A nurse is caring for a female client scheduled to have a pelvic exam. The client tells the nurse, “I’m really nervous.
I’ve never had a pelvic exam before.” Which of the following is an appropriate therapeutic response by the nurse?

A pelvic exam is required if you want birth control pills

Don't worry, I will stay in there with you for the exam

All you need to do is relax during the exam

Tell me more about your concerns

Answer and Explanation

The Correct Answer is D

Rationale for Choice A:
A pelvic exam is required if you want birth control pills. This response is not therapeutic because it dismisses the client's feelings and does not address her concerns. It focuses on the policy or requirement rather than the client's emotional needs. It could make the client feel like her anxiety is not justified or that she has no choice in the matter.

Rationale for Choice B:
Don't worry, I will stay in there with you for the exam. While this response may be intended to provide reassurance, it does not fully address the client's underlying concerns. It offers a solution without first exploring the specific reasons for the client's anxiety. It could also make the client feel dependent on the nurse's presence for comfort, rather than empowering her to manage her own anxiety.

Rationale for Choice C:
All you need to do is relax during the exam. This response is not therapeutic because it minimizes the client's feelings and suggests that she can simply control her anxiety by relaxing. It does not acknowledge the validity of her concerns or provide any guidance on how to manage those concerns. It could make the client feel like her anxiety is her fault or that she is not coping well.

Rationale for Choice D:
Tell me more about your concerns. This is the most therapeutic response because it encourages the client to express her feelings and concerns openly. It validates the client's experience and demonstrates active listening and empathy. It provides an opportunity for the nurse to gather more information about the specific reasons for the client's anxiety and to tailor interventions accordingly. It also empowers the client by allowing her to share her thoughts and take control of the conversation.

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Correct Answer is B

Explanation

Choice A:

Mood swings are a common and expected symptom of early pregnancy due to hormonal changes. They typically do not require medical attention unless they become severe or interfere with daily life.
While it's important to discuss mood swings with a healthcare provider, they are not considered a critical symptom that necessitates immediate action.

Choice C:
Urinary frequency, or the need to urinate more often, is also a common symptom of early pregnancy. It's caused by hormonal changes and the growing uterus putting pressure on the bladder.
While it can be inconvenient, it's typically not a cause for concern unless accompanied by other symptoms, such as pain or burning during urination.

Choice D:
Decreased energy, or fatigue, is another common and expected symptom of early pregnancy.
It's often caused by hormonal changes and the body's increased workload to support the growing fetus.
While it can be frustrating, it's typically not a cause for concern unless it becomes severe or interferes with daily life.

Choice B:
Facial edema, or swelling of the face, is not a common symptom of early pregnancy.
It can be a sign of preeclampsia, a serious pregnancy complication characterized by high blood pressure and protein in the urine.
Preeclampsia can develop suddenly and progress quickly, so it's important to seek medical attention right away if facial edema occurs.
Key Points:
Facial edema is a potential sign of preeclampsia, a serious pregnancy complication.
Mood swings, urinary frequency, and decreased energy are common and expected symptoms of early pregnancy that typically do not require immediate medical attention.
It's important for pregnant women to be aware of potential warning signs and to seek medical advice promptly if they experience any concerning symptoms.

A. Severe nausea and vomiting. B. Uterine enlargement greater than expected for gestational age. C. Copious vaginal bleeding. D. Pelvic pain.

Correct Answer is D

Explanation

Choice A: Severe nausea and vomiting

While nausea and vomiting can be common in early pregnancy, including ectopic pregnancies, they are not specific indicators of an ectopic pregnancy.

Approximately 70-80% of pregnant women experience nausea and vomiting, regardless of the location of the pregnancy. Hence, the presence of severe nausea and vomiting alone would not definitively point towards an ectopic pregnancy.

Choice B: Uterine enlargement greater than expected for gestational age

In an ectopic pregnancy, the fertilized egg implants outside the uterus, typically in the fallopian tube. This means the uterus would not be expected to enlarge as it would in a normal intrauterine pregnancy. In fact, uterine size might be smaller than expected for gestational age in cases of ectopic pregnancy.

Choice C: Copious vaginal bleeding

While vaginal bleeding can occur in ectopic pregnancies, it's not always present and is not the most common initial symptom. When bleeding does occur, it's often lighter than a normal menstrual period and may be brown or dark in color.

Copious vaginal bleeding is more likely to occur in cases of miscarriage or other pregnancy complications.

Choice D: Pelvic pain

Pelvic pain is the most common and characteristic symptom of an ectopic pregnancy.

The pain is often described as sharp, stabbing, or cramping, and it may be localized to one side of the abdomen. The pain can be intermittent or constant, and it may worsen with activity or movement.

The pain is caused by the stretching of the fallopian tube as the ectopic pregnancy grows. In some cases, the pain can be severe enough to cause nausea and vomiting.

Therefore, pelvic pain is the most reliable finding that the nurse should expect in a client with a possible ectopic pregnancy at 8 weeks of gestation.

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A nurse is caring for a female client scheduled to have a pelvic exam. The client tells the nurse, “I’m really nervous. I’ve never had a pelvic exam before.” Which of the following is an appropriate therapeutic response by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has just learned that she is pregnant. The nurse should reinforce with the client to call her provider if she experiences which of the following manifestations?

Correct Answer is B

Explanation

A nurse is caring for a client in the prenatal clinic who has a possible ectopic pregnancy at 8 weeks of gestation. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

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A nurse is caring for a female client scheduled to have a pelvic exam. The client tells the nurse, “I’m really nervous.
I’ve never had a pelvic exam before.” Which of the following is an appropriate therapeutic response by the nurse?