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A nurse is providing teaching to a client about the Papanicolaou (Pap) test. Which of the following information should the nurse include in the teaching?
- A. A yearly Pap test is recommended until 70 years of age.
- B. Pap tests are discontinued following removal of the ovaries.
- C. Avoid having sexual intercourse for 24 hours prior to the Pap test.
- D. Viral infections can be detected by a Pap test.
Correct Answer: C
Rationale: Avoiding intercourse for 24 hours minimizes contamination of cervical cells with external materials, ensuring accurate Pap test results. It is an important preparatory guideline.
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A nurse is caring for a client who gave birth 4 hr ago and is experiencing excessive vaginal bleeding. Which of the following actions should the nurse plan to take first?
- A. Elevate the client's legs to a 30° angle.
- B. Insert an indwelling urinary catheter.
- C. Massage the client's fundus.
- D. Initiate an infusion of oxytocin.
Correct Answer: C
Rationale: Massaging the fundus promotes uterine contraction, which is the first-line intervention to control postpartum hemorrhage caused by uterine atony.
A client reports an intermittent dark brown vaginal discharge for the past three days. What should the nurse do?
- A. The nurse should assess the client for signs of molar pregnancy.
- B. The nurse should evaluate the risk for hypovolemic shock due to blood loss.
- C. The nurse should ensure appropriate laboratory testing for the diagnosis of choriocarcinoma.
- D. The nurse should prioritize preparing the client for suction and curettage.
Correct Answer: A
Rationale: Molar pregnancy often manifests as intermittent dark brown vaginal discharge due to trophoblastic tissue expulsion. It warrants assessment as it correlates with hCG elevation and abnormal placental development.
A nurse is reviewing the laboratory results of a newborn who is 32 hours old and has a cephalohematoma. Which of the following findings should the nurse expect as a result of this condition?
- A. WBC count of 35,000/mm² (normal range: 9,000 to 30,000/mm²).
- B. Glucose level of 35 mg/dL (normal range: greater than 40 to 45 mg/dL).
- C. Bilirubin level of 14.0 mg/dL (normal range: 1.0 to 12.0 mg/dL).
- D. Platelet count of 350,000/mm³ (normal range: 150,000 to 300,000/mm³).
Correct Answer: C
Rationale: A bilirubin level of 14.0 mg/dL is above the newborn normal range of 1.0 to 12.0 mg/dL. This indicates hyperbilirubinemia, commonly seen due to red blood cell breakdown in cephalohematoma.
A nurse is teaching a client about using an intrauterine device (IUD) for contraception. Which of the following client statements indicates an understanding of the teaching?
- A. I will need to have the IUD replaced each year.
- B. I will need to apply a spermicide prior to intercourse.
- C. I should expect my periods to stop while I have the IUD.
- D. I should check for the string each month after menstruation.
Correct Answer: D
Rationale: Checking for the string ensures proper IUD positioning and functionality. This monthly practice helps detect dislodgement or expulsion, which can compromise contraceptive effectiveness.
A nurse is assessing a client who is at 31 weeks of gestation. Which of the following findings should the nurse identify as an indication of a potential prenatal complication?
- A. Periodic tingling of fingers.
- B. Absence of clonus.
- C. Leg cramps.
- D. Blurred vision.
Correct Answer: D
Rationale: Blurred vision may result from severe preeclampsia or elevated blood pressure, signifying potential end-organ damage. It requires immediate medical evaluation to prevent progression to eclampsia.