During a sports physical examination, a 15-year-old female expresses her desire for oral contraceptives. She mentions that she is sexually active and prefers not to inform her parents. What should be the nurse’s course of action?

Advise the client about the risks and benefits associated with oral contraceptives.

Inform the client about how to obtain a variety of free oral contraceptives from the clinic.

Encourage the client to discuss her contraceptive needs with her parents.

Explain that parental consent is required to receive contraceptives.

Answer and Explanation

The Correct Answer is A

Choice A rationale
It’s important to educate the adolescent about the risks and benefits associated with oral contraceptives. This includes potential side effects, effectiveness in preventing pregnancy, and the need for continued use of condoms to prevent sexually transmitted infections.
Choice B rationale
While it’s important to inform the client about how to obtain contraceptives, providing a variety of free oral contraceptives from the clinic may not be feasible or appropriate depending on the specific circumstances and regulations.
Choice C rationale
Encouraging the client to discuss her contraceptive needs with her parents could be beneficial, but it’s also important to respect her autonomy and confidentiality. In many places, adolescents have the right to access contraceptive services without parental consent.
Choice D rationale
The requirement for parental consent to receive contraceptives varies by location. In many places, adolescents can access contraceptive services without parental consent.

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Correct Answer is A

Explanation

= Answer is... Choice A. Severe skin breakdown in the diaper area.

Choice A rationale:

In the case of the 3-month-old infant presenting with difficulty sleeping through the night, severe skin breakdown in the diaper area is the most significant finding requiring attention in care planning for this family. Diaper dermatitis, characterized by erythema, edema, and erosion of the skin in the diaper region, can cause considerable discomfort and distress to the infant. Moreover, severe skin breakdown increases the risk of secondary infections and exacerbates the infant's discomfort, potentially impacting sleep patterns and overall well-being.

Diaper dermatitis often results from prolonged exposure to urine and feces, friction, and the occlusive environment created by diapers. The acidic pH of urine and feces, coupled with the breakdown of urea into ammonia, contributes to skin irritation and inflammation. Additionally, the warm, moist environment beneath the diaper provides an ideal breeding ground for microbial overgrowth, further exacerbating skin damage.

Management of severe diaper dermatitis involves a multifaceted approach, including frequent diaper changes, gentle cleansing of the affected area, application of barrier creams or ointments, and promotion of air exposure to facilitate healing. In severe cases, topical corticosteroids or antifungal agents may be prescribed to reduce inflammation and prevent secondary infections.

Preventing and managing diaper dermatitis is essential not only for alleviating the infant's discomfort but also for promoting uninterrupted sleep patterns. Discomfort associated with diaper rash can lead to increased irritability and difficulty settling down for sleep, contributing to sleep disturbances for both the infant and the caregiver. By addressing the underlying cause of the skin breakdown and implementing appropriate interventions, healthcare providers can support the family in improving the infant's comfort and sleep quality.

Choice B rationale:

The mother stating that the baby is irritable during feedings is indeed noteworthy and may indicate various underlying issues, such as feeding difficulties, gastrointestinal discomfort, or inadequate milk supply. However, while irritability during feedings can contribute to disrupted sleep patterns, it is not as directly relevant to the immediate concern of severe skin breakdown in the diaper area. Nonetheless, addressing feeding concerns is essential for optimizing the infant's nutritional intake and overall well-being.

Choice C rationale:

The mother being a single parent and living with her parents provides contextual information about the family's social support structure but is not directly related to the infant's difficulty sleeping through the night or the significant finding of severe skin breakdown in the diaper area. While family dynamics and support systems play a crucial role in caregiving and may influence the implementation of care strategies, they do not directly address the infant's current health issue.

Choice D rationale:

The fact that the infant's formula has been changed twice may indicate attempts to address feeding-related concerns or suspected formula intolerance. While changes in formula may impact the infant's gastrointestinal comfort and feeding patterns, they do not directly address the primary concern of severe skin breakdown in the diaper area. Nonetheless, evaluating the appropriateness of the current formula and addressing any feeding-related issues remain important aspects of comprehensive care for the infant.

A. Fecal-fat test. B. Sweat-chloride test. C. Pulmonary-function test. D. Potassium chloride test.

Correct Answer is B

Explanation

Choice A rationale
A fecal-fat test is used to measure the body’s ability to break down and absorb fat. It is not used to screen for cystic fibrosis.
Choice B rationale
The sweat-chloride test is the standard diagnostic test for cystic fibrosis. This test measures the amount of chloride, a component of salt, in the sweat. People with cystic fibrosis have two to five times the normal amount of chloride in their sweat.
Choice C rationale
A pulmonary-function test measures how well the lungs are working and can be used to monitor the lung function in people already diagnosed with cystic fibrosis. However, it is not a standard screening test for cystic fibrosis.
Choice D rationale
A potassium chloride test is not used to screen for cystic fibrosis. Potassium chloride is a type of medication used to treat or prevent low amounts of potassium in the blood.

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During a sports physical examination, a 15-year-old female expresses her desire for oral contraceptives. She mentions that she is sexually active and prefers not to inform her parents. What should be the nurse’s course of action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A mother brings her 3-month-old infant to the clinic because the baby does not sleep through the night. Which finding is most significant in planning care for this family?

Correct Answer is A

Explanation

A mother brings her 2-month-old to the well-baby clinic. She states that when she kisses her baby, the infant’s skin tastes salty. The nurse should prepare the mother for what standard diagnostic test to screen for cystic fibrosis (CF)?

Correct Answer is B

Explanation

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A mother brings her 2-month-old to the well-baby clinic. She mentions that when she kisses her baby, the infant’s skin tastes salty. What standard diagnostic test should the nurse prepare the mother for to screen for cystic fibrosis (CF)?

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