Nokea
Most congenital anomalies of the central nervous system (CNS) result from defects in the closure of the neural tube during fetal development. Which factor has the greatest impact on this process?
- A. Maternal diabetes
- B. Maternal folic acid deficiency
- C. Socioeconomic status
- D. Maternal use of anticonvulsant
Correct Answer: B
Rationale: The correct answer is B: Maternal folic acid deficiency. Folic acid is essential for neural tube closure. Deficiency can lead to neural tube defects in the fetus. Maternal diabetes (choice A) can increase the risk, but it's not the primary factor. Socioeconomic status (choice C) may indirectly impact nutrition but isn't directly related to neural tube closure. Maternal use of anticonvulsants (choice D) can increase the risk, but it's not as significant as folic acid deficiency in neural tube closure.
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A pregnant woman at 30 weeks gestation discovers she is HPV positive at her prenatal visit. Upon examination, her provider detects genital warts. Which treatment is not recommended in this case?
- A. Carbon dioxide laser surgery
- B. Electrocautery
- C. Surgical excision
- D. Podophyllin
Correct Answer: D
Rationale: The correct answer is D: Podophyllin. It is contraindicated in pregnancy due to its potential teratogenic effects. Carbon dioxide laser surgery, electrocautery, and surgical excision can be considered safer options for treating genital warts during pregnancy. Podophyllin should be avoided to prevent harm to the developing fetus.
Phototherapy is instituted for an infant. What is the most appropriate nursing action for the infant having phototherapy?
- A. Cover the infant's head with a hat.
- B. Dress the infant lightly in a T-shirt.
- C. Keep the infant's eyes covered.
- D. Reposition the infant at least every 4 to 8 hours.
Correct Answer: C
Rationale: The correct answer is C: Keep the infant's eyes covered. This is important during phototherapy to protect the infant's eyes from potential damage due to exposure to light. Direct light can harm the infant's developing eyes, so covering them is crucial.
Choice A: Cover the infant's head with a hat - This is not necessary for phototherapy as the focus should be on protecting the eyes, not the head.
Choice B: Dress the infant lightly in a T-shirt - While dressing the infant lightly is recommended, it is not as critical as protecting the eyes.
Choice D: Reposition the infant at least every 4 to 8 hours - Repositioning is important for preventing pressure ulcers but is not directly related to the safety of the eyes during phototherapy.
Which should the nurse recommend to the client to relieve premenstrual syndrome (PMS) symptoms? Select all that apply.
- A. NSAIDs to decrease pain
- B. Exercise 5 to 6 times a week
- C. Decrease caffeine
- D. Decrease fiber
Correct Answer: D
Rationale: The correct answer is D, decrease fiber intake. High-fiber foods can worsen bloating and digestive issues associated with PMS. By reducing fiber intake, gas and bloating can be minimized, alleviating these symptoms. NSAIDs (A) can help with pain but do not address other PMS symptoms. Exercise (B) can be beneficial, but it may not directly target PMS symptoms. Decreasing caffeine (C) can help with mood swings, but it is not as effective for physical symptoms compared to reducing fiber intake.
Which are major risk factors for breast cancer? Select all that apply.
- A. Female gender
- B. Increasing age over 50 years
- C. Personal history of breast cancer (in situ or invasive), family history of breast cancer in first-degree relatives (parent, sibling, child)
- D. High-fat diet, Alcohol consumption (two or more drinks/day)
Correct Answer: C
Rationale: The correct answer is C because having a personal history of breast cancer, a family history of breast cancer in first-degree relatives, or both are major risk factors for developing breast cancer. This is due to the presence of genetic mutations that increase the likelihood of developing the disease. Choices A and B are not specific risk factors for breast cancer, although being female and increasing age are associated with higher risk. Choice D, high-fat diet and alcohol consumption, are not considered major risk factors for breast cancer.
The nurse is grading a woman's reflexes. Which of the following grades would indicate reflexes that are slightly brisker than normal?
- A. +1.'
- B. +2.'
- C. +3.'
- D. +4.'
Correct Answer: C
Rationale: The correct answer is C: +3'. This indicates brisk reflexes. A: +1' indicates a low-normal response, B: +2' indicates a normal response, and D: +4' indicates hyperactive reflexes. +3' is slightly brisker than normal, reflecting an increased response without being hyperactive.