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A nurse is conducting a preconception class for a group of parents who are anticipating having children. Which client(s) should the nurse refer for genetic counseling? (Select all that apply)

A couple who express concern about birth defects after using an internet DNA testing site.

A woman and her significant other who are excited about the prospect of having children.

A woman planning to start a second family after the loss of an embryo following an in-vitro fertilization procedure.

A man who states that his father was recently diagnosed with Huntington’s disease.

A couple who plan to use in-vitro fertilization with donated sperm.

Answer and Explanation

Correct Answer : A,C,D,E

The correct answer is Choice A, Choice C, Choice D, Choice E.

Choice A rationale

Genetic counseling is recommended for couples concerned about birth defects to identify any potential genetic abnormalities or risks for inherited conditions.

Choice B rationale

Couples excited about having children do not necessarily require genetic counseling unless there are known risk factors or concerns about genetic conditions.

Choice C rationale

Loss of an embryo following an in-vitro fertilization procedure may indicate underlying genetic issues, warranting further evaluation through genetic counseling.

Choice D rationale

Huntington’s disease is an autosomal dominant disorder; individuals with a family history should seek genetic counseling to assess their risk of inheritance and possible transmission.

Choice E rationale

In-vitro fertilization with donated sperm may involve genetic screening and counseling to ensure the donor's genetic profile is compatible and free of heritable conditions.

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Correct Answer is C

Explanation

Choice A rationale

Administering acetaminophen is not indicated as the temperature of 100.4° F (38° C) is within the normal postpartum range, often due to dehydration or breast engorgement. Acetaminophen should be used cautiously and only if necessary.

Choice B rationale

Assessing perineum for excessive lochia is unnecessary here, as the current vital signs do not indicate hemorrhage. Normal postpartum bleeding gradually decreases in amount and should be monitored accordingly but not prompted by these vitals.

Choice C rationale

Documentation of vital signs is essential to maintain accurate medical records and track any changes in the patient's condition. Accurate records help in identifying trends and making informed decisions about patient care.

Choice D rationale

Reporting a heart rate of 58 beats/minute is unnecessary because bradycardia can be normal in postpartum women, especially if they have good cardiovascular fitness. It is important to monitor for other symptoms before taking further action.

A. Observe for signs of respiratory distress and monitor oxygenation by pulse oximetry. B. Keep infant in warmer with bilirubin lights to maintain temperature of 97.6° F (36.4° C). C. Monitor temperature. D. Continue to monitor glucose levels. E. Explain to the mother that the baby’s respiratory rate needs to be below 60 breaths/minute to be able to breastfeed. F. Tell the mother that she will need to discuss any concerns with the neonatologist. G. Inform the mother that the baby is stable enough to take out of the warmer and bilirubin lights.

Correct Answer is ["A","B","C","D"]

Explanation

Choice A rationale

Monitoring for respiratory distress and checking oxygenation by pulse oximetry are critical in newborns, as they can indicate hypoxemia or respiratory issues requiring prompt intervention.

Choice B rationale

Maintaining the infant's temperature at 97.6°F (36.4°C) using a warmer and bilirubin lights is essential for thermoregulation and treating jaundice, ensuring proper physiological stability.

Choice C rationale

Regular temperature monitoring is vital to detect any signs of hypothermia or hyperthermia, which can indicate underlying health issues and guide appropriate interventions for the newborn.

Choice D rationale

Continued monitoring of glucose levels is crucial for detecting hypoglycemia, a common condition in newborns that can lead to seizures, brain damage, or other severe complications if left untreated.

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A nurse is conducting a preconception class for a group of parents who are anticipating having children. Which client(s) should the nurse refer for genetic counseling? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

The current vital signs for a primipara who delivered vaginally during the previous shift are: temperature 100.4° F (38° C), heart rate 58 beats/minute, respiratory rate 16 breaths/minute, and blood pressure 130/74 mm Hg. Which action should the nurse implement?

Correct Answer is C

Explanation

The nurse is reviewing laboratory results and nurse’s notes to determine which actions to take at this time. Which actions are appropriate for the nurse to take at this time? (Select all that apply)

Correct Answer is ["A","B","C","D"]

Explanation

A diabetic client delivers a full-term large-for-gestational-age (LGA) infant who is jittery. Which action should the nurse take first?

A nurse is conducting a preconception class for a group of parents who are anticipating having children. Which client(s) should the nurse refer for genetic counseling? (Select all that apply)

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