Mod 1 Breast/Female Reproductive Disorders

A patient is having a biopsy that will remove the entire mass, plus a margin of surrounding tissue. What type of biopsy will be documented on the operative permit? a.Excisional biopsy b.Incisional biopsy c.Core biopsy d.Ultrasound-guided core biopsy

a.Excisional biopsy

Which of the following is the extrusion of the rectum into the posterior vagina? a.Rectocele b.Cystocele c.Enterocele d.Uterine prolapse

a.Rectocele

The nurse is providing teaching to a group of older adolescent girls about menstruation and the use of tampons. The nurse would instruct the girls to change tampons at which frequency? a.Every 2 to 4 hours b.Every 4 to 6 hours c.Every 6 to 8 hours d.Every 8 to 10 hours

b.Every 4 to 6 hours

A client who had an anterior colporrhaphy is being discharged. What does the nurse tell the client before her discharge? a."Use a pillow to splint your abdomen." b."Avoid lifting more than 25 lb (11.3 kg)." c."Return to the clinic in 6 weeks for suture removal." d."Do not have sexual intercourse for at least 2 weeks."

a."Use a pillow to splint your abdomen."

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? a. "I will remove and clean it every day." b. "I will report any signs of irritation or bleeding." c."I should have greater ease of emptying my bladder." d. "I should report any foul odor or drainage."

a. "I will remove and clean it every day."

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? a. "Symptoms of endometriosis are increased during normal menstrual cycle." b. "Contraceptives will allow blood to be diverted to the peritoneal cavity." c. "Trapping blood causes less pain or discomfort for clients with endometriosis." d. "Endometriosis is usually cured with surgical menopause."

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

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? a. "Symptoms of endometriosis are increased during normal menstrual cycle." b."Contraceptives will allow blood to be diverted to the peritoneal cavity." c. "Trapping blood causes less pain or discomfort for clients with endometriosis." d. "Endometriosis is usually cured with surgical menopause."

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

A client had a mastectomy with reconstruction, and several axillary nodes were dissected. Which statement by the client indicates good understanding of discharge instructions? a."I must be careful not to injure the arm or hand on the side of my surgery." b."I'm glad that lymphedema is no longer a problem, as it was in my mother's day." c."I will have a hard time waiting for a whole year to see how my breast will look." d."I need to pull my drains out by inch each day until they are totally out."

a."I must be careful not to injure the arm or hand on the side of my surgery."

A client recently had a mammogram. Which statement by the client indicates a need for clarification regarding the importance or purpose of this procedure? a."Now that I have had a mammogram, my risk for getting breast cancer is reduced." b."I will still do a breast self-examination monthly even after the mammogram." c."Yearly mammograms can reduce my risk of dying from breast cancer." d."The amount of radiation exposure from a mammogram is very low."

a."Now that I have had a mammogram, my risk for getting breast cancer is reduced."

Which of the following is the descent of the small intestine into the vaginal vault? a.Enterocele b.Rectocele c.Cystocele d.Uterine prolapse

a.Enterocele

The nurse is caring for four clients in an oncology unit. Following report on diagnosis and treatment, which client would the nurse identify as having the most life-threatening diagnosis? a.A client with stage IV cancer receiving palliative care b.A client diagnosed with a stage one tumor with no lymph node involvement c.A client receiving chemotherapy and radiation with a low blood count d.A client with an estrogen receptor-positive tumor receiving oral chemotherapy

a.A client with stage IV cancer receiving palliative care

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.A cystocele b.A rectocele c.An enterocele d.A urinary tract infection

a.A cystocele

A woman who has been trying to conceive is diagnosed with fibroid tumors of the uterus and is scheduled to have a procedure using a laser through a hysteroscope passed through the cervix. What type of procedure will the nurse prepare the patient for? a.A hysteroscopic resection of myomas b.Laparoscopic myomectomy c.Laparoscopic myolysis d.Laparoscopic cryomyolysis

a.A hysteroscopic resection of myomas

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? a.All options are correct. b.breast cancer c.stroke (CVA) d.heart disease

a.All options are correct.

The nurse is providing information at the local YMCA about screenings for breast and cervical cancer. The nurse should inform young women that they should begin their screenings at what time? a.Annual breast and pelvic examinations are important for all women 21 years of age or older and for those who are sexually active, regardless of age. b.Annual breast and pelvic examinations should begin at age 14 years old. c. Annual breast and pelvic examinations should begin when a woman becomes sexually active. d.Annual breast and pelvic examinations should be performed when a woman begins taking birth control.

a.Annual breast and pelvic examinations are important for all women 21 years of age or older and for those who are sexually active, regardless of age.

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? a.Ask the client to lie on her left side with the right leg bent b.Remind the client the examination will take 5 minutes or less c.Tell the client is not possible to conduct the bimanual examination d.Ask the client to reschedule the appointment for another time

a.Ask the client to lie on her left side with the right leg bent

A nurse is describing the advantages and disadvantages associated with tamoxifen therapy as a means of breast cancer prevention. The nurse would identify that the drug has a beneficial effect on which of the following? a.Bone mineral density b.High density lipoprotein levels c.Risk for endometrial cancer d.Cataract formation

a.Bone mineral density

A postmenopausal client is experiencing low back and pelvic pain, fatigue, and bloody vaginal discharge. What laboratory tests would the nurse expect to see ordered for this client if endometrial cancer is suspected? (Select all that apply.) a.Cancer antigen-125 (CA-125) b.White blood cell (WBC) count c.Hemoglobin and hematocrit (H&H) d.International normalized ratio (INR) e.Prothrombin time (PT)

a.Cancer antigen-125 (CA-125) c.Hemoglobin and hematocrit (H&H)

A client with newly diagnosed gynecologic cancer is being discharged home. Which health care team member does the nurse contact to coordinate nursing care at home for this client? a.Case manager b.Hospice c.Social services d.Primary health care provider

a.Case manager

A nurse is caring for four postoperative clients who each had a total abdominal hysterectomy. Which client should the nurse assess first upon initial rounding? a.Client who has had two saturated perineal pads in the last 2 hours b.Client with a temperature of 99 F and blood pressure of 115/73 mm Hg c.Client who has pain of 4 on a scale of 0 to 10 d.Client with a urinary catheter output of 150 mL in the last 3 hours

a.Client who has had two saturated perineal pads in the last 2 hours

The nurse is assisting a patient with breast-feeding. The patient said that with her last baby, she had a problem with her nipples becoming irritated. What can the nurse suggest to the patient to prevent this problem? Select all that apply. a.Daily washing with water b.Massage with breast milk or lanolin c.Exposure to air d.Hot compresses e.Aspirin

a.Daily washing with water b.Massage with breast milk or lanolin c.Exposure to air

Which of the following is an age-related functional change of the female reproductive system? a.Decreased ovulation b.Increased vaginal lubrication c.Decreased pH of vagina d.Hormone level stability

a.Decreased ovulation

Which of the following diagnostic tests is used as a therapeutic measure for incomplete miscarriage? a.Dilation and curettage (D & C) b.Laparoscopy c.Endometrial ablation d.Endometrial biopsy

a.Dilation and curettage (D & C)

The nurse documents the following history obtained from a female patient: No known allergies Douching 2 to 3 times per week Use of barrier methods for contraception Recent viral upper respiratory infection Estrogen levels within acceptable parameters Which of the following would the nurse identify as a risk factor for the patient developing a vulvovaginal infection? a.Douching b.Barrier contraception c.Viral upper respiratory infection d.Normal estrogen levels

a.Douching

The nurse is teaching a client how to adapt to physical and psychological changes after surgery for ovarian cancer. Which factor is included in the teaching plan? (Select all that apply.) Select all that apply. a.Encouraging the expression of grief and fears b.Suggesting the use of support groups and counseling c.Refraining from sexual intercourse for 6 weeks after surgery. d.Offering vaginal dilators e.Recommending the use of oil-based lubricants for vaginal dryness

a.Encouraging the expression of grief and fears b.Suggesting the use of support groups and counseling c.Refraining from sexual intercourse for 6 weeks after surgery.

Which diagnostic test is indicated for postmenopausal bleeding? a.Endometrial biopsy b.Computed tomography c.Ultrasound d.Magnetic resonance imaging

a.Endometrial biopsy

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? a.Having a bowel movement b.Being able to ambulate c.Voiding an adequate amount of urine d.Tolerating fluids by mouth

a.Having a bowel movement

The community health nurse is providing education to a group of women about risks for breast cancer. Which factor will the nurse include in the education session? (Select all that apply.) Select all that apply. a.High breast density b.First child at age 25 c.Male with gynecomastia d.Nulliparity e.Middle-age woman

a.High breast density d.Nulliparity

Which factors are considered to be indicative of a moderately increased risk of a client's developing breast cancer? (Select all that apply.) a.High postmenopausal bone density b.Ionizing radiation c.Family history of one first-degree relative d.Genetic factors e.First child born after age 30 f.Biopsy-confirmed atypical hyperplasia

a.High postmenopausal bone density b.Ionizing radiation c.Family history of one first-degree relative f.Biopsy-confirmed atypical hyperplasia

The nurse is educating a client on the prevention of toxic shock syndrome (TSS). Which statement by the client indicates a lack of understanding? a.I need to change my tampon every 8 hours during the day. b.At night, I should use a feminine pad rather than a tampon. c.If I dont use tampons, I should not get TSS. d.It is best if I wash my hands before inserting the tampon.

a.I need to change my tampon every 8 hours during the day.

The nurse is giving discharge instructions to a client who had a total abdominal hysterectomy. Which statements by the client indicate a need for further teaching? (Select all that apply.) a.I should not have any problems driving to see my mother, who lives 3 hours away. b.Now that I have time off from work, I can return to my exercise routine next week. c.My granddaughter weighs 23 pounds, so I need to refrain from picking her up. d.I will have to limit the times that I climb our stairs at home to morning and night. e.For 1 month, I will need to refrain from sexual intercourse.

a.I should not have any problems driving to see my mother, who lives 3 hours away. b.Now that I have time off from work, I can return to my exercise routine next week.

Several days before admission, a client reports finding a small lump in the left breast near the nipple. What should the nurse tell the client to do? a.Inform the physician immediately. b.Squeeze the nipple to check for drainage. c.Check the area after the next menses. d.Put a heating pad on the area to reduce inflammation.

a.Inform the physician immediately.

The examiner is preparing to perform a pelvic examination. Which of the following would be done first? a.Inspection of the external genitalia b.Inspection of the cervix c.Specimen collection for a Pap smear d.Bimanual palpation

a.Inspection of the external genitalia

The nurse is preparing the female client for a pelvic examination. In which position will the nurse assist the client? a.Lithotomy position b.Supine position c.Trendelenburg's position d.Lateral recumbent

a.Lithotomy position

Which option is available to women with an increased risk of developing breast cancer? a.Long-term follow-up b.Unilateral prophylactic mastectomy c.Chemotherapy d.Radiation prevention

a.Long-term follow-up

Sentinel lymph node mapping is done to validate the lack of lymph node metastasis. Which complication does this technique help avoid? a.Lymphedema b.Mastalgia c.Breast cancer d.Fibroadenoma

a.Lymphedema

A client is considering breast augmentation. Which of the following would the nurse recommend to the client to ensure that there are no malignancies? a.Mammogram b.Mastopexy c.Ultrasound d.Breast biopsy

a.Mammogram

Which of the following is a term used to describe excessive menstrual bleeding? a.Menorrhagia b.Amenorrhea c.Dysmenorrhea d.Metrorrhagia

a.Menorrhagia

The nurse is gathering data about a client's menstruation. The client reports that she has been experiencing some bleeding that occurs suddenly and without a regular pattern in between her normal menstrual periods. The nurse documents this finding as which of the following? a.Metrorrhagia b.Oligomenorrhea c.Menorrhagia d.Dysmenorrhea

a.Metrorrhagia

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? a.NSAIDs b.ultrasonography c.corticosteroids d.oral hypoglycemia agents

a.NSAIDs

A client with a history of breast cancer is admitted through the emergency department with shortness of breath, weakness, fatigue, and new lower extremity edema. The client's oxygen saturation is 88%. After stabilizing the client, which action by the nurse is most important? a.Obtain a list of the client's medications. b.Orient her to her room and surroundings. c.Place the client on intake and output. d.Assess the client's family cardiac history.

a.Obtain a list of the client's medications.

A client has advanced breast cancer and bone metastasis. Which problem does the nurse consider the priority? a.Pain b.Mobility problems c.Risk for infection d.Malnutrition

a.Pain

While collecting data on reproductive history, the client discloses early menarche, early sexual engagement, chlamydia infection, and treatment for gonorrhea. What is the client at high risk for developing? Select all that apply. a.Pelvic inflammatory disease b.Breast cancer c.Fibroid tumor or myoma d.Cervical cancer e.Urinary tract infection

a.Pelvic inflammatory disease d.Cervical cancer

When performing a clinical breast examination on a client, the nurse palpates a thickened area where the skin folds under the breast. Which is the nurse's best action? a.Proceed with the examination. b.Determine whether the thickness is bilateral. c.Ask how long the thickness has been present. d.Change the client's position and re-assess.

a.Proceed with the examination.

Which of the following is an early symptom of vulvar cancer? a.Pruritus with genital burning b.Fever accompanied by chills c.Severe abdominal pain d.Dyspareunia

a.Pruritus with genital burning

A 28-year-old client is diagnosed with endometriosis and is experiencing severe symptoms. Which actions by the nurse are the most appropriate at this time? (Select all that apply.) a.Reduce the pain by low-level heat. b.Discuss the high risk of infertility with this diagnosis. c.Relieve anxiety by relaxation techniques and education. d.Discuss in detail the side effects of laparoscopic surgery. e.Suggest resources such as the Endometriosis Association.

a.Reduce the pain by low-level heat. c.Relieve anxiety by relaxation techniques and education. e.Suggest resources such as the Endometriosis Association.

Most cervical cancers, if not detected and treated, spread to which area? a.Regional pelvic lymph nodes b.Fundus c.Vagina d.Uterus

a.Regional pelvic lymph nodes

A nurse is caring for a group of breast cancer survivors after mastectomy. Which teaching point should the nurse reinforce about activities 6 weeks after surgery? a.Resume light household work. b.Wear tight-fitting shirts for support. c.Brisk walking and stretching exercises can be introduced. d.Exercise only the unaffected side until seen by the healthcare provider.

a.Resume light household work.

A client is scheduled for a total hysterectomy with a laparoscopic vaginal approach after a diagnosis of microinvasive cervical cancer. What psychological and/or social changes does the nurse expect this client to experience? a.Sexual counseling may be needed, especially if the client has doubts about her ability to feel like a woman and engage in sexual activities. b.The client will be actively involved in her own care in the immediate postoperative period. c.Because the surgery does not affect a visible site, altered body image issues are not as common. d.The client would demonstrate reality testing and would experience a grief reaction immediately after her surgery.

a.Sexual counseling may be needed, especially if the client has doubts about her ability to feel like a woman and engage in sexual activities.

A woman at an employee health fair informs the nurse that she has had vaginal bleeding for the past several days. She is postmenopausal and has not had a menstrual period for the past 4 years. What should the nurse instruct the woman to do? a.She should see her gynecologist or physician as soon as possible. b.She should mention the bleeding episode to her physician at her next appointment. c.She should disregard this bleeding episode, because it is probably normal. d.She should use a birth control method, because she may be fertile with her next ovulation.

a.She should see her gynecologist or physician as soon as possible.

The nurse is taking the history of a 24-year-old client diagnosed with cervical cancer. What possible risk factors would the nurse assess? (Select all that apply.) a.Smoking b.Multiple sexual partners c.Poor diet d.Nulliparity e.Younger than 18 at first intercourse

a.Smoking b.Multiple sexual partners c.Poor diet e.Younger than 18 at first intercourse

A client had a mastectomy nearly a year ago and is distressed over continued tingling and burning in the ipsilateral arm. What orders does the nurse prepare to implement? a.Teach the client about gabapentin (Neurontin). b.Demonstrate the use of heat therapy to the axilla. c.Discuss ways to prevent constipation with pain meds. d.Reassure the client that this will disappear shortly.

a.Teach the client about gabapentin (Neurontin).

A 34-year-old client has been diagnosed with endometriosis. What topic should the nurse emphasize during health education? a.The importance of reporting a possible pregnancy as soon as it occurs b.The need to complete the full course of antibiotics, regardless of symptoms c.The need to have the client's partner undergo diagnostic testing as well d.Signs and symptoms of infection

a.The importance of reporting a possible pregnancy as soon as it occurs

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? a.They lower the level of estrogen in the body blocking the tumor's ability to use it. b.They block progesterone-dependent tumors from growing. c.They attach to endogenous protein receptors to slow the growth of cancerous cells. d.They stimulate the immune system to attack a protein common in many tumors.

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

A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client? a.This condition puts her at a higher risk for cervical cancer, therefore, she should have a Papanicolaou (Pap) smear annually. b.The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days. c.The potential for transmission to her sexual partner will be eliminated if condoms are used every time she and her partner have sexual intercourse. d.The human papillomavirus (HPV), which causes condylomata acuminata, can't be transmitted during oral sex.

a.This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually.

A client who has been diagnosed with breast cancer tells the nurse she wishes to use only natural and complementary interventions. What teaching will the nurse provide? a.This type of therapy would not replace standard treatment. b.If chemotherapy has been recommended, complementary therapies are contraindicated. c.Complementary therapies can only be used after surgery. d.There are many natural herbs that have been shown to treat cancer.

a.This type of therapy would not replace standard treatment.

Which drug is the usual treatment for vulvar dystrophy? a.Topical corticosteroids b.Antibiotics c.Antifungals d.Progestins

a.Topical corticosteroids

During a teaching demonstration on breast self-examination (BSE), the nurse should always explain that the majority of breast cancers are found in the: a.Upper, outer quadrant. b.Lower, outer quadrant. c.Upper, inner quadrant. d.Lower, inner quadrant.

a.Upper, outer quadrant.

While examining the introitus, the nurse practitioner asks the client to "bear down." The nursing student observing the examination knows that the nurse practitioner is assessing the client for which condition? a.Uterine prolapse b.Colorectal cancer c.Female genital mutilation d.Human papillomavirus

a.Uterine prolapse

Which term describes an opening between the bladder and the vagina? a.Vesicovaginal fistula b.Cystocele c.Rectocele d.Rectovaginal fistula

a.Vesicovaginal fistula

A client has scheduled brachytherapy sessions and states that she feels as though she is not safe around her family. What is the best response by the nurse? a.You are only reactive when the radioactive implant is in place. b.To be totally safe, it is a good idea to sleep in a separate room. c.It is best to stay a safe distance from friends or family between treatments. d.You should use a separate bathroom from the rest of the family.

a.You are only reactive when the radioactive implant is in place.

A client who is 4 months postpartum reports significant left breast pain, edema, redness, and an elevated temperature. What would the physician likely order? Select all that apply. a.antibiotic therapy b.a supportive bra c.increased activity d.a breast shield. e.biopsy

a.antibiotic therapy b.a supportive bra

Which is the earliest and the most common symptom of endometrial cancer? a.bleeding b.loss of weight c.pain d.pressure on the bladder

a.bleeding

A client is concerned about the lumps that have developed in her breasts and is fearful of cancer. The client reports variability in the size of the lumps. What could be causing this condition? a.cyclical hormonal changes b.caffeine c.nicotine d.progesterone

a.cyclical hormonal changes

The nurse is providing health education regarding disorders that affect breast tissue. Which symptom is least suggestive of a breast disorder? a.differences in breast size b.breast tenderness c.nipple discharge d.breast mass

a.differences in breast size

A client has been diagnosed with breast cancer and is awaiting cytology results of a biopsy. During client education, the nurse discusses the possible types of breast malignancies. Which is the most common type? a.ductal b.inflammatory c.medullary d.infiltrating lobular

a.ductal

Because of a client's reluctance to begin hormone therapy, the advance nurse practitioner prescribes venlafaxine to decrease the risk of a.hot flashes. b.stroke. c.heart attack. d.blood clots.

a.hot flashes.

Hormone therapy decreases the risk of a.hot flashes. b.stroke. c.heart attack. d.blood clots.

a.hot flashes.

What contributes to breast inflammation in a woman who is breastfeeding? Select all that apply. a.inadequate handwashing b.failure to alternate breasts at each feeding c.insufficient maternal nutrition d.frequently nursing an infant e.organisms on the mother's or infant's skin

a.inadequate handwashing b.failure to alternate breasts at each feeding e.organisms on the mother's or infant's skin

A client is experiencing symptoms associated with menopause. What is a likely recommendation to increase the client's interest in sexual activity? a.low-dose androgens b.antidepressants c.herbal aphrodisiacs d.bisphosphates

a.low-dose androgens

A client is very concerned about possibly having breast cancer, especially after caring for a close family member who recently died from the disease. The nurse informs the client that the primary and most common sign of breast cancer is a: a.painless mass in the breast, most often in the upper outer quadrant. b.painful mass in the breast, most often in the upper outer quadrant. c.painless mass in the breast, most often in the lower quadrant near the nipple. d.painful mass in the breast, most often in the lower quadrant near the nipple.

a.painless mass in the breast, most often in the upper outer quadrant.

Which abnormality is not considered a structural abnormality? a.pelvic inflammatory disease b.endometriosis c.vaginal fistulas d.pelvic organ prolapse

a.pelvic inflammatory disease

A patient had a pessary inserted for long-term treatment of a prolapsed uterus. As part of a teaching plan, the nurse would advise the patient to: a.see her gynecologist to remove and clean the pessary at regular intervals. b.keep the insertion site clean and dry. c.avoid sexual intercourse. d.avoid climbing stairs as much as possible.

a.see her gynecologist to remove and clean the pessary at regular intervals.

A nurse is advising a client who has just had her first menses on how to use a tampon. Instructions include using the least absorbent tampon and changing tampons frequently, at least every 4 to 6 hours. Which condition is the nurse most likely trying to prevent? a.toxic shock syndrome b.vaginitis c.pelvic inflammatory disease d.cervicitis

a.toxic shock syndrome

The nurse is obtaining a history from a client who states recurrent breast tenderness. The client inquires if there is something wrong with her breasts. Which question by the nurse is a priority? a. "Do you have a history of breast disorders and cancer in the family?" b. "Does the tenderness occur around the same time each month?" c. "Have you pulled a muscle or had any injury to the breast?" d. "When did you first recognize the symptoms?"

b. "Does the tenderness occur around the same time each month?"

Following a colposcopy, the confirmation of in situ carcinoma of the cervix has been determined. Which comment by the client indicates an appropriate understanding of the diagnosis? a. "I will not need any further treatment." b. "The cancer has not spread." c. "I will need surgery and chemotherapy to increase my odds for survival." d. "I can wait until I have finished having babies to seek treatment."

b. "The cancer has not spread."

A client reports loss of interest in sexual relations and discomfort during intercourse. Which is the best response by the nurse? a. "Don't worry, every woman goes through this." b. "These are normal, manageable symptoms of menopause." c. "You need to discuss this with your spouse." d. "Hormone replacement therapy can resolve your symptoms."

b. "These are normal, manageable symptoms of menopause."

Which statement made by a client about breast cancer indicates correct understanding of the disease? a."Breast cancer is the leading cause of cancer deaths among women in the United States." b."Breast cancer is the leading type of cancer among women in North America." c."Late onset of menses and early menopause increase the risk for breast cancer." d."Breast cancer decreases with age, and very old women have virtually no risk."

b."Breast cancer is the leading type of cancer among women in North America."

A woman is asking about monthly breast self-examination (BSE). What information does the nurse provide to the client? a."It is a valuable tool for finding breast lumps early." b."After menopause, it is no longer useful." c."BSE should be combined with other assessments." d."Women in their 30s should begin monthly BSE."

c."BSE should be combined with other assessments."

A client has had a right modified radical mastectomy and axillary lymph node dissection. The nurse is teaching the client about measures to reduce the risk of complications. The client demonstrates understanding of the instructions when she states which of the following? a."Anytime I need blood drawn, they should get the sample from my right arm." b."I need to use an electric shaver when shaving my right armpit." c."I can lift with my right arm objects that weigh as much as 15 pounds." d."I should tell my manicurist that it is okay to trim the cuticles on my right hand."

b."I need to use an electric shaver when shaving my right armpit."

Cone biopsy describes a procedure in which cervical tissue is removed as result of detection of abnormal cells. Which statements by the client demonstrates that the client undergoing a cone biopsy understands the discharge instructions? a."I require a repeat conization in 2 weeks after the edema subsides." b."I will avoid having sexual relations until I see the doctor again." c."I will use a Sitz bath to relieve pain caused by the sutures." d."I will need to use a menstrual pad to capture the moisture as my cervix unfreezes."

b."I will avoid having sexual relations until I see the doctor again."

A client is experiencing lymphedema in the arm on the operative side after a modified radical mastectomy. Which statement indicates correct understanding of managing this problem? a."I will reduce my intake of salt and water." b."I will elevate my arm on a pillow at night." c."I will try to drink at least 3 liters of water each day." d."I will wear long sleeves to prevent sun exposure."

b."I will elevate my arm on a pillow at night."

The nurse is performing discharge teaching for a client who is recovering from a total abdominal hysterectomy (TAH). Which client statement indicates a need for clarification? a."I will no longer have menstrual periods." b."I will need to find a new form of birth control." c."I must take my temperature twice a day for the first few days after surgery." d."I cannot jog for 2 to 6 weeks."

b."I will need to find a new form of birth control."

The nurse is preparing to begin a pelvic examination of a female client in the health clinic. The client states, "These exams make me feel so nervous and out of control." How should the nurse respond? Select all that apply. a."The exam takes about 20 minutes but I will make sure you are comfortable the entire time." b."If you feel pain let me know because this is not something you should expect." c."Many people feel nervous before and while having this examination." d."If you like, I can give you a mirror so you can watch the examination." e."It can help you relax if you use deep breath and meditation during the exam."

b."If you feel pain let me know because this is not something you should expect." c."Many people feel nervous before and while having this examination." d."If you like, I can give you a mirror so you can watch the examination." e."It can help you relax if you use deep breath and meditation during the exam."

The nurse is preparing a client for a pelvic examination. The client asks the nurse, "Why do I need to urinate and empty my bladder?" Which response by the nurse would be most appropriate? a."Emptying your bladder allows us to obtain a urine sample for testing." b."It helps make you more comfortable and the exam easier." c."We want to make sure that you don't have an infection." d."A full bladder interferes with getting a specimen for a Pap smear."

b."It helps make you more comfortable and the exam easier."

The nurse is completing community education when asked by a client without health insurance why a mammogram is needed if the women are completing breast self-examinations at home. The nurse is most correct to respond stating which of the following? a."Mammograms are just better." b."Mammograms can detect cysts or tumors too small to palpate." c."Mammograms provide a baseline that shows changes in breast tissue." d."Mammograms provide a reassurance that the breast is free of cancer."

b."Mammograms can detect cysts or tumors too small to palpate."

A client asks how soon after a mastectomy she can engage in sexual activity. Which is the nurse's best response? a."When do you want to resume sexual activity?" b."Most surgeons say to wait several weeks after the operation." c."As soon as the incision has healed completely." d."You shouldn't worry about sexuality right now."

b."Most surgeons say to wait several weeks after the operation."

Which exercise plan or activity does the nurse teach the client for the first postoperative day after a modified radical mastectomy? a."Perform no movement or exercise today. Keep the arm supported and the elbow flexed, and as close to your body as possible." b."Without moving your shoulder, straighten your elbow three times hourly and squeeze a rubber ball with your fingers." c."Face the wall and extend your arm straight out to the wall. Walk your fingers as far above your head as your arm will reach, and then walk them back down." d."Hold your operative arm straight out from the shoulder to the side. Use your nonoperative arm to pull the operative arm completely straight above your head."

b."Without moving your shoulder, straighten your elbow three times hourly and squeeze a rubber ball with your fingers."

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? a.3 to 4 days b.5 to 7 days c.8 to 9 days d.After the 10th day

b.5 to 7 days

Which gynecologic client does the charge nurse assign to an LPN/LVN? (Select all that apply.) Select all that apply. a.A 52 year old who just returned to the unit following a total abdominal hysterectomy. b.A 42 year old who had an abdominal hysterectomy whose primary health care provider wants to remove sutures at her bedside. c.A 48 year old who is receiving IV chemotherapy to treat stage II cervical cancer. d.A 23 year old who is nauseated after her laparotomy and needs to receive antiemetic drugs. e.A 34 year old who had a total hysterectomy for invasive cervical cancer and has a blood pressure (BP) of 88/54 mm Hg.

b.A 42 year old who had an abdominal hysterectomy whose primary health care provider wants to remove sutures at her bedside. d.A 23 year old who is nauseated after her laparotomy and needs to receive antiemetic drugs.

A 20-year-old client is interested in protection from the human papilloma virus (HPV) since she may become sexually active. Which response from the nurse is the most accurate? a.You are too old to receive an HPV vaccine. b.Either Gardasil or Cervarix can provide protection. c.You will need to have three injections over a span of 1 year. d.The most common side effect of the vaccine is itching at the injection site.

b.Either Gardasil or Cervarix can provide protection.

Which client does the RN assess first after receiving change-of-shift report? a.A 45 year old with a history of hypothyroidism who is scheduled for a hysterectomy and bladder suspension. b.A 54 year old with an anterior and posterior colporrhaphy who has an elevated heart rate and an oral temperature of 101.2° F (38.4° C). c.A 50 year old who is receiving morphine through a client-controlled analgesia (PCA) device after a hysterectomy and who rates her pain at a level 3 (0-10 scale). d.A 48 year old who is reporting abdominal pain and light vaginal spotting after an endometrial biopsy.

b.A 54 year old with an anterior and posterior colporrhaphy who has an elevated heart rate and an oral temperature of 101.2° F (38.4° C).

Four women phone the gynecology clinic about having new-onset of spotty vaginal bleeding. Which call does the RN decide to return first? a.A 34 year old with a history of multiple leiomyomas b.A 65 year old with no previous gynecologic problems c.A 48 year old who had an endocervical curettage yesterday d.A 23 year old using medroxyprogesterone acetate

b.A 65 year old with no previous gynecologic problems

A 33-year-old female client is recovering from a modified radical mastectomy with immediate reconstruction. This is the client's fourth day postoperatively. Her vital signs are temperature 99°F, pulse 82, respirations 18, and blood pressure 152/90. She continues to complain of considerable pain, with a pain rating of 9 on a scale of 1 to 10, with 10 being the worst possible pain. The client was discharged home with a prescription for oxycodone and acetaminophen and has been taking the drugs as prescribed. Which assessment finding would cause the nurse to phone the physician? a.Itching and slight erythema at the incision site b.A well-defined oval area near the incision site c.Small amount of serous drainage at the incision site d.White blood count (WBC) of 7,000 μL

b.A well-defined oval area near the incision site

What task does the RN delegate to assistive personnel (AP) working on the medical-surgical unit? a.Inserting a catheter in a client who has a history of uterine prolapse b.Assisting with a sitz bath for a client who is postposterior colporrhaphy c.Giving report to a receiving nurse about a client who is being transferred d.Providing discharge teaching for a client who is scheduled for brachytherapy

b.Assisting with a sitz bath for a client who is postposterior colporrhaphy

A client is struggling with body image after breast cancer surgery. Which behavior indicates to the nurse that the client's coping is maladaptive? a.Requesting a temporary prosthesis b.Avoiding eye contact with staff c.Saying, "I feel like less of a woman" d.Saying, "This is the ugliest scar ever"

b.Avoiding eye contact with staff

A client who underwent an anterior colporrhaphy 6 hours ago has not voided. She reports some discomfort in her suprapubic area. Which of the following would the nurse expect to do? a.Administer a stool softener. b.Catheterize the client. c.Obtain an order for an analgesic. d.Apply ice to the area.

b.Catheterize the client.

A woman in her late 30s has been having unusually heavy menstrual periods combined with occasional urine and stool leakage over the past few weeks. Upon further enquiry, she reveals that she also has postcoital pain and bleeding. To which diagnosis will the investigation most likely lead? a.Hodgkin disease b.Cervical cancer c.Colorectal cancer d.Cancer of the urinary tract

b.Cervical cancer

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? a.Long-term surveillance b.Chemoprevention c.Prophylactic mastectomy d.Radiation therapy

b.Chemoprevention

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? a.Client reports a sensation of pulling in the breast area. b.Client states that feeling in her breast area will gradually subside with time. c.Client demonstrates appropriate use of prescribed analgesic. d.Client identifies appropriate measures to reduce the risk of lymphedema.

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

A client had a mastectomy and axillary node dissection. The nurse empties sanguineous drainage from the client's incisional Jackson-Pratt drain on the first postoperative day. Which other action regarding the drain is of high priority for the nurse? a.Flushing the tubing with urokinase to ensure patency b.Compressing and closing the drain to ensure suction c.Advancing the tubing inch from the insertion site d.Clamping the drain for 2 hours and releasing it for 2 hours

b.Compressing and closing the drain to ensure suction

Which term describes a procedure in which cervical tissue is removed because abnormal cells are detected? a.Colporrhaphy b.Cone biopsy (conization) c.Cryotherapy d.Perineorrhaphy

b.Cone biopsy (conization)

A client is scheduled to undergo a Papanicolaou test. The nurse should advise the client of which preparation? a.Avoid intercourse for 7 days before the procedure b.Do not douche before the procedure c.Make sure the procedure is scheduled during menstruation d.Avoid consuming food that contains iodine 48 hours before the procedure

b.Do not douche before the procedure

A nurse is preparing a teaching plan for a client with a vulvovaginal infection. Which teaching would not be appropriate for the nurse to include? a.Maintain a reclining position for 30 minutes after inserting vaginal medication. b.Douche with a dilute vinegar solution twice a day. c.Wear cotton underwear that is loose-fitting and allows for air flow. d.Refrain from unprotected sexual intercourse with partners.

b.Douche with a dilute vinegar solution twice a day.

Which term refers to painful menstruation? a.Amenorrhea b.Dysmenorrhea c.Ovulation d.Dyspareunia

b.Dysmenorrhea

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? a.Dysmenorrhea b.Dyspareunia c.Dysuria d.Dysthymia

b.Dyspareunia

Nursing students are reviewing various procedures that can be used to obtain a tissue biopsy of the breast. They demonstrate understanding of the material when they identify which of the following as being done using local anesthesia and intravenous (IV) sedation? Select all that apply. a.Fine-needle aspiration b.Excisional biopsy c.Stereotactic biopsy d.Wire needle localization e.Core needle biopsy

b.Excisional biopsy d.Wire needle localization

The nurse is assessing a client with a history of ductal ectasia. Which signs and symptoms supporting this diagnosis does the nurse correlate with this condition? (Select all that apply.) a.A soft mass on palpation b.Greenish-brown nipple discharge c.Enlarged axillary nodes d.A mass with regular borders e.Redness and edema over the site of the mass f.Mass tenderness on palpation

b.Greenish-brown nipple discharge c.Enlarged axillary nodes e.Redness and edema over the site of the mass f.Mass tenderness on palpation

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? a.Chronic pelvic inflammatory disease b.Infertility c.Pelvic pain d.Ascending infection

b.Infertility

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. a.In a cluster, not singular b.Irregular in shape c.Round and lobular d.Fixed to the skin e.Associated with signs of retraction

b.Irregular in shape d.Fixed to the skin e.Associated with signs of retraction

A patient is diagnosed with the most common type of uterine fibroid, an intramural fibroid. The nurse includes which information in teaching the patient about this type of fibroid? a.It lies underneath the outermost layer of the uterus. b.It grows within the wall of the uterine muscle. c.It grows below the inner uterine surface. d.It arises from inside or outside the surface of the uterine muscle.

b.It grows within the wall of the uterine muscle.

A client has recently been diagnosed with stage III endometrial cancer and asks the nurse for an explanation. What response by the nurse is correct about the staging of the cancer? a.The cancer has spread to the mucosa of the bowel and bladder. b.It has reached the vagina or lymph nodes. c.The cancer now involves the cervix. d.It is contained in the endometrium of the cervix.

b.It has reached the vagina or lymph nodes.

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? a.Breast abscess b.Lymphedema c.Fibrocystic breast disease d.Fibroadenoma

b.Lymphedema

A nurse is preparing a presentation for a health fair about preventing breast cancer. Which of the following would the nurse include? a.Delaying childbearing until after age 30 b.Maintaining an ideal weight c.Opting for estrogen only replacement therapy during menopause d.Increasing the intake of caffeinated drinks

b.Maintaining an ideal weight

On a visit to the gynecologist, a client complains of urinary frequency, pelvic discomfort, and weight loss. After a complete physical examination, blood studies, and a pelvic examination with a Papanicolaou test, the physician diagnoses stage IV ovarian cancer. The nurse expects to prepare the client for which initial treatment? a.Radiation therapy b.Major surgery c.Chemotherapy d.None (At this advanced stage, ovarian cancer isn't treatable.)

b.Major surgery

A 45-year-old woman has a family history of breast cancer. She herself was diagnosed with breast cancer 2 months ago. During a routine visit, the physician informs her that she has to undergo radiation as soon as possible to avoid spreading of the cancer. Which symptom would prompt radiation therapy? a.Frequent bloody discharge from the breast b.Massive swelling in her arm c.Coarse skin around her breast d.Nipple retraction

b.Massive swelling in her arm

Which is inconsistent as a risk factor for breast cancer? a.Late menopause b.Multiparity c.Older age d.Family history of breast cancer

b.Multiparity

A client tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client's lump is cancerous? a.Eversion of the right nipple and mobile mass b.Nonmobile mass with irregular edges c.Mobile mass that is soft and easily delineated d.Nonpalpable right axillary lymph nodes

b.Nonmobile mass with irregular edges

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? a.Late menopause b.Nulliparity c.Family history of hypertension d.Family history of breast cancer

b.Nulliparity

An 18-year-old female is diagnosed with possible toxic shock syndrome (TSS) and has these vital signs: T 103.2° F (39.6° C), P 124 beats/min, R 36 breaths/min, BP 84/30 mm Hg. Which primary health care provider request does the nurse implement first? a.Begin infusion of normal saline IV b.Obtain blood cultures × 2 sites. c.Administer corticosteroids as prescribed. d.Give cefazolin as prescribed.

b.Obtain blood cultures × 2 sites. the answer it gives is to give corticosteroids but I do not agree this is the first thing to do

A nurse is providing care to a client who was just admitted with a diagnosis of ectopic pregnancy. When reviewing the client's history, which of the following would the nurse identify as a major risk factor for this client? a.Combined hormonal contraceptive use b.Pelvic inflammatory disease (PID) c.Use of in vitro fertilization d.Habitual abortions

b.Pelvic inflammatory disease (PID)

Which is an inaccurate manifestation of a fibroadenoma? a.Usually tender b.Premenstrual changes do not occur c.Are not round or lobular d.Biopsy is not indicated for definitive diagnosis

b.Premenstrual changes do not occur

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? a.Aggressive treatment, including surgery, radiation, and hormonal therapy b.Recurrence within 2 years of the original diagnosis c.No maternal family history of breast cancer d.Previous therapeutic response to chemotherapy

b.Recurrence within 2 years of the original diagnosis

A client is admitted to the emergency department with toxic shock syndrome. Which action by the nurse is the most important? a.Administer IV fluids to maintain fluid and electrolyte balance. b.Remove the tampon as the source of infection. c.Collect a blood specimen for culture and sensitivity. d.Transfuse the client to manage low blood count.

b.Remove the tampon as the source of infection.

A perimenopausal woman informs the nurse that she is having irregular vaginal bleeding. What should the nurse encourage the patient to do? a.Stop taking her Premarin (hormonal therapy). b.See her gynecologist as soon as possible. c.Disregard this phenomenon because it is common during this life stage. d.Mention it to her physician during her next annual examination.

b.See her gynecologist as soon as possible.

Which of the following would the nurse expect to find when assessing the breasts of a client with fibrocystic breast disease? a.Nipple retraction b.Soft mass c.Enlarged lymph nodes d.Skin dimpling

b.Soft mass

The nurse is doing preoperative teaching for a client who is scheduled for removal of cervical polyps in the office. Which statement by the client indicates a correct understanding of the procedure? a.I hope that I do not have cancer of the cervix. b.There should be little or no discomfort during the procedure. c.There may be a lot of bleeding after the polyp is removed. d.This may prevent me from having any more children.

b.There should be little or no discomfort during the procedure.

The nurse is caring for a client who will be having artificial implants for breast reconstruction. The client is arriving at the physician's office for which procedure to be completed before the surgery can be done? a.Incisional alignment b.Tissue expansion c.Fluid drainage d.Pain control

b.Tissue expansion

A patient diagnosed with endometriosis asks for an explanation of the disease. What should the nurse explain to the patient? a.She has developed an infection in the lining of her uterus. b.Tissue from the lining of the uterus has implanted in areas outside the uterus. c.The lining of the uterus is thicker than usual, causing heavy bleeding and cramping. d.The lining of the uterus is too thin because endometrial tissue has implanted outside the uterus.

b.Tissue from the lining of the uterus has implanted in areas outside the uterus.

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? a.Avoid working in the garden or yard altogether. b.Wear gloves and protective clothing to avoid any injuries. c.Increase the frequency of follow-up visits if she does works. d.Avoid household chores for at least 6 to 9 months.

b.Wear gloves and protective clothing to avoid any injuries.

A client is prescribed androgen therapy. Which of the following would the nurse explain as a possible adverse effect? a.Severe bleeding from the vagina b.Weight gain c.Decreased libido d.Areolar pigmentation

b.Weight gain

Which dinner selection demonstrates an understanding of nutritional therapy used by women to decrease the signs and symptoms of menopause? a.Saltine crackers, fruit cocktail, lima beans, and meatloaf b.Wheat toast, apple slices, broiled chicken breast, and steamed carrots c.White toast, apple sauce, grilled chicken, and glazed carrots d.Corn chips, grapes, lean meat, and baked beans

b.Wheat toast, apple slices, broiled chicken breast, and steamed carrots

A patient is receiving chemotherapy with paclitaxel as treatment for ovarian cancer. The patient arrives at the facility for laboratory testing prior to her next dose of chemotherapy. The results are as follows: Hemoglobin: 12.9 gm/dL White blood cell count: 2,200 /cu mm Platelets: 250,000 /cu mm Red blood cell count: 4,400,00/cu mm Which result would be a cause for concern? a.Hemoglobin level b.White blood cell count c.Platelet count d.Red blood cell count

b.White blood cell count

Which client does the nurse encourage to seek genetic counseling regarding her risk for BRCA1 or BCRA2 gene mutation-related breast cancer? a.Woman whose father had lung cancer and mother had leukemia b.Woman whose sister has breast cancer and mother has ovarian cancer c.Woman whose fraternal twin sister has breast cancer d.Older woman who has bilateral benign breast disease

b.Woman whose sister has breast cancer and mother has ovarian cancer

A client is scheduled to start external beam radiation therapy (EBRT) for her endometrial cancer. Which teaching by the nurse is accurate? (Select all that apply.) a.You will need to be hospitalized during this therapy. b.Your skin needs to be inspected daily for any breakdown. c.It is not wise to stay out in the sun for long periods of time. d.The perineal area may become damaged with the radiation. e.The technician applies new site markings before each treatment.

b.Your skin needs to be inspected daily for any breakdown. c.It is not wise to stay out in the sun for long periods of time. d.The perineal area may become damaged with the radiation.

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: a.she will be in a private room with unrestricted activities. b.a bowel-cleansing procedure will precede radioactive implantation. c.she will be expected to use a bedpan for urination. d.the preferred position in bed will be semi-Fowler's.

b.a bowel-cleansing procedure will precede radioactive implantation.

During a routine sports physical examination, the nurse practitioner recommends HPV vaccination for an 11-year-old girl. Which statements by the client's mother demonstrates understanding of HPV vaccinations? a. "This vaccination is not indicated for my son, since boys cannot receive the HPV vaccine." b. "If my daughter is immunized against HPV, she can delay her first scheduled Pap test." c. "I will track follow-up appointments in my smartphone so she receives all three injections." d. "It's nice that she can take this vaccination intranasally, to avoid repeated injections."

c. "I will track follow-up appointments in my smartphone so she receives all three injections."

A client who has had a left total mastectomy is about to view her surgical site for the first time. Which of the following would be most appropriate for the nurse to say? a."You need to look at the incision so you can heal emotionally." b."Don't be afraid. Everybody feels the same way." c."Do you feel like you're ready to look at your incision now?" d."Did you have reconstructive surgery when they removed your breast?"

c."Do you feel like you're ready to look at your incision now?"

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? a."Ovarian cysts are just that, cysts and not a cause for concern." b."Ovarian cysts can be malignant but this is a rare occurrence." c."Most cysts are benign in younger women, but it's good to have it checked out." d."Since you don't have any symptoms, the chances of having cancer are really remote."

c."Most cysts are benign in younger women, but it's good to have it checked out."

A 52-year-old client asks the nurse how she is to remember when to schedule her clinical breast examination. Which response by the nurse is most correct? a."The office staff can schedule your clinical breast examination twice a year." b."The diagnostic center will send you a reminder card to complete the annual examination." c."The clinical breast evaluation will be completed with annual gynecologic examination." d."You can complete the examination at home and report if you found anything abnormal."

c."The clinical breast evaluation will be completed with annual gynecologic examination."

A client has just been diagnosed with fibrocystic breast disease. She asks what this means in terms of her health. Which is the nurse's best response? a."This increases your risk for breast cancer, so schedule yearly mammograms." b."This will increase as you age, especially if you have never been pregnant." c."This will diminish with menopause if you don't take replacement hormones." d."This is genetic and you should teach your daughters about it."

c."This will diminish with menopause if you don't take replacement hormones."

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? a."This will have no bearing on your test today." b."We will proceed with the examination and reschedule your Pap smear for next week." c."We will reschedule your examination when you have finished menstruating." d."We will do the test and take into consideration that you are menstruating."

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

A client with a family history of breast cancer tells the nurse that she has made several recent lifestyle changes. Which question by the nurse about these practices is most important? a."Are you a vegetarian?" b."Do you drink green tea?" c."What supplements do you use?" d."Do you smoke cigarettes?"

c."What supplements do you use?"

The nurse is teaching a client who is undergoing brachytherapy about what to immediately report to her health care provider. Which signs and symptoms would be included in this teaching? (Select all that apply.) a.Constipation for 3 days b.Temperature of 99 F c.Abdominal pain d.Visible blood in the urine e.Heavy vaginal bleeding

c.Abdominal pain d.Visible blood in the urine e.Heavy vaginal bleeding

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? a.Age at menarche b.Cesarean deliveries c.Age at first pregnancy d.Alcohol use

c.Age at first pregnancy

The clinic nurse is preparing a client for a physical and breast examination. The nurse notes the client's breast appears as shown in the photograph below. Which action by the nurse takes priority? a.Continue preparations and note the finding in the client's chart. b.Ask the client how long this problem has been present. c.Alert the health care provider and prepare to order a mammogram. d.Question the client about routine drug and alcohol intake.

c.Alert the health care provider and prepare to order a mammogram.

A client has undergone a total abdominal hysterectomy and bilateral salpingo-oophorectomy 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? a.Leukopenia b.Neurotoxicity c.Bladder dysfunction d.Clotting deficiencies

c.Bladder dysfunction

The nurse is caring for a female client with uterine leiomyoma. What is the most likely assessment finding the nurse anticipates? a.Anxiety b.Pain c.Bleeding d.Constipation

c.Bleeding

During consultations with the oncologist, a client with cervical cancer is informed that radioactive materials will be inserted in the area of the tumor. She has to undergo these sessions over a period of 3 weeks. Which method of cancer treatment is being described? a.Antineoplastic therapy b.Chemotherapy c.Brachytherapy d.Needle aspiration biopsy

c.Brachytherapy

A 48-year-old woman with the BRCA genetic mutation requests information about early detection for her daughter due to genetic risk. Which information will the nurse convey? a.Breast self-examination (BSE) beginning at 20 years of age is the best way to detect breast cancer. b.Hormone replacement therapy (HRT) combining estrogen and progesterone may be recommended by your daughter's primary health care provider. c.Cancer screening for the daughter would begin at age 38. d.The health care provider will discuss prophylactic mastectomy as the definitive option for prevention.

c.Cancer screening for the daughter would begin at age 38.

A nurse practitioner examines a patient suspected of having endometriosis. The nurse knows that although a definitive diagnosis could not be made without diagnostic treatment (transvaginal ultrasound), the most frequent symptom is: a.Dysuria. b.Low back pain. c.Chronic pelvic pain. d.Dyspareunia.

c.Chronic pelvic pain.

Which client being cared for on the medical-surgical unit is appropriate for the nurse to assign to a nurse who has floated from the intensive care unit (ICU)? a.Recent radical mastectomy client requiring chemotherapy administration b.Modified radical mastectomy client needing discharge teaching c.Client with a Jackson-Pratt drain who had a mastectomy yesterday d.Stage III breast cancer client requesting information about radiation and chemotherapy

c.Client with a Jackson-Pratt drain who had a mastectomy yesterday

A group of students is reviewing information about breast cancer and metastasis in preparation for an examination. The students demonstrate the need for additional study when they identify which of the following as a common site for metastasis? a.Bone b.Lungs c.Colon d.Liver

c.Colon

A nurse is reviewing various treatment methods with a client diagnosed with a cystocele. Which of the following would the nurse describe as a nonsurgical method? Select all that apply. a.Colporrhaphy b.Perineorrhaphy c.Colpexin sphere d.Kegel exercises e.Pessary

c.Colpexin sphere d.Kegel exercises e.Pessary

A 55-year-old post-menopausal woman is assessed by the nurse with a history of dyspareunia, backache, pelvis pressure, urinary tract infections, and a frequent urinary urgency. Which condition does the nurse suspect? a.Ovarian cyst b.Rectocele c.Cystocele d.Fibroid

c.Cystocele

The nurse is teaching a client how to prevent vulvovaginitis. What information does the nurse include? a.Cleanse the inner labia daily with soap and water. b.Monthly douching may help reduce symptoms. c.Do not have unprotected sex with multiple partners. d.Wear snug-fitting polyester undergarments to prevent chafing.

c.Do not have unprotected sex with multiple partners.

Which of the following instructions would be appropriate to include when preparing a woman for an abdominal ultrasound? a.Restrict solid food intake for 2 hours before the test. b.Refrain from douching for at least 1 week before the test. c.Drink at least 1 quart of water an hour before the test. d.Empty the bladder immediately before the test.

c.Drink at least 1 quart of water an hour before the test.

The nurse is caring for a client with breast cancer and removal of axillary lymph nodes. Which assessment finding is documented and brought to the physician's attention as potential lymphedema? a.A reddened area around the breast b.Fluid accumulation under in the axilla c.Enlargement of the arm or hand d.Drainage from the areola

c.Enlargement of the arm or hand

A client is scheduled for an abdominal ultrasound as a follow up to her pelvic examination. Which action by the nurse would be most appropriate? a.Giving the client a mild sedative before the procedure b.Administering laxatives and an enema prior to the procedure c.Ensuring that the client has a full bladder d.Checking that it has been 5 days since the end of her menses

c.Ensuring that the client has a full bladder

The client is asking if there is a pill that can be ordered to control the symptoms of menopause. Which assessment finding is most important in determining nursing care in association with hormone replacement therapy? a.Presence of kyphosis b.Symptoms of hot flashes c.Family history of breast cancer d.History of osteoporosis

c.Family history of breast cancer

A 28-year-old woman is learning about breast self-examination. The nurse teaches the woman that the best time of each month to examine her breasts is during the: a.Week before menstruation occurs. b.Week that menstruation occurs. c.First week after menstruation. d.Week that ovulation occurs.

c.First week after menstruation.

A woman comes to the emergency department reporting vaginal discharge and pelvic pain that increases with urination. The client also reports nausea and vomiting, headache, and anorexia. A pelvic examination reveals cervical motion tenderness. The client is diagnosed with acute pelvic inflammatory disease (PID) and is admitted. Which of the following would be most appropriate to include in this client's plan of care? a.Applying cool compresses to the abdomen b.Instituting airborne infection control precautions c.Maintaining bedrest in the semi-Fowler's position d.Inserting an indwelling urinary (Foley) catheter

c.Maintaining bedrest in the semi-Fowler's position

A 30-year-old woman comes to the clinic for a routine examination. During the visit, the nurse would least likely recommend which of the following as important for health screening? a.Annual pelvic examination b.Yearly clinical breast examination c.Mammography d.Pap smear every 3 years

c.Mammography

Which is the main cause of anemia in a client with active uterine leiomyoma? a.Poor intake of foods containing iron b.Hemolysis c.Menorrhagia d.Pressure of the fibroid on the pelvic veins

c.Menorrhagia

A client is being treated with anastrozole (Arimidex) for breast cancer. The nurse is developing a plan of care for the client. Which intervention is the highest priority? a.Teach the client to weigh herself each day at the same time. b.Instruct the client to keep a symptom journal for menopausal symptoms. c.Monitor the client closely for evidence of osteoporosis. d.Review the client's dietary habits to prevent weight gain.

c.Monitor the client closely for evidence of osteoporosis.

A client is receiving adjuvant chemotherapy for breast cancer. Which is most likely her node status and tumor size? a.Node negative, tumor size 0.3 cm b.Node negative, tumor size 0.5 cm c.Node negative, tumor size 1.2 cm d.Node negative, tumor size 0.2 cm

c.Node negative, tumor size 1.2 cm

A client has a recurrent Bartholin cyst. What is the nurses priority action? a.Apply an ice pack to the area. b.Administer a prophylactic antibiotic. c.Obtain a fluid sample for laboratory analysis. d.Suggest moist heat such as a sitz bath.

c.Obtain a fluid sample for laboratory analysis.

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? a.Back pain b.Low self-esteem c.Others disapprove d.Skin irritation

c.Others disapprove

While caring for a client who is being treated for severe pelvic inflammatory disease (PID), which nursing action minimizes transmission of infection? a.Strictly adhering to the no visitation policy b.Implementing reverse isolation precautions c.Performing hand hygiene when entering the room d.Keeping the client in a sitting position

c.Performing hand hygiene when entering the room

A patient is diagnosed with stage 3 ovarian cancer. The nurse's best response would be to explain that the majority of women (75%) respond to treatment. The nurse should also explain that stage 3 ovarian cancer involves which of the following? a.The presence of the tumor on the external surface of the ovary b.A ruptured tumor capsule with extension into the pelvic region c.Peritoneal metastasis d.Metastasis beyond the peritoneal cavity

c.Peritoneal metastasis

A client is admitted to the health care center with abdominal pain, nausea, and vomiting. The client has a body mass index (BMI) of 30 and reports irregular menstrual cycles and feeling tired all the time. The nurse suspects the client's symptoms to indicate which condition? a.Bacterial vaginosis b.Cancer of the cervix c.Polycystic ovary syndrome (PCOS) d.Endometriosis

c.Polycystic ovary syndrome (PCOS)

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? a.Relieving edema to lower extremities b.Alterations for sexual function c.Prevention of wound complications d.Care of colostomy site

c.Prevention of wound complications

A client is postoperative from a left-sided mastectomy. She says that the incision and the inner side of her arm from the armpit to the elbow are numb. Which is the nurse's best action? a.Teach the client to avoid lifting heavy objects. b.Measure the circumference of the client's left arm. c.Reassure the client that this is an expected finding. d.Notify the surgeon as soon as possible.

c.Reassure the client that this is an expected finding.

The nurse is teaching a client how to perform breast self-examination (BSE). Which of these techniques does the nurse include in the teaching session? (Select all that apply.) Select all that apply. a.Perform the self-examination 1 week before a menstrual period. b.Teach to keep her arm by her side while performing the examination. c.Remind that a clinical breast examination and mammography are still recommended. d.Use light, medium, and then firm pressure to feel the tissue. e.A bra can be left in place during the self-examination.

c.Remind that a clinical breast examination and mammography are still recommended. d.Use light, medium, and then firm pressure to feel the tissue.

Which position occurs when the uterus turns posteriorly as a whole unit? a.Anteversion b.Retroflexion c.Retroversion d.Anteflexion

c.Retroversion

A client with vaginitis complains of itching and burning of the perineum. Which suggestion would be most appropriate to relieve the client's symptoms? a.Use a pure vinegar douche daily. b.Use skin protectants containing zinc oxide. c.Take sitz baths frequently. d.Avoid yogurt with active lactobacilli cultures.

c.Take sitz baths frequently.

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)? a.Anastrozole b.Letrozole c.Tamoxifen d.Exemestane

c.Tamoxifen

A patient has a diagnosis of stage III ovarian cancer and wants to know what organs are involved. What information should be provided to the patient? a.The cancer involves only the ovaries. b.The cancer involves the ovaries with pelvic extension. c.The cancer involves metastases outside the pelvis. d.The cancer involves distant metastases.

c.The cancer involves metastases outside the pelvis.

To treat cervical cancer, a client has had an applicator of radioactive material placed in the vagina. Which observation by the nurse indicates a radiation hazard? a.The client is maintained on strict bed rest. b.The head of the bed is at a 30-degree angle. c.The client receives a complete bed bath each morning. d.The nurse checks the applicator's position every 4 hours.

c.The client receives a complete bed bath each morning.

A patient had a sentinel node biopsy and informs the nurse that something is very wrong with her. The patient explains that she had a bowel movement and urinated and both are a blue color. What should the nurse inform the patient? a.The cancer may be invasive and holding on to some of the dye that is used. b.The patient must be having a reaction to the dye that was used. c.The dye that was used during the biopsy is safe and being excreted. d.The physician will have to discuss this with her.

c.The dye that was used during the biopsy is safe and being excreted.

The client arrives at a public health clinic worried that she has breast cancer since finding a lump in her breast. When assessing the breast, which assessment finding is characteristic of fibrocystic disease? a.One breast is larger than the other. b.The lump is firm and immovable. c.The lump is round and movable. d.Nipple retractions are noted.

c.The lump is round and movable.

A 24-year-old client births a healthy female infant. Incidentally, the client was given diethylstilbestrol (DES) during her pregnancy. It is important that the nurse stresses frequent gynecological examinations of client's daughter when she reaches a certain age because of which concern? a.To ensure regularized menstruation cycles in the client's daughter b.To ensure that the client's daughter has a complication-free pregnancy c.To prevent the onset of vaginal carcinoma in the client's daughter d.To prevent the onset of vulvar cancer in the client's daughter

c.To prevent the onset of vaginal carcinoma in the client's daughter

Which of the following would be most important to determine when assessing a client being admitted for suspected toxic shock syndrome (TSS)? a.Existence of menorrhagia b.Psychological trauma c.Use of superabsorbent tampons d.Use of oral contraceptives

c.Use of superabsorbent tampons

A 32-year-old client has small uterine fibroids and is considering options for treatment. To assist the woman to make a decision about whether to have magnetic resonance-guided focused ultrasound or uterine artery embolization, what will the nurse determine? a.If there is a history of abortion in the past b.Client's risk for uterine cancer c.Whether the client desires to have children d.Age of onset of first menstrual period

c.Whether the client desires to have children

A client who had intracavity radiation treatment for cervical cancer 1 month earlier reports small amounts of vaginal bleeding. This finding most likely represents: a.recurrence of the carcinoma. b.development of a rectovaginal fistula. c.an expected effect of the radiation therapy. d.infection secondary to a change in vaginal flora.

c.an expected effect of the radiation therapy.

A client is undergoing treatment for breast cancer and asks the nurse about "natural" treatments for her chemotherapy-induced nausea. Which is the most appropriate response by the nurse? a."Anything you can take will interfere with your chemotherapy." b."I don't know of any recommended complementary treatments for nausea." c."Black cohosh and flaxseed are good for combating nausea." d."Ginger has been used for nausea, would you consider taking it?"

d."Ginger has been used for nausea, would you consider taking it?"

Which comment made by a client with breast cancer indicates correct understanding regarding cancer causes and prevention? a."I will prevent recurrence of my cancer by eating a low-fat diet from now on." b."If I had breast-fed my children, this would not have happened to me." c."I hope this doesn't increase my risk for bone cancer or lung cancer." d."I will have regular mammograms on my other breast to detect cancer early."

d."I will have regular mammograms on my other breast to detect cancer early."

A client receiving tamoxifen (Tamofen) asks how this therapy helps fight breast cancer. Which is the nurse's best response? a."This agent decreases estrogen levels. so the cancer stops growing." b."The drug causes you to secrete testosterone, which limits cancer growth." c."Tamoxifen kills estrogen-secreting cells and growth of blood vessels to cancer cells." d."It blocks estrogen receptors, and this limits cancer cell growth."

d."It blocks estrogen receptors, and this limits cancer cell growth."

A client had a total abdominal hysterectomy 2 days ago and is to be discharged on antibiotics. What does the nurse include in discharge teaching? a."Stop the antibiotic if you feel nauseated because it will lose its effectiveness." b."You will need to take the drug until your incision heals." c."After your first day at home, you can stop them if you do not have a fever." d."It is important to take them as directed until they are all gone."

d."It is important to take them as directed until they are all gone."

A client who has discovered a lump in her breast becomes tearful when scheduling a mammogram. Which is the nurse's best response? a."All lumps are considered cancerous until proven otherwise." b."Unless you have a relative with breast cancer, this lump is probably benign." c."Diagnosing cancer at this early stage is most likely to result in a cure." d."Many women have breast lumps, and most of the lumps are benign."

d."Many women have breast lumps, and most of the lumps are benign."

The nurse is discussing treatment options with a client newly diagnosed with breast cancer. Which client statement indicates a need for further teaching? a."If I get radiation, I am not radioactive to others." b."I might have chemotherapy before surgery." c."Hormonal therapy is used to prevent cancer growth." d."Radiation will remove the cancer, so I might not need surgery."

d."Radiation will remove the cancer, so I might not need surgery."

Which client has the highest risk of ovarian cancer? a.30-year-old woman taking hormonal contraceptives b.36-year-old woman who had her first child at age 22 c.40-year-old woman with three children d.45-year-old woman who has never been pregnant

d.45-year-old woman who has never been pregnant

Which patient in the ED should the advance nurse practitioner treat first? a.A 32-year-old woman with bloating, headache, and reported depression b.A 48-year-old woman presenting with irregular menses, breast tenderness, and profuse sweating c.A 19-year-old woman with vaginal irritation, malodorous, copious frothy/yellow-green discharge d.A 21-year-old woman reporting sharp colicky abdominal pain, menstrual spotting, and dizziness

d.A 21-year-old woman reporting sharp colicky abdominal pain, menstrual spotting, and dizziness

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.The breasts contain a limited supply of blood vessels. b.Progesterone is primarily responsible for the growth of breast tissue. c.Striated muscle in the nipples contract causing them to become erect. d.A primary function of the female breast is to produce milk.

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

The nurse is providing shift report related to a client newly received back to the unit from the post anesthesia care unit (PACU). The nurse is stating that the client had breast tissue removed with 7 of 14 lymph nodes, the lining of the chest muscles and pectoralis major and minor muscles removed. The oncoming nurse documents which procedure completed? a.A segmental mastectomy b.A total mastectomy c.A modified radical mastectomy d.A radical mastectomy

d.A radical mastectomy

A client who has undergone breast surgery is struggling her sexuality. How will the nurse address the client's concerns? a.Remind the client the she needs to avoid sexual intercourse at this time. b.Ask the client if she is using her surgery as an excuse not to avoid intercourse. c.Give the client a business card for a local counselor. d.Ask the client about satisfaction with sexual relations with her partner.

d.Ask the client about satisfaction with sexual relations with her partner.

A client returns to the recovery room following a mastectomy. An initial postoperative assessment is performed by the nurse. What is the nurse's priority assessment? a.Checking for urinary retention and the need to void. b.Checking the dressing, drain, and amount of drainage. c.Checking level of pain first upon the clients return from the operating room. d.Assessing the vital signs and oxygen saturation levels.

d.Assessing the vital signs and oxygen saturation levels.

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? a.Encourage the client to include protein content in the diet. b.Instruct the client to wear a tight-fitting bra. c.Reduce the frequency of removing and reapplying the dressings. d.Assist the client to pump the breasts to remove breast milk.

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

A client has large breasts. Which health problem is she most likely to develop? a.Breast tenderness b.Breast cancer c.Chest pain d.Back pain

d.Back pain

Assessment of a client reveals evidence of a cystocele. The nurse interprets this as which of the following? a.Herniation of the rectum into the vagina b.Protrusion of intestinal wall into the vagina c.Downward displacement of the cervix d.Bulging of the bladder into the vagina

d.Bulging of the bladder into the vagina

The client is emotionally upset about the recent diagnosis of stage IV endometrial cancer. Which action by the nurse is best? a.Let the client alone for a long period of reflection time. b.Ask friends and relatives to limit their visits. c.Tell the client that an emotional response is unacceptable. d.Create an atmosphere of acceptance and discussion.

d.Create an atmosphere of acceptance and discussion.

How can breast cancer prevention programs best serve at-risk women from lower socioeconomic backgrounds? a.Provide access to health insurance. b.Increase support services. c.Increase access to health care. d.Develop screening and educational programs.

d.Develop screening and educational programs.

The nurse is caring for a postoperative client following an anterior colporrhaphy. What action can be delegated to the unlicensed assistive personnel (UAP)? a.Reviewing the hematocrit and hemoglobin results b.Teaching the client to avoid lifting her 4-year-old grandson c.Assessing the level of pain and any drainage d.Drawing a shallow hot bath for comfort measures

d.Drawing a shallow hot bath for comfort measures

A client tells the nurse in the gynecology clinic that she doesn't get a yearly mammogram because she is afraid of what might be found. Which teaching will the nurse provide? a.People with low breast cancer risk can obtain an MRI instead. b.Detection of breast cancer before or after axillary node invasion yields the same outcome. c.Mammography is needed only if the client has a first-degree relative with breast cancer. d.Early detection is important, as localized breast cancer has a 99% 5-year survival rate

d.Early detection is important, as localized breast cancer has a 99% 5-year survival rate

A client has just returned from a total abdominal hysterectomy and needs postoperative nursing care. What action can the nurse delegate to the unlicensed assistive personnel (UAP)? a.Assess heart, lung, and bowel sounds. b.Check the hemoglobin and hematocrit levels. c.Evaluate the dressing for drainage. d.Empty the urine from the urinary catheter bag.

d.Empty the urine from the urinary catheter bag.

A 30-year-old client whose mother died of breast cancer at age 44, and whose sister has ovarian cancer, is concerned about developing cancer. As a member of the oncology multidisciplinary team, the nurse should suggest that the client ask the physician about which topic? a.Mammogram b.Papanicolaou (Pap) testing every 6 months c.Contacting the American Cancer Society d.Genetic counseling

d.Genetic counseling

Hematoma and seroma formation are complications of breast surgery. Which of the following is the indicator that should be reported to the surgeon? a.Bruising of the skin b.Pain at the site c.Tightness of the skin d.Gross swelling

d.Gross swelling

The nurse is instructing a client with breast cancer who will be undergoing chemotherapy about the side effects of doxorubicin. Which teaching will the nurse provide? a.Report any symptoms of fatigue, cough, or edema to the oncologist. b.There are very few side effects associated with this agent. c.Doxorubicin is a type of selective estrogen receptor modulator (SERM). d.If side effects arise, they begin within 2 days of chemotherapy administration.

d.If side effects arise, they begin within 2 days of chemotherapy administration.

When a female client demonstrates a wart-like growth near the nipple, causing bloody nipple discharge, the client is exhibiting signs of which disease process? a.Paget disease b.Acute mastitis c.Fibroadenoma d.Intraductal papilloma

d.Intraductal papilloma

The nurse in the gynecology clinic is interviewing a patient who informs the nurse that her mother and aunt had carcinoma of the cervix. What does the nurse recognize are two chief symptoms of early carcinoma that the patient should be questioned about? a.Leukoplakia and metrorrhagia b.Dyspareunia and foul-smelling vaginal discharge c. "Strawberry" spots and menorrhagia d.Leukorrhea and irregular vaginal bleeding or spotting

d.Leukorrhea and irregular vaginal bleeding or spotting

The nurse at the gynecology clinic is examining a woman's breasts. Which assessment finding requires immediate notification of the primary health care provider? a.Backache and breast fungal infection b.Ill-defined painful rubbery lump in the outer breast quadrant c.A 1-cm freely mobile rubbery mass discovered by the client d.Nipple discharge and dimpling

d.Nipple discharge and dimpling

A client is being discharged after a total abdominal hysterectomy (TAH). What principle guides the nurse in planning discharge care and teaching? a.Clients in their childbearing years generally adapt better. b.Psychological reactions would be evident by discharge. c.The client can resume normal activities upon discharge. d.No special home equipment will be necessary for the client.

d.No special home equipment will be necessary for the client.

The nurse is caring for a client undergoing mastectomy who asks the nurse about breast reconstruction. Which of these will the nurse include in the discussion? a.Reconstruction of the nipple-areola complex is the first stage in reconstruction. b.Prostheses are not recommended because of the nature of the surgery. c.Reconstruction cannot take place until several months after a mastectomy. d.Some women want breast reconstruction using their own tissue.

d.Some women want breast reconstruction using their own tissue.

A client has undergone a vaginal hysterectomy with a bilateral salpingo-oophorectomy. She is concerned about a loss of libido. What intervention by the nurse would be best? a.Suggest increasing vitamins and supplements daily. b.Discuss the value of a balanced diet and exercise. c.Reinforce that weight gain may be inevitable. d.Teach that estrogen cream inserted vaginally may help.

d.Teach that estrogen cream inserted vaginally may help.

While caring for a client who is being treated for severe PID, the nurse insists on keeping the client in a semisitting position. Which is the correct rationale for this positioning? a.To prevent nosocomial infections to other clients b.To prevent movement, as it increases pain c.To easily distract the client d.To facilitate pelvic drainage and minimize the upward extension of infection

d.To facilitate pelvic drainage and minimize the upward extension of infection

Which is the primary assessment finding in identifying the possible cause of repeated episodes of vaginitis in a female client? a.Tub baths preferred over shower b.Frequent, regular sex with one partner c.Diet high in protein d.Type 2 diabetes mellitus

d.Type 2 diabetes mellitus

Which action would the nurse teach to help the client prevent vulvovaginitis? a.Wipe back to front after urination. b.Cleanse the inner labial mucosa with soap and water. c.Use feminine hygiene sprays to avoid odor. d.Wear loose cotton underwear.

d.Wear loose cotton underwear.