Nokea
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.
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The nurse is providing care to the adult female patient who presents to the emergency department with a suspected myocardial infarction (MI). Which symptom indicates a possible MI for the female patient?
- A. Chest pain that radiates to the right arm and jaw
- B. Episodic nausea/indigestion and palpitations
- C. Sudden onset of trouble walking, and loss of balance
- D. Swelling of the feet and shortness of breath
Correct Answer: B
Rationale: For female patients, the classic symptom of a myocardial infarction (MI) is often different from that in male patients. While chest pain that radiates to the right arm and jaw is a common symptom in male patients, female patients may present with more subtle symptoms. Episodic nausea/indigestion and palpitations are more commonly seen in female patients experiencing a myocardial infarction. It is important for healthcare providers to recognize and consider these atypical symptoms in female patients to ensure timely diagnosis and treatment.
During the childbearing experience, which behavior might the nurse expect from an African-American client?
- A. Seeking prenatal care early in her pregnancy
- B. Avoiding self-treatment of pregnancy-related discomfort
- C. Requesting liver in the postpartum period to prevent anemia
- D. Arriving at the hospital in advanced labor
Correct Answer: D
Rationale: African-American women often arrive at the hospital in far-advanced labor due to viewing pregnancy as a state of wellness, which contributes to delayed prenatal care. Many practice self-treatment for discomfort and may request liver postpartum for anemia prevention.
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.
A nurse is caring for a patient who states she is experiencing a thin vaginal discharge with a strong fishy odor. What test does the nurse prepare?
- A. whiff test
- B. vaginal culture
- C. urine culture
- D. blood test
Correct Answer: A
Rationale: A nurse caring for a patient who presents with a thin vaginal discharge with a strong fishy odor should prepare for performing a whiff test. The whiff test, also known as the amine or sniff test, is used to aid in the diagnosis of bacterial vaginosis (BV). BV is a common vaginal infection characterized by an overgrowth of harmful bacteria in the vagina and can cause symptoms like thin, grayish-white discharge with a strong fishy odor.
The patient makes the statement: “I’m afraid to take the baby home tomorrow.” Which response by the nurse would be the most therapeutic?
- A. “You’re afraid to take the baby home?”
- B. “Don’t you have a mother who can come and help?”
- C. “You should read the literature I gave you before you leave.”
- D. “I was scared when I took my first baby home, but everything worked out.”
Correct Answer: D
Rationale: The best response by the nurse in this situation would be D. By sharing a personal experience of feeling scared when taking their first baby home, the nurse is empathizing with the patient and offering reassurance that everything worked out in the end. This can help the patient feel understood and less alone in their fear, while also providing hope that things will be okay. It validates the patient's feelings and offers a positive perspective, which can be therapeutic in this situation.