NUR 222 - Ch 33 - PrepU

The nurse is educating a patient about the best time to perform breast self-examination (BSE). When does the nurse inform her is the best time after menses to perform BSE?

5 to 7 days

The nurse is monitoring a client with metastatic breast cancer who is receiving morphine for pain control. The nurse would be alert for which of the following?

Excessive sedation, confusion, and weakness

Which statement demonstrates that a client has understood instructions about breast self-examination?

"I need to use the pads of three fingers to apply pressure when checking each breast."

An elderly client, who can void only while standing and pushing upward on the vagina, is ordered a pessary. Which comment from the client indicates a need for further teaching about this device?

"I will remove and clean it every day."

A woman with a 3-cm breast tumor is scheduled for a lumpectomy followed by 5 to 7 weeks of radiation therapy. The patient asks the nurse if this procedure would cure her. What is the nurse's best response?

"Lumpectomy, followed by radiation, has the same predicted long-term survival rates as a mastectomy." (Page 917)

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?

"Most cysts are benign in younger women, but it's good to have it checked out." (Page 938)

A client who wishes to preserve childbearing asks the nurse to explain how taking oral contraceptives will work in the management of endometriosis. Which is the best response by the nurse?

"Symptoms of endometriosis are increased during normal menstrual cycle."

A client reports loss of interest in sexual relations and discomfort during intercourse. Which is the best response by the nurse?

"These are normal, manageable symptoms of menopause."

A patient reports to the nurse that she has a sense of pelvic pressure and urinary problems such as incontinence, frequency, and urgency. The problem has gotten much worse since the birth of her third child. What does the nurse suspect the patient is experiencing?

A cystocele (Page 935)

During a breast examination, which finding most strongly suggests that a client has breast cancer?

A fixed nodular mass with dimpling of the overlying skin (Page 914)

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. (Page 889)

The history of a female patient reveals the following: First coitus at age 16 years; First pregnancy at age 28 years; Sexual intercourse with circumcised partner; Weight appropriate for height. Which of the following would alert the nurse to a *possible risk factor for developing cervical cancer?*

Age at first coitus (Page 942)

A nurse is reviewing a female client's history, which includes the following information: Age at menarche: 14 years, Cesarean delivery: 2 pregnancies, Age at first pregnancy: 35 years, Alcohol use: approximately 1 to 2 glasses of wine/month. The nurse identifies which as a possible *risk factor for the client to develop breast cancer*?

Age at first pregnancy (Page 913)

Which of the following is the *descent of the small intestine into the vaginal vault*?

Enterocele (Page 935)

A female client is diagnosed with breast abscess. She would like to continue to breast-feed her newborn. Which of the following would be most appropriate in this situation?

Assist the client to pump the breasts to remove breast milk.

A client has undergone a total abdominal hysterectomy and bilateral salpingo-oopherectomy as treatment for endometrial cancer. When providing postoperative care to this client the nurse would be alert for signs and symptoms of which of the following?

Bladder dysfunction (Page 947)

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?

Breast symmetry

Assessment of a client reveals evidence of a *cystocele*. The nurse interprets this as which of the following?

Bulging of the bladder into the vagina (Page 935)

Which type of yeast infection is manifested by *white, cheeselike discharge*?

Candidiasis (Page 934)

A 32-year-old client is concerned with the lumps that have developed in her breasts and is fearful of cancer. She reports variability in the size of the lumps. What could be causing her condition?

Cyclical hormonal changes (Page 912)

Which condition is a downward displacement of the bladder toward the vaginal orifice?

Cystocele (Page 935)

How can breast cancer prevention programs best serve at-risk women from lower socioeconomic backgrounds?

Develop screening and educational programs. (Page 913)

The nurse is caring for a group of breast cancer survivors post mastectomy. Which teaching point should the nurse include?

Do not lift objects greater than 15 lb

Which is a risk factor for cervical cancer?

Exposure to HPV (Page 942)

A nurse is reviewing a client's history for possible *risk factors* associated with *breast cancer*. Which of the following would the nurse identify as increasing the client's risk?

First full-term pregnancy at age 34 years (Page 913)

Hematoma and seroma formation are complications of breast surgery. Which of the following is the indicator that should be reported to the surgeon?

Gross swelling (Page 918)

A client, age 42, visits the gynecologist. After examining the client, the physician suspects cervical cancer. The nurse reviews the client's history for risk factors for this disease. Which history finding is a risk factor for cervical cancer?

Human papillomavirus infection at age 32 (Page 942)

The nurse is assessing the breast of a female patient and observes a prominent venous pattern on the left breast. What does the nurse understand that this can be indicative of?

Increased blood supply required by a tumor

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

A young client presenting at the health clinic with *fever and mucopurulent vaginal drainage* is diagnosed with *acute pelvic inflammatory disease (PID)*. Which long-term affect is of greatest concern in the care of this client?

Infertility

A nurse caring for a postmastectomy patient should not perform which of the following on the operative side? Select all that apply.

Intravenous sticks; Blood pressure; Injections; Blood draws (Page 918)

The nurse is assessing an older adult female who has not seen her physician in 2 years. The nurse is assisting the patient into a gown and notices that the patient has *edema and pitting of the skin on the right breast*. What does the nurse understand is the significance of this finding?

It may result from a neoplasm blocking lymphatic drainage, giving the skin an orange-peel appearance, a classic sign of advanced breast cancer.

The nurse is providing care to a client who has had surgery as treatment for breast cancer. The nurse would be alert for the development of which of the following?

Lymphedema (Page 918)

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 (Page 913)

Which term refers to breast pain?

Mastalgia (Page 910)

Which of the following is a term used to describe excessive menstrual bleeding?

Menorrhagia (Page 929)

Which is the main cause of anemia in a client with active uterine leiomyoma?

Menorrhagia (Page 939)

A client is diagnosed with *vaginitis due to trichomonasis*. Which of the following agents would the nurse expect the physician to prescribe?

Metronidazole (Page 933)

Which drug is the most effective treatment for trichomoniasis?

Metronidazole (Page 933)

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

Mother affected by cancer before 60 years of age (Page 913)

A client with *vaginitis* complains of *itching and burning of the perineum*. Which suggestion would be most appropriate to relieve the client's symptoms?

Take sitz baths frequently (Page 938)

Breast cancer is the most commonly diagnosed malignancy in women, except for which of the following?

Non-melanoma skin cancer (Page 912)

The nurse is completing the admission history for a client who is admitted for a reduction mammoplasty. Which of the following client statements is uncommon when explaining the rationale for the procedure?

Others disapprove

A client is considering use of *chemo-prevention* because she is at *high risk for* developing *breast cancer*. What can the nurse do to assist the patient with her decision?

Provide the patient with information regarding the benefits, risks, and possible side effects. (Page 913)

A nurse is using a diagram to educate a client with a pelvic organ prolapse. Which condition would the client have based on the illustration?

Rectocele (Page 936)

Erythropoietin growth factor increases production of which of the following?

Red blood cells (Page 924)

A nurse who works at a college health center frequently treats *female athletes* for this type of *menstrual disorder*. What is the disorder?

Secondary amenorrhea (Page 929)

A perimenopausal woman informs the nurse that she is having irregular vaginal bleeding. What should the nurse encourage the patient to do?

See her gynecologist as soon as possible. (Page 944)

Which type of biopsy is used for nonpalpable lesions found on mammography?

Stereotactic (Page 915)

Students are reviewing information about the use of adjuvant hormonal therapy for breast cancer. They demonstrate understanding of this information when they identify which of the following as an example of a *selective estrogen receptor modulator {SERM}*?

Tamoxifen (Page 913)

Which of the following is an expected outcome for a client 24 hours after an abdominal hysterectomy?

The client will perform leg exercises hourly. (Page 947)

A nurse is using a diagram to educate a client with a pelvic organ prolapse. Which condition would the client have based on the illustration?

Uterine prolapse (Page 936)

A nurse who works in a gynecologist's office frequently cares for patients who are diagnosed with *vulvovaginal candidiasis*. The nurse should teach the patients how to manage and treat the most common symptom of:

Vulvar pruritus. (Page 935)

A patient is having a fine-needle biopsy (FNB) for a mass in the left breast. When the needle is inserted and the mass is no longer palpable, what does the nurse know has most likely occurred?

The mass may be cystic and was ruptured when the needle was inserted. (Page 915)

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. (Page 942)

A nurse is reviewing a client's medical history. Which factor indicates the client is at risk for candidiasis?

Use of corticosteroids (Page 934)

During a follow-up visit, a female client who underwent a mastectomy presents with an infection that requires an antibiotic. She admits she has been doing some gardening. What further instruction and reinforcement of teaching is needed?

Wear gloves and protective clothing to avoid any injuries.

Which group of clients is at high risk of developing breast cancer?

Women who are obese (Page 913)

Sentinel lymph node mapping is done to validate the lack of lymph node metastasis. Which complication does this technique help avoid?

lymphedema (Page 918)

What is the main cause of anemia in a client with active uterine leiomyoma?

menorrhagia (Page 930-931)