Nokea
A nurse working with an infertile couple has made the following nursing diagnosis: Sexual dysfunction related to decreased libido. Which of the following assessments is the likely reason for this diagnosis?
- A. The couple has established a set schedule for their sexual encounters.
- B. The couple has been married for more than eight years.
- C. The couple lives with one set of parents.
- D. The couple has close friends who gave birth to a baby within the past year.
Correct Answer: A
Rationale: A rigid schedule for sexual activity can contribute to decreased libido and sexual dysfunction.
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A woman is in the first stage of labor. The nurse would encourage her to assume which position to facilitate the progress of labor?
- A. supine
- B. lithotomy
- C. upright
- D. knee-chest
Correct Answer: C
Rationale: Research shows that upright positions help reduce the length of labor, improve progress, fetal head descent, reduce pain, and result in a good Apgar score. Recumbent positions can lead to supine hypotension and decrease uterine activity, hindering labor progress. Therefore, encouraging an upright position is the best choice for facilitating labor.
A 4-month-old infant has been diagnosed with a rare genetic disease called neonatal onset multisystem inflammatory disease (NOMID). This disease occurs through an autosomal-dominant inheritance pattern. The parents ask the nurse, 'Which of us passed this disease on to our child?' Which of the following is the nurse's best response?
- A. Only the female carries the gene.
- B. Only the father carries the gene.
- C. Either the mother or the father can carry the gene.
- D. Both the mother and the father have to be carriers.
Correct Answer: C
Rationale: The correct answer is C: Either the mother or the father can carry the gene. In an autosomal-dominant inheritance pattern, only one copy of the mutated gene is needed to express the disease. This means that either parent can pass on the disease gene to the child. Therefore, it is not necessary for both parents to be carriers for the child to inherit the disease. Choices A and B are incorrect because autosomal-dominant diseases do not depend on the gender of the parent carrying the gene. Choice D is incorrect as it implies that both parents must be carriers, which is not a requirement for autosomal-dominant inheritance.
What is the purpose of tracking cervical mucus changes during the menstrual cycle?
- A. To identify signs of infection.
- B. To monitor hormone levels.
- C. To predict ovulation.
- D. To determine the luteal phase length.
Correct Answer: C
Rationale: The purpose of tracking cervical mucus changes during the menstrual cycle is to predict ovulation. Cervical mucus consistency changes throughout the cycle, becoming clear and stretchy around ovulation. This method helps determine the most fertile days for conception. Monitoring hormone levels (B) requires blood tests. Identifying signs of infection (A) involves different symptoms. Determining luteal phase length (D) usually requires tracking basal body temperature.
A woman who is a carrier for sickle cell anemia is advised that if her baby has two recessive genes, the penetrance of the disease is 100%, but the expressivity is variable. Which of the following explanations will clarify this communication for the mother? All babies with 2 recessive sickle cell genes will:
- A. Develop painful vaso-occlusive crises during their first year of life.
- B. Exhibit at least some signs of the disease while in the neonatal nursery.
- C. Show some symptoms of the disease but the severity of the symptoms will be individual.
- D. Be diagnosed with sickle cell trait but will be healthy and disease-free throughout their lives.
Correct Answer: C
Rationale: Individuals with two recessive genes will have the disease, but symptom severity varies.
A nurse is providing care to a client in labor. A pelvic exam reveals a vertex presentation with the presenting part tilted toward the left side of the mother's pelvis and directed toward the anterior portion of the pelvis. When developing this client's plan of care, which intervention would the nurse include?
- A. implementing measures for a vaginal birth
- B. preparing the client for a cesarean birth
- C. assisting with artificial rupture of the membranes
- D. instituting continuous internal fetal monitoring
Correct Answer: A
Rationale: The fetal presentation and position is left occiput anterior position or LOA, which is the most common and most favorable fetal position for birth. LOA along with right occiput anterior position are optimal positions for vaginal birth. Therefore the nurse should implement measures for a vaginal birth. This fetal presentation is not an indication for cesarean birth. Nor is there need for artificially rupturing the membranes. Continuous internal fetal monitoring would be warranted if the woman or fetus was considered to be high risk.