Nokea
A patient diagnosed with a pituitary adenoma has arrived on the neurologic unit. When planning the patients care, the nurse should be aware that the effects of the tumor will primarily depend on what variable?
- A. Whether the tumor utilizes aerobic or anaerobic respiration
- B. The specific hormones secreted by the tumor
- C. The patients pre-existing health status
- D. Whether the tumor is primary or the result of metastasis
Correct Answer: B
Rationale: The correct answer is B: The specific hormones secreted by the tumor. Pituitary adenomas are known to secrete hormones that can lead to various endocrine disorders. Understanding the specific hormones secreted by the tumor is crucial in determining the clinical manifestations and planning appropriate treatment. Choices A, C, and D are incorrect because the primary determinant of the effects of the tumor in this case is the hormonal activity rather than whether the tumor uses aerobic or anaerobic respiration, the patient's pre-existing health status, or whether the tumor is primary or metastatic.
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Which finding on a prenatal visit at 10 weeks might suggest a hydatidiform mole?
- A. Blood pressure of 120/80 mm Hg
- B. Complaint of frequent mild nausea
- C. Fundal height measurement of 18 cm
- D. History of bright red spotting for 1 day weeks ago
Correct Answer: C
Rationale: The correct answer is C: Fundal height measurement of 18 cm. This finding suggests a hydatidiform mole because it is larger than expected for a 10-week pregnancy due to excessive trophoblastic proliferation. A: Blood pressure is within normal range. B: Nausea is common in early pregnancy and not specific to a mole. D: History of bright red spotting is more indicative of a miscarriage or other complications, not necessarily a mole.
Fraternal twins are delivered by your Rh-negative patient. Twin A is Rh-positive and twin B is Rh-negative. Prior to administering Rho(D) immune globulin (RhoGAM), the nurse should determine the results of the
- A. direct Coombs test of twin A.
- B. direct Coombs test of twin B.
- C. indirect Coombs test of the mother.
- D. transcutaneous bilirubin level for both twins.
Correct Answer: C
Rationale: The correct answer is C: indirect Coombs test of the mother. This test is crucial to determine if the mother has developed antibodies against the Rh-positive blood of twin A, which could lead to hemolytic disease of the newborn in future pregnancies. A direct Coombs test of twin A or twin B is not relevant in this scenario as it does not provide information about the mother's antibody status. Transcutaneous bilirubin levels are used to monitor jaundice in newborns and not related to Rh incompatibility. In summary, the indirect Coombs test of the mother is the most relevant test to assess the risk of hemolytic disease in future pregnancies.
The nurse is reviewing the health history of a newly admitted patient and reads that the patient has been previously diagnosed with exostoses. How should the nurse accommodate this fact into the patients plan of care?
- A. The nurse should perform the Rinne and Weber tests.
- B. The nurse should arrange for audiometry testing as soon as possible.
- C. The nurse should collaborate with the pharmacist to assess for potential ototoxic medications.
- D. No specific assessments or interventions are necessary to addressing exostoses.
Correct Answer: C
Rationale: Correct Answer: C
Rationale:
1. Exostoses are bony growths in the external auditory canal.
2. These growths can cause narrowing and obstruction of the canal, affecting hearing.
3. Collaborating with the pharmacist to assess for ototoxic medications is crucial to prevent further hearing impairment.
4. Performing Rinne and Weber tests (choice A) and arranging audiometry testing (choice B) are not directly related to exostoses.
5. Ignoring exostoses (choice D) can lead to worsening hearing loss and potential complications.
Which factor is known to increase the risk of gestational diabetes mellitus?
- A. Previous birth of large infant
- B. Maternal age younger than 25 years
- C. Underweight prior to pregnancy
- D. Previous diagnosis of type 2 diabetes mellitus
Correct Answer: A
Rationale: The correct answer is A: Previous birth of large infant. This factor increases the risk of gestational diabetes mellitus due to a history of delivering a large baby, indicating a higher likelihood of insulin resistance in subsequent pregnancies. Maternal age younger than 25 years (B) is not a known risk factor for gestational diabetes. Being underweight prior to pregnancy (C) is actually associated with a decreased risk of gestational diabetes. A previous diagnosis of type 2 diabetes mellitus (D) is a separate condition and does not directly increase the risk of gestational diabetes.
A 29-year-old patient has just been told that he has testicular cancer and needs to have surgery. During a presurgical appointment, the patient admits to feeling devastated that he requires surgery, stating that it will leave him emasculated and a shell of a man. The nurse should identify what nursing diagnosis when planning the patients subsequent care?
- A. Disturbed Body Image Related to Effects of Surgery
- B. Spiritual Distress Related to Effects of Cancer Surgery
- C. Social Isolation Related to Effects of Surgery
- D. Risk for Loneliness Related to Change in Self-Concept
Correct Answer: A
Rationale: The correct answer is A: Disturbed Body Image Related to Effects of Surgery. This nursing diagnosis is appropriate because the patient expresses concerns about feeling emasculated and a shell of a man after the surgery, indicating a disturbance in his body image. The patient's perception of how the surgery will affect his masculinity is a clear indication of body image disturbance.
Choice B is incorrect because there is no mention of spiritual distress in the patient's statements. Choice C is incorrect as there is no indication that the patient will experience social isolation specifically related to the surgery. Choice D is incorrect as the patient's concerns are primarily related to his body image and not loneliness.