Nursing Elites

1. When teaching a woman about possible side effects of hormone replacement therapy, the nurse should include information about all of the following except:

• A. Hypoglycemia in diabetic women.
• B. The possible return of monthly menses when taking combination hormones.
• C. Increased risk of gallbladder disease.
• D. Increased risk of breast, cervical, and ovarian cancer with long-term use.

Correct answer: A

Rationale: The correct answer is 'Hypoglycemia in diabetic women.' When educating a woman about hormone replacement therapy, it is important to discuss the possible side effects. It is true that monthly menses might return when taking combination hormones, as the progestin can cause this. Additionally, there is an increased risk of gallbladder disease associated with hormone replacement therapy. Furthermore, long-term use of hormone replacement therapy is linked to an increased risk of breast, cervical, and ovarian cancer. However, hypoglycemia is not a common side effect of hormone replacement therapy, especially in diabetic women. In fact, estrogen can have a positive impact on glucose control in some cases, so hypoglycemia would not be a typical concern.

2. What type of immunity do vaccines provide?

• A. active
• B. passive
• C. transplacental
• D. active and passive

Correct answer: A

Rationale: Vaccines provide active immunity by stimulating the immune system to produce antibodies against specific pathogens. Choice B, passive immunity, is acquired from ready-made antibodies, not through vaccination. Choice C, transplacental immunity, is a form of passive immunity transferred from mother to infant, not acquired through vaccines. Therefore, the correct answer is active immunity.

3. A nurse is determining the estimated date of delivery for a pregnant client using Nagele's rule and notes documentation that the date of the client's last menstrual period was August 30, 2013. The nurse determines the estimated date of delivery to be which date?

• A. 30-May-14
• B. 6-Jun-14
• C. 6-Jul-14
• D. 6-May-14

Correct answer: B

Rationale: Nagele's rule is a method used to estimate the date of delivery for pregnant clients. The rule involves subtracting 3 months and adding 7 days to the date of the first day of the last normal menstrual period, then adjusting the year. Subtracting 3 months from August 30, 2013, brings the date to May 30, 2013; adding 7 days results in June 6, 2013. Finally, after correcting the year, the estimated date of delivery is June 6, 2014. Therefore, the correct answer is June 6, 2014. Choices A, C, and D are incorrect because they do not follow the accurate calculation based on Nagele's rule.

4. Which of the following physical findings indicates that an 11-12-month-old child is at risk for developmental dysplasia of the hip?

• A. refusal to walk
• B. not pulling to a standing position
• C. negative Trendelenburg sign
• D. negative Ortolani sign

Correct answer: B

Rationale: The correct answer is 'not pulling to a standing position.' If an 11-12-month-old child is unable to pull to a standing position, it can indicate a risk for developmental dysplasia of the hip. By 15 months of age, children should be walking, so delayed standing can be a red flag. The Trendelenburg sign is associated with gluteus medius muscle weakness, not hip dysplasia, making choice C incorrect. The Ortolani sign is used to detect congenital hip subluxation or dislocation, not developmental dysplasia, making choice D incorrect.

5. At a health screening clinic, a nurse is educating a young woman about breast self-examination (BSE). The nurse determines that the client demonstrates understanding when she makes which statement?

• A. BSE should be performed monthly after the menstrual period.
• B. BSE is performed after the menstrual period.
• C. Monthly BSE is a recommended method for early detection of breast cancer.
• D. Monthly BSE includes inspection before a mirror and palpation both in the shower and while lying down.

Correct answer: D

Rationale: The correct answer is 'Monthly BSE includes inspection before a mirror and palpation both in the shower and while lying down.' BSE should be performed monthly after the menstrual period, not every other month or on the day menstruation begins. Performing BSE on the seventh day of the menstrual cycle when the breasts are smallest and least congested is recommended. While BSE is a useful tool for early detection, it is not the only method. Regular physical examinations and mammograms are also important. The correct technique for BSE includes inspecting the breasts in front of a mirror, palpating in the shower for easier detection, and conducting palpation while lying down for thorough examination.

Similar Questions