Active Learning - Reproductive System
What should be included in the education plan for a patient after axillary lymph node dissection (ALND)? (Select all that apply.) A. Avoid blood pressures, injections, and blood draws in affected extremity B. Wear gloves for gardening C. Maintain cuticles by cutting them D. Use disposable razors for shaving armpits E. Avoid lifting objects greater than 5 to 10 pounds
A B E
A patient is on a surgical unit afte4r a total abdominal hysterectomy. SELECT ALL A. Urine output of 125 mL in the first 8 hours after surgery B. Decreased bowel sounds in all four abdominal quadrants C. report of abdominal pain at the incision site with coughing D. One-inch area of bloody drainage on the abdominal dressing
A D
What topic will the nurse include in the preoperative teaching for a patient admitted for an abdominal hysterectomy? SELECT ALL A. Purpose of ambulation and leg exercises B. Adverse effects of systemic chemotherapy C. Decrease in vaginal sensation after surgery D. Symptoms caused by the drop in estrogen levels
A D
A 27 year old patient who has testicular cancer is being admitted for a unilateral orchiectomy. The patient does not talk to his wife and speaks to the nurse only to answer the admission questions. Which action is appropriate for the nurse to take? A. Teach the patient and the wife that impotence is unlikely after unilateral orchiectomy B. Ask the patient if he ask any questions or concerns about the diagnosis or treatment C. Inform the patient's wife that concerns about sexual function are common with this diagnosis D. Document the patient's lack of communication on the health record and continue pre-op care
B
A 58 years old patient is in the medical-surgical unit after undergoing a radical vulvectomy for vulvar carcinoma. What is the greatest risk to the patient at this time? A. Self-care deficit B. Wound infection C. Inadequate nutrition D. ineffective sexual pattern
B
A healthy 24 year old patient who has been vaccinated against human papillomavirus (HPV) has a normal Pap test result. Which information will the nurse include in patient teaching when calling the patient with the results of the Pap test? A. you can wait until after age 30 before having another pap test B. pap testing is recommended every 3 years for women your age C. no further pap testing is needed until you decide to become pregnant D. yearly pap testing is suggesting for women with multiple sexual partners
B
After a 48 year old patient has a modified radical mastectomy, the pathology report identifies the tumor as an estrogen-receptor positive adenocarcinoma. What topic should the nurse plan to teach the patient? A. Estradiol B. Tamoxifen C. Raloxifene D. Trastuzumab
B
The nurse notes bilateral enlargement of the breasts during examination of a 62 year old male patient. Which action should the nurse take first? A. Refer the patient for mammography B. Questions the patient about current meds C. Explain that this is temporary due to hormonal changes D. Teach the patient how to palpate the breast tissue for lumps
B
A 22 year old patient tells the nurse at the health clinic that he has recently had problems with erectile dysfunction. Which question should the nurse ask to assess for possible etiological factors in this age group? A. "Do you use recreational drugs or drink alcohol?" B. "Do you experience an unusual amount of stress?" C. "Do you have cardiovascular or peripheral vascular disease?" D. "Do you have a history of an erection that lasted for 6 hours of more?"
A
A 51 year old patient with a small immoble breast lump is considering having a fine-needle aspiration (FNA) biopsy. What should the nurse explain as an advantage to this procedure? A. FNA is done in the outpatient clinic, and results are available in 1-2 days B. Only a small incision is needed, resulting in minimal breast pain and scarring C. If the biopsy results are negative, no further diagnostic testing will be needed D. FNA is guided by a mammogram, ensuring that cells are taken from the lesion
A
A patient diagnosed with breast cancer asks the nurse what "triple negative" means. What should an accurate response from the nurse about triple negative breast cancer include? A. The tumor is not likely to be responsive to hormone therapy B. Treatment with chemotherapy is not likely recommended C. HER-2 receptor testing was repeated for a total of three samples D. Estrogen receptor testing identified three hormones causing the cancer
A
Several patients call the urology clinic requesting appointments with the HCP as soon as possible. Which patient will the nurse schedule to be seen first? A. A 22 year old patient who has notices a firm, non-tender lump on his scrotum B. A 25 year old patient who is concerned that his scrotum "feels like a bag of worms" - hydrocele C. A 40 year old patient who has pelvic pain while being treated for chronic prostatitis D. A 70 year old patient who is reporting frequent urinary dribbling after a prostatectomy
A
W.B. is scheduled for a TURP. When you assess his knowledge of the procedure and its effects, you realize he needs further teaching when he says, A. "It is possible that i'll be sterile following this procedure" B. "It is likely that I will become impotent from this procedure" C. "I understand that some retrograde ejaculation may occur" D. "I will have a catheter for a couple of days to keep my urinary system open"
B
What action should the nurse take when a 35 year old patient whose repeat cervical pepe test is abnormal? A. Teach the patient about colposcopy B. Teach the patient about an endometrial colposcopy biopsy C. Prepare for D&C D. administer 3 doses of HPV vaccine
B
What action will the nurse include in the plan of care for a patient with right arm lymphedema? A. Avoid isometric exercise on the right arm B. Assist with application of a compression sleeve C. Keep the right arm at or below the level of the heart D. Check BP on both right and left arms
B
What assessment finding in a 36 year old patient is most indicative of a need for further evaluation? A. Bilateral breast nodules that are tender with palpation B. A breast nodule that is 1 cm in size, nontender and fixed C. A breast lump that increases in size before the menstrual period D. A breast lump that is small and mobile, with a rubbery consistency
B
What topic should the nurse plan to teach the 26 year old patient who has been treated for pelvic inflammatory disease? A. use of hormone therapy (HT) B. Potential complication of infertility C. irregularities in the menstrual cycle D. changes in secondary sex characteristics
B
What will the nurse plan to teach the patient who is incontinent of urine following a radical retropubic prostatectomy? A. Restrict oral fluid intake B. Do pelvic muscle exercises - kegel C. Perform intermittent self-catheterization D. Use belladonna and opium suppositories
B
Which information will the nurse plan to include when teaching a young adult who has a family history of testicular cancer about testicular self-examination? A. Testicular self-examination should be done at least weekly B. Testicular self-examination should be done in a warm shower C. The only structure normally felt in the scrotal sac is the testis D. Call the HCP if one testis is larger than the other
B
What are contraindications for hormone therapy (HT) with an estrogen patch? (Select all that apply.) A. Decreased bone density B. History of breast cancer C. Impaired liver function D. Sensitive skin E. Undiagnosed abnormal vaginal bleeding F. Weight gain
B C E
A 58 year old woman tells the nurse, "I understand that I have stage 2 breast cancer and I need to decide on a surgery, but I feel overwhelmed. What do you think I should do?" Which response by the nurse is best? A. "I would have a lumpectomy, but you need to decide what is best for you." B. "It would not be appropriate for me to make a decision about your health." C. "Tell me what you understand about the surgical opinions that are available" D. "There is no need to make a decision rapidly; you have time to think about this."
C
The nurse is caring for a patient with breast cancer who is receiving chemo with doxorubicin and cyclophosphamide. Which assessment finding is most important to communicate to the health care provider? A. the patient reports fatigue B. The patient eats only 25% of meals C. The patient's apical pulse is irregular D. the patients white blood cell count is 5000 uL
C
What nursing actions should be included in the plan of care for a patient returning to the surgical unit after a left modified radical mastectomy with dissection of axillary lymph nodes? A. Teach the patient to use the ordered patient-controlled analgesia every 10 minutes B. Obtain a permanent breast prosthesis before the patient is discharged from the hospital C. Post a sign at the bedside warning against venipunctures or blood pressures in the left arm D. Insist that the patient examine the surgical incision when the initial dressings are removed
C
What will the nurse ask the patient about to determine the severity of benign prostatic hyperplasia (BPH) symptoms? A. Blood in the urine B. Lower back or hip pain C. Force of urinary stream D. Erectile dysfunction (ED)
C
A patient who has been diagnosed with stage 2 prostate cancer chooses the option of active surveillance. What should the nurse plan to do? A. Vaccinate the patient with sipuleucel-T (Provenge) B. Provide the patient with information about cryotherapy C. Teach the patient about placement of intraurethral stents D. Schulde the patient for an annual prostate-specific antigen testing
D
Patient has a left sided left lumpectomy (breast-conservation surgery) and an axillary lymph node dissection. Which nursing intervention is appropriate to delegate to a licensed practical/vocational nurse(LPN/LVN)? A. Teaching the patient how to avoid injury to the left arm B. Assessing the patient's range on motion for the left arm C. Evaluating the patient's understanding about drain care D. Giving an analgesic 30 minutes before scheduled arm exercise
D
What information about contours bladder irrigation will the nurse teach to the patient who is being admitted for a transurethral resection of the prostate (TURP)? A. bladder irrigation decreases the risk of postop bleeding B. hydration and urine output are maintained by bladder irrigation C. Antibiotic are infused continuously through the bladder irrigation D. Bladder irrigation prevents obstruction of the catheter after surgery
D
What will the nurse teach a patient with metastatic breast cancer who has a new prescription for trastuzumab? A. Hot flashes may occur with the medication B. Serum electrolyte levels will be drawn monthly C. The patient will need frequent eye examinations D. The patient should call if she notices ankle swelling
D
When caring for a patient with continuous irrigation after having transurethral resection of the prostate, which action could the nurse delegate to unlicensed assistive personnel (UAP)? A. Teach the patient how to perform kegel exercises B. monitor for increases in bleeding or presence of clots C. increase the flowrate of the irrigation if clots are noted D. report any patient reports of pain or spasms
D
patient who has a large cystocele was admitted 10 hours ago but has not yet voided. If the patient reports no urge to void, which action should the nurse take first? A. Insert a straight catheter per the PRN order B. Encourage the patient to increases oral fluids C. Notify the health care provider of the inability to void D. Use a bladder scanner to check for urinary retention
D
What can you as a nurse expect in post-op orders of the patient returning from a TURP?
I&O, give suppository to prevent constipating and bearing down
True/False A non-pregant women is more likey to develop ovarian cancer than a women who has been pregant before?
TRUE
what post-op orders can the nurse anticipate with a patient who had oophroectomy?
ambulaiton, anticoagulant, stocking
when a cancer patient who is starting chemo is taking Doxorubicin what is a MAJOR side effect?
causes heart failure, need to check the ejection fracture before giving
a 45 year old non-menopausal women is receiving chemotherapy Tamoxifen what is a major side effect/
high risk for blood clots - need to take DVT precautions
it is important to teach a male what when receiving Antihormone therapy (ADT)
it blocks testerone so be prepared for mood swings, hot flahses.
What can you tell a women about the diagnosis of ovarian cancer?
it is usually caught late and a sign of it might be "gaining weight" but not physical weight just in like my pants wont button
A menopausal patient is taking an aromatise inhibitor, what is a major side effect to watch for? and how can you prevent it?
osteoporosis. can prevent it by getting routine DEXA scan and increase calcium and vitamin D in diet.
