Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother?
- A. Hypoglycemia
- B. Hypercalcemia
- C. Hypoinsulinemia
- D. Hypobilirubinemia
Correct Answer: A
Rationale: The correct answer is A: Hypoglycemia. Infants of diabetic mothers are at risk for hypoglycemia due to excessive insulin production in response to high glucose levels in utero. Monitoring blood glucose levels is crucial to prevent hypoglycemia-related complications.
B: Hypercalcemia is not a major neonatal complication seen in infants of diabetic mothers.
C: Hypoinsulinemia refers to low levels of insulin, which is not typically a concern in infants of diabetic mothers.
D: Hypobilirubinemia is not a common complication in infants of diabetic mothers.
In summary, monitoring for hypoglycemia is essential in infants of diabetic mothers to prevent potential complications.
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The patient is asking the nurse about the best way to stay healthy. The nurse explains to the patient which teaching points? (Select all that apply.)
- A. Increase physical activity.
- B. Keep total fat intake to 10% or less.
- C. Maintain body weight in a healthy range.
- D. Choose and prepare foods with little salt.
Correct Answer: A
Rationale: Step-by-step rationale for why choice A is correct:
1. Increasing physical activity helps in maintaining a healthy weight and overall health.
2. Regular exercise can reduce the risk of chronic diseases like heart disease and diabetes.
3. Physical activity improves mental health and overall well-being.
4. Exercise boosts immunity and helps in managing stress levels.
Summary of why other choices are incorrect:
B. Keeping total fat intake to 10% or less is a specific dietary recommendation and not a comprehensive approach to staying healthy.
C. Maintaining body weight in a healthy range is important but does not encompass all aspects of staying healthy.
D. Choosing and preparing foods with little salt is a specific dietary recommendation and does not address the importance of physical activity in staying healthy.
The advanced practice nurse is attempting to examine the patients ear with an otoscope. Because of impacted cerumen, the tympanic membrane cannot be visualized. The nurse irrigates the patients ear with a solution of hydrogen peroxide and water to remove the impacted cerumen. What nursing intervention is most important to minimize nausea and vertigo during the procedure?
- A. Maintain the irrigation fluid at a warm temperature.
- B. Instill short, sharp bursts of fluid into the ear canal.
- C. Follow the procedure with insertion of a cerumen curette to extract missed ear wax.
- D. Have the patient stand during the procedure.
Correct Answer: A
Rationale: Correct Answer: A. Maintain the irrigation fluid at a warm temperature.
Rationale:
1. Warm fluid helps prevent vertigo and nausea by minimizing stimulation of the vestibular system.
2. Cold fluid can cause dizziness and nausea due to the temperature effect on the inner ear.
3. Warm fluid promotes patient comfort and relaxation during the procedure.
4. Cold fluid can lead to vasoconstriction, potentially exacerbating ear discomfort.
Summary of other choices:
B. Instilling short, sharp bursts of fluid can be uncomfortable and increase the risk of vertigo and nausea.
C. Following with a curette may not be necessary if the irrigation effectively removes the impacted cerumen.
D. Having the patient stand can increase the risk of falling or losing balance due to potential dizziness from the procedure.
A 42-year-old man has come to the clinic for an annual physical. The nurse notes in the patients history that his father was treated for breast cancer. What should the nurse provide to the patient before he leaves the clinic?
- A. A referral for a mammogram
- B. Instructions about breast self-examination (BSE)
- C. A referral to a surgeon
- D. A referral to a support group
Correct Answer: A
Rationale: The correct answer is A: A referral for a mammogram. Given the family history of breast cancer in the patient's father, the nurse should recommend a mammogram as a preventive measure due to increased risk. Mammograms are effective in detecting breast cancer early, especially in individuals with a family history. This can help in early diagnosis and timely intervention if needed.
B: Instructions about breast self-examination (BSE) can be helpful, but in this case, a mammogram is a more definitive screening tool for high-risk individuals.
C: A referral to a surgeon is not necessary at this point as the patient does not exhibit any symptoms of breast cancer.
D: Referral to a support group may be beneficial for emotional support, but the priority should be on proactive screening measures like a mammogram.
Which data found on a patient’s health history would place her at risk for an ectopic pregnancy?
- A. Ovarian cyst 2 years ago
- B. Recurrent pelvic infections
- C. Use of oral contraceptives for 5 years
- D. Heavy menstrual flow of 4 days’ duration
Correct Answer: B
Rationale: The correct answer is B: Recurrent pelvic infections. Pelvic infections can lead to scarring and blockage of the fallopian tubes, increasing the risk of ectopic pregnancy. Ovarian cysts and oral contraceptives are not directly linked to ectopic pregnancies. Heavy menstrual flow does not inherently increase the risk of ectopic pregnancy.
A patient has been referred to the breast clinic after her most recent mammogram revealed the presence of a lump. The lump is found to be a small, well-defined nodule in the right breast. The oncology nurse should recognize the likelihood of what treatment?
- A. Lumpectomy and radiation
- B. Partial mastectomy and radiation
- C. Partial mastectomy and chemotherapy
- D. Total mastectomy and chemotherapy
Correct Answer: A
Rationale: The correct answer is A: Lumpectomy and radiation. For a small, well-defined nodule in the breast, lumpectomy (removal of the lump) followed by radiation therapy is usually the treatment of choice for early-stage breast cancer. This approach aims to preserve the breast while ensuring effective treatment. Partial mastectomy (B) involves removing a larger portion of the breast tissue and is not typically necessary for a small, well-defined nodule. Chemotherapy (C) is generally used for more advanced stages of breast cancer or when the cancer has spread beyond the breast. Total mastectomy (D) is considered when the cancer is more extensive or in cases where lumpectomy is not feasible.
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