Nokea
A nurse is assessing the knowledge of new parents of a child born with Klinefelter syndrome. Which statement accurately describes this genetic disorder?
- A. Klinefelter syndrome is a sex chromosome abnormality.
- B. It affects only female children.
- C. The disorder is expressed as trisomy XYY.
- D. The child with this disorder will grow to be infertile.
Correct Answer: A
Rationale: Klinefelter syndrome, also known as trisomy XXY, is a sex chromosomal deviation that is expressed in males. Turner syndrome (monosomy X) is displayed in females. Most males with Klinefelter syndrome are tall, may be infertile, and are slow to learn; however, those who have mosaic Klinefelter syndrome may be fertile as adults.
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What type of mastectomy removes the entire breast but leaves the chest wall intact?
- A. total simple mastectomy
- B. modified radical mastectomy
- C. skin-sparing mastectomy
- D. nipple-sparing mastectomy
Correct Answer: A
Rationale: A total simple mastectomy is a type of mastectomy that removes the entire breast, including the breast tissue, nipple, and areola, but it leaves the chest wall muscles intact. In this procedure, the lymph nodes under the arm (axillary lymph nodes) are not typically removed. The total simple mastectomy is usually performed when the breast cancer is small and localized, and there is no evidence of spread to the surrounding lymph nodes or chest wall. This surgery is considered less extensive than other types of mastectomies, such as modified radical mastectomy, skin-sparing mastectomy, or nipple-sparing mastectomy, which involve different levels of tissue removal.
The nurse is assessing a 64-year-old female patient. The patient states that she is able to reduce the risk of urinary tract infections (UTIs) by drinking a quart of cranberry juice a day. Which health condition, if present in this patient, contraindicates the use of cranberry juice?
- A. Hypertension, managed with lisinopril
- B. Diabetes type 1, managed with insulin
- C. Atrial fibrillation, managed with warfarin
- D. COPD, managed with inhaled steroids
Correct Answer: C
Rationale: Cranberry juice has the potential to interact with warfarin, a common blood thinner prescribed for conditions such as atrial fibrillation. Cranberry juice contains components that can inhibit the metabolism of warfarin in the body, leading to an increased risk of bleeding. Therefore, patients taking warfarin should avoid or limit their intake of cranberry juice to prevent potential negative interactions. In this case, the patient's use of warfarin to manage atrial fibrillation contraindicates the consumption of cranberry juice in large quantities. It is essential to consult a healthcare provider before making any changes to the diet, especially when taking medications that may interact with certain foods or beverages.
Which statement related to the condition of endometriosis is most accurate?
- A. Endometriosis is characterized by the presence and growth of endometrial tissue inside the uterus
- B. It is found more often in African-American women than in Caucasian or Asian women
- C. Endometriosis may worsen with repeated cycles or remain asymptomatic and disappear after menopause
- D. It is unlikely to affect sexual intercourse or fertility
Correct Answer: C
Rationale: Endometriosis is the growth of endometrial tissue outside the uterus and may cause symptoms such as painful intercourse and infertility. It can worsen with repeated cycles or remain asymptomatic.
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 in labor and birth is caring for a Muslim patient during the active phase of labor. The nurse notes that the patient quickly draws away when touched. Which intervention should the nurse implement?
- A. Ask the charge nurse to reassign you to another patient.
- B. Assume that she does not like you and decrease your time with her.
- C. Continue to touch her as much as you need to while providing care.
- D. Limit touching to a minimum because physical contact may not be acceptable in her culture.
Correct Answer: D
Rationale: The appropriate intervention for the nurse to implement in this situation is to limit touching to a minimum because physical contact may not be acceptable in the patient's culture. In Islam, modesty and privacy are significant aspects of the faith, and physical contact, especially with someone of the opposite gender, may be considered inappropriate or uncomfortable for the patient. Respecting and acknowledging the patient's cultural background and preferences is essential in providing culturally competent care. Therefore, it is important for the nurse to be mindful of the patient's boundaries and minimize any unnecessary physical contact while still providing necessary care and support during labor.