When performing the bimanual examination, the nurse notices that the cervix feels smooth and firm, is round, and is fixed in place (does not move). When cervical palpation is performed, the patient complains of some pain. The nurse's interpretation of these results should be which of these?

Correct Answer: C

Rationale: Step-by-step rationale for the correct answer (C): 1. The cervix is normally mobile and should move when palpated. A fixed cervix may indicate malignancy. 2. Pain during cervical palpation can be a sign of inflammation, infection, or other abnormalities. 3. Smooth and firm cervix, along with pain, raise suspicion of an underlying issue. 4. Therefore, the nurse should interpret these findings as potentially concerning and further assessment is needed. Summary: Choice A is incorrect because the findings are not within normal limits. Choice B is incorrect as the cervix should not be firm. Choice D is incorrect as pain during palpation is significant and should not be dismissed.

Correct Answer: B

Rationale: The correct answer is B: Referral to a gynecologist for further examination. This is the best course of action because an irregular and hard cervix can indicate various underlying issues such as cervical dysplasia, fibroids, or cervical stenosis. A gynecologist can conduct a more thorough evaluation including additional tests like colposcopy or ultrasound to determine the cause and appropriate treatment. A: Performing a Pap smear test may not provide sufficient information about the specific condition causing the irregularity. C: Completing a cervical cancer screening may not address the immediate concern of the irregular and hard cervix. D: Completing an endometrial biopsy is not indicated for assessing cervical abnormalities, as it focuses on the endometrium rather than the cervix.

Correct Answer: C

Rationale: The correct answer is C: Changes in breast size. This is because hormonal changes in early pregnancy can cause breast tenderness, swelling, and darkening of the areola. This typically occurs before a missed period or a positive urine pregnancy test. A missed period (choice A) is a common sign of pregnancy, but not the earliest. A positive urine pregnancy test (choice B) confirms pregnancy but may not be the earliest sign. Abdominal tenderness and bloating (choice D) can occur due to various reasons and are not specific to pregnancy. Therefore, changes in breast size are the earliest and most reliable sign of pregnancy in this scenario.

Correct Answer: A

Rationale: The correct order of structures that transport urine is from the collecting ducts to the urethra is A: Collecting ducts, Minor calyces, Major calyces, Renal pelvis, Ureter, Urinary bladder, Urethra. This is the correct order because urine is first collected in the collecting ducts in the nephrons, then flows into the minor calyces, major calyces, renal pelvis, ureter, urinary bladder, and finally, the urethra for elimination. The other choices are incorrect because they either reverse the order of the structures or place them in a different sequence than the actual physiological process of urine transport in the urinary system.

Correct Answer: C

Rationale: The correct path of blood flow in the kidney is from the abdominal aorta to the renal arteries, then to the segmental arteries, followed by interlobar arteries, arcuate arteries, interlobular arteries, afferent arteries, glomerulus, efferent arteries, peritubular capillaries, interlobular veins, arcuate veins, interlobar veins, renal veins, and finally to the inferior vena cava. Choice C accurately follows this sequential flow of blood, making it the correct answer. Explanation for why other choices are incorrect: - Choice A has the incorrect sequence of interlobar and interlobular arteries, which disrupts the correct flow. - Choice B also has an incorrect sequence of interlobar and interlobular arteries, leading to an inaccurate path. - Choice D has the interlobar and interlobular arteries in the wrong order, deviating from the correct blood flow pathway.