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.
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A:
While an ultrasound can indeed determine if there are multiple fetuses, this is not the primary reason for performing it prior to amniocentesis. The number of fetuses is typically established earlier in pregnancy through routine ultrasounds.
Focusing solely on multiple fetuses might lead the client to believe that ultrasounds are only conducted in such cases, which is not accurate.
Choice B:
Determining fetal age is a crucial aspect of prenatal care, but it's not the main reason for an ultrasound before amniocentesis. Fetal age is typically assessed through earlier ultrasounds, often in the first trimester.
Highlighting fetal age might misinform the client about the specific purpose of the ultrasound in this context.
Choice C:
This is the most appropriate response because it accurately identifies the primary purpose of the ultrasound.
Amniocentesis involves inserting a needle into the amniotic sac to collect a sample of amniotic fluid. To ensure the safety of the procedure and minimize risks to the fetus, it's essential to accurately visualize the location of the amniotic sac and placenta, as well as assess the position of the fetus.
Ultrasound provides real-time imaging that allows the healthcare provider to visualize these structures with precision, guiding the needle insertion and reducing the risk of complications.
Choice D:
While stating that the ultrasound is for imaging is technically correct, it's too general and doesn't provide the specific reason for its use in this context.
A more informative response would clarify the specific imaging goals for amniocentesis, as outlined in Choice C.
Correct Answer is D
Explanation
The correct answer is Choice D.
Choice A rationale: The client's age, being 20 years old, is not a contraindication to the use of a diaphragm. Diaphragms can be used by individuals of reproductive age, provided there are no other contraindications.
Choice B rationale: Having a vaginal birth 6 months ago is not a contraindication to using a diaphragm. The diaphragm's fit may need adjustment, but it can still be used safely postpartum.
Choice C rationale: Smoking cigarettes is a risk factor for several health conditions but is not a specific contraindication for the use of a diaphragm. However, smoking cessation should be encouraged for overall health benefits.
Choice D rationale: Having more than one sex partner increases the risk of sexually transmitted infections (STIs). Diaphragms do not protect against STIs, making it important to use condoms in conjunction with the diaphragm for clients with multiple sex partners.
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