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A client with mild preeclampsia who has been advised to be on bed rest at home asks why doing so is necessary. Which of the following is the best response for the nurse to give the client?
- A. "Bed rest will help you to conserve energy for your labor."'
- B. "Bed rest will help to relieve your nausea and anorexia."'
- C. "Reclining will increase the amount of oxygen that your baby gets."'
- D. "The position change will prevent the placenta from separating."'
Correct Answer: C
Rationale: The correct answer is C because reclining will help improve blood flow to the placenta, increasing oxygen delivery to the baby. This is crucial in preeclampsia to prevent complications such as fetal growth restriction.
A: Incorrect. Bed rest in preeclampsia is not primarily for energy conservation but to reduce blood pressure and prevent further complications.
B: Incorrect. Bed rest does not directly address nausea and anorexia associated with preeclampsia; it focuses on maternal and fetal well-being.
D: Incorrect. Position change does not directly prevent placental separation in preeclampsia; it is more related to maintaining adequate blood flow to the placenta.
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Which statement by the client indicates further teaching is needed about uterine cancer?
- A. A Pap test is used to diagnose uterine cancer.
- B. Uterine cancer is the most common cancer of the reproductive tract.
- C. I used estrogen for 2 years without progesterone. This puts me at risk for developing uterine cancer.
- D. Postmenopausal bleeding could indicate uterine cancer.
Correct Answer: A
Rationale: The correct answer is A because a Pap test is used to detect cervical cancer, not uterine cancer.
1. A Pap test screens for cervical cancer by detecting abnormal cells in the cervix.
2. Uterine cancer is the most common cancer of the reproductive tract, making choice B accurate.
3. Choice C is correct as using estrogen without progesterone can increase uterine cancer risk.
4. Choice D is also accurate as postmenopausal bleeding can be a symptom of uterine cancer.
In summary, the need for further teaching arises from the misconception that a Pap test can diagnose uterine cancer.
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.
The nurse is reviewing the chart of a client who is complaining of heavy bleeding with her menstrual cycles. The nurse is aware that which of the following is a possible cause?
- A. Uterine fibroids
- B. Excessive exercise
- C. Normal finding in pregnancy
- D. Diet high in fat
Correct Answer: A
Rationale: The correct answer is A: Uterine fibroids. Uterine fibroids are noncancerous growths in the uterus that can lead to heavy menstrual bleeding. The nurse should consider this as a possible cause based on the client's symptoms.
Incorrect Choices:
B: Excessive exercise - While excessive exercise can sometimes affect menstrual cycles, it is not a common cause of heavy bleeding.
C: Normal finding in pregnancy - Heavy bleeding during menstrual cycles is not a normal finding in pregnancy.
D: Diet high in fat - While diet can impact overall health, a diet high in fat is not a direct cause of heavy menstrual bleeding.
A 17-year-old client presents to the clinic with concerns that she has not begun menstruating. She states that she is a gymnast and has been competing since she was 9 years old. Based on this history, what does the nurse know the client is most likely experiencing?
- A. Secondary amenorrhea
- B. Polycystic ovary syndrome
- C. Primary amenorrhea
- D. Dysmenorrhea
Correct Answer: C
Rationale: The correct answer is C: Primary amenorrhea. A 17-year-old who has not started menstruating is experiencing primary amenorrhea. This is likely due to her intense physical activity as a gymnast, which can delay the onset of menstruation. Secondary amenorrhea (A) occurs when menstruation stops after it has already begun. Polycystic ovary syndrome (B) is characterized by hormonal imbalances and ovarian cysts, not delayed onset of menstruation. Dysmenorrhea (D) refers to painful menstruation, which is not the issue in this case.
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.