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Which patient may require more help and understanding when integrating the newborn into the family?
- A. A primipara from an upper income family
- B. A primipara who comes from a large family
- C. A multipara (gravida 2) who has a supportive husband and mother
- D. A multipara (gravida 6) who has two children younger than 3 years
Correct Answer: D
Rationale: The correct answer is D. A multipara with 6 pregnancies and 2 children younger than 3 years may require more help and understanding when integrating the newborn into the family due to potential challenges of caring for multiple young children simultaneously. This situation can lead to increased stress, fatigue, and difficulty in managing the needs of all children effectively. In contrast, choices A, B, and C have factors that may provide more support and resources for the new mother, such as being from an upper-income family (A), coming from a large family (B), or having a supportive husband and mother (C), which can help in the integration process.
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Nurses must remember that pregnancy is a time of risk for all women. Which condition is likely the biggest risk for the pregnant client?
- A. Preeclampsia
- B. IPV
- C. Diabetes
- D. Abnormal Pap test
Correct Answer: B
Rationale: IPV during pregnancy is more common than preeclampsia, gestational diabetes, or abnormal Pap tests, and poses greater risks.
A nurse is caring for a client who is at 14 weeks of gestation and has hyperemesis gravidarum. Which of the following medications should the nurse plan to administer?
- A. Digoxin
- B. Calcium gluconate
- C. Vitamin B6
- D. Propranolol
Correct Answer: C
Rationale: Vitamin B6 (pyridoxine) is used to treat nausea and vomiting in pregnancy, including hyperemesis gravidarum.
A couple has been counseled for genetic anomalies. They ask you, 'What is karyotyping?' Which description is most accurate?
- A. Karyotyping will reveal if the baby's lungs are mature.
- B. Karyotyping will reveal if the baby will develop normally.
- C. Karyotyping will provide information about the gender of the baby and the number and structure of the chromosomes.
- D. Karyotyping will detect any physical deformities the baby has.
Correct Answer: C
Rationale: Karyotyping provides genetic information such as gender and chromosomal structure. The lecithin/sphingomyelin (L/S) ratio, not karyotyping, reveals lung maturity. Although karyotyping can detect genetic anomalies, the range of normal is nondescriptive, and not all such anomalies display obvious physical deformities. The term 'deformities' is a nondescriptive word, and physical anomalies may be present that are not detected by genetic studies (e.g., cardiac malformations).
A hospital has achieved Magnet status. Which indicators would be consistent with this type of certification?
- A. There is stratification of communication in a directed manner between nursing staff and administration.
- B. There is increased job satisfaction of nurses, with a lower staff turnover rate.
- C. Physicians are certified in their respective specialty areas.
- D. All nurses have baccalaureate degrees and certification in their clinical specialty area.
Correct Answer: B
Rationale: The correct answer is B because increased job satisfaction and lower staff turnover are key indicators of Magnet status, which focuses on nursing excellence and quality care. This is supported by research showing a correlation between Magnet hospitals and positive nurse outcomes. Choices A, C, and D are incorrect as they do not directly align with the criteria for Magnet status, which primarily emphasizes nursing excellence rather than physician certification or educational requirements for nurses.
Which resource best describes a health care service representing the tertiary level of prevention?
- A. Stress management seminars
- B. Childbirth education classes for single parents
- C. BSE pamphlet and teaching
- D. Premenstrual syndrome (PMS) support group
Correct Answer: D
Rationale: A PMS support group represents tertiary prevention, addressing a condition post-occurrence. Primary prevention includes stress management, childbirth education, and BSE pamphlets, which focus on health promotion and early detection.