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A woman is in her seventh month of pregnancy.
She has been reporting nasal congestion and occasional epistaxis.
The nurse suspects that.

A.

this is a normal respiratory change in pregnancy caused by elevated levels of estrogen.

B.

this is an abnormal cardiovascular change, and the nosebleeds are an ominous sign.

C.

the woman is a victim of domestic violence and is being hit in the face by her partner.

D.

the woman has been using cocaine intranasally.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Nasal congestion and occasional epistaxis (nosebleeds) are common symptoms during pregnancy due to elevated levels of estrogen. Increased estrogen causes mucosal blood vessels to become engorged and more fragile, leading to nasal congestion and occasional nosebleeds. This is a normal respiratory change in pregnancy and not necessarily a cause for concern.

Choice B rationale:

While cardiovascular changes are common in pregnancy, nosebleeds alone are not indicative of abnormal cardiovascular changes unless they are accompanied by other symptoms. The given scenario does not provide enough information to support this choice.

Choice C rationale:

There is no evidence provided to suggest domestic violence (Choice C) as the cause of the woman's symptoms. Additionally, this choice lacks a physiological basis for the symptoms described.

Choice D rationale:

Intranasal cocaine use (Choice D) can indeed cause nasal congestion and frequent nosebleeds. However, the scenario does not provide any information to support this choice, and assuming drug use without evidence is not appropriate.


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Related Questions

Correct Answer is D

Explanation

Choice A rationale:
The child's fever in Kawasaki disease is typically unresponsive to antibiotics. The disease primarily affects blood vessels and can lead to the development of coronary artery aneurysms. Antibiotics are not the mainstay of treatment for Kawasaki disease.
Choice B rationale:
Kawasaki disease does not primarily involve the joints. It is a systemic vasculitis that affects medium-sized arteries throughout the body, including the coronary arteries. Joint involvement is not a characteristic feature of this condition.
Choice C rationale:
Aspirin is actually a crucial part of the treatment for Kawasaki disease. High-dose aspirin therapy (80-100 mg/kg/day) is administered until the child is afebrile, then the dose is reduced and continued for several weeks to prevent blood clots and inflammation in the coronary arteries.
Choice D rationale:
This is the correct answer. The therapeutic management of Kawasaki disease includes the administration of intravenous immunoglobulin (IVIG) and aspirin. IVIG helps reduce inflammation and prevent coronary artery abnormalities, while high-dose aspirin is used for its anti-inflammatory and antiplatelet effects. This combination of treatments has been shown to be effective in reducing the risk of coronary artery complications associated with Kawasaki disease.

Correct Answer is A

Explanation

To calculate the estimated date of confinement (EDC) using Nagele's rule, follow these steps:

  1. Take the first day of the last menstrual period (LMP).

  2. Add 7 days to that date.

  3. Count back 3 months.

  4. Add 1 year to the resulting date, and that will be the EDC.

In this case, the client's LMP started on December 1.

  1. December 1

  2. December 8 (adding 7 days)

  3. September 8 (counting back 3 months)

  4. Add 1 year: September 8 of the following year

So, the most accurate EDC for the client using Nagele's rule would be September 8 of the following year.

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