Reproduction

For which conditions would the nurse prepare and teach a client about breast biopsy? Select all that apply. A. Fluid was not aspirated during fine needle aspiration. B. Hormonal replacement therapy is prescribed. C. Mammogram shows suspicious findings. D. Fluid buildup recurs after aspiration. E. Mass remains palpable after aspiration. F. Aspirated fluid reveals cancer cells.

ACEF

Which common nonsexually transmitted causes will the nurse ask a client about to deter-mine possible causes of vulvovaginitis? Select all that apply. A. Yeast infection B. Herpes simplex C. Feminine hygiene sprays D. Pediculosis pubis E. Tight-fitting clothes F. Vaginal sponges

ACEF

Which reproductive physiologic changes will the nurse expect in an older female client? Select all that apply. A. Drying, smoothing, and thinning of the vaginal walls B. Increased size of the uterus C. Loss of tone and elasticity of the pelvic ligaments and connective tissue D. Hypertrophy of the endometrium E. Increased flabbiness and fibrosis of the breasts F. Decreased size of the labia majora and clitoris

ACEF

In addition to routine assessment, what specific assessment will the nurse perform on a client with very large breasts? A. Careful examination of the size and shape of nipples B. Ask if client has considered breast reduction mammoplasty C. Observe for fungal infection underneath the breasts D. Assess for pain in the bones and joints

C

What does the nurse expect was documented as the presenting symptom for a female client admitted with uterine leiomyomas? A. Foul-smelling vaginal discharge B. Intermittent abdominal pain C. Heavy vaginal bleeding D. Urinary stress incontinence

C

What priority teaching will the nurse provide to a client after mastectomy surgery? A. Begin exercises 3 to 4 days after the surgery. B. A regular diet can be started the first day after surgery. C. Check the surgical site for signs of infection or bleeding. D. Start ambulating the day after surgery.

C

What question does the nurse ask a client, who reported a breast mass 6 months ago, related to possible metastases of breast cancer? A. "Have you had any exposure to radiation or toxic chemicals?" B. "Has your mother or sister ever been diagnosed with breast cancer?" C. "Have you noticed any joint or bone pain or other changes in your body?" D. "Have you developed a cough, shortness of breath, or difficulty sleeping?"

C

Which client does the nurse understand is most suitable to undergo a uterine artery em-bolization procedure for leiomyomas? A. 18-year-old who is unmarried B. 25-year-old who is engaged to be married C. 35-year-old who is married and wants a child D. 46-year-old who is divorced with four children

D

In addition to the pelvic examination, for which diagnostic test will the nurse most likely prepare a client suspected to have uterine leiomyomas? A. Transvaginal ultrasound B. Laparoscopy C. Hysteroscopy D. Endometrial biopsy

A

What does the nurse expect that a 30-year-old female client is most likely to experience when she reports a history of blockages in her fallopian tubes? A. Difficulty conceiving B. Vaginal discharge C. Difficulty controlling weight D. Irregular menses

A

When teaching a client about the loop electro-surgical excision procedure (LEEP) for cervical cancer, what does the nurse instruct the client is expected after the surgery? A. Spotting with slight pain B. Menses-like vaginal bleeding C. Cramps lasting during the first 48 hours D. Watery discharge during the first week

A

When the normal vaginal flora is disrupted, what condition does the nurse expect that a female client is most likely to experience? A. Vaginal infection B. Vaginal dryness C. Irregular menstrual cycles D. Infertility

A

Which actions will the nurse instruct the client to avoid to prevent harm after having a colposcopy procedure? A. Do not douche, use tampons, and have sexual intercourse for 1 week after the procedure. B. Wear a perineal pad and expect bleeding with small clots for the first 24 hours. C. Do not drive or operate heavy machinery while taking the prescribed pain medication. D. Perform breast self-examination every month and report changes to the health care provider.

A

Which client does the nurse understand has the greatest need for evaluation of possible endometrial cancer? A. 63-year-old having bleeding after menopause B. 51-year-old having irregular menses for 6 months C. 35-year-old with report of multiple sexual partners D. 23-year-old with no menstrual period for 3 months

A

Which condition is most likely when the nurse admits a 25-year-old female client, with a self-detected mass in the right breast that is oval-shaped, freely mobile, and rubbery? A. Fibroadenoma B. Ductal ectasia C. Macrocyst D. Papilloma

A

Which exercise will the nurse teach a client to perform on the first day after mastectomy surgery? A. Squeezing the affected hand around a soft, round object B. Hand wall climbing C. Shoulder blade squeezing D. Rope turning

A

Which condition does the nurse expect when a female client reports altered nutritional intake resulting in changes in metabolism? A. Excessive bleeding B. Pelvic inflammatory disease C. Endometriosis D. Amenorrhea

D

During a breast examination, the nurse practitioner palpates a small mass in the client's right breast. What are the most important items to include when documenting this finding? Select all that apply. A. "Face of the clock" location of the mass B. Amount of pressure required to detect the mass C. Size and shape of the mass D. Method used to examine the breast E. Whether the mass is fixed or moveable F. Skin changes around the mass such as dimpling

ACEF

What will the nurse teach about self-care management to a client with mild discomfort from a fibrocystic breast condition? Select all that apply. A. Use analgesics such as acetaminophen for discomfort. B. Avoid dietary caffeine and other stimulants. C. Wear a supportive bra, even when in bed. D. Limit salt intake before menses. E. Local ice or heat application may help control pain. F. Diuretics may help decrease premenstrual breast engorgement.

ABCDE

For which conditions are a pelvic examination and Pap test indicated to assess for? Select all that apply. A. Menstrual irregularities B. Rape trauma or other pelvic injury C. Unexplained abdominal or vaginal pain D. Vaginal discharge, itching, sores, or infection E. Physical changes in the vagina, cervix, and uterus F. Pregnancy and infertility

ABCDEF

What symptoms will the nurse expect a client who had a prophylactic oophorectomy to report? Select all that apply. A. Night sweats B. Mood changes C. Hot flashes D. Weight gain E. Difficulty sleeping F. Chills

ABCDEF

Which activity restrictions will the nurse teach a client to follow after vaginal hysterectomy? Select all that apply. A. Limit stair climbing to less than five times a day. B. Do not lift anything heavier than 5 to 10 lb. C. Gradually increase walking as exercise. D. Do not cross your legs at the knees. E. Avoid sitting for extended periods of time. F. Do not drive until the surgeon tells you it's permitted.

ABCDEF

Which nonsurgical treatments for pelvic organ prolapse would the nurse teach a client about? Select all that apply. A. Pelvic floor muscle (Kegel) exercises B. Space-filling vaginal pessaries C. Bladder training program D. Low-fiber diet E. Stool softeners F. Laxatives

ABCEF

For which complications will the nurse monitor in a client after hysteroscopic surgery for uterine leiomyomas? Select all that apply. A. Embolism B. Fluid overload C. Pneumonia D. Hemorrhage E. Persistent increased menstrual bleeding F. Cardiac dysrhythmias such as atrial fibrillation

ABDE

Which are characteristics that the nurse expects to find in clients with a history of fibrocystic changes (FCC) in the breast? Select all that apply. A. Breast pain B. Tender breast lumps C. Oval shape D. Breast swelling E. Symptom relief after menstruation F. Gynecomastia

ABDE

Which factors will the nurse question a male client about to assess risk for breast cancer? Select all that apply. A. Family history B. BRCA1 and/or BRCA2 mutation C. Respiratory disease D. Testicular disorders E. Obesity F. Hyperthyroidism

ABDE

Which findings will the nurse expect to see when assessing the scrotum of a client? Select all that apply. A. Contracts with exposure to cold B. Suspended below the pubic bone C. Skin of scrotum is lightly pigmented D. Sparse hair follicles E. Pouch skin is thin walled F. Warm compared to surrounding tissues

ABDE

About which factors will the nurse ask a client who is suspected of having uterine leiomyo-mas? Select all that apply. A. Hypertension B. Type 2 diabetes C. Early menarche D. Alcohol use E. Postmenopausal F. Heavy consumption of red meat

ACDF

What information will the nurse include when providing discharge teaching to a client who had a local cervical ablation? Select all that apply. A. Do not use tampons or douche. B. Take tub baths instead of showers. C. Refrain from sexual activity. D. Avoid lifting heavy objects. E. Expect to run a fever for the first week to 10 days. F. Report heavy bleeding or foul-smelling drainage.

ACDF

Which actions will the nurse include in the postoperative care of a client who had a laparoscopy? Select all that apply. A. Administering oral analgesics for incisional pain B. Notifying the health care provider for postoperative shoulder pain C. Instructing the client to change the small adhesive bandage as needed D. Reassuring the client that most painful sensations disappear within 1 to 2 weeks E. Teaching the client to observe the incision for signs of infection or hematoma F. Reminding the client to avoid strenuous activity for 3 to 4 weeks after the procedure

ACE

Which body parts does the nurse teach a client are removed during surgery for endometrial cancer? Select all that apply. A. Uterus B. Vagina C. Fallopian tubes D. Rectum E. Ovaries F. Bladder

ACE

A 51-yr-old patient with a small immobile breast lump is considering having a fine-needle aspiration (FNA) biopsy. What should the nurse explain as an advantage to this procedure? a. FNA 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.

ANS: A FNA is done in outpatient settings, and results are available in 24 to 48 hours. No incision is needed. FNA may be guided by ultrasound but not by mammogram. Because the immobility of the breast lump suggests cancer, further testing will be done if the FNA results are negative.

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

ANS: A The average tampon absorbs 20 to 30 mL.

A 24-year-old woman says she wants to begin using oral contraceptives. Which information from the nursing assessment is important to report to the health care provider before a prescription is considered? a. The patient quit smoking 5 months previously. b. The patient's blood pressure is 150/86 mm Hg. c. The patient has not been vaccinated for rubella. d. The patient has chronic iron-deficiency anemia.

ANS: B Because hypertension increases the risk for morbidity and mortality in women taking oral contraceptives, the patient's blood pressure should be controlled before oral contraceptives are prescribed. The other information will not affect the choice of contraceptive.

A couple is scheduled to have a Huhner test for infertility. What will the nurse instruct the couple about in preparation for the test? 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

ANS: B For the Huhner test, the couple should have intercourse at the estimated time of ovulation and then arrive for the test 2 to 8 hours after intercourse. The other instructions would be used for other types of fertility testing.

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 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."

ANS: B Intense endurance exercise can cause amenorrhea. The other statements by the patient do not suggest any urgent teaching needs.

Which assessment finding in a 36-yr-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 and mobile, with a rubbery consistency.

ANS: B Painless and fixed lumps suggest breast cancer. The other findings are more suggestive of benign processes such as fibrocystic breasts and fibroadenoma. DIF: Cognitive Level: Apply (application) REF: 1212 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity

What topic should the nurse plan to teach a 26-year-old patient who has been treated for pelvic inflammatory disease? a. Use of hormone therapy (HT) b. Potential complication of infertility c. Irregularities in the menstrual cycle d. Changes in secondary sex characteristics

ANS: B Pelvic inflammatory disease may cause scarring of the fallopian tubes and result in difficulty in fertilization or implantation of the fertilized egg. Because ovarian function is not affected, the patient will not require HT, have irregular menstrual cycles, or experience changes in secondary sex characteristics.

An 18-year-old female patient admitted to the emergency department after a motor vehicle crash is scheduled for chest and abdominal x-rays. Which information may alter the plans for the x-rays? a. Report of abdominal pain b. Positive result of hCG test c. Blood pressure of 172/88 mm Hg d. Temperature of 102.1° F (38.9° C)

ANS: B Positive hCG testing indicates that the patient is pregnant and that abdominal x-rays should be avoided if possible. The other information is also important to report promptly, but it will not affect whether the x-rays should be done.

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. Which is the nurse's best response to the patient's concern? a. "You may need additional stimulation with aging." b. "Tell me more about how your reaction has changed." c. "Interest in sex frequently decreases as men get older." d. "Erectile dysfunction is common problem in older men."

ANS: B The initial response by the nurse should be further assessment of the problem. The other statements by the nurse are accurate but may not respond to the patient's concerns.

A 53-yr-old woman who is experiencing 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.

ANS: C Because HT is linked to an increased risk for breast cancer, the patient and health care provider must determine whether to use HT. Breast cancer incidence is increased in women using HT, independent of other risk factors. HT increases the risk for both non-BRCA-associated cancer and BRCA-related cancers. Alternative therapies can be used but are not consistent in relieving menopausal symptoms.

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.

ANS: C Because a heavy menstrual flow is usually indicated by saturating a pad or tampon in 1 to 2 hours, the nurse should first assess how heavy the patient's usual flow is. There is no need to schedule the patient for an appointment that day. The patient may need to call again, but this is not the first action that the nurse should take. Telling the patient that she does not have a heavy flow implies that the patient's concern is not important.

The nurse is providing teaching by telephone to a woman who is scheduled for a pelvic examination and Pap test next week. What instruction should the nurse give? a. Do 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 24 hours before the examination. d. Schedule to have the Pap test just after her menstrual period.

ANS: C Because the results of a Pap test may be affected by douching, the patient should not douche before the examination. The patient may shower or bathe before the examination. The examination may be scheduled without regard to the menstrual period. Sexual intercourse does not affect the results of the examination or Pap test.

Which finding from the nurse's 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.

ANS: C Clear penile discharge may be indicative of a sexually transmitted infection (STI). The other findings are normal and do not need to be reported

What should the nurse explain to a patient being prepared for colposcopy with a cervical biopsy? a. It involves dilation of the cervix and biopsy of the tissue lining the uterus. b. It will take place in a same-day surgery center so that local anesthesia can be used. c. It is similar to a speculum examination of the cervix and should cause little discomfort. d. It requires that the patient have nothing to eat or drink for 6 hours before the procedure.

ANS: C Colposcopy involves visualization of the cervix with a binocular microscope and is similar to a speculum examination. Anesthesia is not required and fasting is not necessary. A cervical biopsy may cause a minimal amount of pain.

Which question is most pertinent for the nurse to ask a 43-yr-old patient about her risk for breast cancer? 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?"

ANS: C Early menarche and late menopause are risk factors for breast cancer because of the prolonged exposure to estrogen that occurs. Cigarette smoking, breast trauma, and fibrocystic breast changes are not associated with increased breast cancer risk.

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 past 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?"

ANS: C Enlargement of the prostate blocks the urethra, leading to urinary changes such as a decrease in the force of the urinary stream. The other questions address possible problems with infection or sexual difficulties, but they would not be helpful in determining whether there were functional changes caused by BPH.

A 58-yr-old woman tells the nurse, "I understand that I have stage 2 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. "It would not be appropriate for me to make a decision about your health." c. "Tell me what you understand about the surgical options that are available." d. "There is no need to make a decision rapidly; you have time to think about this."

ANS: C Inquiring about the patient's understanding shows the nurse's willingness to assist the patient with the decision-making process without imposing the nurse's values or opinions. Treatment decisions for breast cancer do need to be made relatively quickly. Imposing the nurse's opinions or showing an unwillingness to discuss the topic could cut off communication.

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)

ANS: C Some antihypertensives may cause erectile dysfunction, and the nurse should anticipate a change in antihypertensive therapy. The other medications will not affect erectile function.

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 having a pelvic CT with contrast dye. d. A 54-year-old patient who has severe breast tenderness following a needle aspiration breast biopsy.

ANS: C The patient's dyspnea suggests a delayed reaction to the iodine dye used for the CT scan. The other patient's symptoms are not unusual after the procedures they had done.

The nurse is assessing the sexual-reproductive functional health pattern of a 32-year-old woman. Which question is most useful in planning for appropriate health screening? a. "Do you have sex with men, women, or both?" b. "Which gender do you prefer to have sex with?" c. "Are you heterosexual, homosexual, or bisexual?" d. "What types of sexual activities do you engage in?"

ANS: D Asking about activities is the most simply stated question and will increase the likelihood of obtaining the relevant information about possible risk factors associated with sexual activity. Type of activity (genital, anal, oral) is more helpful in determining risk and planning for health screening procedures than asking the gender of the partner. Patients who have sex with both men and women may not identify themselves as homosexual or bisexual.

A patient in the sexually transmitted infection clinic has a positive Rapid Plasma Reagin (RPR) test, but no chancre is visible on assessment. For what test should the nurse expect to send specimens? a. Cytologic studies b. Culture and Gram stain c. Herpes Simplex Antibody Test d. Fluorescent treponemal antibody absorption (FTA-Abs)

ANS: D Because false positives are common with VDRL and RPR testing, FTA-Abs testing is recommended to confirm a diagnosis of syphilis. Gram staining is used for other sexually transmitted infections (STIs) such as gonorrhea and Chlamydia and cytologic studies are used to detect abnormal cells (e.g., neoplastic cells).

What should the nurse plan to teach a 57-year-old man who is scheduled for an annual physical examination? a. Increased risk for testicular cancer b. Possible changes in erectile function c. Normal decreases in testosterone level d. Prostate-specific antigen (PSA) testing

ANS: D PSA testing may be recommended annually for men, starting at age 50 based on the person's risk history and discussion with their HCP. There is no indication that the other patient teaching topics are appropriate for this patient.

What information should the nurse include when teaching a young women's community service group about breast self-examination (BSE)? 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.

ANS: D Performing BSE at the end of the menstrual period will reduce the breast tenderness associated with the procedure. The evidence is not clear that BSE reduces mortality from breast cancer. BSE should be done monthly. Annual mammograms are not routinely scheduled for women younger than age 40 years, and newer guidelines suggest delaying them until age 50.

Which question does the nurse ask when a 22-year-old female client is being evaluated for possible toxic shock syndrome (TSS)? A. "How many pads do you use on heavy flow days?" B. "Have you every used intravaginal estrogen therapy?" C. "Do you have a history of multiple sexual partners?" D. "Do you use an insertable contraceptive device?"

D

For which client is the nurse most likely to administer an iron supplement? A. 23-year-old who has pelvic inflammatory disease B. 32-year-old with heavy menstrual bleeding and an intrauterine device C. 53-year-old who is entering menopause and has a breast mass D. 70-year-old who is diagnosed with benign prostatic hyperplasia

B

What advantage does the nurse discuss with a client who is prescribed trastuzumab for treatment of breast cancer? A. The drug will shrink the tumor. B. It is less likely to harm normal cells. C. Nausea and vomiting are rare side effects. D. Cardiac side effects are not a concern.

B

What does the nurse suspect when a client re-ports identification of a hard breast mass with irregular borders, redness, swelling, nipple dis-charge, and enlarged axillary nodes? A. Intraductal papilloma B. Ductal ectasia C. Fibroadenoma D. Fibrocystic changes

B

When will the nurse expect a client with breast cancer to receive neoadjuvant therapy? A. After surgery to ensure that all cancer cells have been destroyed B. Before surgery to shrink the tumor and make it easier to remove C. With radiation therapy to treat any metastasis that may occur D. During surgery to make sure that all of the tumor cells are removed

B

Which action does the nurse teach a client to prevent harm after breast augmentation surgery? A. Begin exercising by twisting at the waist the day after surgery. B. Walk every few hours to prevent venous thromboembolism (VTE). C. Wait a week or more after surgery before resumption of smoking. D. Have someone stay with you during the first 6 hours after discharge.

B

Which action will the nurse expect to take when a client diagnosed and treated for ovarian cancer has a recurrence? A. Arranging discussions with others who have recurring cancer B. Assessing readiness to explore palliative care and hospice C. Assisting to identify complementary therapies that may be helpful for palliation D. Teaching about radical hysterectomy followed by brachytherapy

B

Which condition is the client most likely to report to the nurse after uterine prolapse? A. "I have to use the bathroom much more often than I used to." B. "It feels like something is falling out down there." C. "I leak urine whenever I laugh, cough, or sneeze." D. "I've had two urinary tract infections in the last 3 months."

B

Which instruction will the nurse give the client immediately before a pelvic exam and Pap test? A. Clean your genitals with warm water. B. Empty your bladder in the bathroom. C. Relax and the test will be less painful. D. Lie flat on the table until the test is over.

B

Which instruction will the nurse provide to the client who is currently receiving brachytherapy for gynecologic cancer? A. Call for help when getting out of bed. B. Stay in bed during the treatment session. C. Use a separate bathroom when you go home. D. Avoid being near children when you are home.

B

Which priority question will the nurse ask to evaluate the current condition of a 40-year-old client who is experiencing heavy vaginal bleeding? A. "Are you sexually active and do you use oral contraceptives?" B. "Are you feeling weak, dizzy, or light-headed?" C. "Is the bleeding related to your menstrual cycle or intercourse?" D. "Are you having any sensations of pain or cramping?"

B

Which sign or symptom detected by the nurse practitioner during clinical breast examination of a client suggests advanced breast cancer? A. Thin, milky discharge from nipple B. Edematous thickening and pitting of breast skin called peau d'orange C. Oval-shaped, mobile, rubbery mass D. Replacement of normal cells with connective tissue and collagen

B

Which health and lifestyle habits does the nurse assess when taking a history from a client with a reproductive health problem? Select all that apply. A. Socioeconomic status B. Dietary intake C. Exercise pattern D. Sleep pattern E. Sexual practices F. Occupational status

BCDE

What will the nurse teach a client who had breast reconstruction about the Jackson-Pratt drain left in place? Select all that apply. A. The drain will be emptied every hour and the amount recorded. B. A drain is usually left in place 1 to 3 weeks after surgery. C. There should be less than 30 mL over 24 hours before the drain is removed. D. Contact the health care provider for excessive drainage. E. Record the color and amount of drainage when the drain is emptied. F. Drainage tubes collect any fluid that accumulates under the surgical area.

BCDEF

Which clinical signs and symptoms will the nurse assess for when a client is admitted with a diagnosis of toxic shock syndrome (TSS)? Select all that apply. A. Itching B. Fever C. Macular rash D. Hypertension E. Myalgias F. Vaginal lesions

BCE

What are the nurse's best actions when a client with uterine leiomyomas reports pelvic pressure, constipation, and urinary retention? Select all that apply. A. Check the lower extremities for fluid retention. B. Assess the abdomen for distention or enlargement. C. Measure fluid intake and urinary output. D. Ask the client if her pants fit tighter now. E. Measure residual urine using a urinary catheter. F. Measure the abdomen as a baseline for comparison.

BDF

Which factors will the nurse assess in a male client who reports decreased libido? Select all that apply. A. Timing of exercise program B. Use of tobacco C. Occupation D. Consumption of alcohol E. Weight gain or loss F. Illicit substance use

BDF

When the nurse explains to a group of women that annual screening mammograms are not recommended for women under 40 years of age, what is the underlying rationale for this decision? A. Breast tumors are uncommon among women under the age of 40 years. B. The amount of radiation exposure outweighs the benefit for women of child-bearing age. C. In younger women there is little difference in the density of normal tissue and malignant tumors. D. In younger women the tumors are likely too small to be detected by mammography.

C

When the nurse takes a history from a male client and finds that he had mumps with orchitis, which common potential complication is possible? A. Decreased libido B. Prostate hypertrophy C. Testicular atrophy D. Impotence

C

Which advice will the nurse provide for a client who is prescribed tamoxifen to decrease the chance of breast cancer recurrence, with regard to the side effects of the drug? A. Ginger ale with the drug will decrease the nausea. B. Have a handrail installed around the bathtub to prevent falls. C. Check your weight and report weight gain to the health care provider. D. Use a soft-bristled toothbrush to prevent bleeding.

C

Which care action will the nurse assign to the assistive personnel (AP) for a client receiving external radiation therapy for treatment of endometrial cancer? A. Gently washing the markings outlining the treatment site B. Monitoring for skin breakdown in the perineal area C. Assisting the client to ambulate to the bathroom if she feels fatigued D. Assessing the urinary catheter and urine output for color and odor

C

Which client does the nurse prioritize as most in need of a pelvic examination? A. 25-year-old with possible urinary tract infection (UTI) B. 53-year-old who reports decreased libido and fatigue C. 62-year-old who reports resumption of menses D. 74-year-old with 25-lb intentional weight loss

C

Which male client does the nurse understand has the greatest risk of developing gynecomastia? A. 25-year-old injured in a touch football game B. 38-year-old with stable angina C. 49-year-old prescribed spironolactone D. 61-year-old with hypothyroidism

C

Which postprocedural findings will the nurse instruct a client who had a prostate biopsy to expect? A. Swelling of the biopsy area and difficulty urinating are expected during the first week. B. A low-grade fever and bright red penile discharge are normal for several days. C. Slight soreness and light rectal bleeding that is bright red are expected for a few days. D. Seminal fluid will appear normal within a day after the procedure.

C

Which preprocedural instructions will the nurse give a client before a mammogram? A. Do not eat or drink anything 2 to 3 hours before the procedure. B. Abstain from sexual relations for 24 hours prior to the procedure. C. Do not use lotions, creams, or powder on your breasts before the study. D. Wear a supportive bra and bring a breast pad for use after testing.

C

Which preventive measure will the nurse include when teaching a group of female clients about prevention of toxic shock syndrome? A. "Use sanitary napkins on heavy flow days." B. "Use superabsorbent tampons only at night." C. "Change the tampon every 3 to 6 hours." D. "Void before and immediately after intercourse."

C

Which priority action will the nurse implement when an older male client reports diffi-culty starting the urine stream? A. Teach the importance of testicular self-exam (TSE). B. Discuss exercises to strengthen pelvic floor muscles. C. Teach signs of urethral obstruction and importance of prostate cancer screening. D. Provide information on testosterone functions and supplements

C

Which statement by a client to the nurse indi-cates that her anterior colporrhaphy has achieved the desired therapeutic outcome? A. "That constipated feeling has resolved." B. "The abdominal pain is almost gone." C. "I have good control over my urination." D. "My vaginal bleeding has completely stopped."

C

What advice will the nurse give to a postmeno-pausal client about when to perform breast self-examination (BSE)? A. Perform breast self-examination on the 15th day of each month. B. The last day of the month is the best day for breast self-examination. C. After menopause, breast self-examination will not detect a mass. D. Choose any day of the month but follow a consistent schedule.

D

What does the nurse tell an African-American client whose prostate-specific antigen (PSA) level is less than 2.5 ng/mL? A. African-American men typically have lower-than-normal PSA levels. B. This level indicates the need for follow-up for possible prostate cancer. C. The test should be repeated on an annual basis to monitor for abnormalities. D. A PSA level of less than 2.5 ng/mL is generally considered a normal value.

D

What finding does the nurse expect when re-viewing a male client's laboratory results and finding a testosterone level of 200 ng/dL? A. Increased muscle mass and weight B. Increase in urinary output C. Testicular pain with nausea D. Changes in sexual performance

D

What is the nurse's best action when an anx-ious, upset client has just been diagnosed with breast cancer and informed that surgery is likely the best treatment option? A. Provide education about treatment options. B. Assist with making independent decisions. C. Provide reassurance about long-term outcomes. D. Listen and allow open discussion about feelings.

D

What normal findings will the nurse expect when assessing the breasts of an older woman? A. Gentle palpation may cause discomfort or mild pain. B. Nipples are retracted and there may be a discharge. C. Tissue is difficult to palpate because of fat deposits. D. Breasts are atrophied, flattened, and elongated.

D

What primary factor does the nurse under-stand is the reason for low survival rates in clients with ovarian cancer? A. Ovarian cancer develops in clients with underlying immunosuppression and poor health. B. There are no specific diagnostic tests that can confirm or rule out ovarian cancer. C. Ovarian cancer does not respond well to conventional radiation or chemotherapy treatments. D. Symptoms are mild and vague, so the cancer is often not detected until in its late stage.

D

What self-management strategy will the nurse recommend to a client to prevent vulvovaginitis? A. Wear lightweight nylon underwear. B. Apply antiseptic cream to the perineal area daily. C. Cleanse the inner labial mucosa with antiseptic soap. D. Choose breathable fabrics to wear such as cotton.

D

What teaching about the affected arm will the nurse provide for a client who had a partial mastectomy (lumpectomy)? A. Do not start any arm or hand exercises until the drains are removed from the incision. B. Do push-ups and arm circles on a routine basis for a full recovery. C. Avoid using the affected arm for having blood pressure measured, receiving injections, or having blood drawn for 2 weeks after surgery. D. Elevate the head of the bed at least 30 degrees, with the affected arm elevated on a pillow while awake.

D

What should the nurse teach the patient who has a possible ovarian cyst and is scheduled for an abdominal and pelvic ultrasound? a. Expect to receive IV contrast during the procedure. b. Drink several glasses of fluids before the procedure. c. Discontinue taking aspirin for 7 days before the procedure. d. You may have mild abdominal cramps after the procedure.

b. Drink several glasses of fluids before the procedure. A full bladder is needed for many ultrasound procedures, so the nurse will have the patient drink fluids before arriving for the ultrasound. The other instructions are not accurate for this procedure.