An 18-year-old with a groin rash and itching is worried about having an STD and does not want his parents to know. What should the nurse say?
- A. We will need to contact your parents.
- B. We will not contact your parents regarding this visit.
- C. Who would you like us to contact about your visit today?
- D. We cannot promise that the hospital will not contact your parents.
Correct Answer: B
Rationale: Adolescents have the right to privacy regarding sexual health, unless there is a risk to life.
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a woman who is pregnant is undergoing an amniocentesis. during the test, elevated levels of AFP are found. this indicate to which of the following conditions :
- A. CP
- B. spina bifida
- C. down syndrome
- D. hydrocephalus
Correct Answer: B
Rationale: Elevated levels of AFP (alpha-fetoprotein) in the amniotic fluid during an amniocentesis often indicate neural tube defects, such as spina bifida. Spina bifida is a condition where the spinal cord does not develop properly, leading to a range of possible issues depending on the severity of the defect. In this case, the elevated AFP levels point towards a higher likelihood of spina bifida rather than other conditions like CP (cerebral palsy), Down syndrome, or hydrocephalus.
The physical manifestations of fetal alcohol syndrome include:
- A. abnormal facial tissue, cleft lip, and cleft palate.
- B. hepatomegaly, hypotonia, and microphthalmia.
- C. microcephaly, short philtrum, and intrauterine growth restriction.
- D. hyperbilirubinemia, jaundice, and failure to thrive.
Correct Answer: C
Rationale: Fetal alcohol syndrome is characterized by microcephaly, a short philtrum, and intrauterine growth restriction, among other features.
Which of the following instructions should Nurse Cheryl include in her teaching plan for the parents of Reggie with otitis media?
- A. Placing the child in the supine position to bottle-feed
- B. Giving prescribed amoxicillin (Amoxil) on an empty stomach
- C. Cleaning the inside of the ear canals with cotton swabs
- D. Avoiding contact with people who have upper respiratory tract infections
Correct Answer: D
Rationale: Nurse Cheryl should include in her teaching plan for Reggie's parents to avoid contact with people who have upper respiratory tract infections. Otitis media is often caused by upper respiratory infections, and exposure to individuals with such infections can increase the risk of exacerbating Reggie's condition or causing recurrent infections. Implementing measures to minimize exposure can help prevent further complications and promote faster recovery for Reggie. Placing the child in the supine position to bottle-feed may increase the likelihood of fluid entering the middle ear, worsening the otitis media. Giving amoxicillin on an empty stomach is not recommended as it can cause gastrointestinal upset and reduce absorption; instead, it should be given with food to enhance efficacy. Cleaning the inside of the ear canals with cotton swabs can be harmful and may cause damage or introduce infection, making it an inappropriate practice in managing otitis media.
The nurse should include which of the following in preprocedure teaching for a patient scheduled for carotid angiography?
- A. "You will be put to sleep before the needle Is inserted."
- B. "The test will take several hours."
- C. "You may fee! a burning sensation when the dye is injected."
- D. "There will be no complications."
Correct Answer: C
Rationale: It is important for the nurse to include in preprocedure teaching for a patient scheduled for carotid angiography the information that the patient may feel a burning sensation when the dye is injected. This information helps prepare the patient for a common sensation during the procedure, reducing anxiety and promoting patient understanding and cooperation. Providing this education enhances the patient's overall experience and enables them to better cope with the procedure. The other options are not accurate or complete in providing necessary preprocedure information for the patient.
A client is receiving the cell cycle-nonspecific alkylating agent thiotepa (thioplex), 60 mg weekly for 4 weeks by bladder instillation as part of a chemotherapeutic regimen to treat bladder cancer. The client asks the nurse how the drug works. How does thiotepa exert its therapeutic effects?
- A. It interferes with deoxyribonucleic acid (DNA) replication only.
- B. It interferes with ribonucleic acid (RNA) transcription only.
- C. It interferes with DNA replication and RNA transcription.
- D. It destroys the cell membrane, causing lysis.
Correct Answer: C
Rationale: Thiotepa is a cell cycle-nonspecific alkylating agent that exerts its therapeutic effects by interfering with both DNA replication and RNA transcription. The alkylating properties of thiotepa lead to the cross-linking of DNA strands, ultimately inhibiting DNA replication. Additionally, thiotepa can also disrupt RNA synthesis, further affecting protein production and cell function. This combined action on DNA replication and RNA transcription contributes to the cytotoxic effects of thiotepa on rapidly dividing cancer cells.