A 36 y.o. woman who has had no prenatal care comes into the hospital in active labor for her fourth child. She has vesicles evident on her perineum. The following nursing actions are appropriate to protect the unborn baby and the staff, EXCEPT:

Correct Answer: D

Rationale: When a woman with vesicles on her perineum comes into the hospital in active labor, it is important to take precautions to protect the unborn baby and the staff. However, applying antibiotic ointment to the vesicles and placing the mother in reverse isolation is not appropriate in this situation. This is because her condition is most likely due to herpes simplex virus (HSV) infection, which can be transmitted to the baby during birth leading to severe complications. Placing the mother in reverse isolation can increase the risk of transmission to the healthcare staff as well. Instead, notifying the obstetrician and nurse midwife about the vesicles as soon as possible is crucial for proper management and preparing for the possibility that the baby may be delivered by cesarean section is important to reduce the risk of transmission during vaginal birth. Maintaining standard precautions is essential to prevent the spread of infection.

Correct Answer: C

Rationale: Microcytic, hypochromic anemia is characterized by small red blood cells with decreased hemoglobin content. Iron deficiency anemia and thalassemia are the two main types of anemia that present with these characteristics. Iron deficiency anemia is caused by a lack of iron in the body, which is essential for the production of hemoglobin. Thalassemia is a genetic disorder that results in decreased production of normal hemoglobin. Both conditions lead to small, pale red blood cells, fitting the description of microcytic, hypochromic anemia. Other choices such as Vitamin B12 deficiency anemia (choice A), folic acid deficiency anemia (choice B), sickle cell anemia (choice D), and anemia of chronic disease (choice D) typically present as normocytic or macrocytic anemias.

Correct Answer: B

Rationale: Levodopa is the antiparkinsonian drug associated with the on-off phenomenon and the wearing-off effect. The on-off phenomenon refers to the sudden and unpredictable fluctuations between periods of symptom control (on) and periods of symptom re-emergence (off) in patients with Parkinson's disease receiving levodopa therapy. This can happen as the disease progresses and the brain becomes less responsive to the medication.

Correct Answer: C

Rationale: Adenotonsillar hypertrophy is the leading cause of obstructive sleep apnea in children.

Correct Answer: D

Rationale: Peritonitis is a major complication of peritoneal dialysis that the nurse should monitor for. Peritonitis is an infection of the peritoneum, the membrane that lines the abdominal cavity and covers the abdominal organs. It can occur when bacteria from the dialysis solution enter the peritoneal cavity. Symptoms of peritonitis may include abdominal pain, cloudy dialysis effluent, fever, and general signs of infection. Prompt recognition and treatment of peritonitis are crucial to prevent complications such as sepsis and peritoneal membrane damage. Regular monitoring and strict aseptic technique during peritoneal dialysis can help reduce the risk of peritonitis.