Nokea
A nurse is caring for a patient who states she is experiencing a thin vaginal discharge with a strong fishy odor. What test does the nurse prepare?
- A. whiff test
- B. vaginal culture
- C. urine culture
- D. blood test
Correct Answer: A
Rationale: A nurse caring for a patient who presents with a thin vaginal discharge with a strong fishy odor should prepare for performing a whiff test. The whiff test, also known as the amine or sniff test, is used to aid in the diagnosis of bacterial vaginosis (BV). BV is a common vaginal infection characterized by an overgrowth of harmful bacteria in the vagina and can cause symptoms like thin, grayish-white discharge with a strong fishy odor.
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A nurse is caring for a client who is receiving oxytocin to augment labor. The client has an intrauterine pressure catheter and an internal fetal scalp electrode for monitoring. Which of the following is an indication that the nurse should discontinue the infusion?
- A. Contraction frequency every 3 min
- B. Contraction duration of 100 seconds
- C. Fetal heart rate with moderate variability
- D. Fetal heart rate of 118/min
Correct Answer: B
Rationale: Contractions lasting longer than 90 seconds (tachysystole) can lead to fetal distress by reducing uteroplacental blood flow. Oxytocin should be discontinued if contractions become excessive. Moderate variability and normal fetal heart rate do not indicate distress.
A father and mother are carriers of phenylketonuria (PKU). Their 2-year-old daughter has the condition. The couple tells the nurse that they are having a second baby. Because their daughter has PKU, they are certain that this baby will not be affecteWhich response by the nurse is the most accurate?
- A. Good planning. You need to take advantage of the odds that are in your favor.
- B. I think you'd better first check with your physician.
- C. You are both carriers; therefore, each baby has a 25% chance of being affected.
- D. The ultrasound indicates a boy, and boys are not affected by PKU.
Correct Answer: C
Rationale: Each child conceived by this couple has a one-in-four chance of being affected with the PKU disorder. This couple still has an increased likelihood of having a child with PKU; having one child already with PKU does not guarantee that they will not have another. These parents need to discuss their options with their physician. However, an opportune time has presented itself for the couple to receive correct teaching about inherited genetic risks. No correlation exists between gender and inheritance of the disorder, because PKU is an autosomal recessive disorder.
The nurse in labor and birth is caring for a Muslim patient during the active phase of labor. The nurse notes that the patient quickly draws away when touched. Which intervention should the nurse implement?
- A. Ask the charge nurse to reassign you to another patient.
- B. Assume that she does not like you and decrease your time with her.
- C. Continue to touch her as much as you need to while providing care.
- D. Limit touching to a minimum because physical contact may not be acceptable in her culture.
Correct Answer: D
Rationale: The appropriate intervention for the nurse to implement in this situation is to limit touching to a minimum because physical contact may not be acceptable in the patient's culture. In Islam, modesty and privacy are significant aspects of the faith, and physical contact, especially with someone of the opposite gender, may be considered inappropriate or uncomfortable for the patient. Respecting and acknowledging the patient's cultural background and preferences is essential in providing culturally competent care. Therefore, it is important for the nurse to be mindful of the patient's boundaries and minimize any unnecessary physical contact while still providing necessary care and support during labor.
Nurses who provide care to victims of IPV should be keenly aware of what?
- A. Relationship violence usually consists of a single episode that the couple can resolve.
- B. Violence often declines or ends with pregnancy.
- C. Financial coercion is considered part of IPV.
- D. Battered women are generally poorly educated and come from a deprived social background.
Correct Answer: C
Rationale: Economic coercion may accompany physical assault and psychologic attacks. IPV rarely ends with a single episode and often escalates during pregnancy.
A woman is 16 weeks pregnant and has elected to terminate her pregnancy. Which is the most common technique used for the termination of a pregnancy in the second trimester?
- A. Dilation and evacuation (D&E)
- B. Methotrexate administration
- C. Prostaglandin administration
- D. Vacuum aspiration
Correct Answer: A
Rationale: Dilation and evacuation (D&E) is the most common method used for termination in the second trimester, typically performed between 13 and 16 weeks.