CH 52, 53, 54, & 55 Take Home Exam

A client who is diagnosed with stage II prostate cancer asks the nurse if a transurethral resection of the prostate (TURP) can be done for this disorder. Which is the best response by the nurse?

"A TURP is a removal of only a portion of the prostate gland."

After teaching a client about the use of a pessary, which statement by the client indicates the need for additional instruction?

"A white or yellow vaginal discharge is expected and normal."

The nurse is providing teaching to a client who is scheduled for a mammogram. Which of the following would the nurse include as a way to avoid artifacts on the x-ray film?

"Avoid using a deodorant with aluminum hydroxide."

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 best?

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

A client with extensive endometriosis is scheduled for a panhysterectomy. Which statement by the client indicates a need for further teaching?

"I will not have to deal with symptoms of menopause."

Which of the following client statements indicates successful teaching of a client who is scheduled to have a Pap test?

"I will stop using any vaginal medications at least 48 hours before the test."

A client has just been diagnosed with endometriosis. Which of the following would be most appropriate to provide the client with support and guidance about treatment options?

"It might help to include your partner in any of the discussions about options."

The nurse is obtaining a health history at the client's annual gynecologic exam. Which of the following statements regarding a Papanicolaou test (Pap test) for cancer screening would delay the exam?

"My menstrual period began yesterday."

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 client with stage IV cancer receiving palliative care

The nurse is providing shift report related to a client newly received back to the unit from the postanesthesia 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 minor muscle removed. The oncoming nurse documents which procedure completed?

A modified radical mastectomy

The nurse is obtaining a health history from a 58-year-old client stating that he is having difficulty obtaining an erection during sexual activity. The client asks how an "erectile medication" works and if there are any side effects to the medication. The nurse explains the action of the medication and directions for use and warns of which side effect related to the client's history?

Angina with nitrate use

The client with prostatitis presents with low back pain, dysuria, and unusual sensation following ejaculation. Which of the following treatments will the nurse anticipate being ordered for this client?

Antibiotics

Which pharmacologic agents pose the greatest risk for urinary retention in a client with benign prostatic hyperplasia (BPH)?

Antihistamines

The nurse knows that the safest treatment for erectile dysfunction in a client with coronary artery disease (CAD) includes which of the following medications?

Apomorphine (Uprima)

Immediately following a transurethral resection of the prostate (TURP), which is the best method to determine if active bleeding is occurring?

Assess catheter tubing.

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?

Enlargement of the arm or hand

A client who comes to the clinic complaining of perineal pain, dysuria, and fever is diagnosed with prostatitis. The nurse understands that which of the following organisms would be the most likely cause?

Escherichia coli

A client is struggling with symptoms of irritability and "feeling crazy" at times. Which assessment data would provide the most important information needed in the development of a treatment plan for this client?

Menstrual diary

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

Others disapprove

A nurse is caring for a client following a culdoscopy. Which assessment data would the licensed practical nurse report to the registered nurse?

Skin, cold; pulse, 110 beat/minute; blood pressure, 104/64 mm Hg

The nurse is caring for a breastfeeding client who has developed a breast abscess. When instructing on the cause of abscess formation, which organism is the most common cause?

Staphylococcus aureus

The nurse is caring for a client who is diagnosed with an estrogen-sensitive tumor and has undergone a mastectomy. When instructing the client on potential medications, which medication(s) are stressed?

Tamoxifen (Nolvadex) and aromatase inhibitors (Femara)

The nurse is obtaining health histories from women at a busy low-income clinic. Which of the following clients should the nurse follow closely as being at high risk for developing breast cancer?

The client has relatives with the BRCA1 mutated gene

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?

The lump is round and movable.

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

The malignancy is localized.

The nurse is outlining the female internal reproductive structures on a diagram. Where on the diagram would the nurse highlight the typical site of ovum fertilization?

The nurse would highlight the fallopian tube.

When instructing clients at a prenatal class, the nurse is most correct to state which medical name as being removed during circumcision?

The prepuce

The nurse is caring for a client who is ordered a sentinel lymph node biopsy. The physician explained the procedure and desired outcome. Which statement, made by the client, indicates a need for further instruction?

The procedure removes all cancer from the body.

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

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

A client complains of having tender and painful breasts, often feeling multiple lumps within her breast tissue. The nurse would need to gather additional information about which of the following?

Timing of symptoms in relation to the menstrual cycle

A client is diagnosed with stage II cancer of the prostate. The nurse interprets this as indicating which of the following?

Tumor is confined to the prostate gland.

Which assessment finding would create the greatest risk to a client ordered a phosphodiesterase (PDE5) inhibitor such as sildenafil (Viagra)?

Use of nitrates

Which of the following would be most important to determine when assessing a client being admitted for suspected toxic shock syndrome (TSS)?

Use of superabsorbent tampons

Which of the following would be most important to include in a teaching plan for a client who has had a vasectomy?

Using a reliable method of contraception for several weeks

A client is ordered a vaginal cream for the treatment of a yeast infection. As the nurse provides instruction, which step for inserting vaginal medications should be highlighted?

Wash applicator after each use.

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

Wear gloves and protective clothing to avoid any injuries.

A family member asks the nurse of the benefits of immunotherapy. The nurse would be most correct to state which of the following?

Immunotherapy stimulates the immune response to attack and rid the body of cancer cells.

A client who is diagnosed with premenstrual syndrome is ordered a gonadotropin-releasing hormone (GnRH). Which is a priority teaching item in the use of this drug?

Increase calcium and vitamin D intake

The nurse is assisting a 30-year-old client in scheduling an appointment for a cervical biopsy. The nurse would recommend that the client schedule the testing at which time?

1 week after completion of the client's menstrual cycle

After examination, a client is found to have a prostatic nodule and is scheduled for prostatic-specific antigen (PSA) testing. When reviewing the results, which of the following would indicate that the nodule is malignant?

12 ng/mL

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

Infertility

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

Lymphedema

A client presents with symptoms of menstrual difficulties and infertility. Which hormone is essential in the maintenance of the endometrium?

Progesterone

A client is receiving chemotherapy as adjuvant therapy in the management of testicular cancer. The nurse also notes that the client is ordered filgrastim (Neupogen) and knows that the client is at greatest risk for which assessment finding?

Fever

The client with benign prostatic hyperplasia (BPH) is considering use of medication in the management of symptoms. Which of the following drugs reduces the size of the prostate without lowering circulating levels of testosterone?

Finasteride (Proscar)

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?

"The cancer has not spread."

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?

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

A young client has just completed the 6-month series of Gardasil vaccine. Which comment by the client would alert the nurse that further teaching is needed?

"This vaccine will prevent human papilloma virus (HPV) from occurring."

A 50-year-old is diagnosed with stage II prostate cancer. The client is upset and verbalizes that he would rather die than have any surgery. Which is the best response by the nurse?

"What concerns you most about having surgery?"

When caring for a client with polycystic ovarian syndrome, the nurse will focus teaching needs in the management of which associated problems? Select all that apply.

- Hypertension - Infertility - Hyperlipidemia

The surgeon has ordered belladonna and opium (B and O) suppositories for the management of a postoperative prostatectomy client who is receiving continuous bladder irrigation. Which of the following symptoms would indicate to the nurse the need for administration of this drug? Select all that apply.

- Increased bladder pressure and pain - Slowed or stopped infusion rate

The physician and nurse are completing a physical examination of the male genitalia. Which assessment findings are documented? Select all that apply.

- Inspection for urethral drainage -Digital rectal examination -Palpation of the testes -Transillumination

Following a laparoscopic-assisted vaginal hysterectomy, which client assessment finding would warrant nursing intervention? Select all that apply.

- Peri-pad changed every shift - Dorsal recumbent positioning with knee bend

The nurse is instructing a couple in the early stages of infertility testing who has just found that the male has a slightly low sperm count. Which easy change can a nurse suggest to a male client?

Wear loose fitting underwear instead of tight ones.

A client is prescribed androgen therapy. Which of the following would the nurse explain as a possible adverse effect?

Weight gain

A nurse is caring for a client who is being evaluated for a lump found on the lateral aspect of the right breast. The client is anxious and asks the nurse if the next step is to have a mastectomy. Which is the nurse's best response?

"Many times, an ultrasound is done to distinguish between a tumor and cyst."

The nurse is caring for a client who has been diagnosed with a breast lump. The physician states that studies indicate a cancerous tumor in situ. The client is anxious and wants to know what may come next. The nurse is most correct to support physician instruction of which of the following?

"Since your tumor appears localized, removal of the tumor is indicated."

A suspicious breast lump is noted on a mammogram. The client asks the nurse which diagnostic test confirms if the lump is cancerous or benign. Which response by the nurse is most correct?

A biopsy

The nurse is caring for a client diagnosed with ductal carcinoma and lymph node involvement. Which diagnostic test, ordered by the physician, does the nurse identify as assessing possible metastasis?

A chest x-ray

The nurse is caring for a client scheduled for a transrectal ultrasonography. Which instruction is essential in obtaining an accurate test?

Administer an enema prior to arrival.

A client is diagnosed with prostatitis. Which of the following is the most important teaching point for the management of this disorder?

Avoid prolonged sitting.

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?

Bone mineral density

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

Cervical cancer

A client is admitted to the hospital with the diagnosis of sepsis secondary to pelvic inflammatory disease. Which transmission-based precaution will be initiated by the nurse?

Contact precautions

A client with history of type 2 diabetes mellitus and coronary artery disease has been diagnosed with stage III prostate cancer and opts for treatment with diethylstilbestrol (DES). Which is the most important nursing assessment finding in this client?

Elevated blood sugar

Which assessment finding is most important in determining which client has a higher risk for developing testicular cancer?

Cryptorchidism as an infant

Which of the following instructions would be appropriate to include when preparing a woman for an abdominal ultrasound?

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

The nurse at a gynecologist's office is obtaining a client history including the fact that several of the client's relatives have had breast cancer. Which general information regarding the most common type of cancer is accurate?

Ductal carcinoma

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

Ibuprofen

The nurse is preparing the female client for a pelvic examination. In which position will the nurse assist the client?

Lithotomy position

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

Painful swelling

The nurse is providing instruction for testicular self-examination to a group of young adolescents. Which is the most correct examination technique?

Palpate each testicle separately, following a warm shower.

Which of the following is an early symptom of vulvar cancer?

Pruritus with genital burning

A group of students are reviewing information related to the male reproductive system structures. The students demonstrate understanding of the information when they identify which structure as an accessory organ?

Seminal vesicles