An elderly woman comes to the clinic because of vaginal bleeding. The healthcare provider finds a vagina tear, which the client reports is likely to have occurred during sexual intercourse. Which content is most important for the nurse to include in this client's teaching plan?

Voiding after intercourse to reduce infection.

Need for scheduling annual well woman exams.

The importance of using vaginal lubricants.

Intercourse positions that can help prevent tears.

Answer and Explanation

The Correct Answer is C

A.   While voiding after intercourse can help reduce the risk of urinary tract infections (UTIs), it is not directly related to preventing vaginal tears. This practice is more relevant for preventing infections rather than addressing the issue of tissue trauma or dryness that may lead to tearing.
B.   Regular well-woman exams are important for overall gynecological health and early detection of potential issues, but they do not directly address the immediate concern of preventing vaginal tears during intercourse.
C.   Vaginal dryness is a common issue in older women, often due to decreased estrogen levels. Dryness can make vaginal tissues more susceptible to tearing during intercourse. Using vaginal lubricants can help reduce friction and prevent tears, making this the most relevant and practical advice for the client in this situation.
D.   While certain positions may be more comfortable and could potentially reduce the risk of tearing, this advice is secondary to addressing the fundamental issue of vaginal dryness. Focusing on lubrication provides a more direct and effective approach to preventing tears.

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Correct Answer is C

Explanation

A. Tilting the pelvis forwards and backwards involves movements of the pelvic girdle, which is more related to the actions of the hip joints and lumbar spine, rather than hinge joints specifically. This action involves the pelvic tilt and is not an exercise for hinge joints like the elbow or knee.
B. Turning the head to the right and left involves rotation of the cervical spine and is associated with pivot joints rather than hinge joints. This action does not involve flexion and extension typical of hinge joints, which are primarily the elbow and knee.
C. This action involves bending the arm at the elbow joint, which is a classic example of a hinge joint. The elbow allows for flexion (bending) and extension (straightening) movements, making it a key example of a hinge joint. This is the correct action for exercising hinge joints.
D. Extending the arm and rotating in circles involves movements of the shoulder joint, which is a ball- and-socket joint, not a hinge joint. The shoulder joint allows for a wide range of movements including circumduction, which is different from the simple flexion and extension movements of hinge joints.

A. Ask the client to describe how they are feeling. B. Administer a PRN dose of a prescribed analgesic. C. Document that the client denies pain in the nurse's notes. D. Confront the client about inconsistent behavior and response.

Correct Answer is A

Explanation

A. Asking the client to describe their feelings provides an opportunity to explore their symptoms in more detail, which might help in understanding their pain better. This approach respects the client's experience and opens a dialogue to assess their discomfort more accurately, especially if they are not expressing it verbally or are having difficulty quantifying it.
B. Administering medication without further assessment might be premature. The client's denial of pain and the presence of grimacing and guarding behavior suggest that there may be underlying discomfort, but it's crucial to assess the situation more thoroughly before administering medication.
C. While documenting the client’s verbal denial of pain is important, it should not be the only action taken. The client's non-verbal cues such as grimacing and guarding behavior suggest that they might be experiencing pain despite their verbal denial.
D. Confronting the client could be perceived as accusatory and might make them feel defensive or uncomfortable. It's important to approach the situation with empathy and understanding rather than confrontation.

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An elderly woman comes to the clinic because of vaginal bleeding. The healthcare provider finds a vagina tear, which the client reports is likely to have occurred during sexual intercourse. Which content is most important for the nurse to include in this client's teaching plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is teaching a client how to do active range of motion (ROM) exercises. To exercise the hinge joints, which action should the nurse instruct the client to perform?

Correct Answer is C

Explanation

An older adult client grimaces and demonstrates guarding behavior, but denies experiencing pain when asked by the nurse to rate the pain on a numeric scale. Which action should the nurse take next?

Correct Answer is A

Explanation

The nurse assesses an older adult client's ability to perform activities of daily living (ADLs). When observing the client ambulate, the nurse notes that the client's posture is upright, and the gait is smooth and steady. Which action should the nurse take next?

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