Nokea
The nurse is providing care to the 35-year-old female patient at the family practice clinic who is in the office for her annual physical examination. Which tests should the nurse recommend are the most appropriate for this patient? Select all that apply.
- A. Papanicolaou test every 5 years
- B. Mammogram every 2 years
- C. DEXA screen every 2 years
- D. HPV every 5 years
Correct Answer: A
Rationale: A. Papanicolaou test (Pap smear) every 5 years - This test is recommended for cervical cancer screening in women aged 30-65 years old. It helps in early detection and prevention of cervical cancer.
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With regard to an obstetric litigation case, a nurse working in labor and birth is found to be negligent. Which intervention performed by the nurse indicates that a breach of duty has occurred?
- A. The nurse did not document fetal heart tones (FHR) during the second stage of labor.
- B. The patient was only provided ice chips during the labor period, which lasted 8 hours.
- C. The nurse allowed the patient to use the bathroom rather than a bedpan during the first stage of labor.
- D. The nurse asked family members to leave the room when she prepared to do a pelvic exam on the patient.
Correct Answer: A
Rationale: In an obstetric setting, failure to document fetal heart tones (FHR) during the second stage of labor is a critical breach of duty by the nurse. Monitoring FHR is essential to assess fetal well-being and detect any signs of distress or complications during labor. Neglecting to document this important vital sign could result in delayed recognition of fetal distress, potentially leading to adverse outcomes for the baby and the mother. Therefore, this intervention indicates negligence on the part of the nurse in this scenario.
A 48-year-old woman has just had a hysterectomy for endometrial cancer. Which statement alerts the nurse that further teaching is needed?
- A. I can't wait to go on the cruise that I have planned for this summer.
- B. I know that the surgery saved my life, but I will miss having sexual intercourse with my husband.
- C. I have asked my daughter to come and stay with me next week after I am discharged from the hospital.
- D. Well, I don't have to worry about getting pregnant anymore.
Correct Answer: B
Rationale: Stating that she will miss having sexual intercourse with her husband indicates that further teaching is needed for this client regarding sexual activities after a hysterectomy. Although intercourse may be initially uncomfortable, the use of water-soluble lubricants, relaxation exercises, and changes in position may be helpful.
Which statement related to the condition of endometriosis is most accurate?
- A. Endometriosis is characterized by the presence and growth of endometrial tissue inside the uterus
- B. It is found more often in African-American women than in Caucasian or Asian women
- C. Endometriosis may worsen with repeated cycles or remain asymptomatic and disappear after menopause
- D. It is unlikely to affect sexual intercourse or fertility
Correct Answer: C
Rationale: Endometriosis is the growth of endometrial tissue outside the uterus and may cause symptoms such as painful intercourse and infertility. It can worsen with repeated cycles or remain asymptomatic.
The patient makes the statement: “I’m afraid to take the baby home tomorrow.” Which response by the nurse would be the most therapeutic?
- A. “You’re afraid to take the baby home?”
- B. “Don’t you have a mother who can come and help?”
- C. “You should read the literature I gave you before you leave.”
- D. “I was scared when I took my first baby home, but everything worked out.”
Correct Answer: D
Rationale: The best response by the nurse in this situation would be D. By sharing a personal experience of feeling scared when taking their first baby home, the nurse is empathizing with the patient and offering reassurance that everything worked out in the end. This can help the patient feel understood and less alone in their fear, while also providing hope that things will be okay. It validates the patient's feelings and offers a positive perspective, which can be therapeutic in this situation.
Which situation is most representative of an extended family?
- A. It includes adoptive children.
- B. It is headed by a single-parent.
- C. It contains children from previous marriages.
- D. It is composed of children, parents, and grandparents living in the same house.
Correct Answer: D
Rationale: An extended family is a type of family unit that includes not only the nuclear family (parents and children) but also other relatives such as grandparents, aunts, uncles, cousins, etc., all living together or in close proximity. Option D, which states that the family is composed of children, parents, and grandparents living in the same house, is most representative of an extended family structure. This situation reflects the multi-generational aspect of an extended family where multiple generations live together and contribute to the household dynamics.