Nokea
A nurse has provided a young woman with preconception counseling. Which of the statements by the woman indicates that the teaching was successful? Select all that apply.
- A. “As soon as I think I may be pregnant, I should stop drinking alcohol.”
- B. “It is important for me to see my medical doctor for a complete physical.”
- C. “I should make sure that my daily multivitamin contains folic acid.”
- D. “When I go to my dentist for a checkup I should state that I may be pregnant.”
Correct Answer: A
Rationale: All the statements indicate successful preconception counseling, covering topics such as alcohol cessation, medical checkups, folic acid intake, dental care, and dietary precautions.
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What does a birth plan help the parents accomplish?
- A. Avoidance of an episiotomy
- B. Determining the outcome of the birth
- C. Assuming complete control of the situation
- D. Taking an active part in planning the birth experience
Correct Answer: D
Rationale: The correct answer is D because a birth plan allows parents to actively participate in planning their birth experience by outlining their preferences and wishes. It helps them communicate their desires to healthcare providers and ensures their preferences are considered during labor and delivery. Choice A is incorrect as avoiding an episiotomy is a specific medical procedure, not the primary purpose of a birth plan. Choice B is incorrect as determining the outcome of birth is not within the control of parents. Choice C is incorrect as assuming complete control of the situation may not be realistic or safe during childbirth.
A laboring woman, G4 P3003, who was 6 cm dilated 1 hour ago cries, 'Hurry. I have to go to the bathroom to have a bowel movement.' The nurse notes that there is an increase in bloody show. Which of the following actions by the nurse is appropriate?
- A. Assess cervical dilation.
- B. Help the woman to the bathroom.
- C. Ask the woman if she needs pain medicine.
- D. Check the fetal heart rate.
Correct Answer: A
Rationale: The urge to have a bowel movement and increased bloody show could indicate that the woman is entering the second stage of labor. The nurse should assess cervical dilation to confirm.
A nurse is teaching the staff about the Institute of Medicine competencies. Which examples indicate the staff has a correct understanding of the teaching? (Select all that apply.)
- A. Use informatics.
- B. Use transparency.
- C. Apply globalization.
- D. Apply quality improvement.
Correct Answer: D
Rationale: The Institute of Medicine competencies include: Provide patient-centered care; work in interdisciplinary teams; use evidence-based practice; apply quality improvement; and use informatics. Transparency is included in the 10 rules of performance in a redesigned health care system, not a competency. While globalization is important in health care, it is not a competency.
The results of a contraction stress test (CST) are positive. Which intervention is necessary based on this test result?
- A. Repeat the test in 1 week so that results can be trended based on this baseline result.
- B. Contact the health care provider to discuss birth options for the patient.
- C. Send the patient out for a meal and repeat the test to confirm that the results are valid.
- D. Ask the patient to perform a fetal kick count assessment for the next 30 minutes and then reassess the patient.
Correct Answer: B
Rationale: The correct answer is B because a positive contraction stress test (CST) indicates potential fetal distress, requiring immediate medical attention. Contacting the health care provider is necessary to discuss birth options for the patient, such as potential induction or cesarean section to prevent harm to the fetus.
A is incorrect because waiting another week could pose risks to the fetus if distress is already present. C is incorrect as sending the patient out for a meal and repeating the test is not a valid or necessary intervention. D is incorrect as a fetal kick count assessment does not address the immediate concerns raised by a positive CST result.
A nurse is providing home care to a home-bound patient treated with intravenous (IV) therapy and enteral nutrition. What is the home health nurse’s primary objective?
- A. Screening
- B. Education
- C. Dependence
- D. Counseling
Correct Answer: B
Rationale: Health promotion and education are traditionally the primary objectives of home care, yet at present most patients receive home care because they need nursing care. Screening is preventive care. The home health nurse focuses on patient and family independence. Counseling is through psychiatric care.