While completing a health assessment for a young adult female with acute appendicitis, the client informs the nurse that there is a chance that she may be pregnant. The operating team is preparing to take the client to surgery. Which intervention should the nurse implement immediately?
Perform a bedside pregnancy test.
Continue with surgery as scheduled.
Calculate gestation from last menstrual cycle.
Notify the surgical team to cancel the surgery.
The Correct Answer is A
Choice A reason: This is correct because performing a bedside pregnancy test is the intervention that should be implemented immediately by the nurse. This is to confirm or rule out pregnancy and inform the surgical team of any possible risks or complications that may affect the client or the fetus.

Choice B reason: This is incorrect because continuing with surgery as scheduled is not an appropriate intervention without verifying the pregnancy status of the client. Surgery may pose serious threats to both maternal and fetal health, such as bleeding, infection, anesthesia complications, or miscarriage.
Choice C reason: This is incorrect because calculating gestation from last menstrual cycle is not an accurate or reliable method of determining pregnancy. The menstrual cycle can vary widely among women and may be affected by various factors such as stress, illness, or medication.
Choice D reason: This is incorrect because notifying the surgical team to cancel the surgery is not a necessary intervention unless pregnancy is confirmed. Appendicitis is a medical emergency that requires prompt surgical treatment to prevent rupture, peritonitis, or sepsis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B", "C","D"]
Explanation
- Choice A: Occupational therapist. This is correct because an occupational therapist can help the client with activities of daily living (ADLs) such as dressing, grooming, eating, and toileting. The client may have difficulty performing these tasks due to the facial droop and weakness caused by the stroke.
- Choice B: Speech therapist. This is correct because a speech therapist can help the client with communication and swallowing problems. The client has garbled speech, which indicates a possible aphasia or dysarthria. The client may also have dysphagia, which is difficulty swallowing, due to the impaired coordination of the muscles involved in swallowing.
- Choice C: Case manager. This is correct because a case manager can coordinate the client's care and discharge planning. The case manager can arrange for referrals, home health services, equipment, and follow-up appointments as needed. The case manager can also provide education and support to the client and family.
- Choice D: Physical therapist. This is correct because a physical therapist can help the client with mobility and balance issues. The client may have hemiparesis or hemiplegia, which is weakness or paralysis of one side of the body. The physical therapist can assist the client with exercises, gait training, and assistive devices to improve the client's functional status.
- Choice E: Chief nursing officer. This is incorrect because a chief nursing officer is not directly involved in the client's recovery. A chief nursing officer is a senior-level executive who oversees the nursing staff and operations of a health care organization. A chief nursing officer may have a role in quality improvement, policy development, and strategic planning, but not in individual client care.
- Choice F: Pharmacy technician. This is incorrect because a pharmacy technician is not directly involved in the client's recovery. A pharmacy technician is a health care professional who assists pharmacists with dispensing medications and other tasks. A pharmacy technician may have a role in preparing, labeling, and delivering medications, but not in providing therapy or education to the client.
- Choice G: Respiratory therapist. This is incorrect because a respiratory therapist is not directly involved in the client's recovery. A respiratory therapist is a health care professional who provides respiratory care to patients with breathing problems. A respiratory therapist may have a role in administering oxygen, nebulizers, ventilators, and other respiratory treatments, but not in addressing the client's stroke-related impairments.
- Choice H: Medical assistant. This is incorrect because a medical assistant is not directly involved in the client's recovery. A medical assistant is a health care professional who performs administrative and clinical tasks in a medical office or clinic. A medical assistant may have a role in scheduling appointments, taking vital signs, drawing blood, and performing basic laboratory tests, but not in providing rehabilitation or education to the client.
Correct Answer is ["F","H"]
Explanation
a) Basic metabolic panel: This is a blood test that measures the levels of electrolytes, glucose, calcium, and kidney function. It is not a priority order for this client because her glucose level is within the normal range and her symptoms are not indicative of electrolyte imbalance or kidney failure.
b) Echocardiogram: This is a test that uses sound waves to create images of the heart and its valves, chambers, and blood flow. It is not a priority order for this client because her chest discomfort may not be related to a cardiac problem and her SpO2 is normal, indicating adequate oxygenation.
c) CT scan of abdomen: This is a test that uses X-rays to create detailed pictures of the organs and structures in the abdomen. It is not a priority order for this client because her abdominal pain is not severe or acute and her nausea and poor appetite may be due to her illness or dialysis.
d) Blood cultures times 2 sets: This is a test that checks for the presence of bacteria or fungi in the blood. It is not a priority order for this client because she does not have signs of infection such as fever, chills, or leukocytosis.
e) Chest X-ray: This is a test that uses X-rays to create images of the lungs and chest wall. It is not a priority order for this client because she does not have respiratory symptoms such as cough, shortness of breath, or wheezes.
f) Place on continuous cardiac monitor: This is an order that requires the nurse to attach electrodes to the client's chest and monitor the heart rate and rhythm continuously. This is a priority order for this client because she has a history of CAD and HTN and reports chest discomfort and lightheadedness, which could indicate a possible myocardial infarction (heart attack) or arrhythmia (irregular heartbeat).
g) CBC: This is a blood test that measures the number and types of blood cells, such as red blood cells, white blood cells, and platelets. It is not a priority order for this client because she does not have signs of anemia, bleeding, or infection.
h) 12 lead EKG: This is a test that records the electrical activity of the heart from 12 different angles. It can detect abnormalities in the heart's rhythm, conduction, or damage. This is a priority order for this client because she has a history of CAD and HTN and reports chest discomfort and lightheadedness, which could indicate a possible myocardial infarction (heart attack) or arrhythmia (irregular heartbeat).
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