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Karen, a 28-year-old female patient, has a hysterosalpingogram ordered but not scheduled. What should the nurse tell the patient?
- A. When your next menses starts, call the office to schedule your procedure.
- B. You may experience uterine cramping during the procedure.
- C. Radiation exposure will be avoided through the use of ultrasound imaging.
- D. The purpose of the test is to evaluate the inside of your uterus and your fallopian tubes.
Correct Answer: A
Rationale: Rationale for Correct Answer (A):
- A is correct because the nurse should instruct the patient to call the office when her next menstrual cycle starts to schedule the hysterosalpingogram. This is essential as the test needs to be performed during a specific phase of the menstrual cycle for accurate results.
Summary of Incorrect Choices:
- B: While uterine cramping may be a possible side effect of the procedure, this information is not the most crucial to communicate to the patient at this time.
- C: While it is important to address concerns about radiation exposure, the use of ultrasound imaging doesn't eliminate the need for the patient to schedule the procedure at the appropriate time in her menstrual cycle.
- D: While this choice provides some information about the purpose of the test, it does not address the immediate action the patient needs to take to schedule the procedure correctly.
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A 25-year-old woman, G0 P0000, enters the infertility clinic stating that she has just learned she is positive for the BRCA1 and the BRCA2 genes. She asks the nurse what her options are for getting pregnant and breastfeeding her baby. The nurse should base her reply on which of the following?
- A. Fertility of women who carry the BRCA1 and BRCA2 genes is similar to that of unaffected women.
- B. Women with these genes should be advised not to have children because the children could inherit the defective genes.
- C. Women with these genes should have their ovaries removed as soon as possible to prevent ovarian cancer.
- D. Lactation is contraindicated for women who carry the BRCA1 and BRCA 2 genes.
Correct Answer: A
Rationale: BRCA1/2 status does not directly affect fertility or breastfeeding.
A woman is in the first stage of labor. The nurse would encourage her to assume which position to facilitate the progress of labor?
- A. supine
- B. lithotomy
- C. upright
- D. knee-chest
Correct Answer: C
Rationale: Research shows that upright positions help reduce the length of labor, improve progress, fetal head descent, reduce pain, and result in a good Apgar score. Recumbent positions can lead to supine hypotension and decrease uterine activity, hindering labor progress. Therefore, encouraging an upright position is the best choice for facilitating labor.
What is the role of hCG in early pregnancy tests?
- A. hCG stimulates ovulation during the menstrual cycle.
- B. hCG levels rise after implantation, confirming pregnancy.
- C. hCG reduces the risk of miscarriage during early pregnancy.
- D. hCG suppresses the menstrual cycle during pregnancy.
Correct Answer: B
Rationale: The correct answer is B because hCG (human chorionic gonadotropin) levels rise after implantation of the fertilized egg in the uterus, confirming pregnancy. This hormone is produced by the developing placenta and is the key marker used in early pregnancy tests to detect pregnancy.
A is incorrect because hCG does not stimulate ovulation; rather, it is produced after ovulation to support pregnancy.
C is incorrect because while hCG plays a role in supporting pregnancy, it does not directly reduce the risk of miscarriage.
D is incorrect because hCG does not suppress the menstrual cycle; it is actually produced during pregnancy and is essential for maintaining the pregnancy.
A woman who is undergoing infertility testing states, "My husband won't discuss this with me. I don't think he cares about or wants a baby." The nurse's ideal response is
- A. "You should confront him about this."
- B. "He probably doesn't understand your concern."
- C. "Men are sometimes less eager to have children."
- D. "It may be harder for him to express his feelings."
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the husband's potential difficulty in expressing his feelings, validating the woman's concerns while also offering empathy. It is important to recognize that discussing infertility can be emotionally challenging for both partners, and the response shows understanding and support.
Choice A is incorrect as it suggests confrontation, which may escalate the situation and lead to further communication breakdown. Choice B implies a lack of understanding on the husband's part, which may not be the case. Choice C is a generalization and may not address the specific dynamics of this couple's situation.
A patient is being interviewed by the nurse. During the family history assessment, the patient reports having had relatives with cancer. Which is the nurse's best response?
- A. Complete a pedigree, noting the types of cancer and which relatives were affected.
- B. Ask whether the cancer was in male or female relatives.
- C. Determine whether the cancer reported in the family history is pertinent to the patient's personal medical history.
- D. Schedule a consult with a genetic counselor to further assess the patient's risk.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Completing a pedigree allows for a visual representation of the family's health history.
2. Noting the types of cancer and affected relatives helps identify patterns and potential genetic risks.
3. This response demonstrates a proactive approach to understanding the patient's genetic predispositions.
Summary of other choices:
B: Asking about the gender of affected relatives does not provide as much detailed information about the types of cancer or specific family members affected.
C: Determining relevance to personal history is important, but a pedigree provides a broader picture for risk assessment.
D: Referring to a genetic counselor may be necessary but completing a pedigree first helps gather essential information for a more informed consultation.