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 C

Explanation

Choice A: African American women have the BRCA 1 and BRCA 2 gene is not the correct answer because it is not a fact but a misconception. BRCA 1 and BRCA 2 are genes that normally help prevent breast and ovarian cancer by repairing DNA damage. However, mutations in these genes can increase the risk of developing these cancers. BRCA mutations are not exclusive to African American women, but they can affect any race or ethnicity. According to the National Cancer Institute, about 12% of American white women and 10% of African American women have a BRCA mutation.

Choice B: American white women respond better to breast cancer treatment is not the correct answer because it is not a fact but a disparity. Breast cancer treatment can include surgery, radiation, chemotherapy, hormone therapy, or targeted therapy. The response to treatment can vary depending on various factors such as tumor type, stage, grade, or molecular profile. However, some studies have shown that American white women have better survival rates and outcomes than African-American women after breast cancer treatment. This disparity may be due to differences in access to care, quality of care, socioeconomic status, or biological factors.

Choice C: Breast cancer is more advanced in African American women when found is the correct answer because it is a fact and a disparity. Breast cancer is a disease that occurs when abnormal cells grow and invade the breast tissue or other parts of the body. The stage of breast cancer describes how far the cancer has spread and how serious it is. Breast cancer can be detected by screening tests such as mammograms or clinical exams such as breast self-exams. However, some studies have shown that African American women are more likely than American white women to be diagnosed with breast cancer at later stages. This disparity may be due to differences in screening rates, awareness, symptoms, or tumor biology.

Choice D: More Hispanic women smoke, which increases their risk is not the correct answer because it is not a fact but a misconception. Smoking is a risk factor for breast cancer, as it can damage the DNA of breast cells and increase the levels of hormones that stimulate cell growth. However, smoking rates are not higher among Hispanic women than other racial or ethnic groups. According to the Centers for Disease Control and Prevention, about 14% of Hispanic women smoke cigarettes compared to 16% of American white women and 14% of African American women.

A. Vaginal intercourse can be resumed after 2 weeks. B. Products of conception will be present in vaginal bleeding. C. Increased intake of zinc-rich foods is recommended. D. Aspirin may be taken for cramps.

Correct Answer is A

Explanation

Choice A: Vaginal intercourse can be resumed after 2 weeks.

Reason: After a dilation and curettage (D&C) procedure, it is generally recommended to avoid vaginal intercourse for about 2 weeks. This allows the cervix and uterus to heal and reduces the risk of infection. Engaging in sexual activity too soon can introduce bacteria into the uterus, which is particularly vulnerable following the procedure.

Choice B: Products of conception will be present in vaginal bleeding.

Reason: This statement is incorrect. After a D&C, the products of conception should have been removed during the procedure. While some bleeding is normal, it should not contain products of conception. Instead, the bleeding should be similar to a menstrual period.

Choice C: Increased intake of zinc-rich foods is recommended.

Reason: There is no specific recommendation for increasing zinc intake following a D&C. The focus is typically on general post-operative care, such as rest, hydration, and monitoring for signs of infection. While a balanced diet is always beneficial, there is no evidence suggesting that zinc-rich foods are particularly necessary after this procedure.

Choice D: Aspirin may be taken for cramps.

Reason: This statement is incorrect. Aspirin is generally not recommended for pain relief after a D&C because it can increase the risk of bleeding. Instead, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are usually recommended for managing cramps and pain.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing a breast cancer presentation for a health forum. Which fact would the nurse expect to address in this presentation?

Correct Answer is C

Explanation

A nurse in the ambulatory surgery center is providing discharge teaching to a client who had a dilation and curettage (D&C) following a spontaneous miscarriage. Which of the following should be included in the teaching?

Correct Answer is A

Explanation

A nurse is assessing a male client recently diagnosed with genital herpes. Which finding would most likely correlate with this diagnosis?

A nurse is working with a woman who has been diagnosed with severe fibrocystic breast disease. After describing the medications that can be used as treatment, the nurse determines that additional teaching is needed when the client identifies which drug as being used?

A nurse reading a journal article about the care of a woman with pelvic organ prolapse would expect to find information on which disorder. Select all that apply.

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

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

A nurse is assessing a male client recently diagnosed with genital herpes. Which finding would most likely correlate with this diagnosis?

Which finding would the nurse expect in a client with bacterial vaginosis?

The public health nurse is teaching young adolescents in a sexual health class the proper use of a condom. Which statements made by the students indicate teaching was successful? Select all that apply.