A nurse is providing teaching to a client about an upcoming hysterosalpingography. Which of the following statements should the nurse include?

"The surgeon will make a small incision in your abdomen."

"You may experience referred shoulder pain."

"Your procedure will be scheduled during menstruation."

"Warm saline will be instilled via the cervix."

Answer and Explanation

The Correct Answer is B

A. "The surgeon will make a small incision in your abdomen.": A hysterosalpingography is a fluoroscopic imaging procedure that does not require surgical incisions. Contrast dye is injected through the cervix to visualize the uterus and fallopian tubes.

B. "You may experience referred shoulder pain.": Referred shoulder pain is a common side effect due to peritoneal irritation caused by the contrast dye if it spills into the peritoneal cavity, particularly when the fallopian tubes are patent. This discomfort is temporary and resolves on its own.

C. "Your procedure will be scheduled during menstruation.": The test is typically scheduled after menstruation but before ovulation (days 7-10 of the cycle) to ensure the uterus is clear of blood and to avoid disrupting an early pregnancy.

D. "Warm saline will be instilled via the cervix.": Hysterosalpingography uses iodine-based contrast dye for X-ray imaging, not warm saline. Saline infusion is used in sonohysterography, which is an ultrasound-based procedure.

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Correct Answer is B

Explanation

A. Client report of pain at the incision site: Pain is expected after a thyroidectomy and can be managed with analgesics. While discomfort can affect recovery, it does not indicate an immediate life-threatening complication.

B. High-pitched sound on inspiration: Stridor suggests airway obstruction due to laryngeal edema or tracheal compression, which can rapidly progress to respiratory distress. Immediate intervention, such as airway support or emergency intubation, is required to prevent asphyxiation.

C. Hypoactive bowel sounds: Decreased bowel sounds are common postoperatively due to anesthesia and immobility. This should be monitored for potential ileus but does not pose an immediate danger.

D. Loose tracheal secretions: Excess secretions may require suctioning, but they do not indicate a critical airway compromise like stridor does. Maintaining a clear airway is essential, but this finding alone is not an emergency.

A. Diminished breath sounds B. Distended neck veins C. Irregular heart rate D. Itching over the incision

Correct Answer is A

Explanation

A. Diminished breath sounds: A pneumothorax occurs when air accumulates in the pleural space, leading to lung collapse. This results in reduced air entry, causing diminished or absent breath sounds on the affected side. Other symptoms may include dyspnea, tachypnea, and chest pain.

B. Distended neck veins: Neck vein distention is more commonly associated with conditions such as cardiac tamponade or superior vena cava syndrome. A pneumothorax typically causes respiratory distress rather than venous congestion. If a tension pneumothorax develops, neck vein distention may occur, but it is not an early or primary sign.

C. Irregular heart rate: While severe cases of pneumothorax can cause cardiovascular compromise due to pressure on the heart and great vessels, an irregular heart rate is not a direct or early indicator. Cardiac arrhythmias are more often seen with electrolyte imbalances, cardiac ischemia, or other primary heart conditions.

D. Itching over the incision: Itching at the catheter insertion site is a common postoperative reaction, often related to healing, adhesive irritation, or mild inflammation. It is not indicative of a pneumothorax, which primarily presents with respiratory distress and absent or diminished breath sounds.

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A nurse is providing teaching to a client about an upcoming hysterosalpingography. Which of the following statements should the nurse include?

Nursing Test Bank

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