Nokea
When a client who is 25 years of age asks the nurse when she should seek fertility counseling, the best response by the nurse is:
- A. "Fertility counseling should be sought when you have been unable to conceive after 1 year of unprotected intercourse."?
- B. "Fertility counseling should be sought when you have not been able to conceive after 6-9 months of unprotected intercourse."?
- C. "The average time it takes someone your age to conceive is 5.3 months, so if you haven't conceived by then, we can refer you."?
- D. "We can give you some guidance now on how to increase your chances of conceiving and then refer you if it doesn't happen within a year."?
Correct Answer: D
Rationale: The best response in this scenario is to offer immediate guidance while also indicating when fertility counseling should be sought. While Choice A is technically correct as guidelines recommend seeking fertility counseling after 1 year of unprotected intercourse, it lacks providing immediate guidance. Choice B suggests seeking counseling after 6-9 months, which is earlier than the standard recommendation of 1 year. Choice C mentions the average time to conceive for someone of the client's age without addressing the client's current concern. Therefore, Choice D is the most appropriate response as it offers immediate guidance along with a plan for referral if needed.
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Which of the following physical findings indicates that an 11-12-month-old child is at risk for developmental dysplasia of the hip?
- A. refusal to walk
- B. not pulling to a standing position
- C. negative Trendelenburg sign
- D. negative Ortolani sign
Correct Answer: B
Rationale: The correct answer is 'not pulling to a standing position.' An 11-12-month-old child not pulling to a standing position may be at risk for developmental dysplasia of the hip. By this age, children typically pull to a standing position, and failure to do so should raise concerns. Refusal to walk is a broader observation and not specific to hip dysplasia. The Trendelenburg sign indicates weakness of the gluteus medius muscle, not hip dysplasia. The Ortolani sign is used to detect congenital subluxation or dislocation of the hip, which is different from developmental dysplasia of the hip.
Nurses caring for clients who have cancer and are taking opioids need to assess for all of the following except:
- A. tolerance.
- B. constipation.
- C. sedation.
- D. addiction.
Correct Answer: D
Rationale: The correct answer is 'addiction.' When caring for clients with cancer who are taking opioids, nurses need to assess for tolerance, constipation, and sedation as these are common side effects of opioid use. Addiction is not a primary concern when managing pain in terminally ill clients, as the goal is effective pain management rather than addiction prevention. Tolerance refers to the body's adaptation to the opioid over time, requiring higher doses for the same effect. Constipation and sedation are common side effects of opioids that nurses need to monitor and manage. Addiction is not a major concern in this population as the focus is on providing comfort and pain relief.
A nurse is preparing to assist the healthcare provider in performing an internal gynecological examination of a client. In which position does the nurse place the client for this examination?
- A. Prone
- B. Left side-lying
- C. Sims
- D. Lithotomy
Correct Answer: D
Rationale: An internal gynecological examination is performed with the client in the lithotomy position. In this position, the client is supine, with the feet in stirrups, the knees apart, and the buttocks at the end of the examining table. The client is draped so that only the vulva is exposed. The lithotomy position provides optimal access for the healthcare provider to perform the examination effectively. The prone position refers to lying on the stomach, which is not suitable for a gynecological exam. The Sims position is a left side-lying position primarily used for administering enemas, not for gynecological examinations.
The nurse is teaching parents of a newborn about feeding their infant. Which of the following instructions should the nurse include?
- A. Use the defrost setting on microwave ovens to warm bottles.
- B. When refrigerating formula, discard partially used bottles after 24 hours.
- C. When using formula concentrate, mix one part water and one part concentrate.
- D. When using powdered formula, mix two parts water and one part powder.
Correct Answer: A
Rationale: The correct answer is to use the defrost setting on microwave ovens to warm bottles. It is essential for parents to be cautious when warming bottles in a microwave oven to prevent superheating of the milk. Choosing the defrost setting and checking the formula temperature before giving it to the baby helps avoid burns. Discarding partially used bottles after 24 hours when refrigerating formula is crucial as it reduces the risk of harmful bacterial growth. Mixing formula concentrate with water in a 1:1 ratio of one part concentrate to one part water ensures proper dilution of the formula. On the other hand, powdered formula should be mixed following the package instructions, typically using two parts water to one part powder. This accurate mixing ratio provides the necessary balance of nutrients for the baby. Adding fresh formula to partially used bottles can introduce pathogens that may harm the infant, underscoring the importance of discarding partially used bottles and preparing formula correctly. Therefore, options B, C, and D are incorrect as they do not address the safe and proper ways to feed a newborn effectively.
Which of the following methods of contraception is able to reduce the transmission of HIV and other STDs?
- A. intrauterine device (IUD)
- B. Norplant
- C. oral contraceptives
- D. vaginal sponge
Correct Answer: D
Rationale: The correct answer is the vaginal sponge. The vaginal sponge, when used with foam or jelly contraception, acts as a barrier method that can reduce the transmission of HIV and other STDs, in addition to preventing pregnancy. In contrast, IUDs, Norplant, and oral contraceptives are effective in preventing pregnancy but do not provide protection against the transmission of HIV and STDs. IUDs prevent pregnancy by affecting sperm movement and survival, Norplant releases hormones to prevent ovulation, and oral contraceptives work by inhibiting ovulation. However, these methods do not create a physical barrier against HIV and STD transmission. It is important to counsel clients using methods like IUDs, Norplant, and oral contraceptives to also use chemical or barrier contraceptives to lower the risk of HIV or STD transmission.