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
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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Related Questions
Correct Answer is B
Explanation
Choice B:
Implantation typically occurs 6 to 12 days after ovulation, not 2 to 3 weeks. This is a crucial distinction because it aligns with the developmental timeline of the early embryo and the physiological changes in the endometrium that prepare for implantation.
The timing of implantation is essential for establishing a viable pregnancy. If implantation occurs too early or too late, it can lead to complications such as early pregnancy loss or ectopic pregnancy.
Understanding the correct timing of implantation is vital for healthcare professionals to provide accurate information and guidance to clients regarding conception and early pregnancy.
Choice A:
Sperm can indeed remain viable in the woman's reproductive tract for up to 5 days. This means that intercourse that occurs several days before ovulation can still lead to conception.
The lifespan of sperm is important for understanding fertility and timing intercourse for those trying to conceive.
Choice C:
Fertilization does typically occur in the outer third of the fallopian tube, also known as the ampulla. This is where the sperm meets the egg, and fertilization takes place.
The location of fertilization is significant because it ensures that the fertilized egg, or zygote, has time to travel down the fallopian tube and implant in the uterus.
Choice D:
Bleeding can sometimes accompany implantation, known as implantation bleeding. This bleeding is usually light and occurs around the time of expected menstruation.
It is important to be aware of implantation bleeding as it can sometimes be mistaken for a menstrual period.
Correct Answer is B
Explanation
Choice A rationale:
A blood pressure of 100/60 is within the normal range and does not pose a contraindication to oral contraceptives. While hypertension (high blood pressure) can be a contraindication, a blood pressure of 100/60 is not considered hypertensive.
However, it's essential to monitor blood pressure regularly in individuals using oral contraceptives, as some may experience a slight increase in blood pressure.
Choice B rationale:
Age is a significant factor when considering oral contraceptive use.
Adolescents under 16 years of age are generally not recommended to use oral contraceptives due to several concerns: Their reproductive systems are still developing, and hormonal contraceptives could potentially disrupt normal growth and development.
Younger adolescents may have more difficulty adhering to a strict daily medication regimen, which is crucial for the effectiveness of oral contraceptives.
They may be at a higher risk of certain side effects, such as irregular bleeding patterns and mood changes.
Acne treatment is often a primary reason for considering oral contraceptives in adolescents. However, alternative acne treatments that are more suitable for younger individuals are available.
Choice C rationale:
A hematocrit of 39 is within the normal range for females and does not contraindicate oral contraceptive use.
Hematocrit measures the proportion of red blood cells in the blood. Oral contraceptives can sometimes cause slight changes in hematocrit levels, but these changes are typically not clinically significant.
Choice D rationale:
A menstrual cycle of 14 days is considered a normal variation and does not pose a contraindication to oral contraceptives. Oral contraceptives can often regulate irregular menstrual cycles, so they may even be beneficial for individuals with shorter or longer cycles.
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