The nurse examines a client who is concerned about the amount of menstrual flow she is having. Which finding indicates an abnormality related to the client's current menstruation?

An odorless, red menstrual blood flow.

Cramping associated with the amount of flow.

Blood clots sized at 0.5 cm (0.2 in) with menstrual flow.

Blood saturation of one pad an hour.

Answer and Explanation

The Correct Answer is D

A. An odorless, red menstrual blood flow: This is considered a normal characteristic of menstruation. Menstrual blood may have a slight metallic scent due to the mixing with vaginal secretions, but an odorless red flow is not a concern and does not suggest abnormality.

B. Cramping associated with the amount of flow: Mild to moderate cramping (dysmenorrhea) is a common and expected part of menstruation related to the release of prostaglandins that cause uterine contractions especially during heavier flow days. While it can be uncomfortable, it is not typically considered abnormal unless severe or disabling.

C. Blood clots sized at 0.5 cm (0.2 in) with menstrual flow: Small blood clots can occur during menstruation, especially during heavier flow, and clots under 1 inch (2.5 cm) in diameter are generally not worrisome. This size is within normal limits and not an indication of a menstrual disorder.

D. Blood saturation of one pad an hour: This finding suggests menorrhagia, or abnormally heavy menstrual bleeding. Saturating a pad or tampon every hour for several consecutive hours is clinically significant and warrants further investigation, as it can lead to anemia and may signal an underlying gynecological issue such as fibroids or a bleeding disorder.

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Correct Answer is D

Explanation

A. Clean the ears to remove excess wax build up: There is no indication of cerumen (ear wax) occlusion based on the visual inspection. The tympanic membranes are clearly visible, suggesting that the ear canals are not obstructed by wax.

B. Culture the white patches for possible fungal growth: Fungal infections of the ear (otomycosis) typically involve the external auditory canal, not the tympanic membrane itself. The patches described are more consistent with tympanosclerosis, which does not require culturing.

C. Referral to an audiologist for a hearing evaluation: While chronic ear infections can affect hearing, the client denies any hearing loss, and the tympanic membranes appear otherwise healthy. There is no immediate need for audiologic referral unless symptoms arise.

D. Record the findings in the client's record: The dense white patches are likely tympanosclerosis, a common, benign finding resulting from scarring due to past ear infections. No treatment is needed if the client is asymptomatic. Proper documentation is the appropriate next step.

A. Alternate both index fingers to touch the tip of nose accurately. B. Extend arms up to 180 degrees beside the ears. C. Extend arms straight out and hold without drifting. D. Hold arms up at 90 degrees while arms are pushed downward.

Correct Answer is B

Explanation

A. Alternate both index fingers to touch the tip of nose accurately:

This tests coordination and cerebellar function rather than shoulder range of motion. It's commonly used in neurological assessments, not musculoskeletal shoulder evaluations.

B. Extend arms up to 180 degrees beside the ears: This movement assesses full shoulder flexion, which is a key component of evaluating shoulder ROM. Normal flexion reaches about 180 degrees, and pain or restriction here could indicate shoulder joint pathology or soft tissue injury.

C. Extend arms straight out and hold without drifting: This technique is used to assess for motor weakness or neurological deficits such as pronator drift. It does not specifically evaluate shoulder ROM.

D. Hold arms up at 90 degrees while arms are pushed downward: This assesses muscle strength, particularly in the deltoids or rotator cuff, but it is not a direct measure of shoulder range of motion. It is more of a resistance test than a ROM test.

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The nurse examines a client who is concerned about the amount of menstrual flow she is having. Which finding indicates an abnormality related to the client's current menstruation?

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Correct Answer is D

Explanation

A client comes to the clinic due to shoulder discomfort and intermittent pain while swimming laps. To identify normal range of motion (ROM) of the client's shoulder, which assessment technique should the nurse ask the client to perform?

Correct Answer is B

Explanation

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