The nurse is collecting data to determine the client’s risk factors related to cervical cancer. The nurse determines which information to be significant?
Multiple sexual partners.
Multiple pregnancies.
Late onset of menarche.
Use of a diaphragm.
The Correct Answer is A
Choice A rationale
Multiple sexual partners increase the risk of human papillomavirus (HPV) infection, which is a significant risk factor for cervical cancer.
Choice B rationale
Multiple pregnancies are not a significant risk factor for cervical cancer.
Choice C rationale
Late onset of menarche is not a significant risk factor for cervical cancer.
Choice D rationale
Use of a diaphragm is not a significant risk factor for cervical cancer.
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Correct Answer is B
Explanation
Choice A rationale
Rephrasing statements the client does not hear is helpful but not the priority action. The priority is to determine if the client uses hearing aids to ensure they can hear instructions and communication effectively.
Choice B rationale
Determining if the client uses hearing aids is the priority action. Ensuring the client has and uses their hearing aids can significantly improve communication and care.
Choice C rationale
Speaking using the usual tone of voice and directly in front of the client is important but secondary to ensuring the client has their hearing aids.
Choice D rationale
Using hand gestures to communicate can be helpful but is not the priority action. The primary focus should be on ensuring the client has their hearing aids for optimal hearing.
Correct Answer is C
Explanation
Choice A rationale
Auscultating for wheezing is important but not the first action. The priority is to administer epinephrine to counteract the severe allergic reaction.
Choice B rationale
Assessing the client’s level of consciousness is important but not the first action. Administering epinephrine takes precedence to stabilize the client’s condition.
Choice C rationale
Administering epinephrine is the first action. It is crucial to counteract the severe allergic reaction and prevent further complications.
Choice D rationale
Monitoring for hypotension is important but not the first action. Administering epinephrine is the priority to stabilize the client’s condition.