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 C

Explanation

The estimated date of delivery (EDD) using Naegele's rule is _.

Step 1: Add 7 days to the first day of the last menstrual period. May 8 + 7 days = May 15

Step 2: Count 3 months back. May - 3 months = February

Step 3: Adjust the year if necessary. The year remains the same.

The estimated date of delivery is February 15 of the following year.

A. Large amount of bright red vaginal bleeding B. Severe pain with no bleeding C. High-grade fever D. Sudden sharp pain in the lower abdomen

Correct Answer is A

Explanation

Choice A rationale:
Large amount of bright red vaginal bleeding is the cardinal sign of placenta previa. This is because the placenta is abnormally positioned low in the uterus, covering the cervix partially or completely. When the cervix starts to dilate in preparation for labor, it can detach from the uterine wall, leading to significant bleeding. The blood is typically bright red, indicating fresh bleeding, and can be painless.
Severity of bleeding: The amount of bleeding can vary from spotting to massive hemorrhage, and it may start suddenly or gradually. Even a small amount of bleeding can be a sign of placenta previa and should not be ignored.
Risks of hemorrhage: Prompt recognition and management of bleeding are crucial to prevent potentially life-threatening hemorrhage for both the mother and the fetus.

Choice B rationale:
Severe pain with no bleeding is not a typical presentation of placenta previa. While some women with placenta previa may experience mild abdominal pain or cramping, severe pain without bleeding is more suggestive of placental abruption, a condition where the placenta prematurely separates from the uterine wall.

Choice C rationale:
High-grade fever is not a direct symptom of placenta previa. However, if a woman with placenta previa develops a fever, it could indicate an infection, which can further complicate the condition and require immediate medical attention.

Choice D rationale:
Sudden sharp pain in the lower abdomen can be a sign of placental abruption but is not characteristic of placenta previa.

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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 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?

Correct Answer is C

Explanation

A nurse is caring for a client who is pregnant and has suspected placenta previa. Which of the following should the nurse monitor the client for?

Correct Answer is A

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?

A nurse is assisting with the care of a client who is in active labor at 9 weeks of gestation. The nurse locates the fetal heart tones above the client's umbilicus at midline. The nurse should suspect that the fetus is in which of the following positions?

A nurse is admitting a client who is at 36 weeks gestation and has pain, bright red vaginal bleeding. The nurse recognizes this finding as an indication of which of the following conditions? Choice Options:

A nurse is assisting with the care of a client who is at 37 weeks of gestation and has placenta previa. Which of the following risks is the primary reason the nurse should avoid performing a pelvic examination?

A nurse is reinforcing teaching with a client who is pregnant about expected changes related to pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

A nurse is reinforcing teaching with a newly licensed nurse. Which of the following complications should the nurse include?

A nurse is assisting with the admission of a client who is at 8 weeks of gestation and has heavy vaginal bleeding. Which of the following actions should the nurse take?

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?