Nokea
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.
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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.
Which client should the nurse refer for further testing?
- A. Left breast slightly smaller than right breast
- B. Eversion (elevation) of both nipples
- C. Faintly visible bilateral symmetry of venous network
- D. Small dimple located in the upper outer quadrant of the right breast
Correct Answer: D
Rationale: A small dimple in the breast is a concerning sign and should be referred for further testing as it can indicate breast cancer.
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.
A father and mother are carriers of phenylketonuria (PKU). Their 2-year-old daughter has the condition. The couple tells the nurse that they are having a second baby. Because their daughter has PKU, they are certain that this baby will not be affecteWhich response by the nurse is the most accurate?
- A. Good planning. You need to take advantage of the odds that are in your favor.
- B. I think you'd better first check with your physician.
- C. You are both carriers; therefore, each baby has a 25% chance of being affected.
- D. The ultrasound indicates a boy, and boys are not affected by PKU.
Correct Answer: C
Rationale: Each child conceived by this couple has a one-in-four chance of being affected with the PKU disorder. This couple still has an increased likelihood of having a child with PKU; having one child already with PKU does not guarantee that they will not have another. These parents need to discuss their options with their physician. However, an opportune time has presented itself for the couple to receive correct teaching about inherited genetic risks. No correlation exists between gender and inheritance of the disorder, because PKU is an autosomal recessive disorder.
A client complains of severe abdominal and pelvic pain around the time of menstruation. This pain has become progressively worse over the last 5 years. She also complains of pain during intercourse and has tried unsuccessfully to become pregnant for the past 18 months. To which condition are these symptoms most likely related?
- A. Endometriosis
- B. PMS
- C. Primary dysmenorrhea
- D. Secondary dysmenorrhea
Correct Answer: A
Rationale: Endometriosis can cause severe pelvic pain dysmenorrhea dyspareunia and infertility. These symptoms are most indicative of endometriosis.