Reduction in congenital rubella is best accomplished by:
- A. Avoiding contact with young children when infections are prevalent
- B. Taking prophylactic antibiotics during the second half of pregnancy
- C. Testing the rubella titer at the first prenatal visit to determine immunity
- D. Immunizing susceptible women at least 28 days before they become pregnant
Correct Answer: D
Rationale: The correct answer is D because immunizing susceptible women at least 28 days before they become pregnant ensures protection against rubella during pregnancy, reducing the risk of congenital rubella syndrome in the fetus. This timing allows for the development of immunity before conception.
Avoiding contact with young children (A) does not directly prevent rubella transmission to pregnant women. Taking prophylactic antibiotics during pregnancy (B) is not recommended for rubella prevention. Testing rubella titer at the first prenatal visit (C) only assesses current immunity status but does not actively prevent congenital rubella.
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The nurse is discussing risk factors for endometriosis with a new nurse. Which client would the nurse identify as being at the highest risk for developing endometriosis?
- A. One who smokes one pack per day
- B. One who states her menstrual cycles are irregular
- C. One who states her mother had endometriosis
- D. One who had a previous cesarean section
Correct Answer: C
Rationale: The correct answer is C because genetics play a significant role in the development of endometriosis. If a client's mother had endometriosis, there is an increased likelihood of her developing the condition. This is due to shared genetic factors that may predispose individuals to endometriosis. Smoking (choice A) is a risk factor for many health conditions but not specifically for endometriosis. Irregular menstrual cycles (choice B) may be a symptom of endometriosis but do not directly increase the risk of developing it. Having a previous cesarean section (choice D) is not a known risk factor for endometriosis.
Which are risk factors for ovarian cancer? Select all that apply.
- A. Talc use on the perineum
- B. First-degree relative with ovarian cancer
- C. Three or more children
- D. High-fat diet
Correct Answer: C
Rationale: The correct answer is C: Three or more children. Multiparity (having three or more children) has been identified as a protective factor against ovarian cancer due to the repeated ovulation and hormonal changes during pregnancy. A: Talc use on the perineum is not a well-established risk factor. B: Having a first-degree relative with ovarian cancer increases the risk, but it is not as significant as having multiple children. D: High-fat diet has been suggested as a risk factor, but the evidence is not as strong as the protective effect of multiparity.
A 17-year-old client presents to the clinic with concerns that she has not begun menstruating. She states that she is a gymnast and has been competing since she was 9 years old. Based on this history, what does the nurse know the client is most likely experiencing?
- A. Secondary amenorrhea
- B. Polycystic ovary syndrome
- C. Primary amenorrhea
- D. Dysmenorrhea
Correct Answer: C
Rationale: The correct answer is C: Primary amenorrhea. A 17-year-old who has not started menstruating is experiencing primary amenorrhea. This is likely due to her intense physical activity as a gymnast, which can delay the onset of menstruation. Secondary amenorrhea (A) occurs when menstruation stops after it has already begun. Polycystic ovary syndrome (B) is characterized by hormonal imbalances and ovarian cysts, not delayed onset of menstruation. Dysmenorrhea (D) refers to painful menstruation, which is not the issue in this case.
What is the clinical finding most likely to be exhibited in an infant diagnosed with erythroblastosis fetalis?
- A. Edema
- B. Immature red blood cells
- C. Enlargement of the heart
- D. Ascites
Correct Answer: B
Rationale: The correct answer is B: Immature red blood cells. Erythroblastosis fetalis is a condition where maternal antibodies attack fetal red blood cells, leading to hemolysis and the release of immature red blood cells (erythroblasts) into the circulation. This can result in anemia and jaundice in the infant. Edema (choice A) is not a typical clinical finding in erythroblastosis fetalis. Enlargement of the heart (choice C) is more commonly associated with conditions like congestive heart failure. Ascites (choice D) is the accumulation of fluid in the abdominal cavity and is not a characteristic finding in erythroblastosis fetalis.
The client calls the nurse and states she has not had a menstrual cycle in 3 months. What does the nurse know is the most common cause of secondary amenorrhea?
- A. Weight loss
- B. Pregnancy
- C. Cancer
- D. Menopause
Correct Answer: B
Rationale: The correct answer is B: Pregnancy. In the case of secondary amenorrhea, where a woman stops menstruating after previously having regular cycles, pregnancy is the most common cause. Pregnancy leads to a halt in the menstrual cycle due to hormonal changes to support the developing fetus. Other choices are incorrect: A) Weight loss can affect menstruation but is not the most common cause of secondary amenorrhea. C) Cancer can also disrupt the menstrual cycle, but it is not the primary cause in this scenario. D) Menopause typically occurs in women in their late 40s to early 50s, and would not be the most common cause of secondary amenorrhea in a younger woman.