A nurse is caring for a 22-year-old female client who is experiencing lower abdominal pelvic pain. The client is at risk of developing a condition due to a finding.

Condition: Ovarian cysts, Finding: Ultrasound shows a fluid-filled sac in the ovary.

Condition: Appendicitis, Finding: Pain localized in the lower right quadrant.

Condition: Endometriosis, Finding: Patient reports cyclical pain.

Condition: Pelvic inflammatory disease, Finding: Elevated white blood cell count.

Answer and Explanation

The Correct Answer is A

Choice A rationale:
Ovarian cysts are fluid-filled sacs that form on or within an ovary. They are a common condition, affecting up to 1 in 5 women at some point in their lives. While most ovarian cysts are benign (non-cancerous), they can sometimes cause symptoms, including pelvic pain.
Ultrasound is a common imaging test that uses sound waves to create pictures of internal organs. It can be used to detect ovarian cysts, which often appear as fluid-filled sacs on the ovary.
The presence of an ovarian cyst on ultrasound, combined with the patient's symptoms of lower abdominal pelvic pain, suggests that the patient is at risk of developing complications from the cyst. These complications can include: Rupture: A ruptured ovarian cyst can cause sudden, severe pain and bleeding.
Torsion: This is when a cyst twists on its stalk, cutting off its blood supply. Torsion can also cause severe pain and may require emergency surgery.

Choice B rationale:
Appendicitis is an inflammation of the appendix, a small, finger-shaped organ located in the lower right abdomen. It is a common cause of abdominal pain, especially in young adults.

However, the patient in this scenario is experiencing pain in the lower abdominal pelvic region, not specifically in the lower right quadrant. This makes appendicitis less likely.
Additionally, the patient does not have any other symptoms that are typically associated with appendicitis, such as fever, nausea, or vomiting.

Choice C rationale:
Endometriosis is a condition in which tissue that normally lines the uterus grows outside of the uterus. It can cause pain, especially during menstruation.
However, the patient in this scenario does not report cyclical pain, which is a hallmark symptom of endometriosis. Additionally, endometriosis is not typically associated with the presence of fluid-filled sacs on the ovaries.

Choice D rationale:
Pelvic inflammatory disease (PID) is an infection of the upper genital tract, including the uterus, fallopian tubes, and ovaries. It is often caused by sexually transmitted infections (STIs).
PID can cause pelvic pain, but it is also typically associated with other symptoms, such as fever, vaginal discharge, and irregular bleeding.
The patient in this scenario does not have any of these other symptoms, and her white blood cell count is not elevated, which makes PID less likely.

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Correct Answer is C

Explanation

Choice A:

While fetal maturity is a factor in the timing of amniocentesis, it's not the primary reason for waiting until 14 weeks.

Earlier in pregnancy, fetal cells are less abundant in the amniotic fluid, making it more challenging to obtain a sufficient sample for accurate testing.

Additionally, the procedure carries a slightly higher risk of miscarriage before 14 weeks.

Choice B:

The audibility of the fetal heartbeat is not directly related to the timing of amniocentesis.

It's typically possible to hear the heartbeat by Doppler ultrasound around 10-12 weeks, but this doesn't mean there's enough amniotic fluid for amniocentesis.

Choice D:

The accuracy of genetic results is not dependent on the timing of amniocentesis after 14 weeks.

As long as a sufficient sample of amniotic fluid is obtained, the accuracy of the results is not affected by gestational age.

Choice C:

The most accurate explanation for why amniocentesis is not performed before 14 weeks is the amount of amniotic fluid. Before 14 weeks, there's typically not enough amniotic fluid to safely extract a sample without potentially harming the fetus or the placenta.

By 14 weeks, there's usually enough fluid to adequately cushion the fetus and the needle during the procedure, reducing the risks involved.

A. The specimen should be refrigerated after collection. B. You should abstain from ejaculation for at least 2 to 3 days prior to the test. C. The specimen should remain at room temperature for 3 to 4 hours prior to transport to the laboratory. D. You will collect the specimen using a condom with spermicide. Sure, I understand your instructions.

Correct Answer is B

Explanation

Choice A rationale:

Refrigerating the specimen after collection is not recommended for semen analysis. Cold temperatures can damage sperm motility and viability, leading to inaccurate results. The specimen should be kept at room temperature and transported to the laboratory within 1 hour of collection. This ensures that the sperm are analyzed under conditions that closely resemble their natural environment within the body, providing the most accurate assessment of their health and function.

Choice C rationale:

Allowing the specimen to remain at room temperature for 3 to 4 hours prior to transport is also not advised. While sperm can survive for a limited time outside the body, prolonged exposure to room temperature can also negatively impact their motility and viability. This can compromise the accuracy of the semen analysis results.

Choice D rationale:

Collecting the specimen using a condom with spermicide is strictly prohibited for semen analysis. Spermicides are designed to kill sperm, and their presence in the sample would render the analysis entirely invalid. It's crucial to collect the specimen directly into a sterile container provided by the laboratory to ensure no contaminants interfere with the analysis.

Choice B rationale:

Abstaining from ejaculation for 2 to 3 days prior to the semen analysis is essential for obtaining accurate results. This timeframe allows for optimal sperm concentration and quality within the ejaculate. Frequent ejaculation can deplete sperm reserves, potentially leading to lower sperm counts and reduced motility in the sample. By adhering to the recommended abstinence period, the chances of obtaining a representative and accurate assessment of the patient's semen quality are significantly increased.

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A nurse is caring for a 22-year-old female client who is experiencing lower abdominal pelvic pain. The client is at risk of developing a condition due to a finding.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has consented to an amniocentesis for genetic cell analysis. The client asks why she can’t have the test before 14 weeks of gestation. Which of the following responses should the nurse make?

Correct Answer is C

Explanation

A nurse is reinforcing teaching with a male client about a semen analysis to be done for suspected infertility. Which of the following information should the nurse include?

Correct Answer is B

Explanation

A nurse is reinforcing teaching with a newly licensed nurse about a biophysical profile. Which of the following information should the nurse include in the teaching?

A nurse is reinforcing teaching about fetal development with a group of women who are pregnant. Which of the following statements should the nurse include in the teaching?

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A nurse in a prenatal clinic overhears a newly licensed nurse discussing conception with a client. Which statement by the newly licensed nurse requires intervention?

A nurse in a prenatal clinic is determining a client's estimated date of delivery using Naegele's rule. The first day of her last menstrual period was May 8. Which of the following dates should the nurse tell the client is her estimated date of delivery?

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