Nokea
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.
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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.
The most conservative approach for early breast cancer treatment involves lumpectomy followed by which procedure?
- A. Radiation
- B. Adjuvant systemic therapy
- C. Hormonal therapy
- D. Chemotherapy
Correct Answer: A
Rationale: Radiation therapy is typically used after lumpectomy to treat early-stage breast cancer.
Which information regarding substance abuse is important for the nurse to understand?
- A. Cigarette smoking has little effect on maternity-related health.
- B. Women, ages 21 to 34 years, have the highest rates of specific alcohol-related problems.
- C. Coffee is a stimulant that has been related to birth defects.
- D. Prescription psychotherapeutic drugs do not affect the fetus.
Correct Answer: B
Rationale: Alcohol abuse during pregnancy has been associated with many negative outcomes. Cigarette smoking impairs fertility and causes low-birth-weight infants.
Which action would be inappropriate for the nurse to perform before beginning the health history interview?
- A. Smile and ask the client whether she has any special concerns.
- B. Speak in a relaxed manner with an even, nonjudgmental tone.
- C. Make the client comfortable.
- D. Tell the client her questions are irrelevant.
Correct Answer: D
Rationale: Telling the client that her questions are irrelevant is inappropriate. Nurses should make the client feel comfortable and respected.
A 32-year-old female patient arrives to the emergency department with heavy uterine bleeding. The nurse finds that the patient had a positive pregnancy test 1 month prior to the visit. What is the potential medical management for this patient's issue?
- A. Endometrial biopsy
- B. Dilation and curettage
- C. Colposcopy
- D. Laparoscopy
Correct Answer: B
Rationale: The correct answer is B: Dilation and curettage. This procedure is indicated for heavy uterine bleeding in the setting of a positive pregnancy test to diagnose and treat conditions such as incomplete miscarriage or ectopic pregnancy. Dilation and curettage involves dilating the cervix and scraping the uterine lining to remove any remaining products of conception. It is important in this case to rule out any potential sources of bleeding that could be life-threatening.
A: Endometrial biopsy is not the appropriate initial management in this scenario as it is primarily used to assess endometrial pathology such as cancer.
C: Colposcopy is a procedure used to examine the cervix and vagina for abnormalities, not typically indicated for heavy uterine bleeding in the setting of a positive pregnancy test.
D: Laparoscopy is a minimally invasive surgical procedure used to view the abdominal organs, not typically indicated for uterine bleeding related to a positive pregnancy test.