Exhibits

A nurse is caring for a client in the emergency department (ED). Which of the following actions should the nurse take? Select all that apply.

Inform the dient that they cannot refuse medical examination

Report laboratory findings to law enforcement.

Prepare to administer prophylaxis for STIs.

Assess for thoughts of self-harm

Recommend emergency contraception to the client.

Answer and Explanation

Correct Answer : C,D,E

A. Inform the client that they cannot refuse medical examination: All patients, including those who have been sexually assaulted, have the legal right to refuse any part of the examination. Informed consent is essential.
B. Report laboratory findings to law enforcement: Unless there is a mandatory reporting law in effect for that specific jurisdiction, results and disclosures require the client's consent before being shared with law enforcement.
C. Prepare to administer prophylaxis for STIs: Clients who have experienced sexual assault are at risk for sexually transmitted infections. Early administration of prophylactic antibiotics is a standard, time-sensitive intervention.
D. Assess for thoughts of self-harm: Sexual assault survivors are at increased risk for depression, suicidal ideation, and PTSD. A mental health assessment should be conducted immediately to ensure safety.
E. Recommend emergency contraception to the client: If pregnancy is a potential concern, emergency contraception should be offered within a limited time window after the assault, regardless of the client’s current hCG level.

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Correct Answer is D

Explanation

A. Flaxseed: Flaxseed is primarily used for its fiber content and potential cholesterol-lowering effects; it is not commonly associated with causing hypotension during surgery.
B. Soy: Soy contains phytoestrogens and may affect hormone levels, but it does not typically increase the risk of hypotension during surgery.
C. Probiotics: Probiotics help maintain gut flora balance and generally have no direct effect on blood pressure or hypotension risk during surgery.
D. Black cohosh: Black cohosh has vasodilatory properties and can lower blood pressure, increasing the risk of hypotension during surgery, especially when combined with anesthesia or other medications.

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Explanation

Rationale for Correct Findings:

Spontaneous abortion: The client is at 10 weeks gestation with moderate, bright red vaginal bleeding, abdominal cramping, and an open cervix. These findings are classic indicators of an inevitable spontaneous abortion, where pregnancy loss is imminent and cannot be prevented.
Cervical dilation: Cervical dilation during early pregnancy, especially in the presence of bleeding and cramping, indicates that the pregnancy is not viable. The open cervix confirms the uterus is preparing to expel its contents, consistent with spontaneous abortion.

Rationale for Incorrect Findings:

Ectopic pregnancy: Ectopic pregnancies typically present with unilateral pelvic pain and are usually associated with lower hCG levels than expected for gestational age. A confirmed intrauterine pregnancy with an open cervix and high hCG makes ectopic pregnancy unlikely.
Molar pregnancy: Molar pregnancies are characterized by markedly elevated hCG levels, larger-than-expected uterine size, and sometimes passage of grape-like vesicles. The client's symptoms do not fit this profile, making this diagnosis less likely.
hCG levels: The hCG level of 30,000 IU/L is within the normal range for 10 weeks gestation and does not indicate any problem. It supports a pregnancy of appropriate dating, not necessarily a spontaneous abortion.
History of chlamydia infections: A history of recurrent chlamydia is a risk factor for ectopic pregnancy due to potential fallopian tube scarring. However, it does not directly support a current diagnosis of spontaneous abortion without additional findings.

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Exhibits A nurse is caring for a client in the emergency department (ED). Which of the following actions should the nurse take? Select all that apply.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Exhibits

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