Nokea
The nurse is taking vital signs of a pregnant woman during her first prenatal visit. The patient asks the nurse if she has to have an HIV test. Which of the following is the nurse's best response?
- A. "Yes, all pregnant women must have the test."
- B. "If you do not have multiple sex partners or inject drugs, it is not necessary."
- C. "Governmental guidelines require an HIV test for all pregnant woman."
- D. "After voluntary pretest counseling, you decide whether HIV testing should be done."
Correct Answer: D
Rationale: The nurse's best response is D, "After voluntary pretest counseling, you decide whether HIV testing should be done." It is important for the pregnant woman to make an informed decision about HIV testing after receiving pretest counseling. The decision should be based on her individual risk factors, concerns, and preferences. The nurse should provide information about the importance of HIV testing during pregnancy, the benefits of knowing one's HIV status, and the available treatment options if the test is positive. Ultimately, the decision should be made by the pregnant woman after considering all the information provided.
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A client has had heavy menstrual bleeding for 6 months. Her gynecologist diagnoses microcytic hypochromic anemia and prescribes ferrous sulfate (Feosol), 300mg PO daily. Before initiating iron therapy, the nurse reviews the client's medical history. Which condition would contraindicate the use of ferrous sulfate?
- A. Pregnancy
- B. Ulcerative colitis
- C. Asthma
- D. Severely impaired liver function
Correct Answer: D
Rationale: Severely impaired liver function is a contraindication for the use of ferrous sulfate. In patients with liver disease, iron metabolism can be affected, leading to potential toxicity from iron accumulation. Ferrous sulfate is primarily metabolized by the liver, so in cases of severely impaired liver function, the metabolism of the drug may be altered, leading to potential adverse effects. It is important to consider alternative iron therapy options in patients with severe liver impairment to avoid potential complications.
A client is diagnosed with metastatic adenocarcinoma of the stomach. The physician prescribes mitomycin (Mutamycin) with other chemotherapeutic agents for palliative treatment. How mitomycin does exert its cytotoxic effects?
- A. It inhibits deoxyribonucleic acid (DNA) synthesis
- B. It's cell cycle-phase specific
- C. It inhibits ribonucleic acid (RNA) synthesis
- D. It inhibits protein synthesis
Correct Answer: A
Rationale: Mitomycin exerts its cytotoxic effects by forming cross-links between adjacent guanine residues in DNA, leading to inhibition of DNA synthesis. This mechanism disrupts the replication of cancer cells, ultimately inducing cell death. Mitomycin is an alkylating agent that primarily targets DNA, making it an effective treatment for certain types of cancers, such as adenocarcinoma of the stomach.
A nurse makes the decision to apply a topical anesthetic to a child's skin before drawing blood. Which ethical principle is the nurse demonstrating?
- A. Autonomy
- B. Beneficence
- C. Justice
- D. Truthfulness
Correct Answer: B
Rationale: The nurse is demonstrating the ethical principle of beneficence by applying a topical anesthetic to the child's skin before drawing blood. Beneficence refers to the obligation to act in the best interest of the patient, promoting their well-being and preventing harm. In this case, the nurse is taking proactive steps to minimize the child's discomfort and potential pain during the blood draw procedure, thus upholding the principle of beneficence.
The nurse is caring for a very low birth weight (VLBW) newborn with a peripheral intravenous infusion. Which statement describes nursing considerations regarding infiltration?
- A. Infiltration occurs infrequently because VLBW newborns are inactive.
- B. Continuous infusion pumps stop automatically when infiltration occurs.
- C. Hypertonic solutions can cause severe tissue damage if infiltration occurs.
- D. Infusion site should be checked for infiltration at least once per 8-hour shift.
Correct Answer: C
Rationale: Infiltration of intravenous fluids in VLBW newborns can lead to serious complications, especially if hypertonic solutions are being administered. Hypertonic solutions have a higher osmolarity than the body's fluids, which can cause severe tissue damage if there is infiltration. It is crucial for the nurse to monitor the infusion site closely for signs of infiltration and take prompt action to prevent further harm to the newborn's delicate skin and tissues. The other options are not directly related to the risk and consequences of infiltration in VLBW newborns.
One of the following is not a feature of attention deficit/hyperactivity disorder (ADHD)
- A. ADHD is multifactorial in origin
- B. female to male ratio is 2 to 6:1
- C. prenatal exposure to nicotine increases the risk of ADHD.
- D. lead intoxication
Correct Answer: D
Rationale: Lead intoxication is not a recognized feature of ADHD but rather a separate condition with its own set of symptoms.