Nokea
Which is a constellation of physical and psychological symptoms beginning in the luteal phase of the menstrual cycle and followed by a symptom-free period?
- A. Endometriosis
- B. Abnormal uterine bleeding
- C. Premenstrual syndrome
- D. Depression
Correct Answer: C
Rationale: Rationale:
1. Premenstrual syndrome (PMS) occurs in the luteal phase due to hormonal changes.
2. PMS includes physical and psychological symptoms.
3. It is followed by a symptom-free period (during menstruation).
4. Endometriosis is a separate condition involving tissue growth outside the uterus.
5. Abnormal uterine bleeding refers to irregular bleeding patterns.
6. Depression is a mental health condition not specific to the menstrual cycle.
Summary:
PMS is the correct answer as it aligns with the timing, symptoms, and pattern described in the question. Endometriosis, abnormal uterine bleeding, and depression do not fully match the criteria provided.
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A patient, 32 weeks pregnant with severe headache, is admitted to the hospital with preeclampsia. In addition to obtaining baseline vital signs and placing the client on bed rest, the physician ordered the following four items. Which of the orders should the nurse perform first?
- A. Assess deep tendon reflexes.'
- B. Obtain complete blood count.'
- C. Assess baseline weight.'
- D. Obtain routine urinalysis.'
Correct Answer: A
Rationale: The correct answer is A: Assess deep tendon reflexes. This is the priority because preeclampsia can progress to eclampsia, a life-threatening condition characterized by seizures. Assessing deep tendon reflexes helps in identifying signs of impending eclampsia. Obtaining a complete blood count (option B) and routine urinalysis (option D) are important in monitoring for complications of preeclampsia but do not address the immediate risk of seizures. Assessing baseline weight (option C) is also important but does not take precedence over assessing deep tendon reflexes in this scenario.
For HIV treatment, the pregnant woman should be expected to receive:
- A. Antibiotics
- B. Protease analogues
- C. Zidovudine
- D. Acyclovir
Correct Answer: C
Rationale: Rationale:
1. Zidovudine (AZT) is recommended for HIV-infected pregnant women to reduce the risk of vertical transmission to the baby.
2. It inhibits viral replication and decreases viral load in the mother, reducing transmission to the fetus.
3. Antibiotics are not effective for HIV treatment. Protease analogues are not typically used in pregnancy due to safety concerns. Acyclovir is used for herpes simplex virus, not HIV.
The nurse taught a class on HPV and cervical cancer. Which statement by the student indicates a need for further teaching?
- A. Most HPV infections resolve on their own within 1 to 2 years.
- B. I can get the HPV vaccination to prevent the most common types of HPV that could cause cervical cancer.
- C. Genital warts cause cervical cancer.
- D. A persistent infection of HPV type 16 or 18 can lead to cervical cancer.
Correct Answer: C
Rationale: The correct answer is C: Genital warts cause cervical cancer.
Rationale:
1. Genital warts are caused by certain types of HPV, not cervical cancer.
2. Most HPV infections do resolve on their own, making choice A correct.
3. HPV vaccination can prevent common types of HPV that cause cervical cancer, supporting choice B.
4. Persistent infection with high-risk HPV types, like 16 or 18, can lead to cervical cancer, aligning with choice D.
Summary:
Option C is incorrect because it inaccurately states that genital warts cause cervical cancer. The other choices are correct in their statements regarding HPV infections, vaccination, and the relationship between specific HPV types and cervical cancer.
The nurse is preparing a 51-year-old client for a vaginal examination. The nurse should place the client in which position?
- A. Prone
- B. Lateral Sims’
- C. Lithotomy
- D. High Fowler’s
Correct Answer: C
Rationale: The correct answer is C: Lithotomy position. This position allows for optimal visualization of the vaginal area and easier access for the examination. The client lies on their back with knees flexed and feet in stirrups, providing proper exposure. Prone (A) is face down and not suitable for a vaginal exam. Lateral Sims' (B) is on the side and not ideal for this exam. High Fowler's (D) is sitting upright, which is not appropriate for a vaginal examination.
The nurse is caring for an Rh-negative mother on the postpartum unit. What scenario indicates the need to administer RhoGAM to this patient?
- A. She has had one Rh-negative child and is pregnant with an Rh-negative child.
- B. She has had an Rh-positive infant and is pregnant with an Rh-positive fetus.
- C. She has had an O-negative child and is pregnant with a B-negative child.
- D. She is a primipara with an O-negative child.
Correct Answer: B
Rationale: Rationale:
1. Rh-negative mother with Rh-positive infant: During delivery, fetal blood can mix with maternal blood leading to sensitization.
2. Sensitization can cause the mother's immune system to produce antibodies against Rh antigen.
3. RhoGAM is administered to prevent antibody formation in Rh-negative mothers carrying Rh-positive infants.
Summary:
- A: Incorrect. No risk of sensitization as both child and fetus are Rh-negative.
- B: Correct. Rh-negative mother with Rh-positive infant at risk for sensitization.
- C: Incorrect. Rh factor mismatch between children doesn't require RhoGAM.
- D: Incorrect. Being primipara or child's blood type doesn't warrant RhoGAM administration.