruction?
- A. Treatment is also required for individuals who are asymptomatic.
- B. Individuals can only spread the infection if symptomatic.
- C. All pregnant women should be screened for chlamydia.
- D. Any sexually active individuals can be infected with chlamydia.
Correct Answer: B
Rationale: The correct answer is B because it is incorrect. Chlamydia can be spread by individuals who are asymptomatic, so the statement that individuals can only spread it if symptomatic is inaccurate. Asymptomatic individuals can still transmit the infection to others. Therefore, this statement indicates a need for further instruction. Choices A, C, and D are all correct statements. Treatment is necessary for asymptomatic individuals to prevent complications, pregnant women should be screened for chlamydia to prevent transmission to the baby, and any sexually active individuals can indeed be infected with chlamydia.
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A patient, 32 weeks pregnant with severe headache, is admitted to the hospital with preeclampsia. In addition to obtaining baseline vital signs and placing the client on bed rest, the physician ordered the following four items. Which of the orders should the nurse perform first?
- A. Assess deep tendon reflexes.'
- B. Obtain complete blood count.'
- C. Assess baseline weight.'
- D. Obtain routine urinalysis.'
Correct Answer: A
Rationale: The correct answer is A: Assess deep tendon reflexes. This is the priority because preeclampsia can progress to eclampsia, a life-threatening condition characterized by seizures. Assessing deep tendon reflexes helps in identifying signs of impending eclampsia. Obtaining a complete blood count (option B) and routine urinalysis (option D) are important in monitoring for complications of preeclampsia but do not address the immediate risk of seizures. Assessing baseline weight (option C) is also important but does not take precedence over assessing deep tendon reflexes in this scenario.
Which infant is most likely to express Rh incompatibility?
- A. Infant of an Rh-negative mother and a father who is Rh positive and homozygous for the Rh factor.
- B. Infant who is Rh negative and a mother who is Rh negative.
- C. Infant of an Rh-negative mother and a father who is Rh positive and heterozygous for the Rh factor.
- D. Infant who is Rh positive and a mother who is Rh positive.
Correct Answer: A
Rationale: Rationale:
1. Rh incompatibility occurs when the mother is Rh-negative and the father is Rh-positive.
2. If the father is homozygous for Rh factor (AA), all offspring will be Rh-positive.
3. The Rh-positive offspring from an Rh-negative mother can lead to Rh incompatibility.
4. Therefore, the infant of an Rh-negative mother and a father who is Rh positive and homozygous for the Rh factor is most likely to express Rh incompatibility.
Summary:
- Choice B is incorrect because both mother and infant are Rh-negative.
- Choice C is incorrect because the father being heterozygous for the Rh factor would not result in all offspring being Rh-positive.
- Choice D is incorrect as both mother and infant are Rh-positive, so there is no risk of Rh incompatibility.
Which statement is not true regarding breast reconstruction?
- A. It promotes symmetry and preserves body image.
- B. It is always done immediately along with the mastectomy.
- C. It does not change survival rates or interfere with therapies or treatment of recurrent disease.
- D. It is associated with low morbidity and high patient satisfaction.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Breast reconstruction is not always done immediately to allow for healing post-mastectomy.
2. Immediate reconstruction may not be suitable for all patients due to various factors.
3. Delayed reconstruction is also a valid option and can be performed at a later time.
4. Therefore, the statement that breast reconstruction is always done immediately along with the mastectomy is not true.
Summary:
A: True - Breast reconstruction aims to promote symmetry and preserve body image.
C: True - Breast reconstruction does not affect survival rates or interfere with treatments.
D: True - Breast reconstruction generally has low morbidity and high patient satisfaction.
A nurse is providing preoperative teaching for a woman who is undergoing a total mastectomy. Which will this teaching include? Select all that apply.
- A. Explain that she will have an IV, a drain, and a dressing in place on awakening. Tell her about expectations she may have regarding physical appearance, pain management, equipment that will be used (IVs, drains, etc.).
- B. Explain that she will be provided pain management as needed; monitor and review the pain scale to be used to identify level of intensity.
- C. Have her elevate the affected arm with pillows.
- D. Turn the woman every 4 hours, alternating between the unaffected side and affected side. To prevent pneumonia and complications, have her cough and take deep breaths every 2 hours, while nurse applies support to the chest.
Correct Answer: C
Rationale: Rationale for Answer C (Correct Answer):
1. Elevating the affected arm with pillows post-mastectomy helps reduce swelling and promote lymphatic drainage, aiding in preventing lymphedema.
2. By elevating the arm, it reduces strain on the surgical site and surrounding tissues, promoting comfort and aiding in the healing process.
3. This positioning also helps in preventing postoperative complications such as shoulder stiffness and contractures.
Summary of Why Other Choices are Incorrect:
- Choice A: While important aspects of preoperative teaching, it does not specifically address the need to elevate the affected arm post-mastectomy.
- Choice B: Pain management is crucial, but it does not directly relate to the need for arm elevation post-mastectomy.
- Choice D: Turning every 4 hours and coughing exercises are important for preventing complications but do not address the specific need for arm elevation post-mastectomy.
The nurse is teaching a woman receiving adjuvant hormonal therapy on how she can manage her side effects and symptoms. Which education and teaching will the nurse include? Select all that apply.
- A. Wear layered clothing and avoid caffeine and spicy foods to help relieve hot flashes
- B. Decrease vaginal dryness by using vaginal moisturizers such as Replens or vitamin E suppositories daily
- C. Manage nausea and vomiting by consuming a bland diet and taking medication first thing in the morning.
- D. Ease musculoskeletal symptoms with warm baths and nonsteroidal analgesics
Correct Answer: B
Rationale: The correct answer is B. Vaginal dryness is a common side effect of hormonal therapy. Using vaginal moisturizers like Replens or vitamin E suppositories can help alleviate this symptom by providing moisture and lubrication. This intervention can improve the woman's comfort and quality of life during treatment.
Choice A is incorrect because wearing layered clothing and avoiding caffeine and spicy foods are strategies typically recommended for managing hot flashes, not vaginal dryness.
Choice C is incorrect as managing nausea and vomiting with a bland diet and medication is not directly related to the management of side effects of hormonal therapy like vaginal dryness.
Choice D is incorrect as warm baths and nonsteroidal analgesics are more commonly used to ease musculoskeletal symptoms, not specifically for managing vaginal dryness.