Nokea
A postpartum client expresses concerns about breastfeeding and worries about inadequate milk supply. What nursing intervention should be prioritized to address the client's concerns?
- A. Assessing the infant's latch and feeding effectiveness
- B. Recommending supplemental formula feedings to ensure adequate nutrition
- C. Educating the client about techniques to increase milk production
- D. Referring the client to a lactation consultant for assistance
Correct Answer: A
Rationale: Assessing the infant's latch and feeding effectiveness should be prioritized as the initial nursing intervention to address the client's concerns about inadequate milk supply. Poor latch can lead to ineffective milk removal, which may result in decreased milk production. By ensuring the infant is latching correctly and effectively transferring milk, the client's milk supply can be optimized. Education about techniques to increase milk production can be provided following the assessment of feeding effectiveness. Referring to a lactation consultant may be necessary for further evaluation and support if issues persist despite correcting the latch. Supplemental formula feedings should be recommended as a last resort after all other interventions have been attempted and if there are concerns about inadequate nutrition for the infant.
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A patient presents with chest pain that occurs at rest and is exacerbated by deep breathing or changes in body position. The pain improves with leaning forward. Which cardiovascular disorder is most likely responsible for these symptoms?
- A. Stable angina
- B. Unstable angina
- C. Pericarditis
- D. Myocarditis
Correct Answer: C
Rationale: Pericarditis is the inflammation of the pericardium, the sac surrounding the heart. Patients with pericarditis typically present with sharp chest pain that worsens with deep breathing, changes in body position, and coughing. The pain tends to improve when the patient leans forward. This characteristic symptom of pericarditis is known as "pleuritic" chest pain. In contrast, stable angina presents as predictable chest pain that occurs with exertion and is relieved by rest or medications. Unstable angina is characterized by chest pain that occurs at rest or with minimal exertion and is considered a medical emergency. Myocarditis involves inflammation of the heart muscle and may present with symptoms such as chest pain, but it does not typically have the characteristic of worsening with deep breathing or changes in body position.
A patient is brought to the emergency department experiencing a possible stroke. What initial diagnostic test for a stroke , usually performed in the emergency department would the nurse prepare the patient for?
- A. 12-lead electrocardiogram
- B. Carotid ultrasound study
- C. Noncontrast computed tomography
- D. Transcranial Doppler flow study
Correct Answer: C
Rationale: In the emergency department setting, the initial diagnostic test typically performed for a patient suspected of having a stroke is a noncontrast computed tomography (CT) scan of the head. This imaging study is crucial in evaluating and diagnosing stroke because it can quickly identify whether the person is having a hemorrhagic stroke (bleeding in the brain) or an ischemic stroke (blood clot blocking a blood vessel). The results of the CT scan help guide immediate treatment decisions, such as administering clot-busting medications for ischemic strokes or preparing for surgical interventions for hemorrhagic strokes. Carotid ultrasound studies and transcranial Doppler flow studies may be performed after the initial CT scan to further assess the extent of damage and the underlying cause of the stroke. The 12-lead electrocardiogram is useful in assessing the heart's electrical activity but is not the primary test for diagnosing stroke.
A 35-year-old woman presents with irregular menstrual cycles, hirsutism, and acne. Which of the following conditions is most likely to be associated with these symptoms?
- A. Polycystic ovary syndrome (PCOS)
- B. Endometriosis
- C. Ovarian cancer
- D. Uterine fibroids
Correct Answer: A
Rationale: Polycystic ovary syndrome (PCOS) is a common hormonal disorder in women of reproductive age. The classic symptoms of PCOS include irregular menstrual cycles, hirsutism (excess hair growth in a male pattern), and acne. Women with PCOS often have enlarged ovaries with multiple small cysts. Other common features include obesity, insulin resistance, and infertility. Endometriosis is characterized by the presence and growth of endometrial-like tissue outside the uterus, leading to symptoms such as pelvic pain and infertility. Ovarian cancer usually presents with nonspecific symptoms and is less likely in a young woman with these specific symptoms. Uterine fibroids are benign tumors that can cause heavy menstrual bleeding and pelvic pressure but are less likely to be associated with hirsutism and acne.
There are pre operative medications given to the patient. Which of the following drugs are given in order to decrease intra-operative anesthetic requirements and pain?
- A. Celebrex (celecoxib)
- B. Acetaminophen (tylenol)
- C. Ibuprofen (motrin)
- D. Demerol (Meperidine HC
Correct Answer: D
Rationale: Demerol (meperidine hydrochloride) is an opioid analgesic commonly used as a preoperative medication to decrease intra-operative anesthetic requirements and provide analgesia. Opioids like Demerol act on the central nervous system to reduce pain sensations, making it an effective choice for preoperative pain management. This can help decrease the amount of anesthesia needed during surgery, leading to better pain control and overall patient comfort during and after the procedure. Celebrex, acetaminophen, and ibuprofen are also used for pain management, but they do not have the same potency and mechanism of action as opioids like Demerol for reducing intra-operative anesthetic requirements.
Nurse Juvy's assessment reveals the following: Heart Rate is 110 beats per minute, has a vigorous cry, moves actively and with good flexion, normal skin color and bluish extremities. What would be thd APGAR score of Baby Sharon?
- A. 7 Points
- B. 5 Points
- C. 10 Points
- D. 9 Points
Correct Answer: B
Rationale: Baby Sharon's APGAR score can be determined by assessing five criteria: heart rate, respiratory effort, muscle tone, reflex irritability, and color. Each criteria is given a score of 0, 1, or 2 points, with 2 being the highest score.