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A client is scheduled to undergo a Papanicolaou (Pap) test in 1 week. Which statement does the nurse make to the client?
- A. 'If you are menstruating, use pads instead of a tampon.'
- B. 'Avoid intercourse for 24 hours before the scheduled examination.'
- C. 'Get a douching kit from the pharmacy and douche 2 hours before the examination.'
- D. 'If you are having a vaginal discharge, obtain a sample of the discharge for inspection.'
Correct Answer: B
Rationale: The correct answer is to 'Avoid intercourse for 24 hours before the scheduled examination.' The Pap test is used to screen for cervical cancer. It is not performed during menstruation or if a heavy infectious discharge is present. Before the test, the client should not douche, have intercourse, or insert anything into the vagina within 24 hours. Instructing the client to use pads instead of a tampon when menstruating can interfere with the test results due to the presence of blood. Douching before the exam is discouraged as it can alter the cervical cells' appearance, affecting the test's accuracy. Obtaining a sample of vaginal discharge for inspection is not a standard pre-Pap test instruction and is unnecessary for the test.
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Which of the following values should be monitored closely while a client is on total parenteral nutrition?
- A. calcium
- B. magnesium
- C. glucose
- D. cholesterol
Correct Answer: C
Rationale: Glucose is the correct value to monitor closely while a client is on total parenteral nutrition. Total parenteral nutrition solutions have high glucose concentrations, necessitating monitoring to prevent complications like hyperglycemia. Calcium, magnesium, and cholesterol are not typically closely monitored during total parenteral nutrition as they are not directly related to the solution's composition or potential associated complications.
An assessment of the skull of a normal 10-month-old baby should identify which of the following?
- A. closure of the posterior fontanel.
- B. closure of the anterior fontanel.
- C. overlap of cranial bones.
- D. ossification of the sutures
Correct Answer: A
Rationale: The correct answer is the closure of the posterior fontanel. By 10 months of age, the posterior fontanel should be closed. The anterior fontanel typically closes around 12-18 months of age. Overlapping of cranial bones is not a normal finding and may indicate craniosynostosis, a condition where the sutures close too early. Ossification of the sutures is also not a normal finding in a 10-month-old baby as the sutures should remain open to allow for the growth of the skull.
How often should the nurse change the intravenous tubing on total parenteral nutrition solutions?
- A. every 24 hours
- B. every 36 hours
- C. every 48 hours
- D. every 72 hours
Correct Answer: A
Rationale: The correct answer is 'every 24 hours.' Changing the intravenous tubing on total parenteral nutrition solutions every 24 hours is crucial due to the high risk of bacterial growth. Bacterial contamination can lead to serious infections in patients receiving total parenteral nutrition. Choices B, C, and D are incorrect because waiting longer intervals between tubing changes increases the risk of bacterial contamination and infection, compromising patient safety. It is essential to maintain a strict 24-hour schedule to minimize the risk of complications associated with bacterial contamination.
A nurse is preparing to assist the healthcare provider in performing an internal gynecological examination of a client. In which position does the nurse place the client for this examination?
- A. Prone
- B. Left side-lying
- C. Sims
- D. Lithotomy
Correct Answer: D
Rationale: An internal gynecological examination is performed with the client in the lithotomy position. In this position, the client is supine, with the feet in stirrups, the knees apart, and the buttocks at the end of the examining table. The client is draped so that only the vulva is exposed. The lithotomy position provides optimal access for the healthcare provider to perform the examination effectively. The prone position refers to lying on the stomach, which is not suitable for a gynecological exam. The Sims position is a left side-lying position primarily used for administering enemas, not for gynecological examinations.
A client turns her ankle. She is diagnosed as having a Pulled Ligament. This should be documented as a:
- A. sprain.
- B. strain.
- C. subluxation.
- D. dislocation.
Correct Answer: B
Rationale: The term 'strain' is the correct choice. A strain refers to the excessive stretching of a muscle or tendon, which aligns with a pulled ligament diagnosis. A sprain, on the other hand, involves ligament injury due to twisting motions. 'Subluxation' indicates a partial dislocation of a joint, not a pulled ligament. 'Dislocation' refers to the complete displacement of bones in a joint, which is not the appropriate term for a pulled ligament.