The nurse in the women's health clinic has four clients who are waiting to be seen. Which client should the nurse see first?

A 19-yr-old client with menorrhagia who has been using superabsorbent tampons and has fever with weakness.

A 35-yr-old client with heavy spotting after having a progestin- containing IUD (Mirena) inserted a month ago.

A 39-yr-old client who is complaining of 4/10 pain after an abdominal hysterectomy.

A 42-yr-old client with secondary amenorrhea who says that her last menstrual cycle was 3 months ago.

Answer and Explanation

The Correct Answer is A

A. A 19-year-old client with menorrhagia who has been using superabsorbent tampons and has fever with weakness: This is the correct choice. Fever and weakness in the context of menorrhagia suggest a possible infection (e.g., toxic shock syndrome) or severe blood loss, which requires immediate evaluation and intervention.

B. A 35-year-old client with heavy spotting after having a progestin-containing IUD (Mirena) inserted a month ago: Spotting after IUD insertion is common and does not suggest an immediate threat to the client’s health.

C. A 39-year-old client who is complaining of 4/10 pain after an abdominal hysterectomy: Mild pain after a hysterectomy is expected and not an emergency.

D. A 42-year-old client with secondary amenorrhea who says that her last menstrual cycle was 3 months ago: While secondary amenorrhea requires evaluation, it is not as urgent as a client with signs of possible infection or blood loss.

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Correct Answer is C

Explanation

A. Epinephrine is used in cases of severe allergic reactions or anaphylaxis, and while it may be appropriate in treating angioedema, the first priority is to ensure the airway is clear and that the client can breathe. Administering epinephrine may be part of the treatment plan but should follow securing the airway and calling for immediate advanced help.

B. This is not appropriate because angioedema can be life-threatening and can rapidly progress to airway obstruction. Reassurance without action would delay necessary interventions and could jeopardize the client’s safety.

C. In cases of angioedema, airway obstruction is the most dangerous complication, as it can lead to asphyxiation. The nurse's first priority is to ensure that the patient's airway remains open and clear. The nurse should immediately call the Rapid Response Team (RRT) for urgent medical intervention, which may include medications (like epinephrine), intubation, or other interventions. Ensuring the airway is open and calling for advanced help are the most critical first steps in managing severe cases of angioedema.

D. While oxygen therapy may be appropriate if the client shows signs of respiratory distress or hypoxia, the immediate concern is securing the airway. Oxygen may be needed after ensuring the airway is open, but the priority is to avoid airway obstruction first. The nurse should secure the airway and then administer oxygen if needed.

A. Neurologic status B. Urine volume C. Cardiac rhythm D. Calcium level

Correct Answer is C

Explanation

A. Neurologic status is important to monitor but is not directly related to evaluating calcium gluconate's effect on hyperkalemia.

B. Urine volume would not directly reflect the immediate effects of calcium gluconate in managing hyperkalemia.

C. Calcium gluconate is given to protect the heart from the effects of hyperkalemia by stabilizing the cardiac membrane. Monitoring the cardiac rhythm is essential to assess the effectiveness of the treatment.

D. The calcium level is relevant for monitoring the calcium treatment, but cardiac rhythm is a more immediate indicator of its effectiveness.

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The nurse in the women's health clinic has four clients who are waiting to be seen. Which client should the nurse see first?

Nursing Test Bank

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Explanation

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