Author Question: The home care nurse is working with a 40-year-old developmentally delayed adult who has had no ... (Read 73 times)

Engineer · **on:** Jun 28, 2018

The home care nurse is working with a 40-year-old developmentally delayed adult who has had no gynecologic well-woman care since her teens. What screenings are recommended for this client?

1. STI screening and Pap smear
2. Clinical breast exam, Pap smear, and serum calcium levels
3. Clinical breast exam, Pap smear, and mammogram
4. Pap smear and vaccination update

Question 2

The nurse is working with a student nurse during assessment of a 2-hour-old newborn. Which action indicates that the student nurse understands neonatal assessment? The student nurse:

1. Listens to bowel sounds then assesses the head for skull consistency, and size and tension of fontanels.
2. Checks for Ortolani's sign, then palpates femoral pulse, then assesses respiratory rate.
3. Determines skin color, then describes shape of the chest and looks at structures and flexion of the feet.
4. Counts the number of cord vessels, then assess genitals, then sclera color and eyelids.

al · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

3
Rationale:
1. A Pap smear is recommended, but STI screening might or might not be indicated, based on whether the client is sexually active and using contraception or not. Sexually transmitted infections are more common in teens and those in their early 20s.
2. A clinical breast exam and Pap smear are recommended gynecologic examinations for women, but a serum calcium level is not part of a routine gynecologic routine physical exam. When any part of an answer is incorrect, the entire answer is incorrect.
3. A clinical breast exam, Pap smear, and mammogram are recommended gynecologic screenings for 40-year-old women.
4. A Pap smear is a recommended gynecologic screening for an adult woman, but a vaccination update is not considered part of gynecologic care.

Answer to Question 2

3
Rationale:
1. The assessment should proceed in a head-to-toe order; the head should be assessed before the bowel sounds.
2. The assessment should proceed in a head-to-toe order; the respiratory rate should be assessed first, when the infant is at rest and undisturbed.
3. This assessment proceeds in a head-to-toe fashion.
4. The assessment should proceed in a head-to-toe order; the sclera and eye assessment should be done prior to assessing genitals.