A client reports to the healthcare provider's office for a routine post-surgical evaluation six weeks after a hysterectomy. Which history-taking approach should the nurse use to gather the needed information?

Perform a head-to-toe physical assessment.

Prepare to collect a vaginal specimen for Papanicolaou smear.

Collect information about the client's activities since surgery.

Conduct a comprehensive review of systems.

Answer and Explanation

The Correct Answer is C

A.   At six weeks post-hysterectomy, a focused assessment that addresses the specific concerns related to the surgery and recovery would be more appropriate. A full physical examination might be too broad for this purpose, although aspects of it might be included if specific issues are identified.
B.   A Pap smear is typically not required during a post-surgical follow-up for a hysterectomy unless there is a specific reason to screen for cervical cancer. In many cases, especially if the hysterectomy was for benign reasons and the cervix was removed, Pap smears might not be necessary.
C.   This approach is highly relevant for a post-surgical evaluation. Gathering information about the client’s activities since surgery helps assess the recovery process, identify any issues or complications, and provide appropriate advice for ongoing care. Activities might include physical activity levels, adherence to post-surgical instructions, any new symptoms, and overall well-being.
D.   A comprehensive review of systems is a thorough approach to identifying any potential issues across various body systems. While this can be useful in some cases, it may be more extensive than necessary for a routine follow-up after a hysterectomy.

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Correct Answer is A

Explanation

A. A firm mass palpated at the bottom of the left rib cage can indicate an enlarged spleen, which is an abnormal finding. Splenomegaly may occur due to various conditions, including infections, liver disease, or blood disorders.
B. Rebound tenderness in the right upper quadrant is indicative of potential inflammation or irritation in the abdominal cavity, often associated with appendicitis or other conditions affecting the right lower quadrant. This finding is not specific to the spleen but rather to the general abdominal assessment and does not indicate an abnormal response related to spleen palpation.
C. Normally, the spleen is not palpable in most people. However, if the spleen is slightly enlarged, its tip may be palpable during deep palpation or when the client is asked to exhale forcefully. While this can be an abnormal finding, it may still fall within a range of normal variability depending on the clinical context.
D. McBurney's point is located in the right lower quadrant of the abdomen and is associated with the appendix. Pain at this location is indicative of potential appendicitis, not an abnormal finding related to spleen palpation. This finding does not provide information about the condition of the spleen.

A. Place the client in a standing position, leaning over the exam bed for inspection. B. Determine if the client uses any over-the-counter preparations for hemorrhoids. C. Position client in left lateral position to inspect perianal area for fissures or sacs. D. Ask the client how long she has experienced discomfort related to hemorrhoids.

Correct Answer is C

Explanation

A. A standing position leaning over the exam bed may not provide the best view or allow for thorough examination of the perianal area. This position is less commonly used and may not be ideal for a focused assessment of hemorrhoids.
B. Finding out if the client uses over-the-counter preparations for hemorrhoids provides useful information about the management and treatment approach being used. However, while this information is valuable, it does not directly involve the physical assessment of the hemorrhoids themselves.
C. The left lateral position (also known as the Sims' position) is commonly used for the examination of the perianal area. It provides optimal access for visual inspection of hemorrhoids, fissures, or other abnormalities in the anal region. This position allows the nurse to examine the area more thoroughly and comfortably, making it the most appropriate choice for a focused assessment of hemorrhoids.

D. Asking about the duration of discomfort provides valuable information about the history and progression of the condition. Understanding how long the client has been experiencing symptoms can help in assessing the chronicity and possible treatment history of the hemorrhoids.

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A client reports to the healthcare provider's office for a routine post-surgical evaluation six weeks after a hysterectomy. Which history-taking approach should the nurse use to gather the needed information?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse examines a client's abdomen. Which finding indicates an abnormal response when palpating the spleen?

Correct Answer is A

Explanation

The nurse is assessing a female client who states that her hemorrhoids are inflamed and hurt constantly. Which intervention is best for the nurse implement to complete a focused assessment?

Correct Answer is C

Explanation

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