Practice Quiz

CNM Certified Nurse Midwife

Category - Primary Care

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A nurse midwife is about to conduct intravaginal assessment through the use of vaginal speculum on a G3P3 female client. Cells will be taken for cytologic studies, and cultures are to be obtained. Which of the following actions by the nurse midwife is the least appropriate?
  1. The nurse midwife uses a water-based gel to lubricate the speculum.
  2. The nurse midwife verifies that no vaginal medications were used before the procedure.
  3. The nurse midwife rolls a sterile, cotton-tipped applicator on the vaginal wall below the cervix to collect cells from the vaginal pool.
  4. Before withdrawing the speculum, the nurse midwife loosens the lever control. The blades are slowly closed, and the speculum is rotated.
Explanation
Answer: A - The least appropriate action of the nurse is to apply water-based gel to the speculum. If cultures are to be obtained, the nurse midwife should not use water or gel to warm or lubricate the speculum. The other options are appropriate actions. If cytologic studies are to be done, vaginal medications and douching should be avoided before the procedure.
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