Nokea
A maternity client is in need of surgery. Which healthcare member is legally responsible for obtaining informed consent for an invasive procedure?
- A. The social worker
- B. The nurse
- C. The physician
- D. The unit secretary
- G. C
Correct Answer: The physician is legally responsible for obtaining informed consent, explaining the procedure's purpose, risks, and alternatives. Nurses may assist, but social workers and unit secretaries have no role in this process.
Rationale:
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A nurse is leading a discussion about contraception with a group of 14-year-old clients. After the presentation, a client asks the nurse which method would be best for her to use. Which of the following responses should the nurse make?
- A. A provider can help you with that after a physical examination.
- B. You are so young. Are you ready for the responsibilities of a sexual relationship?
- C. Because of your age, I think that a barrier method would be the best choice.
- D. Before I can help you, I need to know more about your sexual activity.
- G. A
Correct Answer: Referring to a provider ensures personalized advice after assessing health and needs. Judgmental or assumptive responses can deter adolescents from seeking care, and probing sexual activity may violate privacy.
Rationale:
A nurse is preparing to administer hydrocortisone 100 mg IM daily to a client. Available as hydrocortisone 250 mg/2 mL. How many mL should the nurse administer per dose?(Round the answer to the nearest tenth number. Use a leading zero if it applies. Do not use a trailing zero.)
- G. 0.8 mL
Correct Answer: Using the ratio 250 mg/2 mL = 100 mg/x mL, cross-multiply to get 250x = 200, so x = 0.8 mL. This is the correct dose, rounded to the nearest tenth.
Rationale:
A breast biopsy indicates the presence of malignant cells, and the client is scheduled for a mastectomy. When preparing the client's preoperative plan of care, which area would the nurse most likely address as the priority?
- A. Fluid balance
- B. Body image
- C. Urinary elimination
- D. Activity
- G. B
Correct Answer: Body image is a priority due to the psychosocial impact of mastectomy on identity and self-esteem. Fluid balance, urinary elimination, and activity are less immediate concerns.
Rationale:
When describing the menstrual cycle to a group of young women, the nurse explains that estrogen levels are highest during which phase of the endometrial cycle?
- A. Menstrual
- B. Ischemic
- C. Secretory
- D. Proliferative
- G. D
Correct Answer: Estrogen peaks during the proliferative phase, stimulating endometrial regeneration. Menstrual phase has low estrogen, ischemic phase sees declining levels, and secretory phase is dominated by progesterone.
Rationale:
Which finding would the nurse expect in a client with bacterial vaginosis?
- A. Vaginal pH of 3
- B. Cervical bleeding on contact
- C. Fishy odor of discharge
- D. Yellowish-green discharge
- G. C
Correct Answer: Bacterial vaginosis causes a fishy-smelling, thin, gray-white discharge due to anaerobic bacteria. Vaginal pH rises above 4.5, cervical bleeding suggests other issues, and yellowish-green discharge indicates other infections.
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