CH. 50, 51
Which action will the nurse include in the plan of care for a patient with right arm lymphedema? a. Check blood pressure (BP) on both right and left arms. b. Avoid isometric exercise on the right arm. C. Assist with application of a compression sleeve. D. Keep the right arm at or below the level of the heart.
C
A 50-yr-old patient is preparing to begin breast cancer treatment with tamoxifen. What point should the nurse emphasize when teaching the patient about her new drug regimen? A. "Report any changes in your vision immediately." B. "The medication may cause some breast sensitivity." C. "The drug often alleviates some menopausal symptoms." D. "Abstain from drinking alcohol after you begin taking tamoxifen."
A
A 51-year-old patient with a small immobile breast lump is considering having a fine-needle aspiration (FNA) biopsy. The nurse explains that an advantage to this procedure is that A. FN is done in the outpatient clinic and results are available in 1 to 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
The nurse is performing an assessment on a female patient. What assessment finding should be documented and reported to the primary health care provider? A. Dimpling of breast B. Dark pink genitalia C. Watery cervical mucus D. Triangular hair distribution
A
A 20-year-old student comes to the student health center after discovering a small painless lump in her right breast. She is worried that she might have cancer because her mother had cervical cancer. The nurse's response to the patient is based on the knowledge that the most likely cause of the breast lump is a. fibrocystic complex. b. fibroadenoma. c. breast abscess. d. adenocarcinoma.
B
A 22-year-old patient reports her concern about not having a menstrual period for the past 7 months. Which statement by the patient indicates a possible related factor to the amenorrhea? a. I drink at least 3 glasses of nonfat milk every day. b. I run 7 to 8 miles every day to keep my weight down. C. I was treated for a sexually transmitted infection 2 years ago. d. I am not sexually active but currently I have an IUD.
B
A 22-yr-old patient reports her concern about not having a menstrual period for the past 7 months. Which statement by the patient indicates a possible related factor to the amenorrhea? a. "I drink at least 3 glasses of nonfat milk every day." b. "I run 7 to 8 miles every day to manage my weight." c. "I am not sexually active but currently I have an IUD." d. "I was treated for a sexually transmitted infection 2 years ago."
B
A 24-year-old female says she wants to begin using oral contraceptives. Which information from the nursing assessment is most important to report to the health care provider? A. The patient quit smoking 5 months previously. b. The patients blood pressure is 154/86 mm Hg. C. The patient has not been vaccinated for rubella. D. The patient has chronic iron-deficiency anemia.
B
A 24-yr-old patient had breast augmentation surgery and will be discharged the same day. What instructions should the nurse provide to minimize the risk of complications in the immediate recovery period? A. Avoid wearing a bra until postoperative day 3. B. Avoid strenuous exercise during her recovery period. C. Sleep in a semi-Fowler's position until her scheduled follow-up appointment. D. Enlist a friend or family member to perform passive range-of-motion exercises.
B
Which finding from the nurses physical assessment of a 42-year-old male patient should be reported to the health care provider? a. One testis hangs lower than the other. B. Genital hair distribution is diamond shaped. C. Clear discharge is present at the penile meatus. D. Inguinal lymph nodes are nonpalpable bilaterally.
C
When teaching nursing students about the male sexual response, what should the nurse call the phase that includes ejaculation? A. Plateau phase B. Orgasmic phase C. Resolution phase D. Excitement phase
B
A 72-yr-old patient had a mastectomy for breast cancer 6 months ago and wants to have breast reconstructive surgery. Which motivation for surgery would be most likely? A. Improve the woman's self-image. B. Be able to experience sexual arousal. C. To get a tummy tuck as well as the breast mound. D. Restore the premastectomy appearance of the breast.
A
A patient who is scheduled for a lumpectomy and axillary lymph node dissection tells the nurse, I would rather not know much about the surgery. Which response by the nurse is best? a. Tell me what you think is important to know about the surgery, b. It is essential that you know enough to provide informed consent. C. Many patients do better after surgery if they have more information. D. You can wait until after surgery for teaching about pain management
A
A student nurse prepares a list of teaching topics for a patient with a new diagnosis of breast cancer. Which item should the charge nurse suggest that the student nurse omit from the teaching topic list about breast cancel diagnostic testing? A. CA 15-3 level testing b. HER-2 receptor testing C. Estrogen receptor testing D. Oncotype DX assay testing
A
The nurse is assessing the sexual-reproductive functional health pattern of a 32-year-old woman. Which question is most useful in determining the patients sexual orientation and risk factors? a. Do you have sex with men, women, or both? b. Which gender do you prefer to have sex with? C. What types of sexual activities do you prefer? d. Are you heterosexual, homosexual, or bisexual?
A
The nurse is assessing the sexual-reproductive functional health pattern of a 32-yr-old woman. Which question is most useful in determining the patient's sexual orientation and related risk factors? a. "Do you have sex with men, women, or both?" b. "Which gender do you prefer to have sex with?" c. "What types of sexual activities do you prefer?" d. "Are you heterosexual, homosexual, or bisexual?"
A
The nurse performs a breast examination on a female patient who has never been pregnant, 1 week after her menstrual period. Which finding, if made by the nurse, would indicate a normal breast examination? A. Nipples are soft without retractions. B. Unilateral breast dimpling is present. C. Milky fluid is expressed from the nipples. D. Axillary lymph nodes are fixed and palpable.
A
Which information will the nurse include in patient teaching for a 36-year-old patient who is scheduled for stereotactic core biopsy of the breast? a. A local anesthetic will be given before the biopsy specimen is obtained. b. You will need to lie flat on your back and lie very still during the biopsy. C. A thin needle will be inserted into the lump and aspirated to remove tissue. D. You should not have anything to eat or drink for 6 hours before the procedure.
A
A patient presents with mastalgia. After determining cancer is not present, which strategies may provide relief? (Select all that apply.) A. Application of ice B. Oral contraceptives C. Reduce caffeine intake D. Increase intake of fluids E. Oral antibiotic administration F. Wear a supportive bra during the day
A, b, c, f
The nurse is volunteering at a community center to teach women about breast cancer. What should the nurse include when discussing risk factors? (Select all that apply.) A. Nulliparity B. Alcohol use C. Age 30 or over D. Early menarche E.Late menopause F. Personal history of colon cancer
A, b, d, e, f
A 33-year-old patient has a saline breast implant inserted in the outpatient surgery area. Which instruction will the nurse include in the discharge teaching? a. Take aspirin every 4 hours to reduce inflammation. B. Check wound drains for excessive blood or a foul odor. C. Wear a loose-fitting bra to decrease irritation of the sutures. D. Resume normal activities 2 to 3 days after the mammoplasty.
B
A 36-year-old who has a diagnosis of fibrocystic breast changes calls the nurse in the clinic with symptoms. Which is most important to report to the health care provider? A. There is yellow-green discharge from the patients right nipple. B. There is an area on the breast that is hot, pink, and tender to touch. C. The lumps are firm and most are in the upper outer breast quadrants. D. The lumps are larger and painful before the patients menstrual period.
B
A 58-year-old woman tells the nurse, I understand that I have stage Il 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. Tell me what you understand about the surgical options that are available. C. It would not be appropriate for me to make a decision about your health d. There is no need to make a decision rapidly; you have time to think about this.
B
A couple is scheduled to have a Huhner test for infertility. In preparation for the test, the nurse will instruct the couple about a. being sedated during the procedure. B. determining the estimated time of ovulation. C. experiencing shoulder pain after the procedure. d. refraining from intercourse before the appointment.
B
A male patient with a history of transient ischemic attacks (TIAs) is undergoing rehabilitation following an ischemic stroke. The patient's medical history is likely to be related to what health problems? A. Inguinal hernia B. Erectile dysfunction C. Testosterone deficiency D. Benign prostatic hyperplasia (BPH)
B
After scheduling a patient with a possible ovarian cyst for ultrasound, the nurse will teach the patient that she should a. expect to receive IV contrast during the procedure. B. drink several glasses of fluids before the procedure. C. experience mild abdominal cramps after the procedure. D. discontinue taking aspirin for 7 days before the procedure.
B
An 18-year-old female patient who has been admitted to the emergency department after a motor vehicle crash is scheduled for chest and abdominal x-rays. Which information is most important to report to the health care provider before the x-rays are obtained? A. Severity of abdominal pain b. Positive result of hG test C. Blood pressure 172/88 mm Hg d. Temperature 102.1 F (38.9 C)
B
The nurse is asked to teach an adolescent female patient about menstruation. What is important for the nurse to include when teaching the adolescent? A. The length of the menstrual cycle should be 28 days. B. Menstrual cycles are often irregular for the first 1 to 2 years. C. The female loses around 1 cup of blood with each menstrual period. D. Follicle-stimulating hormone (FSH) causes maturity of the follicle for ovulation.
B
The nurse is caring for a client following a mastectomy. Which nursing interventions would assist in preventing lymphedema on the affected arm? A. Placing cool compresses on arm B. Elevating affected arm on pillow C. Avoiding exercise in immediate post-op period D. Maintain IV site below area on affected arm.
B
The nurse is performing an admission assessment of an older adult male patient prior to bladder resection surgery. What assessment finding of the patient's genitourinary system would be unexpected? A. The patient's left testicle hangs lower than his right. B. Pubic hair is absent from the patient's genital region. C. The patient's intestines are not palpable through the inguinal rings. D. The patient's foreskin can be manually retracted to expose the meatus.
B
The nurse is providing preoperative teaching about the transverse rectus abdominis musculocutaneous (TRAM) procedure to a patient. Which information will the nurse include? a. Saline-filled implants are placed under the pectoral muscles. b. Recovery from the TRAM surgery takes at least 6 to 8 weeks. C. Muscle tissue removed from the back is used to form a breast. d. TRAM flap procedures may be done in outpatient surgery centers.
B
The nurse notes bilateral enlargement of the breasts during examination of a 62-year-old man. Which action should the nurse take first? a. Teach the patient how to palpate the breast tissue for lumps. B. Question the patient about medications being currently used. C. Refer the patient for mammography and biopsy of the breast tissue. d. Explain that this is a temporary condition due to hormonal changes.
B
The nurse provides discharge teaching for a 61-year-old patient who has had a left modified radical mastectomy and lymph node dissection. Which statement by the patient indicates that teaching has been successful? A. I will need to use my right arm and to rest the left one. B. I will avoid reaching over the stove with my left hand. C. I will keep my left arm in a sling until the incision is healed. D. I will stop the left arm exercises if moving the arm is painful.
B
The patient who has been told she will have blood drawn for a prolactin assay asks the nurse, "What is this test for?" What is the best response by the nurse? A. "It will tell you if you are pregnant." B. "It is used to detect a cause of amenorrhea." C. "It will tell us if you have a reproductive cancer." D. "It can indicate if you have a sexually transmitted infection."
B
When assessing a patient for breast cancer risk, the nurse considers that the patient has a significant family history of breast cancer if she has a a. cousin who was diagnosed with breast cancer at age 38. b. mother who was diagnosed with breast cancer at age 42. c. sister who died from ovarian cancer at age 56. d. grandmother who died from breast cancer at age 72.
B
Which 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, mobile, with a rubbery consistency
B
Which information should the nurse include in teaching a patient who is scheduled for external beam radiation to the breast? A. The radiation therapy will take a week to complete. b. Careful skin care in the radiated area will be necessary. C. Visitors are restricted until the radiation therapy is completed. D. Wigs may be used until the hair regrows after radiation therapy
B
Which male patient does the nurse identify is most susceptible to experiencing erectile dysfunction as a consequence of his drug regimen? A. A patient who takes a biguanide for type 2 diabetes. B. A patient who takes a β-adrenergic blocker for hypertension. C. A patient who uses a proton pump inhibitor to control acid reflux. D. A patient who is taking a cephalosporin antibiotic in order to treat cellulitis.
B
Which patient statement indicates that the nurses teaching about tamoxifen (Nolvadex) has been effective? a. I can expect to have leg cramps. b. I will call if I have any eye problems. C. I should contact you if I have hot flashes. d. I will be taking the medication for 6 to 12 months.
B
Which task could the registered nurse delegate to unlicensed assistive personnel (UAP) during the care of a patient who has had recent transverse rectus abdominis musculocutaneous (TRAM) flap surgery? A. Document the condition of the patient's incisions. B. Mobilize the patient in a slightly hunched position. C. Change the patient's abdominal and chest dressings. D. Change the parameters of the patient-controlled analgesic (PCA) pump.
B
The nurse reinforces teaching for a client after a right mastectomy and axillary lymph node dissection. Which statement by the client requires further intervention by the nurse? Select all that apply. A. "I will wear gloves and long sleeves while I am in my garden." B. "The risk for arm swelling will decrease one year after my treatment is completed." C. "I will sleep with my right arm elevated on a small flat pillow from now on." D. "If my right arm begins to feel heavy, I should contact my clinician." E. "It will be necessary for me to wear a compression bandage for the rest of my life."
B, C, E
A 19-year-old patient calls the school clinic and tells the nurse, My menstrual period is very heavy this time. I have to change my tampon every 4 hours. Which action should the nurse take next? a. Tell the patient that her flow is not unusually heavy. b. Schedule the patient for an appointment later that day. C. Ask the patient how heavy her usual menstrual flow is. d. Have the patient call again if the heavy flow continues.
C
A 29-yr-old primiparous patient is breastfeeding a 3-wk-old infant. She reports recent breast tenderness, redness, and fever. Which teaching point should the nurse reinforce when following up on her care? A. Refer the patient for a mammogram as quickly as possible. B. Encourage the patient to continue breastfeeding her infant. C. Ensure patient adheres to her prescribed antibiotic regimen. D. Teach the patient to use warm compresses and the self-limiting nature of illness.
C
A 33-year-old patient tells the nurse that she has fibrocystic breasts but reducing her sodium and caffeine intake and other measures have not made a difference in the fibrocystic condition. An appropriate patient outcome for the patient is a. calls the health care provider if any lumps are painful or tender. b. states the reason for immediate biopsy of new lumps. c. monitors changes in size and tenderness of all lumps in relation to her menstrual cycle. d. has genetic testing for BRCA-1 and BRCA-2 to determine her risk for breast cancer.
C
A 49-year-old man who has type 2 diabetes, high blood pressure, hyperlipidemia, and gastroesophageal reflux tells the nurse that he has had recent difficulty in achieving an erection. Which of the following drugs from his current medications list may cause erectile dysfunction (ED)? a. Ranitidine (Zantac) b. Atorvastatin (Lipitor) C. Propranolol (Inderal) d. Metformin(Glucophage)
C
A 49-yr-old man who has type 2 diabetes, high blood pressure, hyperlipidemia, and gastroesophageal reflux tells the nurse that he has had recent difficulty in achieving an erection. Which of the following drugs from his current medications list may cause erectile dysfunction (ED)? a. Ranitidine (Zantac) b. Atorvastatin (Lipitor) c. Propranolol (Inderal) d. Metformin (Glucophage)
C
A 53-year-old woman at menopause is discussing the use of hormone therapy (HT) with the nurse. Which information about the risk of breast cancer will the nurse provide? a. HT is a safe therapy for menopausal symptoms if there is no family history of BRCA genes. B. HT does not appear to increase the risk for breast cancer unless there are other risk factors. C. The patient and her health care provider must weigh the benefits of HT against the risks of breast cancer. d. Natural herbs are as effective as estrogen in relieving symptoms without increasing the risk of breast cancer.
C
A patient newly diagnosed with stage I breast cancer is discussing treatment options with the nurse. Which statement by the patient indicates that additional teaching may be needed? A. There are several options that I can consider for treating the cancer. B. I will probably need radiation to the breast after having the surgery. C. Mastectomy is the best choice to decrease the chance of cancer recurrence. D. I can probably have reconstructive surgery at the same time as a mastectomy.
C
A woman has sought care because of urinary incontinence. She states that running or jumping often precipitates leakage of urine, an event that has been occurring with increasing regularity in recent months. Which assessment question is most relevant to try to determine the cause of the patient's problem? A. "Do you know if your mother or sisters have had similar problems?" B. "Do you find that you are prone to frequent urinary tract infections?" C. "Did you have any muscle damage when giving birth to your children?" D. "Do you take part in a regular program of physical exercise and stretching?"
C
After a 48-year-old patient has had a modified radical mastectomy, the pathology report identifies the tumor as an estrogen-receptor positive adenocarcinoma. The nurse will plan to teach the patient about a. estradiol (Estrace). b. raloxifene (Evista). C. tamoxifen (Nolvadex). d. trastuzumab (Herceptin).
C
An older adult female patient reports hair growing on her chin. How should the nurse explain this occurrence to this patient? A. There is too much estrogen in your body. B. There is not enough testosterone in your body. C. The estrogen in your body is decreased since menopause. D. The negative feedback system for your hormones is working.
C
An older adult male patient with hypertension is prescribed amlodipine. The nurse should assess for which possible adverse effect? A. Gynecomastia B. Increased sex drive C. Erectile dysfunction D. Prostate gland enlargement
C
During a well woman physical exam, a 43-year-old patient asks about her risk for breast cancer. Which question is most pertinent for the nurse to ask? A. Do you currently smoke tobacco? b. Have you ever had a breast injury? C. At what age did you start having menstrual periods? D. Is there a family history of fibrocystic breast changes?
C
The following patients call the outpatient clinic. Which phone call should the nurse return first? a. A 44-year-old patient who has bloody discharge after a hysteroscopy earlier today B. A 64-year-old patient who is experiencing shoulder pain after a laparoscopy yesterday C. A 34-year-old patient who is short of breath after pelvic computed tomography (CT) with contrast d. A 54-year-old patient who has severe breast tenderness following a needle aspiration breast biopsy
C
The nurse caring for patients in a primary care clinic identifies which patient as at highest risk for developing breast cancer? A. A 59-yr-old who has inherited the APC gene B. A 25-yr-old with fibrocystic breast disease C. A 72-yr-old with a family history of breast cancer D. A 43-yr-old who is obese and leads a sedentary lifestyle
C
The nurse is caring for a 52-year-old patient with breast cancer who is receiving chemotherapy with doxorubicin (Adriamycin) and cyclophosphamide (Cytoxan). Which assessment finding is most important to communicate to the health care provider? A. The patient complains of fatigue. b. The patient eats only 25% of meals. C. The patients apical pulse is irregular. d. The patients white blood cell (WBC) count is 5000/L.
C
The nurse is caring for a patient diagnosed with breast cancer who just underwent an axillary lymph node dissection. What intervention should the nurse use to decrease the lymphedema? A. Keep affected arm flat at the patient's side. B. Apply an elastic bandage on the affected arm. C. Assess blood pressure only on unaffected arm. D. Restrict exercise of the affected arm for 1 week.
C
The nurse is caring for a patient with breast cancer who is receiving high-dose doxorubicin (Adriamycin). Which assessment is most important for the nurse to make? A. Observe for alopecia. B. Determine visual acuity. C. Monitor cardiac rhythm. D. Assess mouth and throat.
C
The nurse is caring for an obese woman after a right mastectomy with axillary lymph node dissection. Which discharge instruction should the nurse include? A. "Arm exercises should not be started for 4 to 6 weeks." B. "Discontinue arm exercises if you have discomfort or pain." C. "Special massage therapy can decrease swelling in your arm." D. "Keep your right arm in a sling to decrease pain and swelling."
C
The nurse is providing teaching by telephone to a patient who is scheduled for a pelvic examination and Pap test next week. The nurse instructs the patient that she should a. not have sexual intercourse the day before the Pap test. b. shower, but not take a tub bath, before the examination. c. avoid douching for at least 48 hours before the examination. d. schedule to have the Pap test just after her menstrual period.
C
The nurse is providing teaching by telephone to a patient who is scheduled for a pelvic examination and Pap test next week. The nurse instructs the patient that she should a. shower, but not take a tub bath, before the examination. B. not have sexual intercourse the day before the Pap test. C. avoid douching for at least 24 hours before the examination. d. schedule to have the Pap test just after her menstrual period.
C
When doing breast self-examination, the female patient should report which finding to the health care provider? A. Denser breast tissue B. Palpable rib margins C. Left nipple deviation D. Different sized breasts
C
Which nursing action should be included in the plan of care for a patient returning to the surgical unit following a left modified radical mastectomy with dissection of axillary lymph nodes? A. Obtain a permanent breast prosthesis before the patient is discharged from the hospital. B. Teach the patient to use the ordered patient-controlled analgesia (PA) every 10 minutes. 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
Which question should the nurse ask when assessing a 60-year-old patient who has a history of benign prostatic hyperplasia (BPH)? A. Have you noticed any unusual discharge from your penis? b. Has there been any change in your sex life in the last year? C. Has there been a decrease in the force of your urinary stream? D. Have you been experiencing any difficulty in achieving an erection?
C
20. When the nurse is working in the womens health care clinic, which action is appropriate to take? A. Teach a healthy 30-year-old about the need for an annual mammogram. b. Discuss scheduling an annual clinical breast examination with a 22-year-old. C. Explain to a 60-year-old that mammography frequency can be reduced to every 3 years. D. Teach a 28-year-old with a BRCA-1 mutation about magnetic resonance imaging (MRI).
D
A 44-year-old patient in the sexually transmitted infection clinic has a positive Venereal Disease Research Laboratory (VDRL) test, but no chancre is visible on assessment. The nurse will plan to send specimens for a. gram stain. b. cytologic studies. C. rapid plasma reagin (PR) agglutination. d. fluorescent treponemal antibody absorption (FTA-Abs).
D
A 68-year-old male patient tells the nurse that he is worried because he does not respond to sexual stimulation the same way he did when he was younger. The nurses best response to the patients concern is which of the following? A. Interest in sex frequently decreases as men get older. b. Many men need additional sexual stimulation with aging. C. Erectile dysfunction is a common problem with older men. d. Tell me more about how your sexual response has changed.
D
A 68-yr-old male patient tells the nurse that he is worried because he does not respond to sexual stimulation the same way he did when he was younger. Which is the nurse's best response to the patient's concern? a. "Interest in sex frequently decreases as men get older." b. "Many men need additional sexual stimulation with aging." c. "Erectile dysfunction is a common problem with older men." d. "Tell me more about how your sexual response has changed."
D
A nurse is teaching a health promotion workshop to a group of women in their 40s and 50s. What information about nipple discharge should the nurse teach to participants? A. Inappropriate lactation necessitates breast biopsy. B. Nipple discharge of any type is a precursor to cancer. C. Galactorrhea is a normal symptom related to perimenopause. D. Unexpected nipple discharge of any type needs medical follow-up.
D
A patient has had left-sided 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 patients range of motion for the left arm C. Evaluating the patients understanding of instructions about drain care d. Administering an analgesic 30 minutes before scheduled arm exercises
D
A patient recently had a unilateral, right total mastectomy and axillary node dissection for the treatment of breast cancer. What nursing intervention should the nurse include in the patient's care? A. Immobilize the patient's right arm until postoperative day 3. B. Maintain the patient's right arm in a dependent position when at rest. C. Administer diuretics prophylactically for the prevention of lymphedema. D. Promote gradually increasing mobility as soon as possible following surgery.
D
A woman calls the clinic because she is having an unusually heavy menstrual flow. She tells the nurse that she has saturated three tampons in the past 2 hours. The nurse estimates that the amount of blood loss over the past 2 hours is__________mL a. 20 to 30 B. 30 to 40 C. 40 to 60 d. 60 to 90
D
After a 26-year-old patient has been treated for pelvic inflammatory disease, the nurse will plan to teach about a. use of hormone therapy (HT). B. irregularities in the menstrual cycle. C. changes in secondary sex characteristics. D. possible difficulty with becoming pregnant.
D
The nurse explains to a 37-year-old patient being prepared for colposcopy with a cervical biopsy that the procedure will... A. involves dilation of the cervix and biopsy of the tissue lining the uterus. B. will take place in a same-day surgery center so that local anesthesia can be used. C. requires that the patient have nothing to eat or drink for 6 hours before the procedure. D. is similar to a speculum examination of the cervix and should result in little discomfort.
D
The nurse explains to a patient being prepared for colposcopy with a cervical biopsy that the procedure... a. involves dilation of the cervix and biopsy of the tissue lining the uterus. b. will take place in a same-day surgery center so that local anesthesia can be used. c. requires that the patient have nothing to eat or drink for 6 hours before the procedure. d. is similar to a speculum examination of the cervix and should result in little discomfort.
D
The nurse is admitting a patient scheduled this morning for lumpectomy and axillary lymph node dissection. Which action should the nurse take first? a. Teach the patient how to deep breathe and cough. b. Discuss options for postoperative pain management. C. Explain the postdischarge care of the axillary drains. d. Ask the patient to describe what she knows about the surgery.
D
The nurse is obtaining a sexual history from a woman who is a new patient in the primary care clinic. It would be most appropriate for the nurse to ask which question first? A. "Have you ever had a sexually transmitted infection?" B. "Have you ever been in a relationship with anyone who hurt you?" C. "Have you ever been forced into sexual acts as a child or an adult?" D. "Are you satisfied with your sexual relationship with your partner?"
D
The nurse performs a breast examination on a 68-yr-old female patient. Which finding indicates further evaluation for breast cancer is needed? A. Bilateral pendulous breasts B. Right breast is warm, painful to touch C. Palpable lump that is tender and movable D. Irregular, nontender lump with induration
D
The nurse provides discharge teaching for a patient who has had a left modified radical mastectomy and axillary lymph node dissection. The nurse determines that teaching has been successful when the patient says, a. "I should keep my left arm supported in a sling when I am up until my incision is healed." b. "I may expose my left arm to the sun for several hours each day to increase circulation and promote healing." c. "I can do whatever exercises and activities I want as long as I do not elevate my left hand above my head." d. "I will continue to exercise my left arm with finger-walking up the wall or combing my hair."
D
The nurse teaches a 53-yr-old patient about screening for early detection of breast cancer. Which statement requires clarification by the nurse? A. "I should plan to have a mammogram every year." B. "A breast examination should be done right after my menstrual period." C. "I will see the health care provider every year for a breast examination." D. "Self-breast examination is a reliable way to detect breast cancer early."
D
The nurse teaching a young womens community service group about breast self-examination (BSE) will include that a. BSE will reduce the risk of dying from breast cancer. b. BSE should be done daily while taking a bath or shower. C. annual mammograms should be scheduled in addition to BSE. D. performing BSE after the menstrual period is more comfortable.
D
The nurse will anticipate teaching a 56-year-old patient who is diagnosed with lobular carcinoma in situ (LCIS) about A. lumpectomy. b. lymphatic mapping. C. MammaPrint testing. d. tamoxifen (Nolvadex).
D
The nurse will plan to teach a 51-year-old man who is scheduled for an annual physical exam about a(n) A. increased risk for testicular cancer. b. possible changes in erectile function. C. normal decreases in testosterone level. d. prostate specific antigen (PSA) testing.
D
The nurse will teach a patient with metastatic breast cancer who has a new prescription for trastuzumab (Herceptin) that 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
The outpatient clinic receives telephone calls from four patients. Which patient should the nurse call back first? a. 57-year-old with ductal ectasia who has sticky multicolored nipple discharge and severe nipple itching b. 21-year-old with a family history of breast cancer who wants to discuss genetic testing for the BRCA gene C. 40-year-old who still has left side chest and arm pain 2 months after a left modified radical mastectomy D. 50-year-old with stage 2 breast cancer who is receiving doxorubicin (Adriamycin) and has ankle swelling and fatigue
D
The patient with breast cancer has a left mastectomy with axillary node dissection. Ten lymph nodes are resected with 3 positive for cancer cells. The patient has stage IIB breast cancer. Which nursing intervention would be most effective in planning care? A. Evaluate left arm lymphatic accumulation. B. Maintain joint flexibility and left arm function. C. Teach her about chemotherapy and radiation therapy. D. Assess the patient's response to the diagnosis of breast cancer.
D
While the nurse is obtaining a nursing history from a 52-year-old patient who has found a small lump in her breast, which question is most pertinent? a. "Do you currently eat black cohosh?" b. "Have you ever had any breast injuries?" c. "Is there any family history of fibrocystic breast changes?" d. "At what age did you start having menstrual periods?"
D
