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. Peristaltic waves: Visible peristaltic waves in adults may suggest an intestinal obstruction or other abnormal gastrointestinal motility. These waves might be seen in very thin individuals as slight rippling movements or those with serious digestive tract issues and require further diagnostic evaluation. However, prominent waves are not normal.

B. Heterogeneous color: Uneven or blotchy abdominal skin color may indicate bruising, poor circulation, inflammation, or underlying pathology. Such a finding is not typical and should prompt further assessment to rule out localized or systemic conditions.

C. Homogeneous color: A consistent, uniform skin tone across the abdomen is a normal finding and indicates healthy skin perfusion. This suggests that there is no localized inflammation, bruising, or vascular compromise present during inspection.

D. Masses: Palpable or visible abdominal masses are considered abnormal and can be associated with tumors, hernias, or organ enlargement. The discovery of a mass necessitates further diagnostic tests to determine its cause and clinical significance.

A. Urinary frequency, unsteady gait, dental enamel erosion. B. Breast tenderness, tremors, high blood pressure. C. Vaginal discharge, presence of genital warts, abdominal tenderness. D. Body weight, hirsutism, thyroid enlargement.

Correct Answer is D

Explanation

A. Urinary frequency, unsteady gait, dental enamel erosion: These findings may suggest a urinary tract infection, neurological issue, or an eating disorder like bulimia. However, none are directly linked to amenorrhea in the context of a negative pregnancy test and recent missed periods.

B. Breast tenderness, tremors, high blood pressure: These symptoms could suggest hyperthyroidism or hormonal imbalance, but they are less specific to the cause of missed periods in this scenario compared to more directly relevant signs like weight or thyroid size.

C. Vaginal discharge, presence of genital warts, abdominal tenderness: These findings are related to sexually transmitted infections or gynecologic conditions, but the client has not had recent intercourse, and her main concern is amenorrhea, making these findings less relevant.

D. Body weight, hirsutism, thyroid enlargement: These are key assessment points when evaluating causes of amenorrhea. Low or high body weight can disrupt hormonal balance, hirsutism may indicate polycystic ovary syndrome (PCOS), and thyroid enlargement could suggest a thyroid disorder both common causes of menstrual irregularities in young women.

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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

The nurse completes inspection of the abdomen on an adult client. Which finding is considered normal for this client?

Correct Answer is C

Explanation

Correct Answer is D

Explanation

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