A laboratory technician arrives to draw blood for a complete blood count (CBC) for a client who had a right-sided mastectomy 8 hours ago. The client has an intravenous line with fluid infusing in her left antecubital space. To obtain the blood specimen, the technician places a tourniquet on the client's right arm. Which action by the nurse would be most appropriate?

Call the surgeon to perform a femoral puncture.

Assist in holding the client's arm still.

Tell the technician to obtain the blood sample from the client's left arm.

Suggest a finger stick be done on one of the client's left fingers.

Answer and Explanation

The Correct Answer is C

Choice A: Call the surgeon to perform a femoral puncture. This action is not appropriate because it is unnecessary and invasive. A femoral puncture is a procedure that involves inserting a needle into the femoral vein in the groin area to obtain a blood sample. It is usually reserved for situations where other veins are inaccessible or unsuitable, such as in trauma or shock. It is not indicated for a routine CBC test.

Choice B: Assist in holding the client's arm still. This action is not appropriate because it is harmful and contraindicated. Holding the client's arm still may cause injury or infection to the arm that has undergone surgery and lymph node removal. It may also increase the risk of lymphedema, which is a condition that causes swelling and pain in the arm due to fluid accumulation and impaired lymphatic drainage.

Choice C: Tell the technician to obtain the blood sample from the client's left arm. This action is appropriate because it is safe and recommended. Obtaining the blood sample from the client's left arm can avoid complications such as injury, infection, or lymphedema in the right arm that has undergone surgery and lymph node removal. The technician can use a different site than the antecubital space, such as the hand or wrist, to avoid interfering with the intravenous line.

Choice D: Suggest a finger stick be done on one of the client's left fingers. This action is not appropriate because it is unreliable and inaccurate. A finger stick is a procedure that involves pricking the finger with a lancet to obtain a small amount of blood for testing. It is usually used for point-of-care testing, such as glucose or hemoglobin levels, but not for a CBC test. A CBC test requires a larger volume of blood and a venous sample for accurate results.

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Correct Answer is D

Explanation

Choice A: A 26-year-old client who has migraine headaches at the start of each menstrual cycle is not the correct answer because they do not have a contraindication for receiving oral contraceptives. Oral contraceptives are pills that contain synthetic hormones (estrogen and progestin) that prevent ovulation and pregnancy. They can also help reduce menstrual cramps, bleeding, and migraines in some women. However, oral contraceptives may increase the risk of stroke in women who have migraines with aura (visual disturbances), so they should be used with caution and under medical supervision.

Choice B: A 28-year-old client who has a history of pelvic inflammatory disease is not the correct answer because they do not have a contraindication for receiving oral contraceptives. Pelvic inflammatory disease is an infection that affects the female reproductive organs, such as the uterus, fallopian tubes, or ovaries. It can be caused by various bacteria, such as chlamydia or gonorrhea, and can lead to infertility, ectopic pregnancy, or chronic pelvic pain if left untreated. Oral contraceptives can help prevent pelvic inflammatory disease by creating a thick cervical mucus that blocks the entry of bacteria into the uterus.

Choice C: A 32-year-old client who has benign breast disease is not the correct answer because they do not have a contraindication for receiving oral contraceptives. Benign breast disease is a term that refers to various noncancerous conditions that affect the breast tissue, such as fibrocystic changes, fibroadenomas, or mastitis. They can cause symptoms such as breast pain, tenderness, or lumps. Oral contraceptives can help reduce the symptoms of benign breast disease by regulating the hormonal fluctuations that influence breast tissue growth.

Choice D: A 38-year-old client who reports smoking one pack of cigarettes every day is the correct answer because they have a contraindication for receiving oral contraceptives. Smoking is a habit that involves inhaling tobacco smoke, which contains harmful substances such as nicotine, tar, or carbon monoxide. Smoking can increase the risk of various diseases such as lung cancer, chronic obstructive pulmonary disease (COPD), or cardiovascular disease. Oral contraceptives can further increase the risk of cardiovascular disease in smokers, especially those who are over 35 years old, by increasing blood pressure, cholesterol levels, and clotting factors. Therefore, oral contraceptives are not recommended for smokers and alternative methods of contraception should be used instead.

A. Bleeding between menses B. Bleeding after intercourse C. Metrorrhagia D. Vaginal discharge

Correct Answer is C

Explanation

Choice A: Bleeding between menses is not the correct answer because it is not a specific clinical manifestation of endometrial polyps. Bleeding between menses is a condition that causes spotting or bleeding at any time other than during the normal menstrual period. It can be caused by various factors such as hormonal imbalance, infection, or pregnancy. It can also occur in some women with endometrial polyps, but it is not a definitive sign of them.

Choice B: Bleeding after intercourse is not the correct answer because it is not a specific clinical manifestation of endometrial polyps. Bleeding after intercourse is a condition that causes bleeding from the vagina or cervix after sexual activity. It can be caused by various factors such as trauma, infection, or cancer. It can also occur in some women with endometrial polyps, but it is not a definitive sign of them.

Choice C: Metrorrhagia is the correct answer because it is a specific clinical manifestation of endometrial polyps. Metrorrhagia is a condition that causes irregular or excessive bleeding from the uterus that is unrelated to the menstrual cycle. It can be caused by various factors such as polyps, fibroids, or cancer. It is a common symptom of endometrial polyps, which are benign growths of the endometrium (the lining of the uterus) that can protrude into the uterine cavity and cause bleeding.

Choice D: Vaginal discharge is not the correct answer because it is not a specific clinical manifestation of endometrial polyps. Vaginal discharge is a fluid that comes out of the vagina and varies in color, consistency, and odor depending on the phase of the menstrual cycle, sexual activity, or health status. It can be caused by various factors such as normal secretions, infection, or inflammation. It is not a common symptom of endometrial polyps, which do not usually affect the vaginal flora or pH.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing contraception options for four clients. The nurse should identify that which of the following clients has a contraindication for receiving oral contraceptives.

Correct Answer is D

Explanation

A nurse is assessing a female client and suspects that the client may have endometrial polyps based on which clinical manifestation?

Correct Answer is C

Explanation

A woman with breast cancer is undergoing chemotherapy. Which side effect would the nurse interpret as being most serious?

The nurse is working with a group of community health members to develop a plan to address the special health needs of women. The group would design educational programs to address which condition is the priority.

A woman is admitted for repair of cystocele and rectocele. She has nine living children. In taking her health history, what would the nurse expect to find?

After teaching a group of adolescent girls about female reproductive development, the nurse determines that teaching was successful when the girls state that menarche is defined as a woman's first:

A nurse in a family planning clinic is caring for a 17-year-old female client who is requesting oral contraceptives. The client states that she is nervous because she has never had a pelvic examination. Which of the following responses should the nurse make?

A nurse is leading a discussion about contraception with a group of 14-year-old clients. After the presentation, a client asks the nurse which method would be best for her to use. Which of the following responses should the nurse make?

To assist the woman in regaining control of the urinary sphincter after bladder surgery, the nurse should teach the client to perform which action?

I can help you with formatting and editing the text. Here are the edited texts: Text 1: A client is diagnosed with uterine fibroids. When reviewing the client's health history, the nurse would identify which finding is associated with the client's condition.