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

Collect information about the client's activities since surgery.

Conduct a comprehensive review of systems.

Prepare to collect a vaginal specimen for Papanicolaou smear.

Perform a head-to-toe physical assessment.

Answer and Explanation

The Correct Answer is A

A. Collect information about the client's activities since surgery: Focusing the history on the client’s recovery, current symptoms, physical activity tolerance, and any complications or concerns since the hysterectomy provides the most relevant information for a postoperative follow-up. This approach helps assess healing and identify any recovery issues.

B. Conduct a comprehensive review of systems: A full review of systems is more appropriate for an annual exam or initial assessment. For a focused postsurgical visit, the nurse should prioritize gathering data related to the surgical recovery rather than reviewing unrelated body systems.

C. Prepare to collect a vaginal specimen for Papanicolaou smear: A Pap smear may not be immediately necessary post-hysterectomy, depending on the type of hysterectomy performed and the client’s cancer risk. It is not a routine part of a 6-week postoperative evaluation unless specifically ordered by the HCP.

D. Perform a head-to-toe physical assessment: A complete physical exam is typically unnecessary at a routine postoperative check unless complications are suspected. A focused history and exam centered on the surgical site and recovery are more appropriate for this visit.

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Correct Answer is C

Explanation

A. Lower body mass index (BMI): A lower BMI is a known risk factor for osteoporosis, especially in older adults. However, on its own, it does not immediately trigger the need for a bone density scan unless accompanied by other risk indicators like fractures or height loss.

B. Diminished appetite: Loss of appetite may contribute to poor nutritional intake, including calcium and vitamin D, which can impact bone health over time. Still, this symptom alone does not directly prompt a bone density screening without other supporting signs.

C. Decreased height: A measurable decrease in height may suggest vertebral compression fractures, a hallmark of osteoporosis. This is a key indicator that warrants further evaluation with a bone density scan (DEXA) to assess for bone loss.

D. 15 lb (6.8 kg) weight loss: While unintentional weight loss may be a concern for many conditions, including cancer or malnutrition, it is not a specific trigger for bone density testing unless associated with other risk factors or signs of bone demineralization.

A. A dark line of pigmentation occurs along the midline of the abdomen. B. Weight gain becomes obvious as the hip circumference increases. C. The areolar color of the nipples changes from pink to dark brown. D. The development of breast buds will form under the nipples.

Correct Answer is D

Explanation

A. A dark line of pigmentation occurs along the midline of the abdomen: This refers to linea nigra, which is more commonly associated with hormonal changes during pregnancy rather than puberty. It is not a typical sign of puberty in adolescent females.

B. Weight gain becomes obvious as the hip circumference increases: While changes in body shape and fat distribution occur during puberty especially with increased fat around the hips and thighs, it is usually a gradual process and not the first noticeable sign.

C. The areolar color of the nipples changes from pink to dark brown: Areolar pigmentation may darken with puberty in some individuals, but it varies by skin tone and is not a reliable or universal first sign of puberty.

D. The development of breast buds will form under the nipples: The appearance of breast buds or thelarche, small, firm lumps form under the nipples, which can sometimes be tender, is typically the first visible sign of puberty in girls, usually occurring around ages 8–13. It signals the beginning of hormonal changes and physical development.

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A client reports to the healthcare provider's (HCP) office for a routine postsurgical 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

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Correct Answer is D

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