The nurse is caring for several clients in a clinic who are at risk for or have been diagnosed with a sexually transmitted infection.
Which client would the nurse anticipate that the provider will see first?
The pregnant client at 6 weeks gestation who is positive for syphilis.
The client who reports a painful lesion on their penis.
The client who tested positive for herpes simplex virus.
The client who would like education regarding the HPV vaccine.
The Correct Answer is A
Triage in a clinic setting requires prioritizing clients based on the potential for permanent harm or transmission. Knowledge of infectious disease impacts on fetal development and the urgency of preventing congenital complications is vital for determining the order of care.
Choice A rationale
Syphilis during pregnancy poses an immediate threat to the fetus, including risks of stillbirth, neonatal death, or congenital syphilis. Early treatment with penicillin is critical to prevent vertical transmission and ensure the health of the developing fetus.
Choice B rationale
A painful penile lesion is often a symptom of herpes or chancroid, which requires evaluation and treatment but is not immediately life-threatening. While uncomfortable, this client is stable and does not take priority over the risk to a fetus.
Choice C rationale
Herpes simplex virus is a chronic condition that causes painful outbreaks but is generally managed with antiviral medications in an outpatient setting. It does not present the same level of urgency as an active syphilis infection in pregnancy.
Choice D rationale
Requesting education for the HPV vaccine is a preventive health measure and is classified as non-urgent. This client is stable and can wait until higher-priority cases involving active infections and pregnancy risks have been addressed by the provider..
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D"]
Explanation
The clinical scenario involves a high-risk pregnancy complicated by preeclampsia or HELLP syndrome. Knowledge of maternal-fetal assessment, seizure prophylaxis, and critical laboratory values is necessary to prioritize interventions that ensure hemodynamic stability and prevent eclampsia or placental abruption in the client.
Choice A rationale
Laboratory results in preeclampsia often show elevated liver enzymes, low platelets (normal 150,000 to 400,000/mm), and proteinuria. Communicating these critical values to the provider is essential for timely medical management, potentially leading to delivery or medication adjustments.
Choice B rationale
Oxygen supplementation ensures adequate maternal arterial oxygen saturation, which directly affects fetal oxygenation via placental perfusion. Maintaining high maternal oxygen levels is vital when the client experiences respiratory compromise or during acute hypertensive crises to prevent fetal hypoxia.
Choice C rationale
Continuous fetal heart rate monitoring provides real-time data on fetal well-being and placental function. In high-risk conditions like preeclampsia, it helps detect late decelerations or decreased variability, which indicate fetal distress or chronic uteroplacental insufficiency requiring intervention.
Choice D rationale
Magnesium sulfate is the primary pharmacological intervention for preventing tonic-clonic seizures in clients with severe preeclampsia. It acts as a central nervous system depressant and neuromuscular blocker, reducing neuronal irritability and the risk of eclampsia development..
Correct Answer is B
Explanation
Safe blood transfusion practices rely on understanding ABO and Rh factor compatibility. Knowledge of antigens and antibodies must be applied to prevent life-threatening hemolytic transfusion reactions, ensuring the recipient's immune system does not attack the donor's red blood cells.
Choice A rationale
Type O negative is the universal donor but can only receive O negative blood. Type A positive blood contains A antigens, which would trigger a hemolytic reaction in an O negative recipient who possesses anti-A antibodies.
Choice B rationale
AB positive is the universal recipient because it lacks anti-A and anti-B antibodies and has the Rh antigen. Therefore, B negative blood can be safely transfused as there are no antibodies to attack the donor cells.
Choice C rationale
An A positive recipient has anti-B antibodies. AB negative blood contains B antigens on the cell surface. Transfusing AB negative blood would cause the recipient's antibodies to attack the donor's B antigens, causing hemolysis.
Choice D rationale
An Rh-negative recipient, such as someone with B negative blood, will develop antibodies if exposed to Rh-positive blood. O positive blood contains the Rh antigen, making it incompatible for an Rh-negative individual due to sensitization..
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