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Which response by the nurse is the most therapeutic when the patient states, “I’m so afraid to N R I G B.C M U S N T O have a cesarean birth”?
- A. “Everything will be OK.”
- B. “Don’t worry about it. It will be over soon.”
- C. “What concerns you most about a cesarean birth?”
- D. “The physician will be in later and you can talk to him.”
Correct Answer: C
Rationale: The most therapeutic response by the nurse when the patient expresses fear about having a cesarean birth is to offer an open-ended question that explores the patient's concerns further. By asking, "What concerns you most about a cesarean birth?" the nurse acknowledges the patient's fears, encourages communication, and allows the patient to express her feelings and fears in more detail. This response shows empathy and enables the nurse to better address the specific worries and anxieties the patient may have about the procedure. The other options do not effectively address the patient's fears and do not promote therapeutic communication.
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A 48-year-old woman has just had a hysterectomy for endometrial cancer. Which statement alerts the nurse that further teaching is needed?
- A. I can't wait to go on the cruise that I have planned for this summer.
- B. I know that the surgery saved my life, but I will miss having sexual intercourse with my husband.
- C. I have asked my daughter to come and stay with me next week after I am discharged from the hospital.
- D. Well, I don't have to worry about getting pregnant anymore.
Correct Answer: B
Rationale: Stating that she will miss having sexual intercourse with her husband indicates that further teaching is needed for this client regarding sexual activities after a hysterectomy. Although intercourse may be initially uncomfortable, the use of water-soluble lubricants, relaxation exercises, and changes in position may be helpful.
A couple asks the nurse about the procedure for surrogate parenting. Which correct responses should the nurse provide for this couple? (Select all that apply.)
- A. Donated embryos can be implanted into the surrogate mother.
- B. The surrogate mother needs to have carried one previous birth to term.
- C. You both need to be infertile to be eligible for surrogate parenting.
- D. Conception can take place outside the surrogate mother’s body and then implanted.
Correct Answer: A
Rationale: A. Donated embryos can be implanted into the surrogate mother: This is a common method in surrogate parenting where embryos from either the intended parents or donors are implanted into the surrogate mother's uterus.
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.
Which statement regarding chromosomal abnormalities is most accurate?
- A. Chromosomal abnormalities occur in approximately 10% of newborns.
- B. Abnormalities of number are the leading cause of pregnancy loss.
- C. Down syndrome is a result of an abnormal chromosomal structure.
- D. Unbalanced translocation results in a mild abnormality that the child will outgrow.
Correct Answer: B
Rationale: Aneuploidy is an abnormality of number that is also the leading genetic cause of mental retardation. Chromosomal abnormalities occur in fewer than 1% of newborns. Down syndrome is the most common form of a trisomal abnormality, an abnormality of chromosome number (47 chromosomes). Unbalanced translocation is an abnormality of chromosomal structure that often has serious clinical effects.
A client has been prescribed adjuvant tamoxifen therapy. What common side effect might she experience?
- A. Weight gain, hot flashes, and blood clots
- B. Vomiting, weight loss, and hair loss
- C. Nausea, vomiting, and diarrhea
- D. Hot flashes, weight gain, and headaches
Correct Answer: A
Rationale: Common side effects of tamoxifen include hot flashes, weight gain, and blood clots. Other side effects like nausea and hair loss are not typical.