Nokea
A patient with an IUD in place has a positive pregnancy test. When planning care, the nurse will base decisions on which anticipated action?
- A. A therapeutic abortion will need to be scheduled since fetal damage is inevitable.
- B. Hormonal analyses will be done to determine the underlying cause of the false-positive test result.
- C. The IUD will need to be removed to avoid complications such as miscarriage or infection.
- D. The IUD will need to remain in place to avoid injuring the fetus.
Correct Answer: C
Rationale: Rationale:
C is correct because when a patient with an IUD in place has a positive pregnancy test, the IUD should be removed to avoid complications such as ectopic pregnancy, miscarriage, or infection. Leaving the IUD in place can increase the risk of adverse outcomes for both the mother and the fetus. Removing the IUD allows for safer management of the pregnancy and reduces potential harm.
Summary:
A: Incorrect. Fetal damage is not inevitable, and a therapeutic abortion is not the immediate action required in this situation.
B: Incorrect. Hormonal analyses are not the priority when a positive pregnancy test with an IUD in place is detected.
D: Incorrect. Leaving the IUD in place can lead to complications and is not the recommended course of action.
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A woman asks the nurse to recommend the best douche for use after menstruation. Which of the following responses by the nurse is appropriate?
- A. Tap water with white vinegar is most refreshing and least allergenic.'
- B. It is really best for women not to douche.'
- C. Any of the over-the-counter douches is satisfactory.'
- D. It is best to douche during menstruation rather than after it is over.'
Correct Answer: B
Rationale: Douching can disrupt the natural vaginal flora and increase the risk of infections, so it is generally not recommended.
A young man is planning to use the condom as a contraceptive device. The nurse should teach him that which of the following actions is needed to maximize the condom's effectiveness?
- A. Use only water-soluble lubricants.
- B. Use only natural lambskin condoms.
- C. Apply the condom to a flaccid penis.
- D. Apply it tightly to the tip of the penis.
Correct Answer: A
Rationale: Water-soluble lubricants should be used with condoms to prevent breakage. Natural lambskin condoms do not protect against STIs, and condoms should be applied to an erect penis.
The nurse is completing the family assessment on a patient at 10 weeks of gestation. What data are included in the family assessment? Select all that apply.
- A. annual income
- B. total number of cousins
- C. number of people living in the household
- D. person in the household who makes the major decisions for the family
Correct Answer: A
Rationale: The correct answer is A: annual income. This data is crucial for assessing the family's financial resources and potential impact on the patient's health and well-being during pregnancy. Annual income can help identify possible financial stressors that may affect access to healthcare, nutrition, and overall prenatal care.
B: Total number of cousins is not typically part of a family assessment during pregnancy and does not directly impact the patient's prenatal care.
C: Number of people living in the household is important for understanding the household dynamics, but it may not be directly related to the patient's prenatal care needs.
D: Identifying the person in the household who makes major decisions is important for understanding family dynamics, but it may not directly impact the patient's prenatal care.
A nurse is teaching the staff about managed care. Which information should the nurse include in the teaching session?
- A. Managed care insures full coverage of health care costs.
- B. Managed care only assumes the financial risk involved.
- C. Managed care allows providers to focus on illness care.
- D. Managed care causes providers to focus on prevention.
Correct Answer: D
Rationale: Managed care describes health care systems in which the provider or the health care system receives a predetermined capitated (fixed amount) payment for each patient enrolled in the program. Therefore, the focus of care shifts from individual illness care to prevention, early intervention, and outpatient care.
The nurse is determining the G/TPAL of a patient at her first prenatal visit. The patient informs the nurse she delivered a set of twins at 32 weeks of gestation who are now 5 years old, delivered her first child 8 years ago 1 week early, and miscarried at 2 months' gestation 3 years ago. What is this patient's Gravida [G] and Parity [P] using the G/TPAL nomenclature?
- A. G3 P1113
- B. G3 P2113
- C. G4 P1113
- D. G4 P2113
Correct Answer: D
Rationale: The correct answer is D: G4 P2113. To determine the Gravida (G) and Parity (P) of the patient:
- Gravida (G): The patient has been pregnant a total of 4 times (twins at 32 weeks, first child 1 week early, miscarriage at 2 months, and current pregnancy). Therefore, G is 4.
- Parity (P): P is divided into four categories: term births (T), preterm births (P), abortions (A), and living children (L). The patient delivered twins at 32 weeks (P2), her first child 1 week early (T1), and had a miscarriage at 2 months (A1). Therefore, the Parity is P2A1L3, represented as 2113. Other choices are incorrect because they do not accurately reflect the patient's obstetric history.