Nokea
A primipara patient asks about possible support options for her during the labor process. She is apprehensive that her family members will not be prepared to assist her during this time. Which option would be most effective for this patient?
- A. Reassure the patient that the labor and birth staff consists of highly trained nurses who are well educated to take care of laboring patients so that should be sufficient.
- B. Encourage the patient to take prepared childbirth classes with her husband because that should provide the best support by a family member.
- C. Provide information to the patient about obtaining a doula during the labor process.
- D. Tell the patient that this is a normal feeling based on fear of the unknown and that it will subside once she starts the labor process.
Correct Answer: C
Rationale: Providing information to the patient about obtaining a doula during the labor process is the most effective option in this scenario. A doula is a trained professional who provides physical, emotional, and informational support to the mother before, during, and after childbirth. They can help the mother feel supported and empowered during labor, especially if family members are unavailable or unprepared to offer the necessary support. Doulas can also help in communication with the medical staff, advocate for the mother's preferences, and provide comfort measures. Therefore, recommending the option of obtaining a doula would help address the patient's concerns about support during labor.
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The nurse is assessing a 64-year-old female patient. The patient states that she is able to reduce the risk of urinary tract infections (UTIs) by drinking a quart of cranberry juice a day. Which health condition, if present in this patient, contraindicates the use of cranberry juice?
- A. Hypertension, managed with lisinopril
- B. Diabetes type 1, managed with insulin
- C. Atrial fibrillation, managed with warfarin
- D. COPD, managed with inhaled steroids
Correct Answer: C
Rationale: Cranberry juice has the potential to interact with warfarin, a common blood thinner prescribed for conditions such as atrial fibrillation. Cranberry juice contains components that can inhibit the metabolism of warfarin in the body, leading to an increased risk of bleeding. Therefore, patients taking warfarin should avoid or limit their intake of cranberry juice to prevent potential negative interactions. In this case, the patient's use of warfarin to manage atrial fibrillation contraindicates the consumption of cranberry juice in large quantities. It is essential to consult a healthcare provider before making any changes to the diet, especially when taking medications that may interact with certain foods or beverages.
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.
A nurse is assessing a newborn whose mother had gestational diabetes. Which of the following findings should the nurse identify as a manifestation of hypoglycemia?
- A. Hypertonia
- B. Jitteriness
- C. Acrocyanosis
- D. Generalized petechiae
Correct Answer: B
Rationale: Jitteriness is a common sign of neonatal hypoglycemia and should be addressed promptly.
Which statement is most accurate regarding the reporting of IPV in the United States?
- A. Asian women report more IPV than do other minority groups.
- B. Caucasian women report less IPV than do non-Caucasians.
- C. Native-American women report IPV at a rate similar to other groups.
- D. African-American women are less likely to report IPV than Caucasian women.
Correct Answer: B
Rationale: Caucasian women report less IPV than other ethnic groups. Asian women report significantly less IPV. Native-American and Alaska Native women report significantly more IPV.
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.