Adults II: Mod 2: Repro, Ch 50, 51, 52, 53
The nurse is demonstrating the technique for performing a testicular self examination (TSE) to a group of men for a company health fair. One of the men asks the nurse at what age a man should begin performing TSE. What is the best answer by the nurse? "It should begin in adolescence." "It should begin in men over age 50." "It should be performed in high-risk males over age 30." "It should begin at age 40."
"It should begin in adolescence."
A 32-year-old client has been diagnosed with an ovarian cyst and asks the nurse, "Should I be worried about cancer?" Which response by the nurse would be most appropriate? "Ovarian cysts are just that, cysts and not a cause for concern." "Ovarian cysts can be malignant but this is a rare occurrence." "Most cysts are benign in younger women, but it's good to have it checked out." "Since you don't have any symptoms, the chances of having cancer are really remote."
"Most cysts are benign in younger women, but it's good to have it checked out." The risk of malignancy in postmenopausal women is much greater than in premenopausal women, with almost all pelvic masses in premenopausal women being benign. However, although typically benign, the cyst should be evaluated to exclude ovarian cancer.
Which client would the nurse identify as being at highest risk for the development of testicular cancer? A 45-year-old White male with a history of hypertension A 25-year-old male with a history of cryptorchidism A 39-year-old Black male who is HIV-negative A 75-year-old White male with erectile dysfunction
A 25-year-old male with a history of cryptorchidism Testicular cancer is most common in between 15 and 34 years of age and is the leading cause of cancer deaths in men between 25 to 34 years of age. Its incidence is higher in White men and men with a history of cryptorchidism (failure for testes to descend). Other clients at risk are those with a family history of the disease, those who are HIV-positive or have developed AIDS, and those who already have had cancer in one testicle.
Which type of yeast infection is manifested by white, cheese-like discharge? Cervicitis Candidiasis Bacterial vaginosis Trichomoniasis
Candidiasis The discharge of candidiasis may be watery or thick, but has a white, cheese-like appearance. The other disorders do not have a cheese-like appearance.
The nurse is preparing a patient for a gynecologic examination when the patient says, "I hope the exam doesn't hurt as much as intercourse with my husband does." What should the nurse document this finding as? Dysmenorrhea Dyspareunia Dysuria Dysthymia
Dyspareunia
The nurse is relating health education to male students when asked where sperm is actually made. Which location is most correct? In the male reproductive system Sperm are present from birth. In the testes within the scrotum In the seminiferous tubules
In the testes within the scrotum Health instruction should be clear, specific, and factual. The specific location for sperm production is in the testes, which lie in the scrotum. More general information is that the sperm are produced in the male reproductive system and immature spermatozoa are formed in the seminiferous tubules. Sperm are not present from birth.
What is the most common location for breast cancer? Upper outer quadrant of the breast Lower half of the breast Nipple-areola complex Upper inner quadrant of the breast
Upper outer quadrant of the breast Most breast cancers are found in the upper outer quadrant of the breast, where most breast tissues are located.
A client asks the nurse what PSA is. The nurse should reply that it stands for: prostate-specific antigen, which is used to screen for prostate cancer. protein serum antigen, which is used to determine protein levels. pneumococcal strep antigen, which is a bacteria that causes pneumonia. Papanicolaou-specific antigen, which is used to screen for cervical cancer.
prostate-specific antigen, which is used to screen for prostate cancer.
The nurse is seeing a client who has been told her Papanicolaou smear results are abnormal. The client states, "I can't believe I have cancer." What is the nurse's best response? "Most of the time there has been a mistake in the cell sample." "Cervical cancer has a very good prognosis." "You were probably menstruating when the sample was taken." "Abnormal results happen for many different reasons, not just cancer."
"Abnormal results happen for many different reasons, not just cancer." The difference could be due to local irritation, a non- HPV, infection, a low-risk or high-risk HPV type, or even a mistake in the preparation of the cell sample. In this case, the best response from the nurse is to tell the client there are many different reasons for an abnormal result. The next step would be to refer the client on for follow up diagnostic testing.
A client is being treated for trichomoniasis. The client has received instructions about the prescribed drug therapy. The nurse determines that the client needs additional teaching when she states which of the following? "I might notice a metallic taste in my mouth while I'm taking the drug." "I need to avoid drinking any alcohol with this drug." "My partner will not need any treatment." "I need to take the medication three times a day for a week."
"My partner will not need any treatment." Trichomoniasis is treated with metronidazole. Both partners are treated and receive a one-time loading dose or smaller dose three times a day for a week. The client may experience a transient metallic taste when taking the drug. Clients are strongly advised to abstain from alcohol when taking metronidazole because of a possible disulfiram-like reaction.
A client with challenging menopausal symptoms has discussed treatment options with the physician and now has some questions for the nurse. The client asks, "What are the potential risks of hormone replacement therapy?" What is the best answer? All options are correct. breast cancer stroke (CVA) heart disease
All options are correct. In using hormonal replacement therapy, the risks of breast cancer and the seriousness of future myocardial infarction and stroke may outweigh the potential benefit of alleviating symptoms associated with menopause. The Women's Health Initiative study revealed an increase in breast cancer, blood clots, stroke, and heart disease in postmenopausal women taking HRT.
The nurse is obtaining a history from a male client who states having difficulty achieving and sustaining an erection. When reviewing the medication history, which medication classification does the nurse anticipate? Bronchodilators Antihypertensives Cardiac dysrhythmics Antibiotics
Antihypertensives Due to the therapeutic effect of antihypertensive medications decreasing blood pressure, the nurse is correct to anticipate a side effect of a male client having difficulty achieving or sustaining an erection. The other medication classifications do not typically have an effect on the male reproductive system.
Which condition is a downward displacement of the bladder toward the vaginal orifice? Rectocele Cystocele Vulvodynia Fistula
Cystoce;e A cystocele results from damage to the anterior vaginal support structures. A rectocele is a bulging of the rectum into the vagina. Vulvodynia is a painful condition that affects the vulva. A fistula is an abnormal opening between two organs or sites.
Which age-related change affects the male reproductive system? Increased prostate secretion Decreased plasma testosterone levels Testes become soft Increased patency
Decreased plasma testosterone levels Changes in gonadal function include a decline in plasma testosterone levels and reduced production of progesterone. The testes become smaller and more firm.
A female patient comes to the clinic with the complaint that she is having a greenish-colored discharge from the nipple and the breast feels warm to touch. What does the nurse suspect these symptoms may indicate? Infection Cancer A ruptured cyst Blocked lymph duct
Infection A green discharge could indicate an infection. Any discharge that is spontaneous, persistent, or unilateral is of concern. Although bloody discharge can indicate a malignancy, it is often caused by a benign wart-like growth on the lining of the duct called an intraductal papilloma.
A client is considering breast augmentation. Which of the following would the nurse recommend to the client to ensure that there are no malignancies? Mammogram Mastopexy Ultrasound Breast biopsy
Mammogram When caring for a client considering breast augmentation, the nurse should provide her with a general guideline to have a mammogram to verify that there are no malignancies. Mastopexy involves a breast lift for drooping breasts. Ultrasound or breast biopsy would not be necessary unless there was evidence of a problem.
A client has a history of dysmenorrhea. During monthly menses, the client experiences incapacitating cramping and passes large clots. The client's primary care physician initiates conservative treatment. What interventions would the physician to recommend? NSAIDs ultrasonography corticosteroids oral hypoglycemia agents
NSAIDs Dysmenorrhea is treated with mild non-narcotic analgesics and by treating the underlying cause if one is identified. Symptomatic relief is accomplished with NSAIDs, which reduce prostaglandins. Prostaglandins are biologic chemicals that exist in endometrial tissue, where they exert a stimulating effect on the uterus, producing cramping and pain.
A client comes to the emergency department complaining of sudden, sharp testicular pain. Further examination reveals torsion of the spermatic cord. Which of the following would the nurse expect to do next? Apply a scrotal support Prepare the client for surgery Apply a dressing over the scrotum Prepare the client for circumcision
Prepare the client for surgery For the client with torsion, immediate surgery is necessary to prevent atrophy of the spermatic cord and preserve fertility. Analgesics would be given preoperatively. Postoperatively, a scrotal support is applied and dressings are inspected for drainage. Circumcision is done to relieve phimosis or paraphimosis.
When developing an educational program for a group of adolescents about sexually transmitted infections (STIs), what should the nurse inform the group about the single greatest risk factor for contracting an STI? The type of contraception used The number of times the person has contact with a partner The number of sexual partners Where the patient lives
The number of sexual partners
Which treatment involves implantation of interstitial radioactive seeds under anesthesia to treat prostate cancer? Hormone therapy Brachytherapy Teletherapy Chemotherapy
Brachytherapy Brachytherapy involves the implantation of interstitial radioactive seeds under anesthesia. Hormone therapy for advanced prostate cancer suppresses androgenic stimuli to the prostate by decreasing the level of circulating plasma testosterone or interrupting the conversion to or binding of DHT. Teletherapy involves 6 to 7 weeks of daily radiation treatments. High-dose ketoconazole (HDK) lowers testosterone through its abilities to decrease both testicular and endocrine production of androgen.
Which is inconsistent with a digital rectal examination (DRE)? Recommended for men older than 50 years of age Assists in screening for cancer of prostate gland Enables examiner to assess size, shape, and consistency of prostate gland Can reveal a hydrocele
Can reveal a hydrocele DRE is recommended as part of the regular health checkup for every man older than 50 years of age. It is a screening for cancer of the prostate gland. It enables the examiner to assess the size, shape, and consistency of the prostate gland. (A hydrocele is a type of swelling in the scrotum that occurs when fluid collects in the thin sheath surrounding a testicle, resolves on it's own, common in newborns)
A woman comes to the clinic complaining of vaginal itching and a discharge. Inspection reveals a thick curd-like white discharge. The nurse suspects which of the following? Candida infection Bacterial vaginosis Trichomonas infection Atrophic vaginitis
Candida infection Complaints of vaginal itching with a thin to thick, curd-like white vaginal discharge suggests a Candida (yeast) infection. Bacterial vaginosis would be manifested by a discharge that is thin and grayish or yellow with a fishy odor. Trichomonas infection is manifested by a malodorous, copious, often frothy yellow-green vaginal discharge. Atrophic vaginitis is manifested by vulvar or vaginal dryness with a scant, often mucoid, but possibly blood-tinged vaginal discharge.
A patient who is scheduled for a gynecologic examination and Pap smear informs the nurse that she just began her menstrual cycle. What is the best response by the nurse? "This will have no bearing on your test today." "We will proceed with the examination and reschedule your Pap smear for next week." "We will reschedule your examination when you have finished menstruating." "We will do the test and take into consideration that you are menstruating."
"We will reschedule your examination when you have finished menstruating." The nurse should not obtain a Papanicolaou (Pap) smear if the woman is menstruating or has other frank bleeding; the examination should be rescheduled to after her menstruation.
A client who has undergone a surgical biopsy of a suspected breast lesion is being prepared for discharge from the ambulatory surgical center. The client is alert and oriented. Which criterion would be of least importance in determining her readiness for discharge? Having a bowel movement Being able to ambulate Voiding an adequate amount of urine Tolerating fluids by mouth
Having a bowel movement For the client to be discharged, she must be able to tolerate fluids, ambulate, and void. Bowel movements would not determine the woman's readiness for discharge.
Which of the following may result if prostate cancer invades the urethra or bladder? Hematuria Backache Hip pain Rectal discomfort
Hematuria Hematuria may result if the cancer invades the urethra or bladder. Symptoms related to metastases include backache, hip pain, perineal and rectal discomfort, anemia, weight loss, weakness, nausea, and oliguria.
Which test is an x-ray study of the uterus and the fallopian tubes after injection of a contrast agent? Laparoscopy Hysterosalpingography Hysteroscopy Endometrial ablation
Hysterosalpingography Hystero = uterus salpingo = fallopian tubes graphy = writing/picture
Which term refers to breast pain? Mastitis Mastalgia Gynecomastia Mammoplasty
Mastalgia Mastalgia refers to breast pain. Mastitis is an inflammation or infection of the breast. Gynecomastia refers to overdeveloped breast tissue typically seen in adolescent boys. Mammoplasty refers to a surgical procedure to reconstruct or change the size or shape of the breast.
The nurse is about to begin conducting a pelvic examination of a client. The client reports having lower back and hip pain anytime she has to lie on her back. What is the best way for the nurse to proceed with the examination? Ask the client to lie on her left side with the right leg bent Remind the client the examination will take 5 minutes or less Tell the client is not possible to conduct the bimanual examination Ask the client to reschedule the appointment for another time
Ask the client to lie on her left side with the right leg bent AKA Sims Position The nurse can inform the client it may take longer or feel differently than it would if she was lying on her back. The presence of a disability does not justify skipping any part or all of the pelvic examination, which is included in the physical assessment.
During a breast examination, which finding most strongly suggests that a client has breast cancer? Slight asymmetry of the breasts A fixed nodular mass with dimpling of the overlying skin Bloody discharge from the nipple Multiple firm, round, freely movable masses that change with the menstrual cycle
A fixed nodular mass with dimpling of the overlying skin A fixed nodular mass with dimpling of the overlying skin is common during late stages of breast cancer. Many women have slightly asymmetrical breasts. Bloody nipple discharge is a sign of intraductal papilloma, a benign condition. Multiple firm, round, freely movable masses that change with the menstrual cycle indicate fibrocystic breasts, a benign condition.
A patient is planning to use a negative-pressure (vacuum) device to maintain and sustain an erection. What should the nurse caution the patient about with the use of this device? Do not use the device while taking nitrates. Do not leave the constricting band in place for longer than 1 hour to avoid penile injury. Watch for erosion of the prosthesis through the skin. Watch for the development of infection.
Do not leave the constricting band in place for longer than 1 hour to avoid penile injury. Negative-pressure (vacuum) devices may also be used to induce an erection. A plastic cylinder is placed over the flaccid penis, and negative pressure is applied. When an erection is attained, a constriction band is placed around the base of the penis to maintain the erection.
A nurse is teaching a client about a circumcision. Which external reproductive structure is removed by circumcision? Prepuce Glans Corpora cavernosa Mons pubis
Prepuce In an uncircumcised male, the prepuce, sometimes referred to as the foreskin, that covers the glans is removed by circumcision. The glans is the rounded head of the penis. The corpora cavernosa is erectile tissue. The mons pubis is fatty tissue near the pubic bones.
A patient is scheduled for a transurethral resection (TUR). The nurse is aware that a disadvantage of this surgical approach is: Recurrent urethral obstruction. Possible damage to the external sphincter. Increased hemorrhage from the prostatic venous plexus. A high incidence of impotence.
Recurrent urethral obstruction. There are six operative procedures for prostatic disorders. Recurrent urethral obstruction is a disadvantage of a TUR or TURP. The other disadvantages refer to other surgeries. Refer to Table 34-4 in the text.
The obstructive and irritative symptom complex caused by benign prostatic hypertrophy is called: prostatitis. prostatism. prostaglandin. prostatectomy.
prostatism Symptoms of prostatism include increased frequency of urination, nocturia, urgency, dribbling, and a sensation that the bladder has not completely emptied. Prostatitis is an inflammation of the prostate gland. Prostaglandins are physiologically active substances present in tissues with vasodilator properties. Prostatectomy refers to the surgical removal of the prostate gland.
A client is scheduled for a transurethral resection of the prostate (TURP). Which statement demonstrates that the expected outcome of "client demonstrates understanding of the surgical procedure and aftercare" has been met? "I'll have to stay in the hospital for about 3 to 4 days after the surgery." "I'll have a small incision on my lower abdomen after the procedure." "The surgeon is going to remove the entire prostate gland." "The surgeon is going to insert a scope through my urethra to remove a portion of the gland."
"The surgeon is going to insert a scope through my urethra to remove a portion of the gland." TURP involves the surgical removal of the inner portion of the gland through an endoscope inserted through the urethra. There is no external skin incision. Typically, the procedure is performed in an outpatient setting but may require an overnight hospital stay.
The nurse is conducting a health history when a middle-aged client states that her last menstrual period was 6 months ago. Upon further questioning, the client also states that symptoms of hot flashes and mood fluctuations. Which question should the nurse ask next? "Do you feel like hurting yourself?" "Are you finished having children?" "When was your first menstrual period?" "Are you taking any hormone replacement therapy?"
"Are you taking any hormone replacement therapy?" To ensure a thorough health history, a client who exhibits symptoms of perimenopause should be assessed for the use of hormone replacement therapy to alleviate the symptoms. This information adds to the data reported by the client. Asking if the client feels like hurting herself may be extreme with the report of mood fluctuations. Asking if the client is finished having children produces little additional data. Asking the first menstrual period is part of the health history but not the best question to ask after the client's statement.
A male client being discharged after having an acute myocardial infarction asks why the health care provider omitted a prescription for sildenafil. Which response will the nurse make? "It must have been accidentally omitted." "The medication cannot be taken for at least 6 months." "I will ask for the prescription before you leave the hospital." "You can ask for the prescription when you have your follow-up appointment."
"The medication cannot be taken for at least 6 months." Sildenafil is a medication used to treat erectile dysfunction. It is contraindicated if the client has had a myocardial infarction within the past 6 months. The prescription was not accidentally omitted and the nurse will not be able to get the prescription for the client before leaving the hospital. The client will not be given the prescription if the appointment is within 6 months following the myocardial infarction.
A client reports loss of interest in sexual relations and discomfort during intercourse. Which is the best response by the nurse? "Don't worry, every woman goes through this." "These are normal, manageable symptoms of menopause." "You need to discuss this with your spouse." "Hormone replacement therapy can resolve your symptoms."
"These are normal, manageable symptoms of menopause." Diminished libido and/or dyspareunia are common symptoms associated with perimenopause. Explaining that this can be a normal finding may help to alleviate worries for the client and provide hope for management of the symptoms. The nurse should avoid telling a client "not to worry" or "talk to someone else" because these can negate client feelings and shut down communication. HRT may not be recommended for this client.
A client with erectile dysfunction is prescribed sildenafil (Viagra). Which of the following would the nurse include in the teaching plan for this client? "You need to take this medication throughout the day to be effective." "The effects of this medication usually last for up to 48 hours." "You may experience headache and some flushing with this drug." "Your blood glucose level might increase when you take this drug."
"You may experience headache and some flushing with this drug." Sildenafil (Viagra) may cause headache, flushing, dyspepsia, diarrhea, nasal congestion, and lightheadedness. It is taken 30 minutes to 4 hours before sexual activity. It can be taken more than once a day, but doing so will not increase its effect. It should be taken only when the client wants to have intercourse, to a maximal dose of 100 mg/24 hours. The drug may cause low blood glucose levels and abnormal liver function tests.
A group of students are reviewing material in preparation for a test on the male and female breasts. The students demonstrate understanding of the material when they identify which of the following? The breasts contain a limited supply of blood vessels. Progesterone is primarily responsible for the growth of breast tissue. Striated muscle in the nipples contract causing them to become erect. A primary function of the female breast is to produce milk.
A primary function of the female breast is to produce milk. A primary function of the female breast is to produce milk, a process called lactation. The breasts contain an abundant supply of blood vessels and lymphatics. Estrogen is the hormone primarily responsible for the growth and development of breast tissue. Smooth muscle in the nipples contracts, causing them to become erect when cold, touched, or sexually stimulated.
A client is undergoing treatment for prostate cancer. He has chemotherapy sessions regularly. However, of late he is showing symptoms of food allergy and loss of appetite. He has lost considerable weight as a result. Which is an appropriate nursing task in this situation? Ensure greater fluid intake. Ask the client to keep a diet diary. Include fruits in the client's diet. Administer serotonin blockers.
Ask the client to keep a diet diary. The appropriate nursing task in this situation is to assess the amount of food eaten. This assessment will help determine nutrient intake. The nurse should ensure adequate fluid hydration before, during, and after drug administration when the client has side effects of nausea and vomiting. Administration of fruits is not recommended when the client is at risk of infection, such as during chemotherapy. Serotonin blockers are administered to control nausea and vomiting.
After teaching a group of students about the signs and symptoms of breast cancer, the instructor determines that additional teaching is needed when the group identifies which of the following? Peau d'orange skin Breast symmetry Nipple retraction Painless mass
Breast symmetry The primary sign of breast cancer is a painless mass in the breast. Other signs of breast cancer include a bloody discharge from the nipple, a dimpling of the skin over the lesion, retraction of the nipple, peau d'orange (orange peel) appearance of the skin, and a difference in size between the breasts.
The nurse is discussing nutritional needs for a postmenopausal patient. What dietary increase should the nurse recommend to the patient? Calcium Iron Salt Vitamin K
Calcium Postmenopausal women should be encouraged to observe recommended calcium and vitamin D intake, including calcium supplements, if indicated, to slow the process of osteoporosis. Iron and vitamin K need not be increased unless there are signs of deficiency. Salt should be eaten in moderation, not increased, to prevent hypertension.
A nurse working in a gynecologist's office reviews breast self-examination (BSE) with a patient and explains the difference between a breast fibroadenoma and a malignancy. Which of the following characteristics associated with a malignancy are most descriptive of this type of mass? Select all that apply. In a cluster, not singular Irregular in shape Round and lobular Fixed to the skin Associated with signs of retraction
Irregular in shape Fixed to the skin Associated with signs of retraction
After teaching a group of students about erectile dysfunction, the instructor determines that the teaching was successful when the students identify which of the following as true? Erectile dysfunction is unrelated to anxiety or depression. Erectile dysfunction is primarily a normal response to aging. Erectile dysfunction may be due to testosterone insufficiency. Erectile dysfunction rarely occurs in clients with diabetes mellitus.
Erectile dysfunction may be due to testosterone insufficiency. Common causes of erectile dysfunction include neurologic disorder like spinal cord injury, perineal trauma, testosterone insufficiency, side effects of drug therapy such as antihypertensives or antidepressants, atherosclerosis, hypertension, and complications of diabetes mellitus. Erectile dysfunction may be related to anxiety or depression. It is not a normal aspect of aging.
A client is ordered continuous bladder irrigation at a rate of 60 gtt/minute. The nurse hangs a 2 L bag of sterile solution with tubing on a three-legged IV pole. She then attaches the tubing to the client's three-way urinary catheter, adjusts the flow rate, and leaves the room. Which important procedural step did the nurse fail to follow? Evaluating patency of the drainage lumen Counter-balancing the I.V. pole Attaching the infusion set to an infusion pump Collecting a urine specimen before beginning irrigation
Evaluating patency of the drainage lumen If the lumen is obstructed, the solution infuses into the bladder but isn't eliminated through the drainage tubing, a situation that may cause client injury. Balancing the pole is important; however, the nurse would have had to address this issue immediately after hanging the 2 L bag. Using an I.V. pump isn't necessary for continuous bladder irrigation. Unless specifically ordered, obtaining a urine specimen before beginning continuous bladder irrigation isn't necessary.
A nurse is teaching a male client who is older than 50 years about prostate cancer. What teaching should be included by the nurse? Have a digital rectal examination. Have a transrectal ultrasound every 5 years. Perform monthly testicular self-examinations, especially after age 50. Have a complete blood count, blood urea nitrogen, and creatinine levels checked yearly.
Have a digital rectal examination. A serum prostate-specific antigen level test and a digital rectal exam, which are recommended by the American Cancer Society, are used to screen for prostate cancer in men with at least a 10-year life expectancy and for men at high risk, including those with a strong family history of prostate cancer and those of African American ethnicity. Testicular self-examinations won't identify changes in the prostate gland because of its location in the body. A transrectal ultrasound, complete blood count, blood urea nitrogen, and creatinine level test are usually done after diagnosis to identify the extent of the disease and potential metastasis.
The nurse is preparing a presentation for a local community group about prostate cancer and possible dietary risk factors. Which of the following would the nurse most likely include? High-iron High-calorie High fiber High-fat diet
High-fat diet Although the cause of prostatic cancer is unknown, there seems to be a relationship with increased testosterone levels and a diet high in fat. No other dietary links have been suggested.
Hormone therapy decreases the risk of hot flashes. stroke. heart attack. blood clots.
Hormone therapy decreases the risk of hot flashes. It increases the risk of stroke, heart attack, and blood clots.
While caring for a client who is being treated for severe pelvic inflammatory disease (PID), which nursing action minimizes transmission of infection? Strictly adhering to the no visitation policy Implementing reverse isolation precautions Performing hand hygiene when entering the room Keeping the client in a sitting position
Performing hand hygiene when entering the room While caring for a client hospitalized with PID, the nurse has to reduce the risk of the spread of pathogenic microorganisms. Meticulous hand hygiene minimizes the transmission of infection. There is no reason to restrict visitors in this situation; however, visitors need to be educated in proper hand hygiene. Reverse isolation is not indicated for this client. A sitting position will not aid in preventing nosocomial infections.
A patient is suspected to have prostate cancer related to observed clinical symptoms. What definitive test can the nurse assist with to confirm a diagnosis of prostate cancer? DRE PSA Prostate biopsy Cystoscopy
Prostate biopsy If prostate cancer is detected early, the likelihood of cure is high (Eggert, 2010). It can be diagnosed through an abnormal finding with the digital rectal examination (DRE), serum prostate-specific antigen (PSA), and ultrasound-guided transrectal ultrasound (TRUS) with biopsy. Detection is more likely with the use of combined diagnostic procedures. The diagnosis of prostate cancer is confirmed by a histologic examination of tissue removed surgically by transurethral resection of the prostate (TURP), open prostatectomy, or ultrasound-guided transrectal needle biopsy.
At a follow-up visit, the client is informed that her breast cancer has recurred. The nurse knows that which situation places the client at risk for developing bone metastases? Aggressive treatment, including surgery, radiation, and hormonal therapy Recurrence within 2 years of the original diagnosis No maternal family history of breast cancer Previous therapeutic response to chemotherapy
Recurrence within 2 years of the original diagnosis Local recurrence may be an indicator that systemic disease will develop in the future, particularly if it occurs within 2 years of the original diagnosis. Local recurrence in the absence of systemic disease is treated aggressively with surgery, radiation, and hormonal therapy. Overall prognosis and optimal treatment are determined by a variety of factors such as the time to recurrence from the original diagnosis and treatment history.
A nurse is obtaining health history from a young adult woman. Which of the following would alert the nurse to a possible problem? Age of 13 years at menarche Menstrual cycle averaging 28 to 29 days Reports of dyspareunia Mucus-like vaginal discharge
Reports of dyspareunia Dyspareunia, or pain with intercourse, is an abnormal finding associated with numerous potential problems. Onset of menarche is usually between 12 to 14 years but could be as early as age 10 or 11 years. The menstrual cycle typically averages 28 days but it can vary from 21 to 42 days. A mucus-like vaginal discharge is normal.
A perimenopausal woman informs the nurse that she is having irregular vaginal bleeding. What should the nurse encourage the patient to do? Stop taking her Premarin (hormonal therapy). See her gynecologist as soon as possible. Disregard this phenomenon because it is common during this life stage. Mention it to her physician during her next annual examination.
See her gynecologist as soon as possible. All women should be encouraged to have annual checkups, including a gynecologic examination. Any woman who is experiencing irregular bleeding should be evaluated promptly.
A young client who awoke with sudden, severe testicular pain with edema arrives at the ED unable to walk and nauseated. After examination, what treatment would the physician likely order? surgery oral anti-inflammatory medications application of heat elevation of testes
Surgery In spermatic cord torsion, immediate surgery is necessary to prevent atrophy of the spermatic cord and preserve fertility.
Which should be included as part of the home care instructions for a client with epididymitis and orchitis? Take prescribed antibiotics Undertake lifting exercises Apply ice to the area after scrotal swelling subsides Resume sexual intercourse
Take prescribed antibiotics Home care for a client with epididymitis and orchitis includes instructions to continue administering prescribed antibiotics and to take Sitz baths, apply local heat after scrotal swelling subsides, avoid lifting, and refrain from sexual intercourse until symptoms are relieved.
A patient comes to the emergency department and tells the nurse, "I took a pill to help me perform and then passed out." The nurse is assessing the patient and finds a nitroglycerin patch on his back. What is the first intervention the nurse must perform? Take the patient's blood pressure. Ask the patient to obtain a urine specimen. Start an IV. Administer atropine 0.5 mg.
Take the patient's blood pressure Based on the patient's comments, he is most likely taking a phosphodiesterase type 5 (PDE-5) inhibitor, which is an oral medication used to treat erectile dysfunction. The most common side effects of this medication include headache, flushing, dyspepsia, diarrhea, nasal congestion, and lightheadedness. These agents are contraindicated in men who take organic nitrates (e.g., isosorbide [Isordil], nitroglycerin), because taken together, these medications can cause side effects such as severe hypotension.
A nurse is teaching a male client to perform monthly testicular self-examinations. Which point is appropriate to make? Testicular cancer is a highly curable type of cancer. Testicular cancer is very difficult to diagnose. Testicular cancer is the number one cause of cancer deaths in males. Testicular cancer is more common in older men.
Testicular cancer is a highly curable type of cancer. Testicular cancer is highly curable, particularly when it's treated in its early stage. Self-examination allows early detection and facilitates the early initiation of treatment. The highest mortality rates from cancer among men are in men with lung cancer. Testicular cancer is found more commonly in younger, not older, men.
Which client has the highest risk of ovarian cancer? 30-year-old woman taking hormonal contraceptives 36-year-old woman who had her first child at age 22 40-year-old woman with three children 45-year-old woman who has never been pregnant
The incidence of ovarian cancer increases in women who have never been pregnant, are older than age 40, are infertile, or have menstrual irregularities. Other risk factors include a family history of breast, bowel, or endometrial cancer. The risk of ovarian cancer is reduced in women who have taken hormonal contraceptives, have had multiple births, or have had a first child at a young age.
The nurse is caring for a client who is ordered a sentinel lymph node biopsy. The physician explained the procedure and desired outcome. Which statement, made by the client, indicates a need for further instruction? The procedure allows for an understanding of the spread of cancer cells. The procedure allows for conservation of breast tissue. The procedure removes all cancer from the body. The procedure includes minimal surrounding tissue damage.
The procedure removes all cancer from the body. Sentinel lymph node mapping involves identifying the first (sentinel) lymph nodes through which the breast cancer cells would spread to regional lymph nodes in the axilla. Validating the lack of lymph node metastasis allows the surgeon to preserve more breast tissue, axillary tissue and chest muscle. Further instruction would be needed to explain that the sentinel lymph node biopsy does not remove cancer from the body.
A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client? This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually. The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days. The potential for transmission to her sexual partner will be eliminated if condoms are used every time she and her partner have sexual intercourse. The human papillomavirus (HPV), which causes condylomata acuminata, can't be transmitted during oral sex.
This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually. Women with condylomata acuminata are at risk for cancer of the cervix and vulva. Yearly Pap smears are very important for early detection. Because condylomata acuminata is a virus, there is no permanent cure. Because condylomata acuminata can occur on the vulva, a condom won't protect sexual partners. HPV can be transmitted to other parts of the body, such as the mouth, oropharynx, and larynx.
A group of students are reviewing the anatomy and physiology of the breasts. The students demonstrate understanding of breast structure when they identify the tail of Spence as an extension of which quadrant? Upper outer Upper inner Lower outer Lower inner
Upper outer The tail of Spence is an area of breast tissue that extends from the upper outer quadrant of the breast into the axilla.
A client underwent a transurethral resection of the prostate gland 24 hours ago and is on continuous bladder irrigation. Which nursing intervention is appropriate? Tell the client to try to urinate around the catheter to remove blood clots. Restrict fluids to prevent the client's bladder from becoming distended. Prepare to remove the catheter. Use sterile technique when irrigating the catheter.
Use sterile technique when irrigating the catheter. If the catheter is blocked by blood clots, it may be irrigated according to physician's orders or facility protocol. The nurse should use sterile technique to reduce the risk of infection. Urinating around the catheter can cause painful bladder spasms. The nurse should encourage the client to drink fluids to dilute the urine and maintain urine output. The catheter remains in place for 2 to 4 days after surgery and is removed only with a physician's order.
A client who has cervical cancer is scheduled to undergo internal radiation. In teaching the client about the procedure, the nurse should tell the client that: she will be in a private room with unrestricted activities. a bowel-cleansing procedure will precede radioactive implantation. she will be expected to use a bedpan for urination. the preferred position in bed will be semi-Fowler's.
a bowel-cleansing procedure will precede radioactive implantation. The nurse should tell the client that she'll receive an enema before the procedure because bowel motility during cervical radiation implant therapy can disrupt or dislodge the implants. The client will be in a private room, but activities will be restricted to keep the implants in place. To keep the bladder empty, an indwelling catheter will be used. Positioning in bed shouldn't exceed a 20-degree elevation because sitting up can cause the implants to move from their intended locations. Semi-Fowler's position is 45 degrees.
x The nurse monitors a male client for symptoms of urethral strictures following a transurethral resection of the prostate (TURP) for the treatment of prostate cancer. (SATA) Client symptoms indicative of this complication that the nurse monitors for following a TURP include: fever erectile dysfunction dysuria straining a weak urinary stream
dysuria straining a weak urinary stream