Vaginal candidacies are suspected in a young woman who complains of severe vaginal itching. Which of the following nursing actions should be performed first when assisting in the collection of a vaginal smear for microscopic examination?

Correct Answer: B

Rationale: In this scenario, the correct answer is option B) Don gloves. When assisting in the collection of a vaginal smear for microscopic examination in a suspected case of vaginal candidiasis, wearing gloves is crucial to prevent the spread of infection and maintain proper hygiene practices. Choosing option A) to inspect the external genitalia first could potentially introduce external contaminants and compromise the accuracy of the smear. Option C) washing hands is important but not the immediate priority since wearing gloves provides a physical barrier. Option D) labeling the specimen is important but should come after ensuring proper hygiene practices to prevent contamination. From an educational perspective, understanding the correct sequence of steps in specimen collection is vital for healthcare professionals to maintain patient safety and accuracy of test results. Emphasizing the importance of infection control practices like wearing gloves can prevent the spread of infections in healthcare settings. It also reinforces the significance of following proper protocols to ensure reliable diagnostic outcomes in patient care.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Torsion of the spermatic cord. Torsion of the spermatic cord occurs when the testicle twists, causing a sudden and severe pain in the scrotum. This condition is a medical emergency as it can lead to decreased blood flow to the testicle, resulting in tissue damage and potential loss of the testicle if not promptly treated. Cryptorchidism (B) is the condition where one or both testes fail to descend into the scrotum. It is a congenital condition and not related to the sudden onset of pain described in the case. Phimosis (C) is the inability to retract the foreskin from the head of the penis. This condition does not present with sudden testicular pain as described in the case. Spermatocele (D) is a cyst-like growth that develops in the epididymis, the coiled tube located behind the testicle. It is usually painless and does not typically cause sudden intense testicular pain. Educationally, understanding the differential diagnosis of testicular pain is crucial for healthcare providers, especially nurses, to provide appropriate and timely care. Recognizing the symptoms and signs of conditions like torsion of the spermatic cord is essential for prompt intervention to prevent complications like testicular ischemia.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Elevate the client's arm on two pillows to promote lymphatic drainage, which can be delegated to a nursing assistant. This task is appropriate for delegation because it is a non-invasive intervention that does not require specialized knowledge or assessment skills. Nursing assistants are trained to assist with activities of daily living and basic patient care, like positioning clients for comfort. Option A) Teach the client why blood pressure measurements are taken on the left arm requires specialized knowledge and explanation that should be provided by a nurse. Option C) Assess the client's right arm for lymphedema involves a comprehensive assessment that requires nursing judgment and skill, so it should not be delegated. Option D) Wrap the client's right arm with elastic bandages involves applying a treatment that requires assessment, judgment, and knowledge of proper technique, making it inappropriate for delegation to a nursing assistant. In an educational context, understanding the principles of delegation is crucial for nursing students and healthcare professionals to ensure safe and effective patient care. Delegation involves assigning appropriate tasks to the right personnel based on their competency level, training, and scope of practice. It is important to differentiate between tasks that can be delegated and those that require specialized skills to maintain patient safety and quality of care.

Correct Answer: D

Rationale: In the context of a home health client who has undergone a radical prostatectomy, delegating the task of assisting the client to ambulate for increasing distances to the home health aide is appropriate. This activity helps in promoting the client's physical mobility and independence in a safe manner, which is crucial for recovery post-surgery. Option A, monitoring the client for symptoms of urinary tract infection, requires a higher level of clinical judgment and assessment skills usually possessed by a nurse or healthcare provider. Home health aides are generally not trained to diagnose or assess medical conditions. Option B, helping the client to connect the catheter to the leg bag, involves a specialized skill that falls within the scope of a licensed healthcare professional due to infection control and catheter care considerations. Option C, assessing the client's incision for appropriate wound healing, also requires specific training and knowledge to identify signs of infection or complications accurately. Educationally, understanding the scope of practice for different healthcare team members is essential for safe and effective patient care delegation. It is crucial to match tasks with the appropriate level of training and competence to ensure quality care delivery and patient safety.

Correct Answer: A

Rationale: The correct answer is A) The nurse observes the client for any discomfort in the shoulders. In a culdoscopy, the procedure involves examining the reproductive organs through the vaginal wall. Shoulder pain post-culdoscopy can be indicative of peritoneal irritation due to the introduction of gas into the abdominal cavity during the procedure. This referred pain to the shoulders is a common side effect and the nurse needs to monitor for it. Option B is incorrect because while monitoring for signs of internal bleeding and shock is important in any post-procedure care, it is not specifically related to culdoscopy. Option C is incorrect as changes in skin color and body temperature are not typical indicators of complications post-culdoscopy. Option D is incorrect as urinary output monitoring is not directly relevant to a culdoscopy procedure. Educationally, understanding the specific post-procedure care for various examinations is crucial for nurses to provide effective and safe patient care. By knowing the expected outcomes and potential complications of procedures like culdoscopy, nurses can intervene promptly and ensure optimal patient outcomes.