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A patient 11 weeks' gestation comes to the emergency room department with c/o dizziness, abdominal pain, and shoulder pain. Lab tests reveal a beta-hcg lower than expected level for gestational age
- A. Ultrasound confirms no intrauterine
- B. The nurse knows the most likely diagnostic is an ectopic pregnancy. What statement should the nurse use to explain to the patient?
- C. The baby is in the fallopian tube, the tube has ruptured and is causing bleeding
Correct Answer: B
Rationale: Step 1: Recognize Symptoms - Dizziness, abdominal pain, shoulder pain, low beta-hcg.
Step 2: Consider Ectopic Pregnancy - Symptoms align with ectopic pregnancy.
Step 3: Rule Out Miscarriage - Low beta-hcg indicates not viable intrauterine pregnancy (Choice A).
Step 4: Understand Ectopic Pregnancy - Explaining ectopic pregnancy (Choice C) and rupture to patient may cause distress.
Step 5: Communicate - Nurse should use simple, empathetic statement (Choice B) to explain the likely diagnosis.
Summary: Choice B is correct as it addresses the likely diagnosis without causing undue distress to the patient, unlike Choices A and C which may lead to confusion and anxiety.
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Which is a disadvantage of the progesterone-only contraception pill?
- A. Side effects could be increased for persons who are underweight.
- B. There could be a decrease in bone mineral density over time.
- C. They may cause irregular bleeding and spotting.
- D. Return to fertility after discontinuing the pill may take several months.
Correct Answer: B
Rationale: The correct answer is B: There could be a decrease in bone mineral density over time. Progesterone-only pills have been associated with a potential decrease in bone density, especially with long-term use. This is because progesterone can have a negative impact on calcium absorption, leading to bone weakening.
A: Side effects could be increased for persons who are underweight - This is not a specific disadvantage of progesterone-only pills and can apply to any contraceptive method.
C: They may cause irregular bleeding and spotting - This is a common side effect of progesterone-only pills but not a significant disadvantage compared to bone density issues.
D: Return to fertility after discontinuing the pill may take several months - This is a temporary effect and not a long-term disadvantage like decreased bone density.
The nurse should designate the highest priority health outcomes to be:
- A. Oxygenation will remain adequate
- B. Body temperature will remain stable
- C. Weight will increase by 30g per day
- D. Heart rate will recover to an acceptable range
Correct Answer: A
Rationale: The correct answer is A because adequate oxygenation is a critical health outcome necessary for cellular function and overall well-being. Without sufficient oxygenation, other bodily functions can be compromised. Stable body temperature (B) is important but not as immediately life-threatening as inadequate oxygenation. Weight gain (C) is not a priority health outcome in this scenario. Heart rate recovery (D) is important but ensuring adequate oxygenation takes precedence in this case.
The nurse is assessing a client in the third trimester with suspected placental abruption. What finding supports this diagnosis?
- A. Painless bright red bleeding.
- B. Boardlike abdomen and severe pain.
- C. Soft, relaxed uterus.
- D. Increased fetal movement.
Correct Answer: B
Rationale: The correct answer is B: Boardlike abdomen and severe pain. This finding supports the diagnosis of placental abruption because it indicates a significant and sudden separation of the placenta from the uterine wall, leading to intense pain and rigidity of the abdomen due to internal bleeding. Painless bright red bleeding (choice A) is more indicative of placenta previa, not placental abruption. A soft, relaxed uterus (choice C) is not typical in placental abruption, which usually presents with uterine tenderness and rigidity. Increased fetal movement (choice D) is not specific to placental abruption and can occur in various pregnancy conditions.
What is the term for nonmedical factors that influence health outcomes, including conditions in which people are born, grow, work, live, and age, and the wider sets of forces and systems shaping the conditions of daily life?
- A. environmental influences
- B. life circumstances
- C. situational occurrences
- D. social determinants of health
Correct Answer: D
Rationale: The correct answer is D: social determinants of health. Social determinants of health refer to the external factors that impact health outcomes. These factors include socioeconomic status, education, employment, social support networks, access to healthcare, and the physical environment. The term encompasses a broad range of influences beyond individual behaviors or genetics.
A: Environmental influences focus more on physical factors like pollution or climate, rather than the broader societal factors.
B: Life circumstances may include individual factors like personal choices or experiences, but do not encompass the societal influences.
C: Situational occurrences imply random events or temporary situations, rather than the persistent societal factors that shape health outcomes.
The nurse is monitoring a client during the first stage of labor. What finding requires immediate intervention?
- A. Contractions every 3–5 minutes.
- B. Baseline fetal heart rate of 110 beats/minute.
- C. Variable decelerations on the fetal monitor.
- D. Client reports back pain during contractions.
Correct Answer: C
Rationale: The correct answer is C because variable decelerations on the fetal monitor indicate umbilical cord compression, which can lead to fetal distress and hypoxia. Immediate intervention is needed to relieve the compression and prevent potential harm to the baby. Contractions every 3-5 minutes (A) are normal in the first stage of labor. A baseline fetal heart rate of 110 beats/minute (B) is within the normal range for a fetus. Client reporting back pain (D) is a common symptom of labor and not necessarily indicative of a complication requiring immediate intervention.