A nurse is admitting a client who is at 35 weeks of gestation and is experiencing mild vaginal bleeding due to placenta previWhich of the following actions should the nurse plan to take?
- A. Initiate continuous monitoring of the FHR.
- B. Administer a dose of betamethasone.
- C. Check the cervix for dilation every 8 hr.
- D. Request that the provider prescribe misoprostol PRN.
Correct Answer: A
Rationale: Continuous fetal heart rate monitoring is essential in placenta previa to assess for fetal distress.
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A 32-year-old female patient arrives to the emergency department with heavy uterine bleeding. The nurse finds that the patient had a positive pregnancy test 1 month prior to the visit. What is the potential medical management for this patient's issue?
- A. Endometrial biopsy
- B. Dilation and curettage
- C. Colposcopy
- D. Laparoscopy
Correct Answer: B
Rationale: The correct answer is B: Dilation and curettage. This procedure is indicated for heavy uterine bleeding in the setting of a positive pregnancy test to diagnose and treat conditions such as incomplete miscarriage or ectopic pregnancy. Dilation and curettage involves dilating the cervix and scraping the uterine lining to remove any remaining products of conception. It is important in this case to rule out any potential sources of bleeding that could be life-threatening.
A: Endometrial biopsy is not the appropriate initial management in this scenario as it is primarily used to assess endometrial pathology such as cancer.
C: Colposcopy is a procedure used to examine the cervix and vagina for abnormalities, not typically indicated for heavy uterine bleeding in the setting of a positive pregnancy test.
D: Laparoscopy is a minimally invasive surgical procedure used to view the abdominal organs, not typically indicated for uterine bleeding related to a positive pregnancy test.
The nurse is preparing a teaching plan for a polycystic ovary syndrome (PCOS) support group.
One of the teaching points will include diet and weight loss to decrease hirsutism and acne. What
is the reasoning for this rationale?
- A. Diet and exercise will promote weight loss, which will decrease
hyperandrogenemia - B. Diet and exercise will decrease the risk of type 2 diabetes and gestational diabetes
- C. Diet and exercise will decrease serum lipid levels and lower the risk for
cardiovascular disease. - D. Diet and exercise will increase the frequency of ovulation and menstruation and
increase fertility.
Correct Answer: E
Rationale: I see that there is a mistake in the question. There is no option "E" provided. Could you please provide the correct answer choice or clarify the question?
A nurse is teaching a client who is to start using a diaphragm for contraception. Which of the following client statements indicates an understanding of the teaching?
- A. I will leave the diaphragm in place for 4 hours following intercourse.
- B. I will remove the diaphragm by catching the rim below the dome with my forefinger.
- C. I will place a thin layer of mineral oil on the diaphragm once per week.
- D. I will place 2 teaspoons of spermicide on the inside of the diaphragm before inserting it.
Correct Answer: D
Rationale: Spermicide should be applied before inserting the diaphragm to maximize contraceptive effectiveness.
What is a risk factor for breast cancer?
- A. menarche at age 15
- B. family history of diabetes
- C. alcohol use of at least 2 drinks per day
- D. history of three vaginal births by age 25
Correct Answer: C
Rationale: The correct answer is C: alcohol use of at least 2 drinks per day. Alcohol consumption has been consistently linked to an increased risk of breast cancer. Alcohol can raise estrogen levels in the body, thereby increasing the risk of developing breast cancer. Menarche at age 15 (choice A) is not a risk factor as early menarche is associated with a slightly decreased risk. Family history of diabetes (choice B) and history of three vaginal births by age 25 (choice D) are not directly linked to breast cancer risk.
Intervention for the sexual abuse survivor is often not attempted by maternity and women's health nurses because of the concern about increasing the distress of the woman and the lack of expertise in counseling. What initial intervention is appropriate and most important in facilitating the woman's care?
- A. Initiating a referral to an expert counselor
- B. Setting limits on what the client discloses
- C. Listening and encouraging therapeutic communication skills
- D. Acknowledging the nurse's discomfort to the client as an expression of empathy
Correct Answer: C
Rationale: The survivor needs support on many levels. Therapeutic communication skills and listening are initial interventions. Referring to a counselor is appropriate but not the most important initial intervention.