A patient who is in her first trimester of pregnancy tells the nurse that she is experiencing significant nausea and vomiting, and asks when it will improve. The nurse should reply:

"Did your mother have significant nausea and vomiting?"

"Many women experience nausea and vomiting until the third trimester."

"At about the time you begin to feel the baby move, the nausea and vomiting will subside."

"Usually, by the beginning of the second trimester, the nausea and vomiting improve."

Answer and Explanation

The Correct Answer is D

A. "Did your mother have significant nausea and vomiting?": Asking about the mother’s pregnancy history does not provide an answer to the client’s concern and does not address the expected course of symptoms.

B. "Many women experience nausea and vomiting until the third trimester.": Nausea and vomiting rarely persist into the third trimester. Suggesting this may cause unnecessary anxiety, as the majority of women experience improvement before this stage of pregnancy.

C. "At about the time you begin to feel the baby move, the nausea and vomiting will subside.": Quickening, or the first perception of fetal movement, usually occurs between 16 and 20 weeks. Although nausea may already have subsided by this point, using this as a marker is not accurate for explaining the expected improvement of symptoms.

D. "Usually, by the beginning of the second trimester, the nausea and vomiting improve.": Nausea and vomiting, often called morning sickness, typically begin around 4–6 weeks and resolve by 12–14 weeks of gestation. This corresponds to the start of the second trimester.

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Correct Answer is D

Explanation

A. distal to proximal: Assessing from distal to proximal does not follow the recommended approach because it may miss important findings in the larger joints that influence distal movement. Proximal structures should be assessed first since they provide stability and strength to distal areas.

B. posterior to anterior: Moving from posterior to anterior is not the standard sequence for musculoskeletal assessment. The goal is to assess systematically, focusing on overall function and progression rather than body surface orientation.

C. anterior to posterior: Similar to posterior-to-anterior, this sequence does not align with musculoskeletal assessment standards. Changing orientation does not provide a structured approach to identifying joint or muscle abnormalities.

D. proximal to distal: The correct method is to examine joints and muscles from proximal to distal. This approach ensures evaluation of the larger, supporting joints first, which helps in understanding how proximal function influences distal performance and detecting abnormalities in a logical sequence.

A. Once the speculum is in the ear, release the traction. B. Use the smallest speculum to decrease the amount of discomfort. C. Pull the pinna up and back before inserting the speculum. D. Tilt the person's head forward during the examination.

Correct Answer is C

Explanation

A. Once the speculum is in the ear, release the traction: Traction on the pinna should be maintained throughout the examination to keep the ear canal straight. Releasing it too soon may obstruct visualization of the tympanic membrane.

B. Use the smallest speculum to decrease the amount of discomfort: The largest speculum that comfortably fits should be used to allow better illumination and visualization. A very small speculum limits the field of view and may compromise accuracy of the assessment.

C. Pull the pinna up and back before inserting the speculum: For adults, pulling the pinna up and back helps straighten the ear canal, making it easier to insert the otoscope and visualize internal structures. This is the correct method for adult ear examination.

D. Tilt the person's head forward during the examination: Tilting the head is not necessary for an otoscopic exam in adults. The essential technique is proper traction on the pinna, not repositioning of the entire head.

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A patient who is in her first trimester of pregnancy tells the nurse that she is experiencing significant nausea and vomiting, and asks when it will improve. The nurse should reply:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When performing a musculoskeletal assessment, the nurse knows that the correct approach for the examination should be head to toe and:

Correct Answer is D

Explanation

The nurse is performing an otoscopic examination on an adult. Which of the following is true?

Correct Answer is C

Explanation

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