Nokea
The nurses working at a newly established birthing center have begun to compare their performance in providing maternal-newborn care against clinical standards. This comparison process is most commonly known as what?
- A. Best practices network
- B. Clinical benchmarking
- C. Outcomes-oriented practice
- D. Evidence-based practice
Correct Answer: C
Rationale: Outcomes-oriented practice measures the effectiveness of interventions and quality of care against benchmarks or standards.
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The nurse is assessing a 33-year-old female patient who comes to the family practice clinic with complaints of excessive menstrual bleeding with bleeding between periods for the past 6 months. The health care provider has performed an endometrial biopsy and has discontinued the patient's oral contraceptives. What is the rationale for this treatment?
- A. This condition is often associated with use of oral contraceptives and may subside upon discontinuation.
- B. This condition is often associated with type 2 diabetes and must be controlled with a different type of birth control.
- C. This condition is often associated with hyperplasia of the endometrial tissue, which is exacerbated with oral contraceptives.
- D. This condition is often associated with ovarian cysts, which are exacerbated with the use of oral contraceptives.
Correct Answer: C
Rationale: The correct rationale for discontinuing the oral contraceptives in a patient with excessive menstrual bleeding and bleeding between periods is that this condition is often associated with hyperplasia of the endometrial tissue, which can be exacerbated with the use of oral contraceptives. Endometrial hyperplasia is a condition characterized by the abnormal thickening of the lining of the uterus, which can lead to heavy or prolonged menstrual bleeding. Estrogen contained in oral contraceptives can contribute to this thickening of the endometrial tissue, potentially worsening the patient's symptoms. By discontinuing the oral contraceptives, the provider aims to reduce the estrogen levels in the body, which may help alleviate the symptoms associated with endometrial hyperplasia. An endometrial biopsy is also important in this case to further investigate the underlying cause of the abnormal bleeding.
Which client would be an ideal candidate for injectable progestins such as Depo-Provera (DMPA) as a contraceptive choice?
- A. The ideal candidate for DMPA wants menstrual regularity and predictability.
- B. The client has a history of thrombotic problems or breast cancer.
- C. The ideal candidate has difficulty remembering to take oral contraceptives daily.
- D. The client is homeless or mobile and rarely receives health care.
Correct Answer: C
Rationale: DMPA requires only four injections a year, making it ideal for clients who have difficulty remembering to take daily oral contraceptives.
The nurse is interviewing a patient who is 6-weeks pregnant. The patient asks the nurse, “Why is elective abortion considered such an ethical issue?” Which response by the nurse is most appropriate? N R I G B.C M
- A. Abortion requires third-parUty cSonseNnt. T O
- B. The U.S. Supreme Court ruled that life begins at conception.
- C. Abortion law is unclear about a woman’s constitutional rights.
- D. There is a conflict between the rights of the woman and the rights of the fetus.
Correct Answer: D
Rationale: The most appropriate response by the nurse is that there is a conflict between the rights of the woman and the rights of the fetus when discussing elective abortion as an ethical issue. This response highlights the ethical dilemma involved in abortion, where one must consider the rights and autonomy of the pregnant woman as well as the potential rights of the fetus. Ethical debates often revolve around balancing these conflicting rights and interests, making elective abortion a complex and sensitive issue. It acknowledges the ethical implications of abortion without making definitive statements or legal references like the other options.
Which documentation on a woman's chart on postpartum day 14 indicates a normal involution process?
- A. Moderate bright red lochial flow
- B. Breasts firm and tender
- C. Fundus below the symphysis and nonpalpable
- D. Episiotomy slightly red and puffy
Correct Answer: C
Rationale: By postpartum day 14, the fundus should be below the symphysis and nonpalpable, indicating normal involution.
To ensure client safety, the practicing nurse must have knowledge of The Joint Commission's current 'Do Not Use' list of abbreviations. Which term is acceptable for use regarding medication administration?
- A. q.o.or Q.O.D.
- B. MSO4 or MgSO4
- C. International Unit
- D. Lack of a leading zero
Correct Answer: C
Rationale: I.U.' and i.u.' are no longer acceptable because they could be misreaThe leading zero should be used before a decimal point.