The nurse is preparing a handout for female adolescents on the menstrual cycle. What phase of the cycle occurs if fertilization does not take place?
- A. Menstrual
- B. Proliferative
- C. Secretory
- D. Ischemic
Correct Answer: D
Rationale: The ischemic phase of the menstrual cycle occurs when the corpus luteum degenerates in the absence of fertilization. This leads to a decline in progesterone and estrogen levels, resulting in the shedding of the uterine lining during menstruation.
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What physical findings would the nurse expect in a bulimic client?
- A. Mastoiditis.
- B. Hirsutism.
- C. Gynecomastia.
- D. Esophagitis.
Correct Answer: D
Rationale: Repeated vomiting damages the esophagus.
The nurse is assessing a client with hyperemesis gravidarum. What finding requires immediate intervention?
- A. Urine output of 50 mL/hr.
- B. Weight loss of 5 pounds in 2 weeks.
- C. Dry mucous membranes and poor skin turgor.
- D. Nausea relieved by eating crackers.
Correct Answer: C
Rationale: Dehydration, indicated by dry mucous membranes and poor skin turgor, requires immediate intervention in hyperemesis gravidarum.
In teaching parents to use a bulb syringe to suction an infant, the nurse should teach them to:
- A. suction the back of the throat vigorously.
- B. always suction the nose before suctioning the mouth.
- C. use it only once a day.
- D. insert the syringe into the sides of the mouth.
Correct Answer: B
Rationale: Suctioning the nose first prevents pushing secretions further down the throat.
What nursing intervention is appropriate for a woman diagnosed with syphilis?
- A. Council the woman about how to live with a chronic infection.
- B. Question the woman regarding symptoms of other sexually transmitted infections.
- C. Assist the primary health care practitioner with cryotherapy procedures.
- D. Educate the woman regarding the safe disposal of menstrual pads.
Correct Answer: B
Rationale: Syphilis often coexists with other STIs, so questioning is important.
A nurse is caring for a client following an amniocentesis. The nurse should observe the client for which of the following complications?
- A. Hyperemesis
- B. Proteinuria
- C. Hypoxia
- D. Hemorrhage
Correct Answer: D
Rationale: Following an amniocentesis, the nurse should observe the client for the potential complication of hemorrhage. Amniocentesis is a procedure where a small amount of amniotic fluid is extracted from the amniotic sac surrounding the fetus for various diagnostic purposes. The risk of hemorrhage is associated with this invasive procedure due to the possibility of damaging blood vessels within the uterus during the insertion of the needle. It is important for the nurse to closely monitor the client for any signs of bleeding, such as vaginal bleeding, abdominal pain, or signs of shock, and report any concerns promptly to the healthcare provider for further evaluation and management.