A nurse at the family planning clinic triages several clients over the phone. Which of the following clients should the nurse instruct to come to the clinic?
A client who uses a diaphragm for contraception and has lost 30 lb in the past 6 months dieting
A client who had an intrauterine device (IUD) inserted yesterday and has cramping and bleeding
A client who has started taking oral contraceptives and is experiencing bright red vaginal breakthrough bleeding
A client who has sharp pain in her shoulder following a laparoscopic tubal ligation yesterday
The Correct Answer is D
A. Weight loss while using a diaphragm is not typically an urgent concern and may be related to dieting; the client should be advised to follow up with her primary care provider for further
evaluation.
B. Cramping and bleeding are common side effects following an IUD insertion and typically do not require immediate attention unless severe or accompanied by other concerning symptoms;
the client should be advised to monitor her symptoms and follow up if they worsen.
C. Breakthrough bleeding is a common side effect of starting oral contraceptives and may resolve on its own after a few cycles; the client should be advised to continue taking her pills as prescribed and to follow up if the bleeding persists or worsens.
D. Shoulder pain following a laparoscopic procedure may indicate a potential complication such as referred pain from gas used during the procedure or more serious issues such as internal bleeding or organ injury; the client should be instructed to come to the clinic for further
evaluation and management.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Inform the client of available community resources is an important action because the client will likely need additional support, such as hospice care, counseling, or child care services. However, before providing resources, the nurse must assess the client’s understanding of their diagnosis to ensure any interventions are tailored to their current needs and readiness.
B. Assist the client in finding child care options - While important, addressing community resources takes precedence as it may encompass finding child care options as well.
C. Agree upon short-term goals for the client - Establishing goals is important but may come after addressing immediate needs.
D. Ask the client about their understanding of the diagnosis is the priority action. Before any other interventions, the nurse must assess the client’s knowledge and perception of their condition. This foundational step allows the nurse to provide appropriate education, clarify any misconceptions, and ensure that all care planning aligns with the client’s needs, values, and readiness to engage in discussions about their care.
Correct Answer is B
Explanation
A. Administering furosemide may also be appropriate for managing heart failure symptoms, but the priority action based on the client's condition is to withhold digoxin.
B. The client's vital signs indicate bradycardia (pulse 52/min), which is a common adverse effect of digoxin, especially in the setting of heart failure. Withholding digoxin is necessary to prevent further exacerbation of bradycardia and potential toxicity.
C. Withholding spironolactone may be considered if there are concerns about electrolyte imbalances, but it is not the priority action in this scenario.
D. Administering ferrous sulfate is not indicated based on the client's chart findings; there is no indication of anemia or iron deficiency.
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