Nokea
Many communities now offer the availability of free-standing birth centers to provide care for low-risk women during pregnancy, birth, and postpartum. When counseling the newly pregnant patient regarding this option, the nurse should be aware that this type of care setting includes which advantages? (Select all that apply.)
- A. Staffing by lay midwives
- B. Equipped for obstetric emergencies
- C. Less expensive than acute care hospitals
- D. Safe, homelike births in a familiar setting
Correct Answer: B
Rationale: B. Equipped for obstetric emergencies: Free-standing birth centers are equipped to handle any obstetric emergencies that may arise during labor and birth. They have the necessary equipment and trained staff to respond quickly and effectively to emergencies to ensure the safety of both the mother and baby.
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Nurses, certified nurse-midwives, and other advanced practice nurses have the knowledge and expertise to assist women in making informed choices regarding contraception. A multidisciplinary approach should ensure that the woman's social, cultural, and interpersonal needs are met. Which action should the nurse first take when meeting with a new client to discuss contraception?
- A. Obtain data about the frequency of coitus.
- B. Determine the woman's level of knowledge concerning contraception and her commitment to any particular method.
- C. Assess the woman's willingness to touch her genitals and cervical mucus.
- D. Evaluate the woman's contraceptive life plan.
Correct Answer: B
Rationale: Determining the woman's level of knowledge about contraception and her commitment to a method is the first step. This provides the nurse with the necessary background before moving on to a diagnosis and appropriate method choices.
The nurse is assessing a 33-year-old female patient who comes to the family practice clinic with complaints of excessive menstrual bleeding with bleeding between periods for the past 6 months. The health care provider has performed an endometrial biopsy and has discontinued the patient's oral contraceptives. What is the rationale for this treatment?
- A. This condition is often associated with use of oral contraceptives and may subside upon discontinuation.
- B. This condition is often associated with type 2 diabetes and must be controlled with a different type of birth control.
- C. This condition is often associated with hyperplasia of the endometrial tissue, which is exacerbated with oral contraceptives.
- D. This condition is often associated with ovarian cysts, which are exacerbated with the use of oral contraceptives.
Correct Answer: C
Rationale: The correct rationale for discontinuing the oral contraceptives in a patient with excessive menstrual bleeding and bleeding between periods is that this condition is often associated with hyperplasia of the endometrial tissue, which can be exacerbated with the use of oral contraceptives. Endometrial hyperplasia is a condition characterized by the abnormal thickening of the lining of the uterus, which can lead to heavy or prolonged menstrual bleeding. Estrogen contained in oral contraceptives can contribute to this thickening of the endometrial tissue, potentially worsening the patient's symptoms. By discontinuing the oral contraceptives, the provider aims to reduce the estrogen levels in the body, which may help alleviate the symptoms associated with endometrial hyperplasia. An endometrial biopsy is also important in this case to further investigate the underlying cause of the abnormal bleeding.
A nurse is caring for a patient who was diagnosed with urethritis. What does the nurse identify as a possible cause?
- A. Neisseria gonorrhoeae
- B. Escherichia coli
- C. pregnancy
- D. spermicides
Correct Answer: A
Rationale: Urethritis is inflammation of the urethra usually caused by an infection. Neisseria gonorrhoeae, commonly known as gonorrhea, is a sexually transmitted bacterium known to cause urethritis. It is a common cause of urethritis in sexually active individuals. Escherichia coli is associated with urinary tract infections but not typically urethritis. Pregnancy is not a cause of urethritis. Spermicides can potentially irritate the urethra but are not a common cause of urethritis.
Which condition would leuprolide acetate (Lupron) be prescribed for?
- A. Anovulatory cycles
- B. Uterine fibroids
- C. Polycystic ovary disease (PCOD)
- D. Luteal phase inadequacy
Correct Answer: B
Rationale: Leuprolide acetate is used to treat endometriosis and uterine fibroids, not anovulatory cycles or PCOD.
A charge nurse is working on a postpartum unit and discovers that one of the patients did not receive AM care during her shift assessment. The charge nurse questions the nurse assigned to provide care and finds out that the nurse thought “the patient should just do it by herself because she will have to do this at home.” On further questioning of the nurse, it is determined that the rest of her assigned patients were provided AM care. The assigned nurse has violated which ethical principle?
- A. Justice
- B. Truth
- C. Confidentiality
- D. Autonomy
Correct Answer: A
Rationale: Justice in healthcare ethics refers to the fair and equal distribution of resources, care, and treatment. In this scenario, the nurse's decision to not provide AM care to the specific patient, while providing care to other patients, violates the principle of justice. It is unfair and unjust to selectively provide care based on personal assumptions rather than patients' needs. All patients should be treated equally and receive appropriate care regardless of individual beliefs or assumptions.