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 reason: Increased vaginal discharge is a normal and expected outcome of using a pessary, as it helps to lubricate and cleanse the vagina.

Choice B reason: Urinary tract infection is not a common side effect of using a pessary, as it does not interfere with urination or introduce bacteria into the urinary tract.

Choice C reason: Vaginitis is not a common side effect of using a pessary, as it does not cause inflammation or infection of the vagina. However, the client should maintain good hygiene and use vaginal cream or gel as prescribed to prevent irritation.

Choice D reason: Vaginal ulceration is a serious and possible side effect of using a pessary, as it can cause pressure necrosis and erosion of the vaginal mucosa. The client should report any bleeding, pain, or foul-smelling discharge to the provider and have the pessary removed and replaced regularly.

A. Rectal incontinence B. Rectocele C. Urinary incontinence D. Cystocele E. Enterocele

Correct Answer is ["B","C","D","E"]

Explanation

Choice A: Rectal incontinence is not the correct answer because it is not a disorder related to pelvic organ prolapse. Rectal incontinence is a condition that causes loss of control over bowel movements, resulting in leakage of stool or gas. It can be caused by various factors, such as nerve damage, muscle weakness, or diarrhea.

Choice B: Rectocele is the correct answer because it is a disorder related to pelvic organ prolapse. Rectocele is a condition that occurs when the rectum bulges into the vagina due to weakening of the pelvic floor muscles and connective tissue. It can cause symptoms such as constipation, difficulty emptying the bowel, or a feeling of pressure or fullness in the vagina.

Choice C: Urinary incontinence is the correct answer because it is a disorder related to pelvic organ prolapse. Urinary incontinence is a condition that causes loss of control over urination, resulting in leakage of urine or urgency to urinate. It can be caused by various factors, such as stress, urge, overflow, or mixed types of incontinence.

Choice D: Cystocele is the correct answer because it is a disorder related to pelvic organ prolapse. Cystocele is a condition that occurs when the bladder bulges into the vagina due to weakening of the pelvic floor muscles and connective tissue. It can cause symptoms such as frequent urination, difficulty emptying the bladder, or a feeling of pressure or fullness in the vagina.

Choice E: Enterocele is the correct answer because it is a disorder related to pelvic organ prolapse. Enterocele is a condition that occurs when the small intestine bulges into the vagina due to weakening of the pelvic floor muscles and connective tissue. It can cause symptoms such as lower back pain, pelvic pressure, or difficulty having bowel movements.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A postmenopausal woman with uterine prolapse is being fitted with a pessary. The nurse would be most alert for which side effect?

Correct Answer is D

Explanation

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.

Correct Answer is ["B","C","D","E"]

Explanation

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.

A nurse is preparing a class discussion on the clinical manifestations of a heart attack observed in women. Which symptoms would the nurse include as key assessment data? Select all that apply.

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?

A woman who has undergone a right-sided modified-radical mastectomy returns from surgery. Which nursing intervention would be most appropriate for the nurse to include in the client's plan of care at this time?

Assessment of a female client reveals a thick, white vaginal discharge. She also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has:

A pregnant woman diagnosed with syphilis comes to the clinic for a visit. The nurse discusses the risk of transmitting the infection to her newborn, explaining that this infection is transmitted to the newborn through the:

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 is being used.

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: