Nokea
A woman has been diagnosed with chlamydia. The nurse would expect the client to complain of which of the following signs/symptoms?
- A. No signs or symptoms.
- B. Painful lesions on the labia.
- C. Foul-smelling discharge.
- D. Severe lower abdominal pain.
Correct Answer: A
Rationale: Chlamydia is often asymptomatic, but if symptoms occur, they may include discharge or pain.
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The nurse is providing patient teaching to a client who plans to bottle feed her newborn infant. Which of the following information should be included in the education session?
- A. The baby should be burped after every 3 ounces of formula.
- B. If the bottle nipple is not filled throughout the feeding, the baby may take in a large amount of air.
- C. The best way to heat formula for the baby is in the microwave.
- D. If the mother is busy with her other children, she can prop the baby bottle up on a blanket or towel.
Correct Answer: B
Rationale: The bottle nipple should be filled with formula throughout the feeding to prevent the baby from taking in air, which can cause discomfort and gas.
A nurse is teaching the staff about the Institute of Medicine competencies. Which examples indicate the staff has a correct understanding of the teaching? (Select all that apply.)
- A. Use informatics.
- B. Use transparency.
- C. Apply globalization.
- D. Apply quality improvement.
Correct Answer: D
Rationale: The Institute of Medicine competencies include: Provide patient-centered care; work in interdisciplinary teams; use evidence-based practice; apply quality improvement; and use informatics. Transparency is included in the 10 rules of performance in a redesigned health care system, not a competency. While globalization is important in health care, it is not a competency.
The nurse is scheduling the next appointment for a healthy primigravida currently at 28 weeks gestation. When will the nurse schedule the next prenatal visit?
- A. 1 week
- B. 2 weeks
- C. 3 weeks
- D. 4 weeks
Correct Answer: B
Rationale: The correct answer is B (2 weeks) because for a healthy primigravida at 28 weeks gestation, it is recommended to schedule prenatal visits every 2 weeks during the third trimester. This frequency allows for closer monitoring of both the mother and the baby's well-being as they near the delivery date. Option A (1 week) is too frequent and unnecessary for a healthy pregnancy at this stage. Option C (3 weeks) and Option D (4 weeks) are too far apart and may not provide adequate monitoring and support during the critical final weeks of pregnancy.
A client asks the nurse, “Could you explain how the baby’s blood and my blood separate at delivery?” Which of the following responses is appropriate for the nurse to make?
- A. “When the placenta is born, the circulatory systems separate.”
- B. “When the doctor clamps the cord, the blood stops mixing.”
- C. “The separation happens after the baby takes the first breath. The baby’s oxygen no longer has to come from you.”
- D. “The blood actually never mixes. Your blood supply and the baby’s blood supply are completely separate.”
Correct Answer: D
Rationale: The maternal and fetal blood supplies are separate throughout pregnancy, with oxygen and nutrients exchanged through the placenta.
Which analysis of maternal serum is the best predictor of chromosomal abnormalities in the fetus?
- A. Biophysical profile
- B. Multiple-marker screening
- C. Lecithin-to-sphingomyelin ratio
- D. Blood type and crossmatch of maternal and fetal serum
Correct Answer: B
Rationale: The correct answer is B: Multiple-marker screening. This analysis measures levels of certain proteins and hormones in maternal serum to assess the risk of chromosomal abnormalities in the fetus. It is considered the best predictor because abnormal levels of these markers can indicate conditions like Down syndrome. Biophysical profile (A) assesses fetal well-being but does not directly predict chromosomal abnormalities. Lecithin-to-sphingomyelin ratio (C) is used to assess fetal lung maturity, not chromosomal abnormalities. Blood type and crossmatch (D) are important for identifying Rh incompatibility but do not predict chromosomal abnormalities.