In some Middle Eastern and African cultures, female genital mutilation (female cutting) is a prerequisite for marriage. Women who now live in North America need care from nurses who are knowledgeable about the procedure and comfortable with the abnormal appearance of their genitalia. When caring for this patient, the nurse can formulate a diagnosis with the understanding that the patient may be at risk for which of the following? (Select all that apply.)
- A. Infection
- B. Laceration
- C. Hemorrhage
- D. Obstructed labor
Correct Answer: A
Rationale: Female genital mutilation (FGM) can lead to various short-term and long-term complications, putting the woman at risk for infection (such as urinary tract infections and pelvic infections due to poor healing and scar tissue), hemorrhage (excessive bleeding during or after the procedure or in subsequent sexual encounters), and obstructed labor (due to scarring and narrowing of the birth canal, which can lead to prolonged labor, tears, and even fistula formation). These risks highlight the importance of providing appropriate care, support, and education for women who have undergone FGM.
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What information would the nurse include when teaching a patient about core needle biopsy?
- A. It can be performed with or without ultrasound guidance.
- B. Local anesthetic is not needed before this procedure.
- C. It is usually performed in the outpatient surgery center.
- D. A special dye is injected into the area around the tumor.
Correct Answer: C
Rationale: Core needle biopsy is typically performed in an outpatient setting such as a clinic or outpatient surgery center. This procedure involves using a hollow needle to extract a small tissue sample from the suspicious area for further examination. Performing the core needle biopsy in an outpatient setting allows for a more convenient and efficient process for both patients and healthcare providers. Additionally, outpatient facilities are equipped to handle minor procedures like core needle biopsies in a safe and controlled environment.
A nurse is working in the area of labor and birth. Her assignment is to take care of a gravida 1 para 0 woman who presents in early labor at term. Vaginal exam reflects the following: 2 cm, cervix posterior, –1 station, and vertex with membranes intact. The patient asks the nurse if she can break her water so that her labor can go faster. The nurse’s response, based on the ethical principle of nonmaleficence, is which of the following?
- A. Tell the patient that she will have to wait until she has progressed further on the vaginal exam and then she will perform an amniotomy.
- B. Have the patient write down her request and then call the physician for an order to implement the amniotomy.
- C. Instruct the patient that only a physician or certified midwife can perform this procedure.
- D. Give the patient an enema to stimulate labor.
Correct Answer: A
Rationale: The correct response based on the ethical principle of nonmaleficence, which refers to the duty to do no harm, is to tell the patient that she will have to wait until she has progressed further on the vaginal exam and then perform an amniotomy. In this scenario, breaking the patient's water prematurely could introduce risks and potential harm without clear medical necessity. Performing an amniotomy too early could increase the risk of infection or cause umbilical cord prolapse, which can be harmful to both the mother and the baby. Therefore, it is important for the nurse to wait until the patient has progressed further in labor before considering an amniotomy.
Which issue is a major concern among members of lower socioeconomic groups?
- A. Practicing preventive health care
- B. Meeting health needs as they occur
- C. Maintaining an optimistic view of life
- D. Maintaining group health insurance for their families
Correct Answer: B
Rationale: Members of lower socioeconomic groups often struggle to access and afford healthcare services. Unlike those in higher socioeconomic classes who can afford preventive care, individuals in lower socioeconomic groups typically wait to seek medical care until they have significant health issues or emergencies. Factors such as cost barriers, lack of health insurance, transportation issues, and limited access to healthcare facilities contribute to this problem. As a result, the major concern among individuals in lower socioeconomic groups is the ability to meet their health needs as they occur rather than focusing on preventive healthcare practices. This issue can lead to poorer health outcomes and increased healthcare costs in the long run.
The nurse is preparing to teach the community about risk factors for the second most common cancer of the female reproductive system. Which of the following groups of women are at higher risk for this cancer? Select all that apply.
- A. Menopausal women with an intact uterus who receive hormonal therapy
- B. Women who have undergone treatment for breast cancer
- C. Women who have many pregnancies and nursed their infants
- D. Women who smoke and have many sexual partners
Correct Answer: A
Rationale: A. Menopausal women with an intact uterus who receive hormonal therapy are at higher risk for endometrial cancer, which is the second most common cancer of the female reproductive system. Estrogen therapy without progesterone can increase the risk of endometrial cancer due to unopposed estrogen stimulation.
The nurse is planning a teaching session for staff on ethical theories. Which situation best reflects the Deontologic theory?
- A. Approving a physician-assisted suicide
- B. Supporting the transplantation of fetal tissue and organs
- C. Using experimental medications for the treatment of AIDS
- D. Initiating resuscitative measures on a 90-year-old patient with terminal cancer
Correct Answer: D
Rationale: Deontologic theory, also known as deontological ethics, focuses on the duty to follow moral rules and obligations regardless of the consequences. In this scenario, initiating resuscitative measures on a 90-year-old patient with terminal cancer reflects a commitment to upholding the duty to provide care and uphold the sanctity of life. Despite the patient's poor prognosis, the nurse is ethically bound to provide care according to established principles and guidelines, emphasizing duty over outcome. This aligns with the Deontologic theory's emphasis on following moral rules and obligations without consideration of the consequences.