A woman arrives at the clinic for her annual examination. She tells the nurse that she thinks she has a vaginal infection and has been using an over-the-counter cream for the past 2 days to treat it. The nurse's initial response should be to:
ask the woman to reschedule the appointment for the examination.
ask the woman to describe the symptoms that indicate to her that she has a vaginal infection.
reassure the woman that using vaginal cream is not a problem for the examination.
inform the woman that vaginal creams may interfere with the Papanicolaou (Pap) test for which she is scheduled.
The Correct Answer is D
Choice A reason: Asking the woman to reschedule the appointment for the examination is not the best response, as it may delay the detection and treatment of any potential problems. The nurse should inform the woman about the possible effect of the vaginal cream on the Pap test and offer her the option to reschedule or proceed with the examination.
Choice B reason: Asking the woman to describe the symptoms that indicate to her that she has a vaginal infection is a good way to assess the woman's condition and provide education, but it is not the initial response. The nurse should first inform the woman about the possible effect of the vaginal cream on the Pap test and then ask her about her symptoms.
Choice C reason: Reassuring the woman that using vaginal cream is not a problem for the examination is not true, as vaginal creams can alter the pH of the vaginal environment and affect the accuracy of the Pap test. The nurse should inform the woman about the possible effect of the vaginal cream on the Pap test and explain the importance of avoiding vaginal creams, douches, or intercourse for 48 hours before the test.
Choice D reason: Informing the woman that vaginal creams may interfere with the Pap test for which she is scheduled is the best response, as it educates the woman about the purpose and procedure of the Pap test and allows her to make an informed decision about whether to reschedule or proceed with the examination. The nurse should also explain the risks and benefits of both options and respect the woman's choice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Cerebral compression is the cause of early decelerations, as it reflects the fetal head compression during uterine contractions. Early decelerations are decreases in the FHR that begin and end with the onset and end of a contraction, respectively. They are symmetrical and mirror the shape of the contraction. Early decelerations are normal and benign, as they indicate that the fetus is responding to the increased intracranial pressure and maintaining adequate oxygenation.
Choice B reason: Cord compression is not the cause of early decelerations but of variable decelerations. Variable decelerations are abrupt and irregular decreases in the FHR that vary in onset, duration, and depth. They are usually caused by the umbilical cord being compressed or occluded by the fetal body, the maternal pelvis, or the uterine contractions. Variable decelerations can indicate fetal distress or hypoxia, especially if they are severe, frequent, or prolonged.
Choice C reason: Uteroplacental insufficiency is not the cause of early decelerations, but of late decelerations. Late decelerations are decreases in the FHR that begin after the peak of a contraction and return to the baseline after the contraction ends. They are symmetrical and have a gradual onset and recovery. They are usually caused by the reduced blood flow and oxygen delivery to the placenta and the fetus due to maternal or fetal factors. Late decelerations can indicate fetal distress or hypoxia, and require immediate intervention.
Choice D reason: Spontaneous rupture of membranes is not the cause of early decelerations, but it can be a risk factor for cord compression and variable decelerations. Spontaneous rupture of membranes is the breaking of the amniotic sac and the release of the amniotic fluid, which usually occurs during labor or shortly before it. Spontaneous rupture of membranes can cause the umbilical cord to prolapse or slip into the vagina, where it can be compressed or kinked by the fetal head or the contractions.
Correct Answer is A
Explanation
Choice A reason: Fetal sleep cycles are a normal physiological cause of decreased variability in the FHR, which is the fluctuation of the baseline FHR above and below 2 cycles per minute. Fetal sleep cycles usually last 20 to 40 minutes and do not affect the fetal well-being.
Choice B reason: Umbilical cord compression is an abnormal cause of decreased variability in the FHR, as it reduces the blood flow and oxygen delivery to the fetus. It can also cause variable decelerations, which are abrupt decreases in the FHR below the baseline.
Choice C reason: Altered cerebral blood flow is an abnormal cause of decreased variability in the FHR, as it indicates a compromise in the fetal central nervous system. It can also cause late decelerations, which are gradual decreases in the FHR after the peak of a contraction.
Choice D reason: Fetal hypoxemia is an abnormal cause of decreased variability in the FHR, as it reflects a severe lack of oxygen in the fetal blood. It can also cause sinusoidal pattern, which is a smooth, undulating waveform in the FHR.
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