A patient calls the clinic for instructions before having a Papanicolaou (Pap) smear. The most appropriate instructions from the nurse are:

Correct Answer: B

Rationale: The correct answer is B because avoiding intercourse, inserting anything into the vagina, or douching within 24 hours of the appointment helps ensure an accurate Pap smear result. Intercourse, vaginal products, and douching can introduce foreign substances or disrupt the natural vaginal flora, potentially affecting the test results. Option A is incorrect because using pads during menstruation is a general recommendation and not specific to a Pap smear appointment. Option C is incorrect because bringing a sample of discharge is not necessary for a Pap smear. Option D is incorrect because douching is not recommended before a Pap smear as it can alter the vaginal environment.

Correct Answer: C

Rationale: The correct answer is C: Weight loss and fatigue. In the context of vaginal bleeding and cramping, weight loss and fatigue are concerning signs that may indicate a potential miscarriage. Weight loss could be due to decreased appetite or nutritional deficiencies associated with the stress of a miscarriage. Fatigue may result from hormonal changes and emotional distress. Assessing for weight loss and fatigue helps the nurse monitor the patient's overall well-being and provide appropriate support. Choice A (Hyperthyroidism) is incorrect as it is not directly related to the symptoms of vaginal bleeding and cramping suggestive of a possible miscarriage. Choice B (High blood pressure) is also incorrect as it is not typically associated with early signs of a miscarriage. Choice D (Changes in breast size or tenderness) is incorrect as these symptoms are more commonly related to pregnancy rather than miscarriage.

Correct Answer: A

Rationale: The correct answer is A: 5 to 10 years. IUDs are long-acting reversible contraceptives effective for 5 to 10 years depending on the type. Hormonal IUDs last around 5 years, while copper IUDs can last up to 10 years. This extended duration provides reliable contraception for an extended period with minimal user intervention. Choice B: 1 to 2 years is incorrect because IUDs have a longer duration of effectiveness. Choice C: 3 to 5 years is incorrect as it falls short of the typical duration of effectiveness for most IUD types. Choice D: Indefinitely is incorrect as IUDs do have a maximum effective period, after which they need to be removed or replaced.

Correct Answer: D

Rationale: The correct answer is D: Pelvic inflammatory disease (PID). PID can lead to scarring and narrowing of the fallopian tubes, increasing the risk of ectopic pregnancy. This is because the fertilized egg may get stuck in the narrowed tube, leading to an ectopic pregnancy. A: Previous pelvic surgery is a risk factor, but it is not the most common one for ectopic pregnancy. B: Endometriosis can also affect fallopian tubes but is not the most common risk factor for ectopic pregnancy. C: Tubal ligation is a form of contraception that reduces the risk of pregnancy but does not increase the risk of ectopic pregnancy. In summary, PID is the most common risk factor for ectopic pregnancy due to its potential to cause fallopian tube scarring and narrowing, leading to the implantation of the fertilized egg outside the uterus.

Correct Answer: A

Rationale: The correct answer is A: Albumin. Albumin is a protein normally found in blood but not in urine. Its presence in urine, known as proteinuria, may indicate a problem with the kidneys such as kidney damage or dysfunction in filtering blood. Bilirubin (B) is a product of red blood cell breakdown and its presence in urine indicates liver or bile duct issues. Ammonium (C) is a normal byproduct of protein metabolism and is excreted in urine. Urea (D) is a waste product of protein metabolism and is normally found in urine.