A nurse is caring for a 22-year-old female client who is experiencing lower abdominal pelvic pain. The client is at risk of developing a condition due to a finding.
Condition: Ovarian cysts, Finding: Ultrasound shows a fluid-filled sac in the ovary.
Condition: Appendicitis, Finding: Pain localized in the lower right quadrant.
Condition: Endometriosis, Finding: Patient reports cyclical pain.
Condition: Pelvic inflammatory disease, Finding: Elevated white blood cell count.
The Correct Answer is A
Choice A rationale:
Ovarian cysts are fluid-filled sacs that form on or within an ovary. They are a common condition, affecting up to 1 in 5 women at some point in their lives. While most ovarian cysts are benign (non-cancerous), they can sometimes cause symptoms, including pelvic pain.
Ultrasound is a common imaging test that uses sound waves to create pictures of internal organs. It can be used to detect ovarian cysts, which often appear as fluid-filled sacs on the ovary.
The presence of an ovarian cyst on ultrasound, combined with the patient's symptoms of lower abdominal pelvic pain, suggests that the patient is at risk of developing complications from the cyst. These complications can include: Rupture: A ruptured ovarian cyst can cause sudden, severe pain and bleeding.
Torsion: This is when a cyst twists on its stalk, cutting off its blood supply. Torsion can also cause severe pain and may require emergency surgery.
Choice B rationale:
Appendicitis is an inflammation of the appendix, a small, finger-shaped organ located in the lower right abdomen. It is a common cause of abdominal pain, especially in young adults.
However, the patient in this scenario is experiencing pain in the lower abdominal pelvic region, not specifically in the lower right quadrant. This makes appendicitis less likely.
Additionally, the patient does not have any other symptoms that are typically associated with appendicitis, such as fever, nausea, or vomiting.
Choice C rationale:
Endometriosis is a condition in which tissue that normally lines the uterus grows outside of the uterus. It can cause pain, especially during menstruation.
However, the patient in this scenario does not report cyclical pain, which is a hallmark symptom of endometriosis. Additionally, endometriosis is not typically associated with the presence of fluid-filled sacs on the ovaries.
Choice D rationale:
Pelvic inflammatory disease (PID) is an infection of the upper genital tract, including the uterus, fallopian tubes, and ovaries. It is often caused by sexually transmitted infections (STIs).
PID can cause pelvic pain, but it is also typically associated with other symptoms, such as fever, vaginal discharge, and irregular bleeding.
The patient in this scenario does not have any of these other symptoms, and her white blood cell count is not elevated, which makes PID less likely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale for Choice A:
Judgmental and shaming: The statement "You are so young. Are you sure you are ready for the responsibilities of a sexual relationship?" conveys judgment and may make the adolescent feel ashamed or embarrassed. This can create a barrier to open communication and discourage the teen from seeking further guidance.
Dismisses the teen's concerns: It does not directly address the teen's question about contraception, suggesting that her concerns are not valid or important.
Does not provide helpful information: It does not offer any guidance or education about contraception, leaving the teen without the information she needs to make informed decisions about her sexual health.
Rationale for Choice B:
Erects barriers to access: Requiring parental consent for an examination can delay or prevent the teen from obtaining contraception, even if she is legally allowed to do so without parental consent.
Discourages open communication: It may make the teen feel like she cannot trust the nurse or that her privacy will not be respected, leading her to withhold information or avoid seeking further help.
Rationale for Choice C:
Defers responsibility: It shifts the responsibility for providing contraception counseling to the doctor, potentially delaying the teen's access to information and services.
May not be necessary: A physical examination is not always required before prescribing contraception, and in some cases, a nurse practitioner or other qualified health professional can provide this service.
Rationale for Choice D:
Open and non-judgmental: It invites the teen to share information about her sexual activity without judgment or pressure. Gathers essential information: It allows the nurse to assess the teen's individual needs and preferences, which is crucial for recommending the most appropriate contraceptive method.
Promotes informed decision-making: It empowers the teen to make informed choices about her sexual health by providing her with accurate and comprehensive information about contraception.
Correct Answer is B
Explanation
The correct answer is choice b. Quickening occurs between the fourth and fifth months of pregnancy.
Choice A rationale:
Quickening does not start soon after implantation. Implantation occurs around 6-10 days after fertilization, but quickening, which is the first feeling of fetal movements, typically happens much later in pregnancy.
Choice B rationale:
This is the correct answer. Quickening usually occurs between 16 to 20 weeks of pregnancy, which corresponds to the fourth and fifth months.
Choice C rationale:
Quickening does not start during the last trimester. By the last trimester, fetal movements are usually strong and frequent, and the mother has been feeling them for several months.
Choice D rationale:
Quickening does not occur between the second and third month of pregnancy. At this stage, the fetus is still too small for its movements to be felt by the mother.
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