A clinic nurse is assessing a client with a suspected diagnosis of endometriosis.
Which of the following findings in the client's medical history should the nurse identify as consistent with a diagnosis of endometriosis?

A history of pelvic inflammatory disease (PID).

An atypical Papanicolaou smear at her last clinic visit.

Dysmenorrhea that is unresponsive to NSAIDS.

Abdominal bloating starting several days before menses.

Answer and Explanation

The Correct Answer is C

Choice A rationale

While pelvic inflammatory disease can lead to infertility, it does not specifically cause endometriosis. PID involves infection of the reproductive organs, while endometriosis is the presence of endometrial tissue outside the uterus, characterized by pain and inflammation during menstruation.

Choice B rationale

An atypical Papanicolaou smear indicates abnormal cervical cells, often related to infection or precancerous changes, but is not indicative of endometriosis. Endometriosis involves ectopic endometrial tissue and does not affect cervical cell morphology directly.

Choice C rationale

Dysmenorrhea unresponsive to NSAIDs is a hallmark of endometriosis. This condition causes severe pain due to the inflammation and cyclic bleeding of ectopic endometrial tissue, often resulting in scarring and adhesions that exacerbate discomfort during menstruation.

Choice D rationale

Abdominal bloating starting before menses may be associated with premenstrual syndrome or other hormonal changes rather than endometriosis. Although some women with endometriosis report bloating, it is not a definitive diagnostic criterion compared to chronic pain and infertility.

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Correct Answer is B

Explanation

Choice A rationale

Elevated AFP levels are not typically associated with Down syndrome. In fact, pregnancies with Down syndrome often show decreased levels of AFP in maternal serum screening. AFP is a protein produced by the fetal liver, and its levels vary depending on developmental abnormalities like neural tube defects, not chromosomal disorders like Down syndrome.

Choice B rationale

Elevated AFP levels in a pregnant patient indicate potential neural tube defects such as spina bifida. Spina bifida results from incomplete closure of the fetal neural tube during early pregnancy, leading to exposure of neural tissues. AFP leaks into the maternal serum through this defect, thus raising its concentration significantly, which serves as a marker.

Choice C rationale

AFP levels are generally low in cases of Down syndrome due to chromosomal anomalies. Trisomy 21 pregnancies display distinctive serum markers, including decreased AFP. Elevated AFP does not signify Down syndrome because the pathology involves a different spectrum of physiological abnormalities.

Choice D rationale

While spina bifida is indeed a condition associated with elevated AFP, this statement is less accurate due to the phrasing. AFP elevations serve as an indicator rather than definitive confirmation of spina bifida. Further diagnostic tests like ultrasonography or amniocentesis are needed to confirm the condition.

A. Wear a tight-fitting nursing bra with breast pads inside. B. Apply breast milk to the nipples before each feeding. C. Change the infant's position on the nipples. D. Start breastfeeding with the nipple that is less sore. E. Apply ice packs to the nipples before each feeding.

Correct Answer is ["A","B","C"]

Explanation

Choice A rationale

Interviewing the client privately ensures confidentiality and allows for honest disclosure of the situation without fear of intimidation or manipulation by accompanying individuals. This approach is critical in identifying domestic abuse victims and initiating proper interventions.

Choice B rationale

A calm, caring, and professional demeanor fosters trust and reduces the client’s anxiety or fear. It ensures the nurse-patient relationship is non-threatening, encouraging the teen to open up about her experiences and facilitating accurate assessment and care.

Choice C rationale

Assessing whether the teen feels safe helps identify her immediate risks and the presence of a potential threat. Recognizing unsafe living conditions enables the nurse to involve appropriate protective and social services to ensure the client’s safety.

Choice D rationale

Contacting the police should be done only with the client’s consent unless mandated by law. Immediate police involvement without consent may jeopardize the client’s trust in the healthcare system and compromise her willingness to seek help in the future.

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A clinic nurse is assessing a client with a suspected diagnosis of endometriosis.Which of the following findings in the client's medical history should the nurse identify as consistent with a diagnosis of endometriosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which statement made by a pregnant patient indicates teaching was effective related to an elevated alpha fetoprotein (AFP) level?

Correct Answer is B

Explanation

A nurse is caring for a client who is 2 days postpartum, is breastfeeding, and reports nipple soreness.Which of the following measures should the nurse suggest to reduce discomfort during breastfeeding?

Correct Answer is ["A","B","C"]

Explanation

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A clinic nurse is assessing a client with a suspected diagnosis of endometriosis.
Which of the following findings in the client's medical history should the nurse identify as consistent with a diagnosis of endometriosis?