A nurse is reviewing the records of several clients to determine cervical cancer screening recommendations. Which of the following clients should the nurse refer for a Papanicolaou (Pap) test?

A 21-year-old client who had a normal Pap test one year ago.

A 32-year-old client who had a total vaginal hysterectomy last year.

A 47-year-old client who had a negative combined Pap and HPV test 5 years ago.

A 15-year-old client who recently completed the vaccine series for human

Answer and Explanation

The Correct Answer is A

A. A 21-year-old client who had a normal Pap test one year ago. The American Cancer Society (ACS) and the U.S. Preventive Services Task Force (USPSTF) recommend that cervical cancer screening (Pap test) begin at age 21, regardless of sexual history. Screening should be done every 3 years for individuals aged 21-29, assuming results are normal. Since this client had a Pap test one year ago, they do not need immediate screening but should follow the standard 3-year interval.
B. A 32-year-old client who had a total vaginal hysterectomy last year. A total hysterectomy (removal of the uterus and cervix) for non-cancerous reasons generally means that Pap tests are no longer necessary. However, if the hysterectomy was due to cervical cancer, continued screening might be needed.
C. A 47-year-old client who had a negative combined Pap and HPV test 5 years ago. For clients 30-65 years old, Pap tests can be done every 3 years OR combined Pap and HPV (co-testing) every 5 years. Since this client had a negative co-test 5 years ago, they are due for screening now, but they would not have been referred earlier.
D. A 15-year-old client who recently completed the vaccine series for human papillomavirus (HPV). The HPV vaccine does not replace the need for Pap tests but helps reduce the risk of cervical cancer. Routine Pap testing does NOT begin before age 21, so this client does not yet need screening.

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Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

The first client the nurse should assess is Client 3 (Pulmonary Edema) followed by Client 1 (Hip Fracture).

Rationale:

Client 3 (Pulmonary Edema) – Highest Priority:

1. Pulmonary edema is a life-threatening condition that can impair oxygenation.
2. The client has a history of congestive heart failure (CHF) and a chest x-ray confirming pulmonary edema.
3. Immediate assessment is required to evaluate for respiratory distress, oxygenation status, and potential need for diuretics or oxygen therapy.

Client 1 (Hip Fracture) – Second Priority:

1. The x-ray confirms a fractured femoral neck, which can cause severe pain, bleeding, and immobility.
2. The nurse must assess for circulation, sensation, and movement (CSM) of the affected limb and manage pain.
3. While this is urgent, it is not as immediately life-threatening as pulmonary edema.

Priority Order (Using ABCs & Maslow’s Hierarchy):

Client 3 – Pulmonary Edema (Airway/Breathing concern)
2. Client 1 – Hip Fracture (Risk for bleeding, pain, mobility issues)
3. Client 4 – Low Potassium (Risk for cardiac arrhythmias, needs electrolyte management)
4. Client 6 – Poor Diabetes Control (HbA1c 9%, requires education & glucose monitoring)
5. Client 5 – Malnutrition (Prealbumin 12 mg/dL, needs nutrition support for wound healing)
6. Client 2 – Hyperlipidemia (Not an immediate concern, requires long-term management)

A. Plan to assign a different nurse to the client each shift. B. Start discharge planning on the day of admission. C. Request that the client complete a satisfaction survey at discharge. D. Limit the number of interdisciplinary team members managing the client's care.

Correct Answer is B

Explanation

A. Plan to assign a different nurse to the client each shift. Assigning different nurses each shift disrupts continuity of care. Whenever possible, consistent nursing assignments improve client outcomes.
B. Start discharge planning on the day of admission. Discharge planning should begin upon admission to ensure a smooth transition of care, reduce hospital readmissions, and promote better long-term outcomes.
C. Request that the client complete a satisfaction survey at discharge. While client feedback is valuable, it does not directly contribute to continuity of care during the hospital stay.
D. Limit the number of interdisciplinary team members managing the client's care. Interdisciplinary collaboration (e.g., physicians, nurses, physical therapists, social workers) is crucial in providing comprehensive and continuous care, especially for complex cases.

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A nurse is reviewing the records of several clients to determine cervical cancer screening recommendations. Which of the following clients should the nurse refer for a Papanicolaou (Pap) test?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a medical-surgical unit is caring for 6 clients. Exhibits Complete the following sentence by using the lists of options. The first client the nurse should assess is dropdownfollowed bydropdown

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

Rationale:

Priority Order (Using ABCs & Maslow’s Hierarchy):

A charge nurse on an acute care unit is planning care for a client. Which of the following actions should the nurse take to promote the client's continuity of care?

Correct Answer is B

Explanation

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