Nokea
The nurse is providing care to a 35-year-old female patient who complains of low back pain, pain with defecation, pelvic pressure, and premenstrual spotting. The health care provider has prescribed the hormonal therapy Lupron for this condition. What is the goal of this prescription?
- A. To prevent pregnancy at this time to promote healing
- B. To suppress menstruation and further growth of the tissue
- C. To prevent retrograde menstruation outside the uterine cavity
- D. To increase blood flow to decrease the endometrial lining
Correct Answer: B
Rationale: The goal of prescribing Lupron for this patient is to suppress menstruation and further growth of the tissue. Lupron is a hormonal therapy that works by suppressing the production of certain hormones that stimulate the growth of endometrial tissue. In conditions like endometriosis, where the endometrial tissue grows outside the uterus, suppressing menstruation can help alleviate symptoms such as pelvic pain, back pain, and pelvic pressure. By halting the growth of the tissue, Lupron can help manage the symptoms associated with endometriosis and improve the patient's quality of life.
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The telephone triage nurse receives a call from a patient who is 5 days postoperative total
abdominal hysterectomy. The patient states that her pain is not relieved with the medications and
that she has noticed blood in her urine. The nurse instructs the patient to report immediately to the
emergency department. What does the nurse suspect as the surgical complication?
- A. Possible complication related to the anesthesia
- B. Possible injury to the ureters or bladder
- C. Possible hemorrhage from the internal incision
- D. Possible peritoneal venous thromboembolism
Correct Answer: D
Rationale: In this situation where the patient is 5 days postoperative total abdominal hysterectomy and experiencing pain that is not relieved with medications, the nurse should suspect a possible hemorrhage from the internal incision. Although some pain is expected postoperatively, severe or worsening pain that is not relieved with medications can indicate a complication such as internal bleeding. Immediate medical attention is needed to assess and manage any potential hemorrhage to prevent further complications or adverse outcomes. Other signs of internal bleeding may include symptoms such as increasing abdominal distention, tachycardia, hypotension, and signs of shock.
Which patient will most likely seek prenatal care?
- A. A 15-year-old patient who tells her friends, “I just don’t believe that I am pregnant”
- B. A 28-year-old who is in her second pregnancy and abuses drugs and alcohol
- C. A 20-year-old who is in her first pregnancy and has access to a free prenatal clinic
- D. A 30-year-old who is in her fifth pregnancy and delivered her last infant at home with the help of her mother and sister
Correct Answer: C
Rationale: The patient in option C is the most likely to seek prenatal care. This is because she is in her first pregnancy, indicating that she may be more inclined to seek medical guidance and support for the first time experience of pregnancy. Furthermore, the fact that she has access to a free prenatal clinic suggests that she has the resources and opportunity to obtain proper prenatal care, which can significantly benefit her and her baby's health. In contrast, the patients in the other options either demonstrate risky behaviors (such as drug and alcohol abuse in option B) or have previously given birth without professional medical assistance (as indicated in option D), which may indicate lower likelihood of seeking prenatal care. The patient in option A also demonstrates denial of pregnancy, which could delay seeking necessary prenatal care.
Which nursing diagnosis should the nurse identify as a priority for a patient in active labor?
- A. Risk for anxiety related to upcoming birth
- B. Risk for imbalanced nutrition related to NPO status
- C. Risk for altered family processes related to new addition to the family
- D. Risk for injury (maternal) related to altered sensations and positional or physical
changes
Correct Answer: D
Rationale: The priority nursing diagnosis for a patient in active labor should focus on ensuring the safety and well-being of the mother and the baby. "Risk for injury (maternal) related to altered sensations and positional or physical changes" is the most crucial diagnosis in this scenario as it directly addresses potential risks and complications that may occur during labor and delivery. This nursing diagnosis includes considerations for the physical changes the mother undergoes during labor, such as altered sensations and positioning, which can increase the risk of injury. By identifying and addressing this risk promptly, the nurse can help prevent potential harm to the mother and ensure a safe delivery process.
The telephone triage nurse receives a call from a patient who is 5 days postoperative total
abdominal hysterectomy. The patient states that her pain is not relieved with the medications and
that she has noticed blood in her urine. The nurse instructs the patient to report immediately to the
emergency department. What does the nurse suspect as the surgical complication?
- A. Possible complication related to the anesthesia
- B. Possible injury to the ureters or bladder
- C. Possible hemorrhage from the internal incision
- D. Possible peritoneal venous thromboembolism
Correct Answer: D
Rationale: In this situation where the patient is 5 days postoperative total abdominal hysterectomy and experiencing pain that is not relieved with medications, the nurse should suspect a possible hemorrhage from the internal incision. Although some pain is expected postoperatively, severe or worsening pain that is not relieved with medications can indicate a complication such as internal bleeding. Immediate medical attention is needed to assess and manage any potential hemorrhage to prevent further complications or adverse outcomes. Other signs of internal bleeding may include symptoms such as increasing abdominal distention, tachycardia, hypotension, and signs of shock.
The nurse is providing care to a 72-year-old female patient. While providing care, the nurse instructs the patient to slowly rise from a sitting or prone position. What is the pathophysiological reason for this instruction?
- A. The patient is at higher risk for fractures due to postmenopausal osteoporosis.
- B. The patient is at higher risk for hypotension due to decreased baroreceptor sensitivity.
- C. The patient is at higher risk for falls due to decreased muscle strength and balance
- D. The patient is at higher risk for adverse drug reactions due to decreased hepatic function
Correct Answer: B
Rationale: As people age, their baroreceptor sensitivity decreases, making them more prone to orthostatic hypotension, especially when changing positions quickly. Orthostatic hypotension is a significant concern in the elderly population as it can lead to falls and injuries. By instructing the patient to rise slowly from a sitting or prone position, the nurse is helping to prevent a rapid drop in blood pressure that can occur with sudden position changes. This precaution is particularly important in elderly patients to minimize the risk of falls and subsequent injuries.