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The nurse is admitting a young adult female patient to the emergency department after an automobile accident and is scheduled for abdominal x-rays. Which of the following information is most important to report to the health care provider before the x-rays are obtained?
- A. Abdominal pain
- B. Positive hCG testing
- C. Temperature 38.9°C
- D. Bruising on the abdomen
Correct Answer: B
Rationale: A positive hCG test indicates pregnancy, and radiation from x-rays could harm the fetus, making this the most critical information to report. Abdominal pain, fever, and bruising are important but less urgent in this context.
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A patient calls the clinic because of an unusually heavy menstrual flow. She tells the nurse that she has saturated two tampons in the past 2 hours. Which of the following amounts of blood loss should the nurse estimate from the patient's information?
- A. 10-20 mL
- B. 20-30 mL
- C. 30-40 mL
- D. 40-60 mL
Correct Answer: D
Rationale: The average tampon absorbs 20-30 mL. Since the patient saturated two tampons in 2 hours, the estimated blood loss is 40-60 mL.
Which information about a female patient who wants to start using oral contraceptives is most important to report to the health care provider?
- A. The patient quit smoking 6 months previously.
- B. The patient's blood pressure is 164/90 mm Hg.
- C. The patient has a history of migraines.
- D. The patient is 35 years old.
Correct Answer: B
Rationale: Since hypertension increases the risk for morbidity and mortality in women taking oral contraceptives, the patient's blood pressure should be controlled before oral contraceptives are prescribed. The other information will also be reported but will not affect the choice of contraceptive.
A couple who has not been able to conceive is scheduled for a postcoital test for infertility. Which of the following information should the nurse provide to the couple in preparation for the test?
- A. Possible shoulder pain after the procedure
- B. Sedative medications used during the procedure
- C. Ways to determine the estimated time of ovulation
- D. How long to refrain from intercourse before the test
Correct Answer: C
Rationale: For the postcoital test, the couple should have intercourse at the estimated time of ovulation and then arrive for the test 2-8 hours after intercourse. The other instructions would be used for other types of fertility testing.
The nurse is assessing a patient who had a hysterosalpingogram, endometrial biopsy, and cervical biopsy in the outpatient clinic this morning and now reports feeling light-headed and short of breath. Which of these symptoms is most important to report to the health care provider?
- A. Abdominal cramping
- B. Vaginal spotting
- C. Light-headedness
- D. Dyspnea
Correct Answer: C
Rationale: The patient's light-headedness suggests a possible vasovagal response or other complication post-procedure, requiring immediate attention. Dyspnea could also be significant, but light-headedness is prioritized due to its potential to indicate hypoperfusion or shock. Abdominal cramping and vaginal spotting are expected after these procedures.
A male patient who is 53 years of age is scheduled for an annual physical exam. Which of the following information should the nurse include in the teaching plan?
- A. Increased risk for testicular cancer
- B. Possible changes in erectile function
- C. Normal decreases in testosterone level
- D. Annual digital rectal examination
Correct Answer: D
Rationale: A digital rectal examination is required for all men who have symptoms of prostate trouble, such as difficulty in initiating the flow and the urge to void frequently. This examination should be performed annually for all men 50 years of age or older. There is no indication that the other patient teaching topics are appropriate for this patient.