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. Weigh the diaper of an infant for output. B. Assess the dressing of the infant that is two days post-operative. C. Calculate the Morse Fall Scale for the preschool child. D. Perform assessment of a child's developmental milestones.

Correct Answer is A

Explanation

Choice A rationale

Weighing an infant's diaper for output is a task suitable for unlicensed assistive personnel (UAP) because it involves data collection rather than clinical judgment or critical thinking. The results can be recorded and reported to the nurse for further assessment and interpretation.

Choice B rationale

Assessing a post-operative dressing requires clinical judgment to identify signs of infection, dehiscence, or other complications. This task is within the scope of a licensed nurse and should not be delegated to UAP to ensure patient safety.

Choice C rationale

Calculating the Morse Fall Scale involves understanding and interpreting risk factors, which requires critical thinking and clinical judgment. It is inappropriate for delegation to UAP, as they are not trained to analyze or interpret clinical data.

Choice D rationale

Performing an assessment of a child's developmental milestones requires knowledge of growth and development patterns, as well as clinical judgment to interpret findings. This task is outside the scope of UAP and must be performed by a licensed nurse.

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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?

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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

Which task is most appropriate for the nurse to delegate to the unlicensed assistive personnel on a pediatric unit?

Correct Answer is A

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?