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What assessment finding suggests that a patient may have fibrocystic breast changes?
- A. green-tinged nipple discharge
- B. ongoing breast pain
- C. firm, ropy feel of the breast tissue under the skin
- D. peau d’orange appearance of the skin
Correct Answer: C
Rationale: Fibrocystic breast changes typically present with breast pain and a cyclic pattern of nodularity and/or lumps in the breast tissue. The characteristic assessment finding that suggests fibrocystic breast changes is the firm, ropy feel of the breast tissue under the skin. This texture is due to the presence of fibrous tissue and cysts within the breast, which can be felt during the physical examination. While nipple discharge and skin changes like peau d’orange can be associated with different breast conditions, the firm and ropy feel of the breast tissue is more specific to fibrocystic changes.
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A nurse is working in the area of labor and birth. Her assignment is to take care of a gravida 1 para 0 woman who presents in early labor at term. Vaginal exam reflects the following: 2 cm, cervix posterior, –1 station, and vertex with membranes intact. The patient asks the nurse if she can break her water so that her labor can go faster. The nurse’s response, based on the ethical principle of nonmaleficence, is which of the following?
- A. Tell the patient that she will have to wait until she has progressed further on the vaginal exam and then she will perform an amniotomy.
- B. Have the patient write down her request and then call the physician for an order to implement the amniotomy.
- C. Instruct the patient that only a physician or certified midwife can perform this procedure.
- D. Give the patient an enema to stimulate labor.
Correct Answer: A
Rationale: The correct response based on the ethical principle of nonmaleficence, which refers to the duty to do no harm, is to tell the patient that she will have to wait until she has progressed further on the vaginal exam and then perform an amniotomy. In this scenario, breaking the patient's water prematurely could introduce risks and potential harm without clear medical necessity. Performing an amniotomy too early could increase the risk of infection or cause umbilical cord prolapse, which can be harmful to both the mother and the baby. Therefore, it is important for the nurse to wait until the patient has progressed further in labor before considering an amniotomy.
Which issue is a major concern among members of lower socioeconomic groups?
- A. Practicing preventive health care
- B. Meeting health needs as they occur
- C. Maintaining an optimistic view of life
- D. Maintaining group health insurance for their families
Correct Answer: B
Rationale: Members of lower socioeconomic groups often struggle to access and afford healthcare services. Unlike those in higher socioeconomic classes who can afford preventive care, individuals in lower socioeconomic groups typically wait to seek medical care until they have significant health issues or emergencies. Factors such as cost barriers, lack of health insurance, transportation issues, and limited access to healthcare facilities contribute to this problem. As a result, the major concern among individuals in lower socioeconomic groups is the ability to meet their health needs as they occur rather than focusing on preventive healthcare practices. This issue can lead to poorer health outcomes and increased healthcare costs in the long run.
Which of the following statements highlights the nurse’s role as a researcher?
- A. Reading peer-reviewed journal articles
- B. Working as a member of the interdisciplinary team to provide patient care
- C. Helping patient to obtain home care postdischarge from the hospital
- D. Delegating tasks to unlicensed personnel to allow for more teaching time with patients
Correct Answer: A
Rationale: Reading peer-reviewed journal articles highlights the nurse's role as a researcher because it involves staying current with the latest evidence-based practices, advancements in healthcare, and research findings. Nurses who engage in reading such articles are able to enhance their knowledge, critical thinking skills, and decision-making abilities, which are crucial aspects of conducting research and applying research findings to patient care. By continuously educating themselves through reviewing peer-reviewed literature, nurses contribute to the advancement of nursing practice and further research in the field.
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.
A nurse is caring for a pregnant patient who asks when she should be tested for GBS. What does the nurse tell the patient?
- A. 34–35 weeks
- B. 36–37 weeks
- C. 38–39 weeks
- D. 39–40 weeks
Correct Answer: B
Rationale: The nurse should inform the pregnant patient that Group B Streptococcus (GBS) testing is typically done between 36 and 37 weeks of pregnancy. Testing at this time allows for optimal identification of GBS colonization during childbirth. It is important to test at this stage to determine the presence of GBS in the birth canal, as GBS can be passed to the newborn during delivery, which may lead to serious infections. Testing later in pregnancy increases the likelihood of obtaining accurate results closer to the due date, enabling appropriate management to be implemented to reduce the risk of transmission to the newborn.