Nokea
Spontaneous termination of a pregnancy is considered to be an abortion if
- A. the pregnancy is less than 20 weeks.
- B. the fetus weighs less than 1000 g.
- C. the products of conception are passed intact.
- D. there is no evidence of intrauterine infection.
Correct Answer: A
Rationale: The correct answer is A because spontaneous termination of a pregnancy is considered an abortion if it occurs before 20 weeks gestation. This is based on the medical definition of abortion as the termination of a pregnancy before the fetus is able to survive outside the womb. Choices B, C, and D are incorrect as they do not accurately reflect the criteria for defining abortion. B and D are specific conditions related to the fetus and the presence of infection, while C refers to passing products of conception intact, which can happen in both spontaneous and induced abortions.
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A nurse would identify that a colleague needs additional instruction on standard precautions when the colleague exhibits which of the following behaviors?
- A. The nurse wears face protection, gloves, and a gown when irrigating a wound.
- B. The nurse washes the hands with a waterless antiseptic agent after removing a pair of soiled gloves.
- C. The nurse puts on a second pair of gloves over soiled gloves while performing a bloody procedure.
- D. The nurse places a used needle and syringe in the puncture-resistant container without capping the needle.
Correct Answer: C
Rationale: The correct answer is C because putting on a second pair of gloves over soiled gloves during a procedure violates standard precautions by increasing contamination risk. Here's the rationale:
1. Standard precautions require removing soiled gloves before putting on new ones to prevent cross-contamination.
2. Wearing multiple gloves increases the risk of tearing and exposure to pathogens.
3. This behavior shows a lack of understanding of proper infection control practices.
Summary of other choices:
A: Wearing face protection, gloves, and a gown when irrigating a wound is a correct practice.
B: Washing hands with waterless antiseptic after removing soiled gloves is correct.
D: Placing a used needle and syringe in a puncture-resistant container without capping the needle is incorrect, but not as severe as choice C.
The nurse is caring for a patient who has just been told that her ovarian cancer is terminal and that no curative options remain. What would be the priority nursing care for this patient at this time?
- A. Provide emotional support to the patient and her family.
- B. Implement distraction and relaxation techniques.
- C. Offer to inform the patients family of this diagnosis.
- D. Teach the patient about the importance of maintaining a positive attitude.
Correct Answer: A
Rationale: The correct answer is A: Provide emotional support to the patient and her family. This is the priority as the patient has received devastating news and needs immediate support. Emotional support can help the patient cope with the diagnosis, express feelings, and make decisions. B: Implementing distraction techniques may not address the patient's emotional needs in this critical situation. C: Offering to inform the family of the diagnosis is important but not the priority at this moment. D: Teaching about maintaining a positive attitude may not be appropriate as the patient is facing a terminal illness.
A nurse exchanges information with the oncomingnurse about a patient’s care. Which action did the nurse complete?
- A. A verbal report
- B. An electronic record entry
- C. A referral
- D. An acuity rating
Correct Answer: A
Rationale: The correct answer is A: A verbal report. This is because exchanging information verbally between nurses allows for real-time communication, ensuring important details are accurately conveyed. Electronic record entry (B) involves documenting information in the patient's record but does not involve direct communication. Referral (C) refers to transferring the patient's care to another healthcare provider. Acuity rating (D) is a tool used to determine the severity of a patient's condition and does not involve exchanging information between nurses.
During a recent visit to the clinic a woman presents with erythema of the nipple and areola on the right breast. She states this started several weeks ago and she was fearful of what would be found. The nurse should promptly refer the patient to her primary care provider because the patients signs and symptoms are suggestive of what health problem?
- A. Peau dorange
- B. Nipple inversion
- C. Pagets disease
- D. Acute mastitis
Correct Answer: C
Rationale: Rationale:
1. Erythema of nipple/areola in one breast can be a sign of Paget's disease, a rare form of breast cancer.
2. Paget's disease may also present with itching, tingling, or a burning sensation in the affected area.
3. Referring the patient promptly is crucial for early detection and appropriate management.
4. Peau d'orange (A) is a sign of advanced breast cancer, not typically presenting with erythema alone.
5. Nipple inversion (B) may be benign or related to other conditions, not typically presenting with erythema.
6. Acute mastitis (D) presents with breast pain, warmth, swelling, and fever, but not typically with isolated erythema of the nipple/areola.
A nurse is using the explanatory model to determinethe etiology of an illness. Which questions should the nurse ask? (Select all that apply.)
- A. How should your sickness be treated?
- B. What do you call your problem?
- C. How does this illness work inside your body?
- D. What do you fear most about your sickness?
Correct Answer: B
Rationale: The correct answer is B: What do you call your problem? In the explanatory model, this question helps the nurse understand the patient's perspective and cultural beliefs about their illness. By asking how the patient labels their illness, the nurse gains insight into the patient's understanding of the illness, which can influence their treatment adherence and outcomes. The other options are incorrect because:
A: How should your sickness be treated? - This question focuses on treatment preferences rather than understanding the patient's beliefs.
C: How does this illness work inside your body? - This question is more aligned with the biomedical model, seeking physiological explanations rather than patient perspectives.
D: What do you fear most about your sickness? - While important for assessing emotional aspects, this question does not directly address the patient's explanatory model.