A nurse is collecting data from a client who has been taking medroxyprogesterone for 6 months. Which of the following statements by the client should the nurse identify as the priority to report?
I have occasional vaginal spotting."
I have developed brown patches on my face."
I have breast tenderness."
I have intermittent calf pain."
The Correct Answer is D
A) I have occasional vaginal spotting: Vaginal spotting can occur as a side effect of medroxyprogesterone, especially in the first few months of use. While this should be monitored, it is not an immediate concern that requires urgent reporting unless the spotting becomes heavy or persistent, which could indicate other issues.
B) I have developed brown patches on my face: The development of brown patches on the face (known as melasma) is a known side effect of hormonal contraceptives, including medroxyprogesterone. Although this is an undesirable cosmetic effect, it is not an urgent medical concern that requires immediate attention.
C) I have breast tenderness: Breast tenderness is a common side effect of medroxyprogesterone and other hormonal medications. It is usually mild and resolves over time. While the client should continue to monitor the tenderness, it does not present an immediate risk or require urgent intervention.
D) I have intermittent calf pain: Intermittent calf pain could be a sign of a more serious complication, such as a deep vein thrombosis (DVT), especially since medroxyprogesterone can increase the risk of blood clots. This symptom should be reported immediately to the healthcare provider, as a DVT could potentially lead to a pulmonary embolism if left untreated, which is a life-threatening condition. Therefore, this is the priority finding to report.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) You can splint the incision with a pillow when changing position: Splinting the incision with a pillow is an excellent nonpharmacological method to manage pain during position changes after a cesarean section. The pillow helps provide support to the incision site, reduces strain on the abdominal muscles, and minimizes discomfort when the client moves. This is a safe and effective intervention to help with pain management.
B) You should change position as little as possible: While minimizing movement might seem like a way to prevent pain, it can lead to complications like muscle stiffness, poor circulation, and respiratory issues. It’s important for clients to change positions to promote comfort, circulation, and lung expansion, but they should do so with support to manage pain effectively.
C) You should use patterned paced breathing when changing positions: Patterned paced breathing is a helpful relaxation technique that can be used in various situations, including labor and delivery. However, it is not the most appropriate response in this context, as the client’s pain is more related to physical discomfort from the incision, and physical support (like splinting the incision) would be more effective in managing this type of pain.
D) You can apply counterpressure to your back with each position change: While counterpressure can be beneficial for back pain during labor, it is not the most relevant technique for managing pain after a cesarean section, where the pain is related to the abdominal incision site. Splinting the incision provides more targeted support for post-cesarean discomfort.
Correct Answer is D
Explanation
A) "I will wash my baby’s head using a moist towelette": Using a moist towelette to wash a newborn’s head is not the best approach. Newborns should be bathed gently with warm water and mild soap, especially for sensitive areas like the scalp. A moist towelette could irritate the baby’s delicate skin or lead to unnecessary chemicals on the skin.
B) "I will give my baby a bath every day": Giving a newborn a bath every day is not typically necessary. Bathing a newborn 2-3 times per week is usually sufficient to keep the baby clean without drying out the skin. Daily baths can be too harsh on a newborn’s skin, especially in the first few weeks.
C) "I will bathe my baby under a faucet of running water": Bathing a newborn under running water can be dangerous, as it may be difficult to control the temperature of the water or the baby could be at risk of slipping. It is safer to use a basin of warm water and a soft washcloth to gently bathe the baby.
D) "I will wash my baby's face with a warm, wet washcloth without soap": This is the correct and safe approach to washing a newborn’s face. Newborns have very sensitive skin, and it’s best to wash the face with just warm water and a soft washcloth to avoid irritation. Using soap on the face may dry out or irritate their delicate skin.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.
