A nurse is caring for a female client who is scheduled to have a pelvic examination.
The client tells the nurse, "I'm really nervous because I've never had a pelvic exam before.”. Which of the following is an appropriate therapeutic response by the nurse?
"Tell me more about your concerns.”.
"All you need to do is relax during the exam.”.
"Don't worry.
"A pelvic exam is required if you want birth control pills.”.
will stay in there with you for the exam.”.
The Correct Answer is A
Choice A rationale:
"Tell me more about your concerns" is an appropriate therapeutic response by the nurse. It encourages the client to express her worries and fears about the pelvic examination. Open-ended questions like this one allow the nurse to better understand the client's specific concerns, which can help in addressing them effectively.
Choice B rationale:
"All you need to do is relax during the exam" may come across as dismissive and may not address the client's anxiety effectively. It's important to acknowledge the client's feelings and offer support rather than making the situation seem overly simplistic.
Choice C rationale:
"Don't worry. I will stay in there with you for the exam" might make the client feel like she has no control over the situation and can be invasive. While offering support is important, it's essential to respect the client's autonomy and provide emotional support through active listening and communication.
Choice D rationale:
"A pelvic exam is required if you want birth control pills" is not an appropriate response to the client's anxiety about the pelvic exam. This response does not address the client's concerns and may not provide the necessary emotional support or information she needs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Has mitral valve insufficiency. This client's medical condition is not an indication for an amniotic fluid alpha-fetoprotein screening. Alpha-fetoprotein screening is typically used to assess the risk of neural tube defects and chromosomal abnormalities in the fetus. Mitral valve insufficiency is unrelated to this screening.
Choice B rationale:
History of preterm labor. A history of preterm labor is not a direct indication for amniotic fluid alpha-fetoprotein screening. This screening is primarily used to detect neural tube defects and chromosomal abnormalities in the fetus. Preterm labor history is not related to these conditions.
Choice C rationale:
History of delivering a child with a neural tube defect. This is the correct choice. A history of delivering a child with a neural tube defect is a strong indication for amniotic fluid alpha-fetoprotein screening. The screening is used to assess the risk of neural tube defects in subsequent pregnancies. It is crucial for early detection and management if the risk is high.
Choice D rationale:
Has been exposed to AIDS. Exposure to AIDS (HIV) is not a direct indication for amniotic fluid alpha-fetoprotein screening. This screening is primarily focused on assessing fetal health and the risk of specific congenital abnormalities. HIV exposure is unrelated to the purpose of this screening.
Correct Answer is C
Explanation
Answer and explanation
A nurse is reinforcing teaching with a newly licensed nurse about the complications associated with maternal gestational diabetes. Which of the following complications should the nurse include? The correct answer is choice C: Newborn hypoglycemia.
Choice A rationale:
Small for gestational age (SGA) newborns are not typically associated with maternal gestational diabetes. Instead, maternal diabetes (both pre-gestational and gestational) is more commonly linked to larger-than-average babies, known as macrosomia or LGA (large for gestational age).
Choice B rationale:
Oligohydramnios is a condition characterized by a decreased volume of amniotic fluid, which can have various causes. While maternal diabetes can contribute to certain complications, it is not a direct cause of oligohydramnios.
Choice C rationale:
Newborn hypoglycemia is a significant complication associated with maternal gestational diabetes. When a pregnant woman has diabetes, her baby may experience high blood sugar levels in the womb, leading to increased insulin production. After birth, the baby's insulin production continues, causing a drop in blood sugar levels, which can result in hypoglycemia. Therefore, this is a complication that should be emphasized in teaching.
Choice D rationale:
Placenta previa is not directly related to maternal gestational diabetes. It is a condition in which the placenta partially or completely covers the cervix, leading to bleeding during pregnancy. It is a separate complication from gestational diabetes and should not be included in teaching about the complications of maternal diabetes.
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