ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 56 Questions
Question 1 of 5
A 33-year-old female patient who uses oral contraceptives tells the nurse, 'I want to have children in a few years.' Which of the following responses by the nurse is best?
Correct Answer: A
Rationale: The probability of successfully becoming pregnant decreases after age 35 although some patients may have no difficulty in becoming pregnant, this probability further decreases after age 40. Oral contraceptives do not need to be withdrawn for several years for a woman to become pregnant. Although the patient may be fertile for many years, it would be inaccurate to indicate that there is no concern about infertility as she becomes older. Although the risk for infertility increases after age 35, not all patients have difficulty in conceiving.
Question 2 of 5
A couple is considering the possibility of in vitro fertilization (IVF). The woman tells the nurse that they cannot afford IVF on her husband's salary, and the husband replies that if the wife would get a job, they would have enough money. Which of the following nursing diagnoses is appropriate?
Correct Answer: C
Rationale: IVF treatments are very costly. The statements made by the couple are consistent with the diagnosis of defensive coping. No data indicate that ineffective sexuality and ineffective denial are problems. Although the couple is quarrelling about finances, the data do not provide information indicating that the finances are inadequate.
Question 3 of 5
A patient who is trying to become pregnant asks the nurse about ways to determine when she is most likely to conceive. Which of the following information is the basis of the nurses' response?
Correct Answer: A
Rationale: Ovulation prediction kits indicate when luteinizing hormone (LH) levels first rise. Ovulation occurs about 28-36 hours after the first rise of LH. This information can be used to determine the best time for intercourse. Body temperature rises at ovulation. Postcoital cervical smears are used in infertility testing, but they do not predict the best time for conceiving and are not obtained by the patient. Determination of the time of ovulation can be predicted by basal body temperature charts or ovulation prediction kits and is not dependent on regular menstrual periods.
Question 4 of 5
The nurse is caring for a patient who has an induced abortion with suction curettage at an ambulatory surgical centre. Which of the following instructions should the nurse include when discharging the patient?
Correct Answer: B
Rationale: Because infection is a possible complication of this procedure, the patient is advised to avoid intercourse until the reexamination in 2 weeks. Patients may be started on contraceptives on the day of the procedure. The patient should call the doctor if heavy vaginal bleeding occurs. No change in the regularity of the menstrual periods is expected.
Question 5 of 5
A patient is scheduled for an induced abortion using methotrexate with misoprostol. Before the procedure, which of the following information should the nurse discuss with the patient?
Correct Answer: A
Rationale: Takes place over 5-7 days, or longer and involves several trips to the health care provider. Risk of incomplete abortion, surgical abortion may be necessary. General anaesthesia is not needed for this procedure. It is used in patients that are 7 weeks gestation or less (within the period of the embryo), so there is no chance of delivering a live fetus. Using methotrexate with misoprostol for an induced abortion is both safe and effective.