Nokea
A 17-year-old, sexually active female client is seen in the family planning clinic and requests hormonal contraceptives. Before examination, the nurse should explain the importance of regular Papanicolaou (Pap) smears. This recommendation is based on the current screening guidelines of the American Cancer Society for Pap smears, which state that:
- A. Pap smears are recommended every other year.
- B. If four consecutive annual Pap smears are negative, the client should schedule repeat Pap smears every 3 years.
- C. The initial Pap smear should be done at age 12.
Correct Answer: B
Rationale: American Cancer Society guidelines recommend Pap smears every 3 years after four consecutive normal annual smears for women who are sexually active or over 21. Screening does not start at age 12, and every-other-year screening is not standard.
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What would be the nurse's best response to the client's expressed feelings of isolation as a result of having hepatitis?
- A. Don't worry. It's normal to feel that way.'
- B. Your friends are probably afraid of contracting hepatitis from you.'
- C. I'm sure you're imagining that!'
- D. Tell me more about your feelings of isolation.'
Correct Answer: D
Rationale: Encouraging the client to express feelings (D) fosters therapeutic communication and addresses emotional needs. Dismissing feelings (A, C) or assuming others' fears (B) is non-therapeutic and unhelpful.
The nurse is assessing a client with a recent history of an above-the-knee amputation presenting with phantom limb pain. The nurse anticipates a prescription for
- A. aripiprazole
- B. oxycodone
- C. amitriptyline
- D. hydroxyzine
Correct Answer: C
Rationale: Amitriptyline, a tricyclic antidepressant, is commonly used for neuropathic pain, including phantom limb pain, due to its effects on nerve signaling.
Which statement by a client with acute renal failure indicates understanding of dietary restrictions?
- A. I will avoid oranges.
- B. I can eat unlimited protein.
- C. I should drink less water.
- D. I will eat more spinach.
Correct Answer: A
Rationale: Oranges are high in potassium, which should be avoided in acute renal failure.
A client with uric acid stones is prescribed a low-purine diet. Which food is allowed?
- A. Liver.
- B. Chicken.
- C. Apples.
- D. Sardines.
Correct Answer: C
Rationale: Apples are low in purines, suitable for a uric acid stone diet.
A client on peritoneal dialysis reports cloudy effluent. The nurse should:
- A. Continue the exchange.
- B. Notify the physician.
- C. Increase dwell time.
- D. Administer pain medication.
Correct Answer: B
Rationale: Cloudy effluent suggests peritonitis, requiring immediate medical attention.