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A father and mother are carriers of phenylketonuria (PKU). Their 2-year-old daughter has the condition. The couple tells the nurse that they are having a second baby. Because their daughter has PKU, they are certain that this baby will not be affecteWhich response by the nurse is the most accurate?
- A. Good planning. You need to take advantage of the odds that are in your favor.
- B. I think you'd better first check with your physician.
- C. You are both carriers; therefore, each baby has a 25% chance of being affected.
- D. The ultrasound indicates a boy, and boys are not affected by PKU.
Correct Answer: C
Rationale: Each child conceived by this couple has a one-in-four chance of being affected with the PKU disorder. This couple still has an increased likelihood of having a child with PKU; having one child already with PKU does not guarantee that they will not have another. These parents need to discuss their options with their physician. However, an opportune time has presented itself for the couple to receive correct teaching about inherited genetic risks. No correlation exists between gender and inheritance of the disorder, because PKU is an autosomal recessive disorder.
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Which response by the nurse is the most therapeutic when the patient states, “I’m so afraid to N R I G B.C M U S N T O have a cesarean birth”?
- A. “Everything will be OK.”
- B. “Don’t worry about it. It will be over soon.”
- C. “What concerns you most about a cesarean birth?”
- D. “The physician will be in later and you can talk to him.”
Correct Answer: C
Rationale: The most therapeutic response by the nurse when the patient expresses fear about having a cesarean birth is to offer an open-ended question that explores the patient's concerns further. By asking, "What concerns you most about a cesarean birth?" the nurse acknowledges the patient's fears, encourages communication, and allows the patient to express her feelings and fears in more detail. This response shows empathy and enables the nurse to better address the specific worries and anxieties the patient may have about the procedure. The other options do not effectively address the patient's fears and do not promote therapeutic communication.
The nurse is assessing a 42-year-old patient who presents to the gynecology office with complaints of pelvic pressure, backaches, menorrhagia, and urinary frequency. The health care provider has diagnosed the patient with leiomyoma of the uterus. What are the treatment options for this condition? Select all that apply.
- A. Routine pelvic examinations to assess rate of disease process
- B. Oral contraceptives to control the bleeding and pain
- C. Myomectomy for women who desire pregnancy
- D. Hysterectomy for women who do not desire pregnancy
Correct Answer: B
Rationale: - Oral contraceptives are a common treatment option for leiomyoma of the uterus to help control the bleeding and pain associated with the condition.
Which response by the nurse is the most therapeutic when the patient states, “I’m so afraid to N R I G B.C M U S N T O have a cesarean birth”?
- A. “Everything will be OK.”
- B. “Don’t worry about it. It will be over soon.”
- C. “What concerns you most about a cesarean birth?”
- D. “The physician will be in later and you can talk to him.”
Correct Answer: C
Rationale: The most therapeutic response by the nurse when the patient expresses fear about having a cesarean birth is to offer an open-ended question that explores the patient's concerns further. By asking, "What concerns you most about a cesarean birth?" the nurse acknowledges the patient's fears, encourages communication, and allows the patient to express her feelings and fears in more detail. This response shows empathy and enables the nurse to better address the specific worries and anxieties the patient may have about the procedure. The other options do not effectively address the patient's fears and do not promote therapeutic communication.
A nurse is caring for a client who is experiencing preterm labor and has a new prescription for terbutaline. Which of the following findings is a contraindication for the administration of this medication?
- A. Heart disease
- B. Cervical dilation of 2 cm
- C. Gestational age of 34 weeks
- D. Allergy to penicillin
Correct Answer: A
Rationale: Terbutaline is a tocolytic that can cause cardiovascular side effects and is contraindicated in clients with heart disease.
Which situation is most representative of an extended family?
- A. It includes adoptive children.
- B. It is headed by a single-parent.
- C. It contains children from previous marriages.
- D. It is composed of children, parents, and grandparents living in the same house.
Correct Answer: D
Rationale: An extended family is a type of family unit that includes not only the nuclear family (parents and children) but also other relatives such as grandparents, aunts, uncles, cousins, etc., all living together or in close proximity. Option D, which states that the family is composed of children, parents, and grandparents living in the same house, is most representative of an extended family structure. This situation reflects the multi-generational aspect of an extended family where multiple generations live together and contribute to the household dynamics.