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A nurse is developing a plan of care for a newborn who has hyperbilirubinemia and a prescription for phototherapy. Which of the following interventions should the nurse include?
- A. Check the newborn's temperature every 8 hr.
- B. Apply moisturizing lotion to the newborn's skin every 4 hr.
- C. Give the newborn 1 oz of glucose water every 4 hr.
- D. Reposition the newborn every 2 to 3 hr.
Correct Answer: D
Rationale: Frequent repositioning ensures even exposure to phototherapy light, promoting bilirubin breakdown.
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The nurse would advise the patient to report what symptom immediately during a PD-1 (checkpoint inhibitor) infusion?
- A. nausea
- B. fatigue
- C. dizziness
- D. diarrhea
Correct Answer: C
Rationale: Correct Answer: C (dizziness)
Rationale:
1. Dizziness can indicate a serious adverse reaction like immune-mediated neurotoxicity, requiring immediate attention.
2. Nausea, fatigue, and diarrhea are common side effects of checkpoint inhibitors but usually not emergencies.
3. Dizziness can be a sign of a potentially life-threatening condition, making it crucial to report immediately.
Summary:
- A: Nausea is a common side effect but not typically requiring immediate attention.
- B: Fatigue is a common side effect but usually does not warrant immediate reporting.
- D: Diarrhea is a known side effect but generally not an urgent concern compared to potential neurological issues signaled by dizziness.
The nurse provides education to a client about to undergo external radiation therapy. Which statement by the client reassures the nurse that the teaching has been effective?
- A. I am using ointment to keep my skin from drying out.
- B. I wash the irradiated area with deodorant soap.
- C. My diet is high in protein, and I drink at least 2000 ml of fluid a day.
- D. I wash off the markings for the radiation site after each treatment.
Correct Answer: C
Rationale: To maintain good nutrition, the woman should eat high-protein meals or use protein supplements and should have a high daily fluid intake of 2 to 3 L. The woman is counseled about good skin care and taught to avoid soaps, ointments, cosmetics, and deodorants because these may contain metals that would alter the radiation dose she receives.
Which statement regarding the Family Systems Theory is inaccurate?
- A. Family system is part of a larger suprasystem.
- B. Family, as a whole, is equal to the sum of the individual members.
- C. Changes in one family member affect all family members.
- D. Family is able to create a balance between change and stability.
Correct Answer: B
Rationale: Family Systems Theory posits that the family as a whole is greater than the sum of its individual members, meaning the family's dynamics are more complex than just the sum of each individual. The other statements are accurate according to this theory.
The United States ranks poorly in terms of worldwide infant mortality rates. Which factor has the greatest impact on decreasing the mortality rate of infants?
- A. Providing more women’sN sheRlterIs G B.C M U S N T O
- B. Ensuring early and adequate prenatal care
- C. Resolving all language and cultural differences
- D. Enrolling pregnant women in the Medicaid program by their eighth month of pregnancy
Correct Answer: B
Rationale: The correct answer is B: Ensuring early and adequate prenatal care. Prenatal care plays a crucial role in monitoring the health of the mother and the developing fetus, detecting and managing any potential health issues early on, and providing essential education on nutrition and healthy practices. This ultimately leads to healthier pregnancies, reduced risks of complications, and improved outcomes for both the mother and the infant. Providing more women's shelters (A) may help address social issues but does not directly impact infant mortality rates. Resolving language and cultural differences (C) is important for effective healthcare delivery but is not the primary factor in reducing infant mortality. Enrolling pregnant women in Medicaid (D) is beneficial for access to healthcare but does not address the importance of early and adequate prenatal care in reducing infant mortality rates.
A nurse is caring for a patient who has just been diagnosed with chlamydia and wants to know when she can have sex with her boyfriend again. What is the best response from the nurse?
- A. “You should not have sex until 7 days after you complete treatment and your partner gets treatment.”
- B. “You can have sex as soon as you finish the medicine.”
- C. “You can have sex once your partner takes the medicine.”
- D. “There is no need to wait.”
Correct Answer: A
Rationale: The correct answer is A. The rationale is as follows:
1. Chlamydia is a sexually transmitted infection that requires treatment to prevent transmission.
2. The patient should complete the full course of treatment to ensure the infection is cleared.
3. Waiting 7 days after completing treatment allows time for the medication to be effective and for the patient's partner to also receive treatment.
4. Having sex before completing treatment and ensuring the partner is treated can lead to re-infection and further transmission.
Therefore, choice A is the best response.
Summary of incorrect choices:
B: Incorrect as having sex immediately after finishing the medicine without waiting for partner treatment can lead to re-infection.
C: Incorrect as both partners need to complete treatment to prevent re-infection.
D: Incorrect as waiting is necessary to ensure the infection is fully treated and transmission is prevented.