Nokea
The nurse is preparing a woman for an abdominal ultrasound. Which instruction would be appropriate for the nurse to include?
- A. Restrict solid food intake for 2 hours before the test.
- B. Refrain from douching for at least 1 week before the test.
- C. Drink at least 1 quart of water an hour before the test.
- D. Empty the bladder immediately before the test.
Correct Answer: C
Rationale: Drinking at least 1 quart of water 45 minutes to 1 hour before the test and not voiding until after the test ensures a full bladder and facilitates transmission of the ultrasound waves. It also elevates the bowel away from the other pelvic organs. The client should restrict solid food intake for 6 to 8 hours before the test to avoid having images of the test obscured by gas and intestinal contents. There is no restriction on douching for this test. A full bladder, not an empty one, facilitates this test.
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The nurse is caring for a client scheduled for a transrectal ultrasonography. Which instruction is essential in obtaining an accurate test?
- A. Self-administer an enema prior to arrival.
- B. Take a low-dose sedative prior to arrival.
- C. Avoid fluids after midnight.
- D. Empty the bladder prior to the exam.
Correct Answer: A
Rationale: The client will need to have an enema to remove stool from the rectum so that the ultrasound can penetrate through the tissues to visualize structures of the prostate. Typically, a sedative is not needed as the client uses normal relaxation techniques. Urine status is not the focus of the exam requiring that fluids be withheld. For the client's comfort, the nurse may encourage emptying the bladder before the exam.
A parent of an adolescent female is asking the nurse for guidelines of when the daughter should have her first Papanicolaou test (Pap test) and then the subsequent frequency. The nurse is most correct to state which?
- A. The first Pap test should be at age 16 years and then annually thereafter.
- B. The first Pap test should be no later than 18 years of age and then every other year afterward.
- C. The first Pap test should be between 25 and 29 years and then every 3 years afterward.
- D. The first Pap test should be within the first year of menstruation and annually afterward.
Correct Answer: C
Rationale: The American Cancer Society (ACS) recommends no testing/screenings for women aged 21 to 24 years. Women between the ages of 25 and 29 years have the recommendation for HPV testing to be every 5 years (preferred), the HPV/Pap co-test every 5 years (acceptable), or the Pap test every 3 years (acceptable).
The nurse is assisting a 30-year-old client in scheduling an appointment for a cervical biopsy. The nurse would recommend that the client schedule the testing at which time?
- A. 1 week after completion of the client's menstrual cycle
- B. 2 weeks before the onset of the client's menstrual cycle
- C. 3 weeks after the onset of the client's menstrual cycle
- D. 2 weeks after the cessation of the client's menstrual cycle
Correct Answer: A
Rationale: Because the client is premenopausal, the nurse would recommend scheduling the cervical biopsy for 1 week after the end of a menstrual period, when the cervix is least vascular. Scheduling the test for any other time would be inappropriate.
A nurse is caring for a client following a culdoscopy. Which assessment data would the licensed practical nurse report to the registered nurse?
- A. Pain level of 7 on the 0-to-10 pain scale
- B. Skin, cold, pulse, 110 beat/minute, blood pressure, 104/64 mm Hg
- C. Dark drainage noted on surgical pad
- D. Fleshy smell noted to perineal region
Correct Answer: B
Rationale: Culdoscopy is performed to visualize the uterus, broad ligaments, and fallopian tubes. An endoscope is inserted through a small incision made in the posterior vaginal wall. Afterward, the nurse must observe for signs of internal bleeding and shock. A client with cold and clammy skin, a rapid pulse, and low blood pressure indicates shock and the need to consult the registered nurse and even the physician. All of the other symptoms are able to be addressed by the licensed practical nurse. The client is to be medicated. Dark drainage and a fleshy smell to the perineal area are normal for old surgical drainage.
The nurse is obtaining a history from a male client who states having difficulty achieving and sustaining an erection. When reviewing the medication history, which medication classification does the nurse anticipate?
- A. Bronchodilators
- B. Antihypertensives
- C. Cardiac dysrhythmics
- D. Antibiotics
Correct Answer: B
Rationale: Due to the therapeutic effect of antihypertensive medications decreasing blood pressure, the nurse is correct to anticipate a side effect of a male client having difficulty achieving or sustaining an erection. The other medication classifications do not typically have an effect on the male reproductive system.