Nokea
The nurse is counselling a couple who are interested in intrauterine insemination (IUI) with sperm from a donor and ask the nurse how long the procedure will take. Which of the following time frames is the basis for the nurses' response?
- A. About 1 hour
- B. 2-4 hours
- C. At least a full day
- D. 2-3 days
Correct Answer: D
Rationale: The option is intrauterine insemination (IUI) with sperm from the partner or a donor and takes 2-3 days for the complete procedure.
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The nurse is assessing a patient who is on the surgical unit after a radical abdominal hysterectomy. Which of the following findings is most important to report to the health care provider?
- A. Decreased bowel sounds in all four abdominal quadrants.
- B. Urine output of 100 mL in the first 8 hours after surgery.
- C. Symptom of pain at the incision site with coughing
- D. One inch increased abdominal girth
Correct Answer: B
Rationale: The decreased urine output indicates possible low blood volume and further assessment is needed to assess for possible internal bleeding. The other findings are not unusual after this surgery.
The nurse is caring for a patient with persistent menorrhagia. Which of the following parameters should the nurse monitor?
- A. Estrogen level
- B. Complete blood count (CBC)
- C. Gonadotropin-releasing hormone (GnRH) level
- D. Serial β-human chorionic gonadotropin (hCG) results
Correct Answer: B
Rationale: Because anemia is a likely complication of menorrhagia, the nurse will need to check the CBC. Estrogen and GnRH levels are checked for patients with other problems, such as infertility. Serial β-hCG levels are monitored in patients who may be pregnant, which is not likely for this patient.
An 18-year-old visits the health clinic for a routine check-up. To determine whether a Pap test is needed, which of the following questions should the nurse ask?
- A. Do you use any illegal substances?
- B. Have you ever had sexual intercourse?
- C. How old were you when your menstrual periods started?
- D. Do you have any cramping with your menstrual periods?
Correct Answer: B
Rationale: The current Canadian Cancer Society recommendation is that a Pap test be done every 1-3 years, for women between age 21 and 69 years. The information about menstrual periods and substance abuse will not help to determine whether the patient requires a Pap test.
The nurse is caring for a patient who has undergone a radical vulvectomy for vulvar carcinoma. Which of the following nursing diagnoses is priority at this time?
- A. Bathing self-care deficit related to pain
- B. Risk for infection as evidenced by invasive procedure (contamination of the wound with urine and stool)
- C. Imbalanced nutrition: less than body requirements related to insufficient dietary intake
- D. Risk for ineffective sexual pattern as evidenced by impaired relationship with significant other (disfiguration caused by the surgery)
Correct Answer: B
Rationale: Complex and meticulous wound care is needed to prevent infection and delayed wound healing. The other nursing diagnoses may also be appropriate for the patient but are not the highest priority immediately after surgery.
A 33-year-old female patient who uses oral contraceptives tells the nurse, 'I want to have children in a few years.' Which of the following responses by the nurse is best?
- A. You may have more difficulty becoming pregnant after about age 35.
- B. You have many years of fertility left, so there is no rush to have children.
- C. You should plan to stop taking oral contraceptives several years before you want to become pregnant.
- D. If you do not have children within the next few years, it will be very difficult for you to become pregnant.
Correct Answer: A
Rationale: The probability of successfully becoming pregnant decreases after age 35 although some patients may have no difficulty in becoming pregnant, this probability further decreases after age 40. Oral contraceptives do not need to be withdrawn for several years for a woman to become pregnant. Although the patient may be fertile for many years, it would be inaccurate to indicate that there is no concern about infertility as she becomes older. Although the risk for infertility increases after age 35, not all patients have difficulty in conceiving.