A 43-year-old woman accompanied by her husband reports to the nurse a history of pelvic adhesions and bilateral distal occlusion of both fallopian tubes
... [Show More] with large hydrosalpinges. Both ovaries are buried in thick vascular adhesions. Adoption is not a consideration for the couple. What is the nurse's most appropriate recommended therapy for this couple? IVF using donor eggs O Gamete intrafallopian transfer (GIFT) OIVF using her own eggs Lysis of adhesions and surgical mobilization of the ovaries Ovulation induction using gonadotropins with intrauterine inseminations A mother brings her 2 year old to the clinic because of her concerns about the child's nutritional status. She tells the nurse that for the last week the child has refused to eat anything except crackers and peanut butter and jelly sandwiches. Which of the following measures would be the most appropriate for the nurse to suggest? O Don't be overly concerned about the child's behavior, because food fads usually last only a short time (quizlet) O Give the child extra time to play outside if she eats what the family eats at mealtime. O Consult a physician, because the child's behavior will lead to nutritional deficiency O Insist the child eat small portion of the family's meal to maintain adequate nutrition. A 19-year-old woman with a complaint of never having had menses comes to your office. Physical examination shows that she is 1.37 m tall and weighs 94 lb. She lacks breast and pubic hair development. There is webbing of her neck and cubitus valgus. Given the description of this patient, which of the following is her most likely diagnosis as would be advised by the nurse? Turner's syndrome Testicular feminization. Klinefelter's syndrome O Congenital adrenal hyperplasia (CAH) Normal but delayed development Marielle Mendoza, 25-year-old G3P2 in her sixth week of pregnancy, by last menstrual period (LMP) calculation, has an endovaginal ultrasound examination because of vaginal contact: [email protected] bleeding. The ultrasound confirms an intrauterine pregnancy with fetal cardiac activity present and fetal pole length consistent with 6 weeks' gestation. Scan of the adnexae reveals a 5-cm simple cyst on the left ovary. Which of the following statements made by the nurse needs no further teaching? The ovarian cyst should not be removed. This patient likely has both an intrauterine pregnancy and an ectopic pregnancy. This patient should be told that she will probably miscarry. First-trimester vaginal bleeding is uncommon and implies a poor pregnancy outcome. This patient has a blighted ovum. The nurse educator is preparing to conduct a teaching session for the nursing staff regarding the theories of growth and development. Regarding the physical growth of preschool children (3-5 yr); all the following are true: (Select all that apply) 7-8 cm height increment/yr head will grow only an additional 5-6 cm up to18 yr all 20 primary teeth have erupted by 3 yr average wt 20 kg and height 40 inch by 4 yr 4-5 kg weight increment/yr A school nurse's evaluation during an annual physical examination of Edward, a 14-year old reveals a BMI in the 90th percentile. He also has a lifestyle that includes spending 4 hours a day, playing video games and eating supper while watching television. What is the priority nursing diagnosis for Edward? Imbalanced Nutrition: More than Body Requirements related to excessive intake and sedentary lifestyle (quizlet) Fatigue related to malnutrition Disturbed Body Image related to distorted perception of body size and shape (quizlet) Delayed Growth and Development related to inappropriate intake Mrs. Deborah Moreno, 23 year-old nullipara is admitted at the labor room at 10:00 o'clock A.M. IE findings are: 4 cm dilated, 70% effaced, cephalic, station -2, intact bag of water. Oxytocin was given. Uterine contractions are strong and regular. At 12:00 o'clock P.M., IE findings are: 7 cm dilated, 80% effaced, cephalic, station -2, ruptured bag of water. Is Mrs. Deborah experiencing normal labor? Why or why not? No, this is abnormal labor. There is no change in descent. Yes, this is normal labor. Uterine contractions are regular and strong. Yes, this is normal labor. Cervix is 7 cm dilated, 80% effaced. Yes, this is normal labor. Bag of water has ruptured. No, this is abnormal labor. Bag of water has already ruptured. abused by her father. father angrily approaches the nurse and "I'm taking daughter home. She's told me what people up to, we're out here!" The nurse makes which therapeutic response? want to help your daughter. It will be best you agree to your daughter stay here for now." "Your daughter remain the police you attempt to take her." "Try to listen me, you will most certainly order you to bring her again." "Your daughter work help everyone straighten out the circumstances that caused this." A lumbar puncture is performed on a child suspected to have bacterial meningitis, and cerebrospinal fluid (CSF) is obtained for analysis. The nurse reviews the results of the CSF analysis and determines that which results would verify the diagnosis? Cloudy CSF, elevated protein, and decreased glucose levels Clear CSF, decreased pressure, and elevated protein level Clear CSF, elevated protein, and decreased glucose levels Cloudy CF, decreased protein, and decreased glucose levels Miss Deborah Moreno, 18 year-old, Gravida 1 Para 0, 39-40 weeks AOG, was brought to the Delivery Suite due to labor pains. She delivered via normal spontaneous delivery after 10 hours of labor. Her newborn child was noted to have cephalhematoma. Which of the following statements is not a characteristic of the baby's condition? The periosteal limitations with definite palpable edges will not differentiate the cephalhematoma from caput succedaneum This is usually caused by injury to the periosteum of the skull during labor and delivery Hemorrhage can occur over one or both parietal bones Cephalhematoma may not appear for hours after delivery, often growing larger and disappearing only after several weeks Mrs. Deborah Moreno is a 34-year-old woman who gave birth to her first child, an 8.5-lbs baby boy, yesterday. You notice her sitting by her hospital bed, dressed ready to go home, reading a brochure on birth control. An individual's or a couple's choice of contraceptive method should be made carefully,, with complete knowledge about the advantages, disadvantages and even the side effects. Upon reading the brochure, Mrs. Moreno asks about tubal ligation and the procedure. Which of following statement/s are correct? Select all that apply. Sterilization of women could include removal of the uterus. Refers to minor surgical procedure, whereby the fallopian tubes are occluded by cautery, clamping or blocking the tubes and preventing passage of both sperm and ova. Tubal Ligation is safe and has 100% effectiveness rate. Same procedure like vasectomy. The mother with human immunodeficiency virus (HIV) infection brings her 10-month-old infant to the clinic for a routine checkup. The health care provider has documented that the infant is asymptomatic for HIV infection. After the checkup, the mother tells the nurse that she is so pleased that the infant will not get HIV. The nurse should make which most appropriate response to the mother? "Most children infected with HIV develop symptoms within the first 9 months of life, and some become symptomatic sometime before they are 3 years old." "I am so pleased also that everything has turned out fine." "Because symptoms have not developed, it is unlikely that your infant will develop HIV infection." "Everything looks great, but be sure that you return with your infant next month for the scheduled visit." A nurse at a community health care clinic is teaching parents about measures to take to prevent and manage obesity in children. The nurse determines that a parent needs additional teaching about these measures if the parent states she will do which of the following? Allow eating in between meals and snack times. Offer healthy foods options. Avoid eating at fast-food restaurants. Keep unhealthy food out of the house. Establish consistent times for meals and snacks. A 38-year-old G4P3 at 18 weeks age of gestation has BP of 150/100 mmHg with no other signs and symptoms. Her prepregnancy BP was 130- 140/80-90 mmHg controlled by intake of a calcium channel blocker. Urinalysis is negative for proteinuria. The nurse correctly identifies that this is what type of hypertensive disorder in pregnancy? Chronic hypertension Gestational hypertension Pre-eclampsia Chronic hypertension w/ superimposed pre eclampsia Mrs. Deborah Moreno, Gravida 1 Para 1001, delivered vaginally to a full-term infant without complications. After the first postpartum day, she tells Nurse Marina, on duty that she's afraid that something is wrong because she's perspiring and urinating more than normal. Her temperature is 100.00F (37.80C). Nurse Marina should appropriately reply: "It's common to perspire and urinate a lot after childbirth; your body is getting rid of the excess fluid that was used in pregnancy." "You're probably responding to an infection in your body: I'll call the doctor and report your symptoms." "You're probably responding to an infection in your body: I'll call the doctor and report your symptoms." "I'm surprised you're urinating a lot because you don't have other signs of diabetes." Mrs. Deborah Moreno, Gravida 1 Para O is now at 20 weeks age of gestation. As the nurse is performing an abdominal examination, she perceives a heartbeat at the pace of 136 in the right upper quadrant and also at the midline below the umbilicus. The sources of these sounds are which of the following? (Select all that apply) Fetal heart rate: Funic soufflé Heart rates of two fetuses Uterine souffle Maternal heart rate A 19-year-old, primigravida, at 34 weeks' gestation comes in for severe headache and visual blurring. Previous blood pressure on prior prenatal checkup at 14 weeks was at 140/90 mm Hg. Presently, her blood pressure was 170/110 mm Hg. She presented with bipedal edema. There were no uterine contractions. Then she developed generalized tonic-clonic seizures last for about 40 secs. What is the most likely type of hypertensive disorder in pregnancy? Chronic hypertension with superimposed hypertension Chronic hypertension Severe pre-eclampsia O Eclampsia A school-wide in-service program about child abuse is being conducted by a nurse. In the open forum, the nurse was asked to describe common indicators of abuse. Which of the following signs would the nurse include? (Select all that apply). Caregivers and parents who are reluctant to take the child for treatment for an injury Statement by the day care provider that the child was injured by falling off a chair Lack of emotional response from child to a playground injury Explanation of the injury from the child and caregiver or parent that are similar A guardian is complaining to the school nurse that her 16-year-old nephew who plays varsity football has been "eating too much junk." Which comment by the school nurse is appropriate? "Because your son is so active, he might need three thousand or more calories daily." "Two thousand calories are more than enough to support his needs." "Talk to him about the benefits of good nutrition and stopping all fast food intake." "Discuss the need for him to add fruits and vegetables to his diet." A G5P5 patient develops marked bleeding after delivery of the infant that continues as severe hemorrhage after the spontaneous delivery of the placenta that appears intact on inspection. The bladder is empty. The uterine fundus is firm at the umbilicus. She has an epidural. The nurse determines that the client is experiencing which of the following conditions? Cervical tear Rupture of a classic uterine scar Dehiscence of a uterine scar Spontaneous rupture of an intact uterus Traumatic rupture of the intact uterus A hospitalized 2 year old client screams and shouts that he wants a "bottle". His parents are puzzled and state that he has drank from a cup for the past year. The nurse explanation statement is which of the following? "Regression to an earlier behavior often helps the child cope with stress and anxiety." "Irritability is exhibited in all age groups." "Temper tantrums often represent the child's need for parental attention." "Various forms of punishment are necessary when such behavior occur." Maria, a mother of an adolescent boy complains that her son has had some recent behavioral changes. He comes home from school every day, closes his door, and refrains from interaction with his family. The nurse's best response to Maria is: "You should speak with your son and ask him directly what is wrong with him". "You should set limits with your son and tell him that this is unacceptable behavior". "Your son's behavior is abnormal, and he is going to need a psychiatric referral". "Your son's behavior is normal. You should listen to him without being judgmental". The nurse is teaching parents about Erik Erikson's psychosocial theory of development. According this theory, a child who is between 3 and 6 years of age is going through which of the following stages? Initiative versus guilt Identity versus role confusion Autonomy versus shame and doubt. Industry versus inferiority A 28-year-old G2PO at 39 weeks is in early labor. She is 2 cm dilated and 90% effaced, with contractions every 4 to 5 minutes. The fetal heart tones are reassuring. Her nurse steps out for a moment and returns to find her having a seizure. The nurse administers a 4-g magnesium bolus. The seizure stops. The fetal heart tone variability is flat, but there are no decelerations. What would the nurse next therapies be aimed at? Keeping the patient free of convulsions, coma, and acidosis Reducing edema with diuretics Giving hypotensive agents until the blood pressure is 110/70 mm Hg Giving 3 g of magnesium sulfate every 3 hours Prepare for immediate delivery by cesarean section 35 age blurring. On prenatal check-up week prior, BP was noted 130/85 mmHg her 110/70. examination, BP was now at 160/110 mmHg, FHT 140/min, no contractions after ten Cervix was 1cm, 30% effaced, intact membranes, station-2. Most likely hypertensive disorder in pregnancy diagnosis is: Severe preeclampsia Chronic hypertension Mild preeclampsia Chronic hypertension with superimposed preeclampsia Miss Deborah Moreno, 18 year-old, Gravida 1 Para 0, 4 ft 11 tall was referred to the maternity clinic. Which of the following does this procedure measure? Shape of the pubic arch True conjugate Transverse diameter of the inlet Flare of the iliac crests Elasticity of the levator muscles Miss Deborah Moreno, 18-year-old Gravida O presents for care because a condom broke during sexual intercourse. Coitus occurred 1 day ago when she was at midcycle. She does not wish to be pregnant and will terminate the pregnancy if menses does not occur. Regarding her fear of pregnancy, which is the most appropriate next step in her management? Advise her to await her next menses before taking any action Advise her that unprotected midcycle coitus has a 5% risk of pregnancy (B) prescribe intravaginal misoprostol (Cytotec) Advise immediate douching Prescribe a brief course of levonorgestrel The school nurse is conducting health teaching regarding sleep patterns in school age children. regarding growth and development. The following statements about sleep are true: (Select all that apply) Sleep is the first cycle of sleep Rapid eye movement (REM) sleep is responsible for dreams Both cycles are needed for sufficient sleep REM sleep protect brain from injury Melatonin which is secreted in dark-light cycles secreted from hypothalamus slow-wave The mother discusses with the nurse that her toddler asks every night for a bedtime story. The mother asks why the child does this. The nurse would explain that this behavior demonstrates which the following? Ritualism Object permanence Dependency Conservation Miss Deborah Moreno, 18 year old, Gravida 1 Para 0, 40 weeks AOG is in labor. She has been having a long prodromal labor but has finally entered active phase of Stage 1. She is excited and wants to know what she should expect as a typical labor course. Average durations of active labor without epidural analgesia are best expressed by which of the following? First stage, 750 minutes; second stage, 80 minutes; third stage, 5 minutes First stage, 750 minutes; second stage. 80 minutes; third stage, 30 minutes First stage, 80 minutes: second stage, 20 minutes: third stage, 5 minutes First stage, 120 minutes; second stage, 80 minutes; third stage, 5 minutes First stage, 80 minutes; second stage. 20 minutes: third stage, 20 minutes Miss Deborah Moreno, 20 years old, Gravida 0 presents in the lying in clinic requesting hormonal contraception. She has been researching her options on the Web and has become confused by the large variety of OC pills available, including monophasic, multiphasic, and progesterone only. She asks how the pill prevents pregnancy and why the variety of preparations. Which of the following is the primary mechanism by which OCS prevent pregnancy? Inhibiting serum follicle-stimulating hormone (FSH) levels Inhibiting serum luteinizing hormone (LH) levels Inducing endometrial atrophy Inducing lymphocytic endometritis Increasing cervical mucus viscosity The nurse knows that teaching about car seat safety to the parents of a 4-year-old child has been effective when which statement is made? "Now that our child is 4 years old, weighs 40 pounds, and is 42 inches tall, we can move to a forward-facing booster seat." "Now that our child is 4 years old, she can sit in the regular car seat and use the seat belt and shoulder belt like adults." "Now that our child is 4 years old, she can sit in her booster seat in the front seat." "Our 4-year-old must stay in her forward-facing car seat until she is 6 years old." A mother of a 14-year-old senior high school female calls the health center and asks the nurse at what age a pelvic exam should be done. The girl is menstruating regularly. What other data might suggest to the nurse that the girl should have the exam now rather than wait until she is 18 years of age? The girl discusses that she has many boyfriends. The girl participates in several sports. The mother had her first pelvic exam at 14 years of age. The girl has a history of anorexia. A chronic hypertensive patient presents with complaints of decreased fetal movement. Her prenatal care has been sporadic but it appears that she is at 37 weeks' gestation with an estimated fetal weight of 2,200 g. Concerns are raised regarding placental reserves for oxygenating the fetus. This can be most directly assessed by which of the following nurse actions? Biophysical profile A fetal ultrasound growth curve Lecithin/sphingomyelin (L/S) ratio Maternal alpha-fetoprotein Maternal estriol production Mrs. Deborah Moreno, 24 y/o G2P1 (1001) was admitted due to passage of watery discharge and onset of regular abdominal cramps. Initial IE was 4cm already station -2, 4 hours later patient was 7 cm dilated station -2, contractions came in regularly every 3 5minutes lasting 50-60 seconds, which of the following actions are appropriate? Observe progress of labor Augment labor with oxytocin Prepare patient for emergency CS Give patient epidural anesthesia Hydrate and place patient on left lateral decubitus A couple contemplating a pregnancy are in today for an appointment at a genetic counselling clinic to identify and interpret their risk of an inherited autosomal recessive disorder. The clients have one child with Tay-Sachs disease, but neither of the clients have the disease. They are in the clinic for genetic counseling prior to conceiving another child. What would be the phenotypic ratios that would be best advised by the nurse? 25% homozygous dominant: 50% heterozygous dominant: 25% homozygous recessive 75% homozygous dominant: 25% homozygous recessive 100% homozygous dominant 50% heterozygous dominant: 50% homozygous dominant 100% homozygous recessive Mrs. Deborah Moreno, a 23-year-old Gravida 1 at 40 weeks' gestation was seen in the Obstetric Unit with the complaint of contractions happening every 4 to 8 minutes and each lasts approximately 1 minute. She describes good fetal movement and refuses any leakage of fluid or vaginal bleeding. The nurse places an external tocometer and reports that the patient is having contractions every 2 to 10 minutes. You note contractions are mild on palpation. On examination, the cervix is 2 cm dilated, 50% effaced, and the vertex is at -1 station. Mrs. Deborah had the same cervical examination in your office last week. The patient is in what stage of labor? False labor Active labor Latent labor Stage 1 of labor Stage 2 of labor Mrs. Deborah Moreno, 25 year old G1P0 seeks consult at a Maternity Clinic. A non-stress test was requested by the attending physician. During the procedure, the tracing displays a relatively flat line for fetal movement, making it difficult to evaluate the fetal heart rate (FHR). To mark the strip, Nurse Marina should instruct the client to push the control button at which time? At the beginning of each fetal movement At the beginning of each contraction After every three fetal movements At the end of fetal movement The nurse educator is preparing to conduct a teaching session for the nursing staff regarding the theories of growth and development. These facts are true regarding the developmental stage of preschool children. (Select all that apply) handedness is achieved by 3 years of age boys are usually later than girls in achieving bladder control egocentric thinking masturbation knowing gender by 4 years Mrs. Deborah Moreno, 43 years old seeks consult at the Municipal Maternity Clinic. What is the complete obstetric score of the patient given the following history? 1. 2000 FT via SVD male, alive 2. 2001 Spontaneous abortion 15 weeks AOG 3. 2012 H. mole 4. 2017 Preterm twin gestation via SVD, both females, 1 died after 1 year, the other, alive 5. 2018 FT via SVD male, FDU 6. 2019 Ectopic pregnancy 7. 2021 Present pregnancy OG7P3 (2132) OG7P3 (1232) O G7P3 (1232) OG7P3 (2133) Deborah Moreno, year old, G1P0, was admitted due decrease fetal movement with uterine contractions. Cervix - cm dilated, 80% effaced, station Bag of water. Uterine contractions every to minutes, strong, 60 seconds Which the following may happen the uterus becomes overstimulated during augmentation labor? Tetanic contractions prolonged more than 90 seconds Weak contraction prolonged more than 70 seconds Increased pain with bright red vaginal bleeding Increased restlessness and anxiety In a teleconsultation, the parents of a Mario, a 17-year-old male are concerned about his recent attitude changes, physical changes, and lack of interest in eating. Which intervention should the nurse Erika consider first? Ask the teen privately whether he is using any substances such as drugs or alcohol Refer to a family counselor, so the family can work together on the changes. Ask the parents whether they have alcohol in the home. O Tell the physician to order drug screens to check for substance abuse. Mrs. Deborah Moreno, 28 year old nullipara came to the Well-Family Maternity birthing clinic for the first time for a regular checkup? Her last menstrual period was on March 27, 2021. The mother was asking for an exact date of fertilization/conception. Although you cannot identify the exact date you can predict that it most likely occurred during what date? April 10, 2021 March 13, 2021 March 20, 2021 April 3, 2021 A 4-year-old child is admitted to the hospital for abdominal pain. The mother reports that the child has been pale and excessively tired and is bruising easily. On physical examination, lymphadenopathy and hepatosplenomegaly are noted. Diagnostic studies are being performed on the child because acute lymphocytic leukemia is suspected. The nurse understands that which diagnostic study should confirm this diagnosis? Bone marrow biopsy Platelet count Lumbar puncture White blood cell count The nurse prepares a list of home care instructions for the parents of a child who has a plaster cast applied to the left forearm. Which instructions should NOT be included on the list? Place a heating pad on the lower end of the cast and over the fingers if the fingers feel cold. Keep small toys and sharp objects away from the cast. Elevate the extremity on pillows for the first 24 to 48 hours after casting to prevent swelling. Contact the health care provider (HCP) if the child complains of numbness or tingling in the extremity. Miss Deborah Moreno, 16-year-old, G1PO has come to the Municipal Community Health Clinic for a pelvic examination and Pap smear. During the assessment interview, Miss Deborah states that she is sexually active. She and her boyfriend sometimes use condom. She doesn't want to take any pill or medicine because she can't afford it and she's afraid that her parents will find out that she's having sex. Does Miss Deborah need any additional health teaching to be well informed about reproductive life planning? During the assessment interview, Miss Deborah mentioned about the use of condoms. Which of the following statement/s is/are incorrect? (Select all that apply) Latex condoms have additional potential of preventing the spread of communicable diseases including STI and even airborne transmission. It is not recommended to wear during coitus between partners who do not maintain a monogamous relationship. There are no contraindications to the use of condoms except for a [Show Less]