A nurse is caring for a client who is at 37 weeks of gestation and has placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?

"There is an increased risk of introducing infection.”

"This could initiate preterm labor.”

"This could result in profound bleeding.”

"There is an increased risk of rupture of the membranes.”

Answer and Explanation

The Correct Answer is C

Choice A rationale:

While there is a risk of infection with any internal examination, it is not the primary reason for avoiding internal examinations in a client with placenta previa. The main concern is avoiding trauma to the placenta, which could result in significant bleeding.

Choice B rationale:

Although internal examinations may potentially stimulate uterine contractions, leading to preterm labor in some cases, this is not the primary reason for avoiding such examinations in clients with placenta previa. The primary concern remains the risk of bleeding due to placental disruption.

Choice C rationale:

The correct explanation for the nurse to provide is that an internal examination could result in profound bleeding. Placenta previa occurs when the placenta partially or completely covers the cervix, and any manipulation of the cervix or uterus through an internal examination could disrupt the placenta and cause severe bleeding, endangering both the mother and the baby.

Choice D rationale:

While there is a risk of rupturing the membranes during an internal examination, this is not the primary reason for avoiding such examinations in clients with placenta previa. The primary concern remains the risk of bleeding due to placental disruption.

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Correct Answer is C

Explanation

Choice A rationale:

Current guidelines recommend that women aged 21 to 29 have a Pap test every three years, and those aged 30 to 65 can either have a Pap test every three years or a Pap plus HPV (human papillomavirus) test every five years. After age 65, and with a history of normal results, Pap tests may be discontinued.

Choice B rationale:

The nurse should not include choice B, "Pap tests are discontinued following removal of the ovaries,” in the teaching. The presence or absence of ovaries does not affect the need for Pap testing. The Pap test is primarily used to screen for cervical cancer, and its necessity is determined based on age and previous screening results, not on ovarian status.

Choice C rationale:

Patients are advised to avoid sexual intercourse, douching, or using vaginal medications for 24 hours before the test to ensure accurate results.

Choice D rationale:

The nurse should not include choice D, "Viral infections can be detected by a Pap test,” in the teaching. The Pap test is not designed to detect viral infections. Instead, it is used to detect abnormal cervical cells, which may indicate pre-cancerous or cancerous changes.

A. Instruct the client to wash their hands prior to breastfeeding. B. Teach the client about proper latching-on techniques. C. Encourage the client to alternate breastfeeding with formula feeding. D. Instruct the client to avoid using a breast pump. E. Encourage the client to allow their nipples to air dry after feedings.

Correct Answer is ["A","B","E"]

Explanation

Choice A rationale:

Instructing the client to wash their hands before breastfeeding helps prevent the transmission of infection to the breast and the baby.

Choice B rationale:

Teaching the client about proper latching-on techniques ensures effective breastfeeding, reduces the risk of nipple damage, and promotes comfort for both the client and the baby.

Choice C rationale:

Encouraging the client to alternate breastfeeding with formula feeding is not recommended for a client with mastitis. Mastitis is an inflammation of the breast tissue often caused by bacterial infection, and continuing breastfeeding helps to clear the infection and maintain milk supply.

Choice D rationale:

Instructing the client to avoid using a breast pump is not necessary in this situation. Breastfeeding and pumping can continue to help drain the breast adequately, which is essential for resolving mastitis.

Choice E rationale:

Encouraging the client to allow their nipples to air dry after feedings helps promote healing and prevents further irritation to the nipples.

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A nurse is caring for a client who is at 37 weeks of gestation and has placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?

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Correct Answer is C

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Correct Answer is ["A","B","E"]

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