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 A

Explanation

A. Repeat vocalizing the letter "E" while the thorax is auscultated: Egophony is assessed by having the client say "E" while the nurse auscultates the chest. In the presence of lung consolidation, such as in a lung abscess, the "E" sound may be auscultated as an "A"—a finding known as the "E-to-A" change, which is a hallmark of egophony.

B. Whisper "one, two, three" in sequence during auscultation of the thorax: This technique is used to assess whispered pectoriloquy, not egophony. It helps detect areas of lung consolidation if whispered words are heard clearly through the stethoscope.

C. Repeat the number "99" during a systematic auscultation of the thorax: This test is used to assess bronchophony, increased loudness and clarity of spoken words, another sign of lung consolidation. Clear transmission of "99" may suggest fluid or consolidation in the lungs.

D. Breathe in and out while all lobes of both lungs are auscultated: This is a standard part of respiratory assessment but is not specific for egophony. It helps detect abnormal breath sounds like wheezes, crackles, or diminished sounds, not vocal resonance changes.

A. Nasal polyps. B. Laryngeal polyps. C. Foreign body obstruction. D. Peritonsillar abscess.

Correct Answer is D

Explanation

A. Nasal polyps: Nasal polyps are soft, noncancerous growths in the nasal passages or sinuses, often linked to chronic inflammation, asthma, or allergies. They do not cause sore throat, fever, or difficulty swallowing, and are not associated with strep pharyngitis.

B. Laryngeal polyps: Laryngeal polyps typically present with hoarseness due to vocal cord involvement but are not associated with high fever, painful swallowing, or infections like streptococcal pharyngitis. They are usually non-infectious and develop gradually.

C. Foreign body obstruction: A foreign body obstruction causes sudden onset symptoms such as choking, coughing, or respiratory distress. This does not align with a progressive infectious presentation like fever and muffled voice, which suggests a localized infection.

D. Peritonsillar abscess: A peritonsillar abscess is a common complication of untreated or severe streptococcal pharyngitis. It presents with high fever, difficulty swallowing (dysphagia), muffled or "hot potato" voice, and unilateral throat pain due to pus collection near the tonsils.

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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

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