CNM Certified Nurse Midwife

Category - Gynecology

A 25-year-old female client comes to the clinic for a Pap smear. The result of the test reveals a low grade squamous intraepithelial lesion or LSIL. Which of the following is the next action of the nurse midwife?
  1. Inform the client that a repeat Pap smear should be done in three months.
  2. Inform the client that she needs to have a Pap smear in two years.
  3. Perform colposcopy.
  4. Inform the client that she needs to have a Pap smear after a year.
Explanation
Answer: D - The next action of the nurse midwife is to inform the client that she needs to have a Pap smear after a year. A squamous intraepithelial lesion, or LSIL, indicates early changes in the size and shape of the cells found on the surface of the cervix. This finding is also called mild dysplasia, indicating that the abnormal, non-cancerous cells can be cancerous after some time. When a Pap smear reveals atypical squamous cells, the client should have another Pap smear in three months. Women with normal test results are scheduled for another Pap smear in two years. Colposcopy is ordered for clients with mild dysplasia. This test uses a device that is placed at the entrance of the vagina to examine the cervix closer.
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