Nokea
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.
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When reviewing a new patient’s birth plan, the nurse notices that the patient will be bringing a doula to the hospital during labor. What does the nurse think that this means?
- A. The patient will have her grandmother as a support person.
- B. The patient will bring a paid, trained labor support person with her during labor.
- C. The patient will have a special video she will play during labor to assist with relaxation.
- D. The patient will have a bag that contains all the approved equipment that may help with the labor process.
Correct Answer: B
Rationale: A doula is a trained labor support person who provides physical, emotional, and informational support to the mother before, during, and after childbirth. They are not typically a family member like a grandmother (option A) and do not involve playing a special video (option C) or bringing a bag of equipment (option D). The presence of a doula can help improve birth outcomes, provide continuous support, and enhance the birthing experience for the mother.
The nurse is formulating a nursing care plan for a postpartum patient. Which actions by the nurse indicate use of critical thinking skills when formulating the care plan? (Select all that apply.)
- A. Using a standardized postpartum care plan
- B. Determining priorities for each diagnosis written
- C. Writing interventions from a nursing diagnosis book
- D. Reflecting and suspending judgment when writing the care plan
Correct Answer: B
Rationale: B. Determining priorities for each diagnosis written: Prioritizing nursing diagnoses based on the patient's needs and condition requires critical thinking skills. The nurse must be able to identify the most urgent issues to address first in the care plan.
Which goal is most appropriate for the collaborative problem of wound infection?
- A. The patient will not exhibit further signs of infection.
- B. Maintain the patient’s fluid intake at 1000 mL/8 hour.
- C. The patient will have a temperature of 98.6F within 2 days.
- D. Monitor the patient to detect therapeutic response to antibiotic therapy.
Correct Answer: A
Rationale: The most appropriate goal for the collaborative problem of wound infection is "The patient will not exhibit further signs of infection." This goal directly addresses the issue of controlling and resolving the infection within the wound, leading to the overall improvement in the patient's condition. By ensuring that the patient does not exhibit further signs of infection, healthcare providers can monitor the effectiveness of treatment interventions and prevent any complications that may arise from the infection spreading or worsening. In contrast, options B, C, and D are not directly related to addressing the wound infection itself, making them less appropriate goals for this specific problem.
A 48-year-old female patient presents to the OB/GYN clinic for her annual examination. She states that she has had the following symptoms: mood swings, irregular menstrual cycles, forgetfulness, food cravings, and a decrease in libido. Which of the following does the nurse suspect the patient is experiencing?
- A. Menopause
- B. Perimenopause
- C. Postmenopause
- D. Pregnancy
Correct Answer: B
Rationale: Perimenopause is the transitional period leading to menopause that usually begins in a woman's 40s but can start earlier. During this phase, women may experience symptoms such as mood swings, irregular menstrual cycles, forgetfulness, food cravings, and a decrease in libido, as described by the patient in this case. These symptoms are caused by hormonal fluctuations as the ovaries start to produce less estrogen in preparation for menopause. Menopause occurs when a woman has not had a menstrual period for 12 consecutive months. Postmenopause, on the other hand, refers to the stage after menopause, where menopausal symptoms have generally subsided. The symptoms described by the patient are more indicative of the perimenopausal stage rather than pregnancy, as they are typical signs of hormonal changes associated with the menopausal transition.
A nurse is admitting a patient to the labor and birth unit in early labor that was sent to the facility following a checkup with her health care provider in the office. The patient is a gravida 1, para 0, and is at term. No health issues are discerned from the initial assessment, and the nurse prepares to initiate physician orders based on standard procedures. Which action by the nurse manager is warranted in this situation?
- A. No action is indicated because the nurse is acting within the scope of practice.
- B. The nurse manager should intervene and ask the nurse to clarify admission orders directly with the physician.
- C. The nurse manager should review standard procedures with the nurse to validate that orders are being carried out accurately.
- D. The nurse manger should review the admission procedure with the nurse.
Correct Answer: B
Rationale: In this scenario, the nurse is admitting a patient based on orders initiated by the physician during an office visit. Given that the patient is in early labor and has no discernible health issues, the nurse manager should intervene and ask the nurse to clarify the admission orders directly with the physician. It is important to ensure clarity and accuracy when carrying out physician orders, especially in situations where there may be ambiguity or room for misinterpretation. By verifying the orders with the physician, the nurse can help prevent any potential errors or miscommunications that may impact the patient's care.