Exam 4

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?

"We will reschedule your examination when you have finished menstruating."

Which nursing question is essential when caring for a client prior to a pelvic examination?

"Would you like to void at this time?"

Which client has the highest risk of ovarian cancer?

45-year-old woman who has never been pregnant

Several male clients are scheduled to come to the clinic for an annual physical examination. The nurse would expect to prepare which client for a digital rectal examination (DRE)?

A 52-year-old man in good health

The nurse working on the postoperative unit receives a report on various clients. Based on the information provided, whom should the nurse see first?

A 67-year-old male patient recovering from a prostatectomy, with a potassium level of 4.0 mEq/L and a serum sodium level of 130 mEq/L. Vital signs are temperature 99.2°F, pulse 88, respirations 22, and blood pressure 156/92.

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?

A primary function of the female breast is to produce milk.

While obtaining the history, a client reports that her mother was treated with diethylstilbestrol (DES) during her pregnancy. The nurse determines that this client is at risk for which of the following?

Cervical cancer

A client has returned to the floor after undergoing a transurethral resection of the prostate (TURP). The client has a continuous bladder irrigation system in place. The client reports bladder spasms. What is the most appropriate nursing action to relieve the discomfort of the client?

Administer a smooth-muscle relaxant as ordered.

The client with pelvic inflammatory disease (PID) is to receive broad-spectrum antibiotic therapy. Which of the following would the nurse least likely expect to administer?

Amoxicillin

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?

Ask the client to keep a diet diary.

Which is inconsistent with a digital rectal examination (DRE)?

Can reveal a hydrocele

During a routine office visit, a client mentions difficulty maintaining an erection. While reviewing the client's medical history, the nurse notes the client's medication history. Which medication would the nurse interpret as a potential cause of erectile dysfunction? Select all that apply.

Clonidine Lorazepam Nadolol Fluoxetine

A nurse practitioner is conducting a history and physical on a 42-year-old woman. One of the questions asked of someone in this age group is the type of medications that the patient's mother took during her pregnancy. The nurse is assessing for a past history of ______ use.

Diethylstilbestrol

When a female client reports profuse purulent discharge, dysuria, and bleeding, the advance practice nurse is most likely to prescribe which medication to treat this condition?

Doxycycline for 1 week

A client diagnosed with breast cancer has developed neutropenia secondary to chemotherapy. Which of the following would the nurse anticipate as being ordered to address the neutropenia? Select all that apply.

Filgrastim Pegfilgrastim

A 48-year-old man recently diagnosed with benign prostatic hyperplasia (BPH) reports consuming <i>Serenoa repens</i> (saw palmetto berry). The nurse needs to intervene if the physician orders which treatment?

Finasteride

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

The nurse is obtaining a medication history from a client who is reporting erectile dysfunction. Which medication would the nurse identify as being least likely to contribute to the client's condition?

Ibuprofen

A 42-year-old man has come to the clinic for an annual physical. The nurse notes in the client's history that his father was treated for breast cancer. What should the nurse provide to the client before he leaves the clinic?

Instructions about breast self-examination (BSE)

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.

Irregular in shape Fixed to the skin Associated with signs of retraction

The nurse reports to work an evening shift on the postsurgical unit. Based on the information received before beginning the shift, which client does the nurse need to see first?

June, 2 days after abdominal surgery, reports chest discomfort. June's vital signs are temperature, 99.4°F, pulse 98, respirations 12, and blood pressure 140/86.

The nurse recognizes which statement as accurately reflecting a risk factor for breast cancer?

Mother affected by cancer before 60 years of age

A client is receiving adjuvant chemotherapy for breast cancer. Which is most likely her node status and tumor size?

Node negative, tumor size 1.2 cm

A 49-year-old woman reports that her last known menstrual cycle occurred over 1 year ago. Her records indicate gravida 0, para 0. Upon further review of the chart, the nurse notes that the client has a positive maternal history of hypertension. Moreover, the client has a positive paternal history of diabetes. With no additional significant history noted, which of the nurse's findings is consistent as a risk factor for breast cancer for this client?

Nulliparity

A client with breast cancer is receiving chemotherapy as part of the treatment plan. The client develops neutropenia and is scheduled to receive pegfilgrastim (Neulasta). The nurse would expect this drug to be given at which time?

Once, approximately 24 hours after chemotherapy

A 59-year-old African American man has opted for hormonal androgen deprivation therapy (ADT) to treat his prostate cancer. Which surgical procedures is the client most likely to undergo?

Orchiectomy

Following morning hygiene of an elderly client, the nurse is unable to replace the retracted foreskin of the penis. Which is the most likely outcome?

Painful swelling

A client who is to have a pelvic examination has a disability that interferes with her ability to place her feet on the foot rests of the examination table. The nurse would assist the client to assume which position?

Sims

Report this Question Following a radical vulvectomy, the nurse is preparing the client for discharge to home. Which care intervention would be considered the priority for this client?

Prevention of wound complications

Ovulation occurs midway between days 17 and 22 (usually at day 14) in a normal 28-day menstrual cycle. Conception occurs during ovulation. If an egg is fertilized, this hormone will continue to be produced to protect the egg until the placenta takes over. Which of the following is the correct hormone?

Progesterone

A nurse is employed by a fertility clinic. Diagnostic testing is being completed to determine the source of the male not producing viable sperm to enable ovum fertilization. Which male structures does the nurse consider if the problem is narrowed to sperm survivability?

Prostate gland

The nurse is working with a couple who is being evaluated for infertility. What nursing intervention would be most appropriate for this couple's likely needs?

Referring them to appropriate community resources

A 51-year-old woman is experiencing perimenopausal symptoms and expresses confusion around the possible use of hormone therapy (HT). She explains that her mother and aunts used HT and she is unsure why few of her peers have been prescribed this treatment. What should the nurse explain to the client?

Research has shown that significant health risks are associated with HT.

A 55-year-old client with a history of type 1 diabetes presents at the clinic reporting erectile dysfunction. The physician prescribes tadalafil to be taken 1 hour before sexual intercourse. The nurse reviews the client's history prior to instructing the client on the use of this medication. What disorder will contraindicate the use of tadalafil?

Retinopathy

The nurse is caring for a client with a diagnosis of vulvar cancer who has returned from the PACU after undergoing a wide excision of the vulva. How should this client's analgesic regimen be best managed?

Scheduled analgesia should be administered around-the-clock to prevent pain.

The student nurse studying the male reproductive tract demonstrates understanding movement of testicular secretions when they exit the penis by selecting which pathway?

Seminiferous tubules, epididymis, vas deferens, ejaculatory duct

Which nursing diagnoses may be appropriate for a client with prostate cancer? Select all that apply.

Sexual dysfunction Anxiety Readiness for enhanced knowledge

A nurse is developing a plan of care for a client with gonorrhea who has presented at the clinic. The nurse should include what in the care plan for this client?

The client should also be treated for chlamydia.

A female client is diagnosed with carcinoma in situ of the endometrium. The nurse interprets this as which of the following?

The malignancy is localized.

A client with breast cancer is scheduled to undergo chemotherapy with aromatase inhibitors. Which of the following best reflects the rationale for using this group of drugs?

They lower the level of estrogen in the body blocking the tumor's ability to use it.

Which assessment finding would create the greatest risk to a client ordered a phosphodiesterase inhibitor such as sildenafil?

Use of nitrates

A client is undergoing a diagnostic workup for suspected testicular cancer. When obtaining the client's history, the nurse checks for known risk factors for this type of cancer. Testicular cancer has been linked to:

cryptorchidism.

A client who is postoperative day 12 and recovering at home following a laparoscopic prostatectomy has reported that he is experiencing occasional "dribbling" of urine. How should the nurse best respond to this client's concern?

inform the client that urinary control is likely to return gradually.

During the health history, a client informs the nurse that the client's mother was prescribed DES early in her pregnancy for the client. The nurse must stress the need for frequent gynecological examinations for this client in order to:

prevent the onset of cervical cancer.

The nurse has identified the following nursing diagnosis on the plan of care for a client who has undergone breast cancer surgery: Disturbed sensory perception related to nerve irritation in the affected breast area. Which of the following indicates that the outcome has been achieved?

Client states that feeling in her breast area will gradually subside with time.

A client has been diagnosed with epididymitis after examination and diagnostic tests. What treatments would the nurse expect the healthcare provider to order? Select all that apply.

response: Scrotal elevation Comfort measures Cold compresses

Based on the nurse's knowledge of the probable first indicator of prostate cancer, which of the following questions should be included in the history and physical examination?

"Do you have any perineal discomfort?"

While taking a health history on a 20-year-old female client, the nurse learns that the client is taking miconazole. The nurse is justified in presuming that this client has what medical condition?

Candidiasis

A 33-year-old female client with three children has had a follow-up mammogram after an abnormal BSE. Mammogram findings reveal incidental microscopic abnormal tissue growth in the left breast lobules. The physician orders tamoxifen for the client. The nurse understands that the physician is implementing which primary prevention modality to treat this client?

Chemoprevention

A client presents to the emergency department with paraphimosis. The health care provider is able to compress the glans and manually reduce the edema. Once the inflammation and edema subside, the nurse should prepare the client for what intervention?

Circumcision

Upon examination, the nurse practitioner notes a backward positioning of the client's uterus. How would the nurse document this finding?

Retroversion