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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.
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A patient arrives to the clinic 2 hours late for her prenatal appointment. This is the third time she has been late. What is the nurse’s best action in response to this patient’s tardiness?
- A. Ask the patient if she has a way to tell the time.
- B. Ask the patient if she is deliberately being late for her appointments.
- C. Determine if the patient wants this baby and if this is her way of acting out.
- D. Determine if the patient arrives after the start time for other types of appointments.
Correct Answer: C
Rationale: The nurse's best action in response to the patient's tardiness is to determine if the patient wants this baby and if this is her way of acting out. Tardiness to prenatal appointments can sometimes indicate underlying issues such as ambivalence towards the pregnancy or emotional distress. By addressing the patient's motivation for being consistently late, the nurse can better understand and support her needs. This approach allows for a more patient-centered and compassionate response, aiming to address any possible concerns or challenges the patient may be facing.
A nurse is caring for a patient who has HSV and is pregnant. The patient is concerned about the fetus. What medication is safest to take?
- A. valacyclovir
- B. none
- C. acyclovir
- D. famciclovir
Correct Answer: C
Rationale: Acyclovir is the antiviral medication of choice for treating HSV (Herpes Simplex Virus) infections during pregnancy due to its known safety profile. It is classified as Category B by the FDA, indicating that there is no evidence of risk to the fetus based on animal studies. Valacyclovir and famciclovir, on the other hand, are both classified as Category B (risk cannot be ruled out) and Category C (animal studies have shown adverse effects) by the FDA, respectively. It is generally recommended to avoid taking unnecessary medications during pregnancy, but if treatment for HSV is necessary, acyclovir is considered the safest option.
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.
The nurse is providing care to a 72-year-old female patient. While providing care, the nurse instructs the patient to slowly rise from a sitting or prone position. What is the pathophysiological reason for this instruction?
- A. The patient is at higher risk for fractures due to postmenopausal osteoporosis.
- B. The patient is at higher risk for hypotension due to decreased baroreceptor sensitivity.
- C. The patient is at higher risk for falls due to decreased muscle strength and balance
- D. The patient is at higher risk for adverse drug reactions due to decreased hepatic function
Correct Answer: B
Rationale: As people age, their baroreceptor sensitivity decreases, making them more prone to orthostatic hypotension, especially when changing positions quickly. Orthostatic hypotension is a significant concern in the elderly population as it can lead to falls and injuries. By instructing the patient to rise slowly from a sitting or prone position, the nurse is helping to prevent a rapid drop in blood pressure that can occur with sudden position changes. This precaution is particularly important in elderly patients to minimize the risk of falls and subsequent injuries.
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.