An 18-year-old girl presents to her nurse practitioner for a wellness visit and immunizations prior to entering college. She wants to know when she needs to start having Pap smears. What is the most appropriate response by the nurse practitioner?
"Are you thinking about getting on the Pill?"
"Pap smears are recommended starting at age 21 or within 3 years of sexual activity, whichever comes first."
"You don't have to worry about that; I know you aren't sexually active yet."
"Why? Have you started having sex?"
The Correct Answer is B
Choice A reason: This response is inappropriate and irrelevant to the question. Pap smear guidelines are based on age and sexual activity, not contraceptive use. It also risks making assumptions about the patient’s intentions.
Choice B reason: Current guidelines recommend initiating Pap smear screening at age 21, regardless of sexual activity. This response provides accurate, evidence-based information and respects the patient’s autonomy and inquiry.
Choice C reason: This response is dismissive and assumes the patient’s sexual activity status. It fails to provide the necessary health education and may discourage future engagement in preventive care.
Choice D reason: This response is intrusive and judgmental. It does not answer the patient’s question and may create discomfort or mistrust in the clinical relationship.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Osteoarthritis is not caused by bacterial infection. While septic arthritis involves infection, OA is a degenerative joint disease resulting from mechanical wear and tear, not infectious etiology.
Choice B reason: OA is not an autoimmune disorder and is not linked to Epstein-Barr virus. Autoimmune joint diseases such as rheumatoid arthritis involve immune-mediated synovial inflammation, which is not characteristic of OA.
Choice C reason: This description applies to rheumatoid arthritis, not OA. In RA, synovial inflammation leads to joint destruction and deformity due to autoimmune mechanisms. OA involves cartilage degeneration without significant synovial inflammation.
Choice D reason: OA is a chronic, progressive condition characterized by the breakdown of articular cartilage, subchondral bone remodeling, and joint space narrowing. It leads to pain, stiffness, and reduced mobility, especially in weight-bearing joints like the hips.
Correct Answer is D
Explanation
Choice A reason: Structural group therapy may be beneficial for social skills and peer support but is not sufficient for managing medication nonadherence in chronic schizophrenia. It lacks the intensive, individualized outreach needed for this scenario.
Choice B reason: Inpatient hospitalization is appropriate for acute psychiatric crises, such as danger to self or others, but may not be necessary if the patient is stable and simply nonadherent. It is not a long-term solution for chronic management.
Choice C reason: Intensive outpatient programs provide structured treatment but may not offer the level of outreach and flexibility needed for patients who are resistant to care or disengaged from services.
Choice D reason: Assertive Community Treatment (ACT) is a multidisciplinary, team-based approach designed for individuals with severe mental illness who are nonadherent or difficult to engage. It includes outreach, medication management, and support in the community, making it the most appropriate choice for this client.
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