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

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

A 39-year-old client with heavy spotting after having a progestin-containing IUD (Mineral Inserted a month ago.

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

Answer and Explanation

The Correct Answer is D

A. A 42-year-old client with secondary amenorrhea who says that her last menstrual cycle was 3 months ago: Secondary amenorrhea requires assessment and evaluation, but it is generally not an immediate threat to the client’s health.

B. A 39-year-old client who is complaining of 4/10 pain after an abdominal hysterectomy: Postoperative pain of moderate intensity is expected and can be managed with routine interventions. While important, it does not indicate an urgent or life-threatening problem.

C. A 39-year-old client with heavy spotting after having a progestin-containing IUD inserted a month ago: Heavy spotting warrants assessment but is usually not immediately life-threatening unless associated with signs of hemodynamic instability.

D. A 19-year-old client with menorrhagia who has been using superabsorbent tampons and has fever with weakness: This client exhibits signs of possible infection and significant blood loss. Fever, weakness, and menorrhagia suggest a risk for sepsis or anemia, making this client the highest priority for immediate assessment and intervention.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Ask the client about preferred forms of address: The safest and most respectful approach is to ask the client how they prefer to be addressed. This acknowledges the possibility of a name discrepancy, respects the client’s identity, and avoids assumptions based on appearance or chart information.

B. Explain that the chart must contain an error: Assuming the chart is wrong may embarrass the client or create mistrust. The chart could be accurate but reflect a preferred name, legal name, or gender identity that differs from appearance.

C. Apologize and declare confusion about the client: Expressing personal confusion can make the client uncomfortable and does not resolve the situation professionally. It may undermine the client’s confidence in the nurse’s competence.

D. Ask Mrs. Smith where her husband is right now: Making assumptions about marital status or gender based on chart name is inappropriate and irrelevant to the client’s care. This approach risks offense and does not clarify identity or preferred address.

A. Increase 0.9% Normal Saline information to 250 ml/hr per protocol. B. Administer Furosemide (Lasix) 20 mg IV push. C. Collect UA for culture and sensitivity. D. Collect blood cultures and start Vancomycin 1 gm IV.

Correct Answer is B

Explanation

A. Increase 0.9% Normal Saline infusion to 250 mL/hr per protocol: The client’s sodium is slightly elevated and CVP/PAWP values suggest hypovolemia. Increasing isotonic fluids is appropriate to restore intravascular volume and support perfusion.

B. Administer Furosemide (Lasix) 20 mg IV push: Furosemide is a diuretic that promotes fluid loss, which is contraindicated in this client who shows signs of dehydration and possible hypovolemia. Administering it could worsen hypotension and compromise perfusion.

C. Collect UA for culture and sensitivity: Collecting a urine sample is appropriate for identifying the source of infection, particularly with elevated WBC and potential sepsis indicators. This supports targeted antibiotic therapy.

D. Collect blood cultures and start Vancomycin 1 gm IV: Blood cultures and empiric antibiotic therapy are essential for suspected sepsis. Initiating antibiotics after culture collection aligns with standard sepsis management protocols.

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Test Name	Results	Reference Range
WBC	12,000	4,000-1,000
Na+	149 mEq/L	135-145 mEq/L
K+	5.0 mEq/L	3.5-5.0 mEq/L
Cl-	110 mEq/L	96-106 mEq/L
pH	7.34	7.35-7.45
PaCO2	34 mm Hg	35-45 mm Hg
PaO2	78 mm Hg	80-100 mm Hg
HCO3	21 mEq/L	22-26 mEq/L

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

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Correct Answer is B

Explanation

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