A patient being seen for the first time in the perinatal clinic ...

[stevenposner]

A patient being seen for the first time in the perinatal clinic has multiple complaints, such as fatigue, anger outbursts, chronic pelvic pain, and feelings of anxiety. What action by the nurse is best?
 
  A.
  Assess the woman for a history of sexual assault.
  B.
  Document the patient's complaints on the chart.
  C.
  Refer the woman to a psychiatric nurse practitioner.
  D.
  Review the woman's past medical history with her.

Question 2

A woman undergoing her first prenatal visit for a current pregnancy is reluctant to discuss her past obstetrical history with the nurse. Which action by the nurse is best?
 
  A.
  Document the woman's refusal to answer these particular questions in the chart.
  B.
  Explain that past obstetrical experiences frequently recur in later pregnancies.
  C.
  Inform the woman that the clinic cannot provide comprehensive care without a complete history.
  D.
  Tell the woman that you need the information in order to continue with the prenatal visit.

[lindahyatt42]

Answer to Question 1

ANS: A
Women who have been victims of sexual assault often complain of various emotional difficulties, such as depression, anger, anxiety, and gynecologic problems. They are often reluctant to disclose their past history of abuse. When women have these complaints, the nurse should investigate the possibility of sexual assault. Documentation should be thorough; however, this answer is not complete. The patient may or may not need a referral; the nurse needs to assess the patient further. Reviewing past medical history is an important part of assessing a patient, but does not take into account the unique nature of this problem.

Answer to Question 2

ANS: B
A complete obstetrical history should cover the current pregnancy as well as all other pregnancies because complications experienced in previous pregnancies often recur. The nurse should gently explain this in a nonthreatening, nonjudgmental manner, focusing on helping the woman obtain the best outcomes possible. Documentation is always an important nursing responsibility, but the nurse needs to act and not just document. Informing the woman that the clinic cannot provide comprehensive care without the history or telling her that she needs to provide more information to continue the visit is judgmental and sounds vaguely threatening.