Chapter 10: Disorders of the Reproductive System (Test)

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When collecting a specimen from the client who may have gonorrhea, which nursing action is correct? 1. Wearing latex gloves 2. Using a disinfectant 3. Asking the client to provide the specimen 4. Refrigerating the specimen immediately

1

A 24-year-old woman is being treated for endometriosis. A laparoscope will be used to remove ectopic tissue. When the client asks where the laparoscope will be inserted, the nurse correctly identifies which structure? 1. Abdomen 2. Vagina 3. Uterine cervix 4. Uterine fundus

1

A 25-year-old woman has repeated vaginal infections. The symptoms suggest that the client has candidiasis caused by the yeastlike microorganism Candida albicans (C. albicans). After C. albicans is identified as the causative organism, the nurse would expect the physician to prescribe which treatment? 1. A nonprescription antifungal medication 2. A prescription oral penicillin 3. A prescription broad-spectrum antibiotic 4. A vaginal douche with a vinegar solution

1

A 20-year-old college student calls her physician's office and reports to the nurse that she is bleeding vaginally at a time other than her expected menses. If the client reports all of the following data, which factor is most likely contributing to the bleeding? 1. The client has been taking an oral contraceptive for 2 months. 2. The client has just changed employment and is under unusual stress. 3. The client's sexual partner has a sexually transmitted disease. 4. The client has been using a vibrator to elicit sexual arousal.

1

A 34-year-old woman makes an appointment with a physician concerning her pattern of heavy menstrual bleeding. A pelvic examination is scheduled. Which instruction is most appropriate if a Papanicolaou (Pap) smear will be obtained at the time of the pelvic examination? 1. Avoid douching for several days before your appointment. 2. Stop using any and all forms of contraception temporarily. 3. Drink at least 1 quart of liquid an hour before your appointment. 4. Avoid having sexual intercourse for a week before the test.

1

A 64-year-old client with uterine cancer is scheduled to undergo an abdominal hysterectomy under general anesthesia. Before the client returns from the postanesthesia care unit, the registered nurse asks the practical nurse to help revise the hysterectomy client's care plan. Which nursing diagnosis is most appropriate for the nurse to add to the client's care plan at this time? 1. Risk for Ineffective Airway Clearance 2. Risk for Imbalanced Nutrition 3. Ineffective Coping 4. Impaired Verbal Communication

1

A client with an abnormal Pap smear has a colposcopy performed in her physician's office. Before the client leaves the office, the nurse correctly instructs her to report which unusual problem associated with this procedure? 1. Excessive bleeding 2. Inability to void 3. Pressure during bowel elimination 4. Pain in the right lower quadrant

1

A female client receives a 6-month supply of oral contraceptives . Which instruction is appropriate to include when providing the client with oral contraceptive teaching? 1. Take oral contraceptives at the same time each day. 2. Take oral contraceptives on an empty stomach. 3. Take oral contraceptives on the first day of menses. 4. Take oral contraceptives in the morning with food.

1

A nurse obtains a history from a 20-year-old client who says she does not menstruate. Which question is most important for the nurse to ask next? 1. "Have you ever had any menstrual periods?" 2. "Do you have any pubic hair growth?" 3. "Have you ever been sexually attracted to males?" 4. "Are there any siblings with a similar problem?"

1

A pelvic ultrasound (sonogram) using a transabdominal approach is scheduled for the client. When preparing the client for the sonogram, which instruction is most important for the nurse to emphasize? 1. Do not void for several hours before the test. 2. Begin fasting at midnight before the test. 3. Take a mild analgesic such as aspirin before the test. 4. Use an antiseptic soap when showering before the test.

1

Before the physician performs the vaginal examination, which nursing intervention is most important? 1. Arrange to have a female nurse present during the examination. 2. Instruct the client on the dangers of cervical cancer. 3. Palpate the internal organs to obtain a baseline assessment. 4. Encourage the client to instill a personal vaginal lubricant.

1

During a routine sports physical, the nurse notes that a 15-year-old male client has an undescended testicle. When the client asks how this condition will affect him sexually, which response by the nurse is most appropriate? 1. "It most likely will have little effect on your masculinity." 2. "It means that you will probably be impotent." 3. "You may notice that your breasts will enlarge later." 4. "Your sex drive will be not be like that of other boys."

1

On the basis of the location and extent of this client's surgery, it is most appropriate for the nurse to closely assess for which postoperative complication? 1. Shallow breathing 2. Inadequate nutrition 3. Impaired bowel motility 4. Signs of skin breakdown

1

Postoperative orders call for applying anti-embolism stockings to the client's leg following her hysterectomy. Which intervention for applying anti-embolism stockings is most appropriate to include in the client's care plan? 1. Have the client wear the stockings continuously, but remove and reapply them at least twice a day. 2. Have the client wear the stockings continuously during the day hours, and remove them at night. 3. Have the client wear the stockings only when getting up to ambulate. 4. Have the client wear the stockings only while in bed.

1

The nurse is assigned to discuss family planning and various methods of contraception with a group of women who have expressed an interest in this topic. One participant asks the nurse, "How do oral contraceptives prevent pregnancy?" The nurse correctly explains that the combination oral contraceptives prevent pregnancy by interfering with the sperm reaching the ovum and by which other method? 1. Preventing ovulation 2. Depressing progesterone secretion 3. Depressing formation of the corpus luteum 4. Thickening the uterine lining

1

The physician sees a 42-year-old woman for suspected fibroid tumors (myomas). In addition to pressure in the pelvic region, which sign or symptom is the client most likely to reveal during a nursing history? 1. Heavy menstrual bleeding 2. Light menstrual bleeding 3. Abdominal pain at the time of ovulation 4. Breast tenderness during menstruation

1

When a client with a transurethral resection of the prostate (TURP) complains of bladder discomfort and a feeling of urgency to void, which nursing action is best to take first? 1. Check that the urinary drainage catheter is patent. 2. Administer a prescribed analgesic as soon as possible. 3. Change the client to semi-Fowler's position. 4. Get the client out of bed to ambulate for a while.

1

When counseling a female client with a new diagnosis of genital herpes, which statement by the nurse is accurate? 1. "Have a Pap test done at least every 6 months." 2. "Avoid having vaginal intercourse for at least 6 months." 3. "If you take your medicine, you will not infect anyone else." 4. "Your infection provides immunity for any future children."

1

When the nurse teaches a client who has been diagnosed with a chlamydial infection, which statement is accurate? 1. "Your sexual partner needs simultaneous treatment." 2. "There's no known cure for this kind of infection." 3. "This is a rare type of 'sexually transmitted disease." 4. "Men manifest symptoms, but infected women do not."

1

Which recommendation by the nurse is most appropriate to reduce the risk of blood clots while the client is taking hormonal contraceptives? 1. Stop smoking while taking hormonal contraceptives. 2. Drink a high volume of fluid to dilute the blood. 3. Keep the legs elevated while sitting in a chair. 4. Take a baby aspirin daily at the same time as the oral contraceptive.

1

Which suggestion by the nurse will best promote the client's comfort? 1. Using a scrotal support 2. Wearing cotton briefs 3. Buying larger underwear 4. Applying a hot compress

1

While assessing a male client with tertiary syphilis, which finding is most characteristic of this stage of the disease? 1. Stabbing leg pain 2. Red, raised rash 3. Penile ulcer 4. Patchy hair loss

1

After obtaining a health and sexual history, the nurse suspects that the client has signs and symptoms of gonorrhea. If the client is typical of others with gonorrhea, which statements made by the client will help to make the diagnosis? Select all that apply. 1. " I have burning when I urinate." 2. " I have a yellow drainage from my penis." 3. " I had sexual intercourse 5 days ago." 4. " I have a painless ulceration on my penis." 5. " I have little blisters on my penis and scrotum." 6. " I have extra skin growing around my penis."

123

Which instructions should the nurse include in the client's discharge plan? Select all that apply. 1. Continue exercises 3 times per day. 2. Avoid lifting objects more than 15 pounds. 3. Use gloves while doing yard or house work. 4. Get at least 8 hours of sleep per night. 5. Avoid drinking caffeinated or alcoholic beverages. 6. Postpone getting a prosthesis for at least 6 months.

123

A participant asks the nurse about the use of the birth control patch that some of her friends have started to use. The nurse explains about the use of the patch and reviews the side effects of this type of birth control. Which side effects should the nurse address in the explanation? Select all that apply. 1. Skin irritation 2. Irregular vaginal bleeding 3. Fluid retention 4. Increased blood pressure 5. Nausea and vomiting 6. Infection

12345

Which information regarding safer sex practices should the nurse include in the client's teaching plan? Select all that apply. 1. "Be selective in choosing sexual partners." 2. "Do not share vibrators or other sexual equipment." 3. "Avoid intercourse if you have signs of a sexually transmitted disease." 4. "Urinate after having intercourse." 5. "Store condoms away from excessive heat." 6. "Keep birth control patches in the refrigerator."

12345

The physician prescribes medroxyprogesterone acetate (Depo-Provera) 150 mg I.M. for contraception for a 28-year-old woman. What actions are appropriate when administering this medication? Select all that apply. 1. Confirm that the client is not pregnant. 2. Give the injection deeply into the dorsogluteal site. 3. Schedule administration of the first injection to coincide with the time of ovulation. 4. Inform the client to return every 3 months for another injection. 5. Inform the client to use an additional form of contraception for the first week after an injection. 6. Apply ice to the injection site for 2 to 3 minutes before administering the drug.

124

Which information should be gathered before the nurse can advise the student appropriately regarding methods of birth control? Select all that apply. 1. The adolescent's lifestyle 2. Whether she is currently sexually active 3. Whether she has had a Pap smear in the last year 4. The date of her last menstrual period 5. Where she is currently working

124

A postmenopausal woman receives a prescription for alendronate (Fosamax). What health teaching information should the nurse provide? Select all that apply. 1. Take the medication with a full glass of water. 2. Refrain from eating for 30 minutes after taking the medication. 3. This medication helps relieve hot flashes and irritability. 4. Take the medication upon awakening. 5. Do not lie down after taking the medication. 6. Take the medication with food or a glass of milk.

1245

Which assessment findings recorded by the nurse indicate high risk factors for developing breast cancer? Select all that apply. 1. The client began menstruating before age 12. 2. The client had three full-term pregnancies. 3. The client has a sister diagnosed with breast cancer. 4. The client has very large breasts. 5. The client has had radiation treatment to the chest. 6. The client has had breast implants.

135

A client makes an appointment with her gynecologist because she has been having vaginal bleeding between her regular menstrual periods. On the basis of the client's history and physical examination, the physician suspects cervical cancer and orders further diagnostic tests. To determine the significance of the client's symptomatic bleeding, which questions are most important for the nurse to ask? Select all that apply. 1. "Has your energy level changed remarkably?" 2. "Do you have intercourse more than once a week?" 3. "How many sanitary pads do you use?" 4. "Is the bleeding light or dark red?" 5. "Do you have itching and swelling of the labia?" 6. "Have you have weight loss in the last few months?"

136

A 21-year-old client is recovering from acute pelvic inflammatory disease (PID). When assigning a nursing assistant to this client's care, which instruction for disposing of soiled drainage pads is correct? 1. Flush all perineal pads down the toilet. 2. Put the pads in biohazard waste bags. 3. Place the pads in the client's wastebasket. 4. Enclose the soiled pads in a clean paper bag.

2

A 59-year-old client with ovarian cancer is receiving anti-neoplastic chemotherapy following a total hysterectomy. To accurately determine the dosage of anti-neoplastic drugs, which information is essential to obtain from the client's chart? 1. Urine output for past 24 hours 2. Body weight and height 3. Date of surgery 4. Drug allergies

2

A 65-year-old client makes an appointment for a routine physical examination. When the physician asks the nurse to prepare the client for a prostate examination, which position is preferred? 1. Lithotomy 2. Modified standing 3. Dorsal recumbent 4. Fowler's

2

A client with a hydrocele has the fluid aspirated from his scrotum. The physician orders a cold application to the area. When carrying out this intervention, which action is most appropriate? 1. Apply ice to the site in a sealed plastic bag. 2. Place a covered ice pack to the scrotum. 3. Position the client on a hypothermia blanket. 4. Seat the client on an ice-filled ring.

2

A nurse makes an office appointment for a male teenaged client who thinks he may have a sexually transmitted disease. To facilitate obtaining truthful information regarding this client's sexual history, which attitude is most important for the nurse to convey? 1. Sympathetic 2. Nonjudgmental 3. Encouraging 4. Optimistic

2

A nurse refers a client with genital warts to a gynecologist, who confirms that they are caused by human papillomavirus. When the client asks if there is any danger associated with this condition, which response by the nurse is best? 1. "The condition can be treated with an antibiotic, such as penicillin or tetracycline." 2. 'The condition appears to increase the risk of cancer of the vulva, vagina, and cervix." 3. "The condition can be prevented by taking birth control pills." 4. "The condition is not dangerous and requires no treatment at this time."

2

After the diagnosis of fibroid tumors is confirmed, the client is scheduled for a dilation and curettage in the ambulatory surgery department. Before the client is discharged, which nursing observation is most important for the nurse to document? 1. The client can eat without nausea. 2. The client can empty her bladder. 3. The client's pelvic pain is relieved. 4. The client's perineal pad has been changed.

2

Although it has not been conclusively proven, the nurse explains that some women with fibrocystic disease get relief from their symptoms by eliminating which substance from their diet? 1. Alcohol 2. Caffeine 3. Saturated fat 4. Refined sugar

2

Another participant asks the nurse to explain the difference between oral contraceptive packages that have 21 pills and those that have 28 pills. Which statement correctly describes oral contraceptive packages that contain 28 pills? 1. Packages containing 28 pills are biphasic and release a constant amount of estrogen and an increasing amount of progesterone throughout the cycle. 2. Packages containing 28 pills have 7 placebo pills and allow a woman to maintain a routine of taking a pill a day without missing a dose. 3. Packages containing 28 pills have 21 pills that contain estrogen and 7 pills that contain progesterone and are called "combination oral contraceptives". 4. Packages containing 28 pills are prescribed for women who have a 28-day menstrual cycle instead of a 21-day menstrual cycle.

2

Because of her persistent symptoms, the client chooses to undergo surgery to correct the cystocele. She is instructed to catheterize herself for approximately 1 week after being discharged. Which outcome best demonstrates that the client is performing self-catheterization appropriately? 1. She empties 50 mL of urine from her bladder each time. 2. She is free of signs of a urinary tract infection. 3. She inserts the catheter for 30 minutes each time. 4. She maintains a urinary record of time and amount.

2

Before discharging a postmenopausal mastectomy client, which instruction concerning breast self-examination (BSE) is most correct? 1. Examine your remaining breast upon awakening from sleep. 2. Examine your remaining breast on the first day of the month. 3. Examine your remaining breast after you finish your shower. 4. Examine your remaining breast before your yearly mammogram.

2

Before taking the client to the room where the pelvic examination will be performed, which nursing action is most appropriate? 1. Ask the client to sign a consent form. 2. Give the client an opportunity to void. 3. Offer the client a mild analgesic . 4. Help the client instill a vaginal lubricant.

2

During a subsequent visit, when the client has recovered from the orchitis, the nurse uses the opportunity to teach him how to perform testicular self-examination. Which statement by the nurse accurately explains the technique for testicular self-examination? 1. Palpate each testicle simultaneously. 2. Roll each testicle between the thumb and fingers. 3. Examine your testicles at least once yearly. 4. Perform the self-examination in a cool room.

2

During the physical and pelvic examination by the physician, the nurse notices that the client has several tattoos on the insides of her thighs and on her labia and has nipple and navel piercings. Before the client leaves the office, the nurse should obtain further information regarding which topic? 1. The name of the person who did the tattoos and piercings 2. Whether the client is practicing safe, protected sex 3. The client's sexual experiences with members of both sexes 4. The names of all of the client's sexual partners

2

If the client asks for information on special bras and prosthetic devices following her mastectomy, which organization is the best resource to recommend? 1. American Garment Industry 2. American Cancer Society 3. Breast Prosthetics Association 4. Organization for Mammary Cosmetics

2

If the client experiences all of the following signs and symptoms following the laparoscopy, which one can the nurse attribute directly to the endoscopic procedure? 1. Nausea and vomiting 2. Shoulder discomfort 3. Urinary frequency 4. Leg cramps

2

In addition to a mild analgesic, the physician also recommends that the client use sitz baths as a comfort measure for the prostatitis. Which instruction by the nurse is correct concerning sitz bath regimen? 1. Use cool tepid water. 2. Soak for 20 minutes. 3. Add mild liquid soap to the water. 4. Massage the scrotum while bathing.

2

The client is scheduled to undergo electrocauterization after the diagnostic tests confirm that she has an early stage of cervical cancer. After the electrocauterization procedure, which discharge instruction is most appropriate? 1. "Douche in 24 hours to remove debris and blood clots." 2. "Avoid heavy lifting until you have had a surgical follow-up examination." 3. "Remain in bed as much as possible over the next 5 days." 4. "Avoid any sexual activity for 1 week."

2

The client undergoes a transurethral resection of the prostate (TURP) and is returned to the nursing unit with a three-way catheter for administering intermittent bladder irrigations. Because the physician is concerned about the client's renal status, he orders that urine output be calculated every 4 hours. If the nurse instills 1,000 mL of irrigant in the 4-hour time frame, and there is 1,275 mL in the drainage collection bag at the end of the 4 hours, what is the total urine output? Calculate the amount. ________ 1. 1000 mL 2. 275 mL 3. 525 mL 4. 600 mL

2

The client' s bladder is distended after the catheter is removed even though she is urinating approximately 100 mL with each voiding. The physician instructs the nurse to recatheterize the client and measure the residual urine. Which nursing action is most appropriate to carry out the medical order? 1. Catheterize the client as soon as possible. 2. Catheterize the client after her next voiding. 3. Connect the catheter to gravity drainage. 4. Use a small-gauge catheter to drain the bladder.

2

The nurse asks whether the client currently practices breast self-examination (BSE), then takes the opportunity to show her the proper technique. The client states that she examines her breasts in the shower and while lying down. The nurse recommends that the client should also inspect her breasts from which position? 1. Bending from the waist 2. Standing before a mirror 3. Arching the back 4. Leaning from side-to-side

2

The nurse correctly informs the client that the BSE techniques that involve making small concentric circles or dividing the breast into wedges, which resemble the spokes of a wheel, should begin from which anatomic point? 1. Beginning with the nipple and extending to the outer margins of the breast 2. Beginning with the outer margins of the breast and extending toward the nipple 3. Beginning with the sternum and extending toward each axilla 4. Beginning with each axilla and extending toward the sternum

2

The physician advises the client to go to the emergency department for catheterization. Unless the physician specifies otherwise, what is the maximum volume of urine the nurse should drain from the client at this time? 1. 500 mL 2. 1,000 mL 3. 1,500 mL 4. 2,000 mL

2

The physician examines a 22-year-old client who has a swollen, painful scrotum. The physician suspects epididymitis and orders a clean-catch urine specimen for a culture and sensitivity test. When the nurse asks the client to repeat the instructions for collecting a clean-catch urine specimen, which statement indicates the client needs further clarification? 1. "I must clean my penis." 2. "I must collect all the urine." 3. "I must retract the foreskin." 4. "I must use a sterile container."

2

The physician recommends an excisional biopsy followed by an immediate modified radical mastectomy if the biopsy shows malignant cells. If the client tells the nurse that she would prefer to postpone the mastectomy until the biopsy has been more thoroughly examined, which is the most appropriate initial nursing action? 1. Explain that most biopsies are accurate. 2. Advocate her choice of treatment. 3. Discourage her from opposing the physician. 4. Recommend that she seek a second opinion.

2

The physician requests that the client with vaginal bleeding come to the office. When the client arrives, she is accompanied by a female friend. The nurse assigns the client to an examination room, but as the client's friend follows the client into the room, the nurse stops her. The client says to the nurse, "It's OK, we're lesbians." Which action by the nurse is most appropriate? 1. Allow the client's partner to stay in the examination room. 2. Ask the client's friend to remain in the waiting room. 3. Ask the physician to make the decision in this situation. Confer with the physician regarding his thoughts about the situation. 4. Suggest that the client's friend wait just outside the examination room door.

2

The transfer form for a 72-year-old woman being admitted to a nursing home indicates that she has a prolapsed uterus. When the nurse does a physical assessment, which technique is best for detennining the extent of the prolapse? 1. Examine the perineum when the client rolls from side to side. 2. Examine the perineum as the client stands and bears down. 3. Examine the perineum with the client in a dorsal recumbent position. 4. Examine the perineum with a lubricated speculum and flashlight.

2

What information provided by the nurse is most appropriate for the client who plans on douching twice a week? 1. Use a concentrated solution of vinegar and water. 2. Avoid frequent douching because it removes helpful microorganisms. 3. Instill no more than 8 to 16 oz of irrigant solution with each douching. 4. Discontinue the instillation if cramping occurs.

2

When obtaining a sexual history from this client, which question is most important for the nurse to ask? 1. "Have you ever had a painless sore on your penis?" 2. "Does any sexual partner have similar symptoms?" 3. "At what age did you first have sexual intercourse?" 4. "When did you last have sexual intercourse?"

2

When the nurse administers the parenteral form of the anti-neoplastic drug, which nursing action is best for preventing accidental self-absorption of the drug? 1. Use only prefilled syringes. 2. Wear disposable examination gloves. 3. Dilute the drug with saline solution. 4. Mix the drug in a closed vial.

2

Which activity of daily living is most therapeutic for the nurse to recommend for preserving the hospitalized client's muscle strength and joint flexibility in the arm on the operative side? 1. Feeding herself 2. Brushing her hair 3. Writing letters 4. Washing her chest

2

Which gynecologic symptom reported by a female client is most suggestive of trichomoniasis ? 1. A series of fluid-filled vesicles on the vagina 2. Vaginal drainage that causes intense itching 3. Vaginal drainage that resembles milk curds 4. Tenderness and pressure in the lower abdomen

2

Which health practice is most appropriate for the nurse to teach this client? 1. Take showers rather than tub baths if possible. 2. Wipe away from the vagina following a bowel movement. 3. Use a lanolin-based soap for genital cleansing. 4. Avoid sexual intercourse more than once a week.

2

Which staff nurse is best suited to care for a client with a radioactive implant? 1. A male nurse with oncology nursing experience 2. A female nurse who has had a hysterectomy 3. A female nurse who has survived cancer herself 4. A male nurse whose mother died of cancer

2

Which statement by a participant indicates a need for additional teaching regarding safe and effective use of oral contraceptives? 1. "I need to use an additional form of contraception if I forget to take my pill." 2. "Women who have painful menstrual cramping should not take oral contraceptives." 3. "Oral contraceptives should be discontinued 3 to 4 months before I plan to get pregnant." 4. "If I take antibiotics or antihistamines at the same time as my oral contraceptives, I could see some spotting."

2

A 35-year-old woman makes an appointment with her physician because she has felt several lumps in her right breast. She is scheduled for a mammogram. When the office nurse gives the client instructions on how to prepare for the mammogram, which is most accurate? Select all that apply. 1. "You will need to shave your underarm hair the morning of the test." 2. "Do not wear any underarm deodorant the day of the test." 3. "Wipe each breast with an antiseptic pad before the test." 4. "Do not wear constricting clothing to the test." 5. "Avoid wearing body powder the day of the test." 6. "Refrain from applying lotion to the breasts or axillae."

256

If a female client with an intrauterine device describes the following symptoms, which are most likely related to her birth control device? Select all that apply. 1. Breast tenderness 2. Heavy menstrual flow 3. Steady weight gain 4. Chronic acne 5. Periods that last longer than normal 6. Painful menstrual cramping

256

Internal radiation therapy is used to treat the client who has been diagnosed with advanced cervical cancer. An applicator containing radioactive material is inserted into the client's vagina. Because the client is receiving this type of radiation therapy, the nurse should plan to include which nursing intervention in the care plan? Select all that apply. 1. Elevate the head of the bed to 90 degrees. 2. Maintain the client on strict bed rest. 3. Place urine and feces in a closed container. 4. Weigh the client daily before breakfast. 5. Stand at a distance and talk with the client from the doorway. 6. Spend as little time as possible with the client.

256

A 30-year-old woman has an appointment for a routine pelvic examination. She asks the office nurse when she should begin undergoing routine mammography. If the client is asymptomatic and at low risk for breast cancer, the nurse would be correct in advising her to have a baseline mammogram at what age? 1. 25 2. 35 3. 40 4. 50

3

A 56-year-old client has had difficulty retracting the foreskin over the glans of his penis. He is scheduled for a circumcision. Besides assessing the dressing for signs of bleeding, which other postoperative nursing assessment is a priority following this surgical procedure? 1. Checking the client's deep-breathing efforts 2. Assessing the client's ability to achieve an erection 3. Monitoring the volume of urine output 4. Monitoring the infusion of l.V. antibiotics

3

A 68-year-old client with prostate cancer undergoes a suprapubic prostatectomy. He returns to the nursing unit with an indwelling catheter in his urethra and a cystostomy tube in his abdomen. Which nursing order is most appropriate to add to the client's initial postoperative care plan? 1. Connect the cystostomy tube to a leg bag for drainage. 2. Secure the cystostomy tube to the client's thigh. 3. Ensure that the cystostomy tube is unclamped at all times. 4. Clamp the indwelling catheter when the cystostomy tube is irrigated.

3

A 72-year-old client with a history of benign prostatic hypertrophy (BPH) phones the nurse at his physician' s office, stating that he has not been able to urinate in the last 16 hours. In the early stages of BPH, the nurse expects the physician to monitor the progression of disease with which diagnostic test? 1. A semiannual prostate-specific antigen (PSA) test 2. An annual cystoscopy 3. A digital rectal examination 4. A retrograde pyelogram

3

A culture indicates that a client has nonspecific urethritis from a nongonococcal organism, Chlamydia trachomatis. The physician prescribes doxycycline (Vibramycin) 100 mg b.i.d. with a sufficient number of capsules for 7 days of treatment. Which information given by the nurse is most appropriate to provide to the client? 1. Take the medication until the symptoms clear. 2. Refill the prescription if symptoms persist. 3. Take the medication for the full amount of time. 4. Treatment of the infection is likely to be lifelong

3

A middle-aged client with inflamed testes is being seen at a local clinic. The physician diagnoses orchitis. When the nurse gathers the client data, which information is most suggestive as the cause of the client's condition? 1. The client has multiple sexual partners. 2. The client is an active homosexual. 3. The client was never immunized for mumps. 4. The client had a previous sports-related scrotal injury.

3

A physician prescribes an oral antibiotic for a client with prostatitis. Which instruction by the nurse about the client's antibiotic use is a priority? 1. Drink a glass of milk when taking the medication. 2. Report if your urine becomes a lighter color. 3. Take the medication until it is completely gone. 4. Monitor your body temperature on a daily basis.

3

A pregnant client is considering a tubal ligation after the birth of her child. Which statement indicates that the client is misinformed? 1. "I will have a small abdominal incision." 2. "This procedure is not easily reversed." 3. "I will no longer menstruate afterward." 4. "Recovery should occur in a brief time."

3

A radical inguinal orchiectomy is performed on a 22-year-old client with testicular cancer. Which comment by the patient indicates that he has misinterpreted the consequences of his surgery? 1. "My beard will continue to grow." 2. "My voice will sound higher." 3. "My sperm count will be raised." 4. "My sex drive will be unaffected."

3

Before surgery a urinary catheter was inserted. Today, the physician orders that the client's catheter can be removed. Which action is most important for the nurse to perform first? 1. Clean the client's labia with soap and water. 2. Measure the urine in the drainage bag. 3. Remove the fluid from the balloon. 4. Disconnect the client's catheter and drainage bag.

3

During a presurgical assessment, a 67-year-old woman tells the nurse that she has felt a lump in her left breast for the last 6 months. If the lump has the following characteristics when the nurse palpates the breast tissue, which one is most suggestive that the lump may be cancerous? 1. The lump can be easily moved about. 2. The lump is about 1/2'' (1 cm). 3. The lump is irregularly shaped. 4. The lump is near the aureola.

3

If the cystocele is not severe, which suggestion by the nurse can best aid the client's incontinence? 1. Recommend the purchase of absorbent underwear. 2. Show her how to apply an external catheter. 3. Teach her to exercise her perineal muscles. 4. Instruct her to limit her fluid intake.

3

One participant states that she is considering using the basal body temperature method of natural family planning and asks the nurse the correct way to use this method. Which statement is correct concerning the proper use of the basal body temperature method of natural family planning? 1. The client should record the pattern of her menstrual cycle for 6 to 8 months before actually using the method. 2. The client should regularly monitor the consistency of vaginal bleeding during menstruation. 3. The client should take her temperature every morning before rising for 6 months before using the method. 4. The client should have her sex partner withdraw his penis from the vagina just before ejaculation.

3

The nurse correctly teaches a couple that immediately after a vasectomy, it is best to continue using an alternative birth control method for which time period? 1. 1 week 2. 1 month 3. 6 weeks 4. 6 months

3

The nurse discusses healthy sexual behaviors with the client. Which risk factor predisposes the client to acquiring a sexually transmitted disease? 1. Experiencing early puberty 2. Finding sex information on the Internet 3. Having multiple sex partners 4. Receiving limited sex education

3

To prevent infection with the human immunodeficiency virus (HIV), a client says he uses a condom when having intercourse. Which technique can the nurse suggest to provide additional protection from HIV? 1. Remove the condom immediately after intercourse. 2. Wash the penis with a dilute vinegar solution. 3. Use a spermicide containing nonoxynol-9. 4. Apply copious amounts of vaginal lubricant.

3

When modifying the postoperative care plan, the nurse should plan to include which nursing measure to prevent arm swelling on the client's operative side? 1. Applying an ice pack to the site 2. Applying warm compresses to the site 3. Keeping the arm elevated 4. Ambulating the client frequently

3

Which instruction is best when teaching the client about inserting vaginal medication? 1. Place the applicator just inside the vaginal opening. 2. Insert the applicator while sitting on the toilet. 3. Instill the medication just before retiring for sleep. 4. Put on disposable latex gloves before applying the drug.

3

Which nursing instruction is best to provide to the client with chlamydia to prevent a recurrence of the infection? 1. Shower or bathe after intercourse. 2. Wash your hands well using an antiseptic soap. 3. Encourage your sexual partners to be tested and treated. 4. Make sure you receive adequate nutrition and fluid intake.

3

Which question is most important to ask to ensure valid analysis of the vaginal specimen? 1. "When did you last have sexual intercourse?" 2. "How old were you when you had your first pregnancy ?" 3. "What was the date of your last menstrual period?" 4. "Have you ever used oral contraceptives?"

3

lf the nurse must handle the radioactive implant, which action best protects the nurse? 1. Putting on sterile vinyl gloves 2. Washing hands before putting on vinyl gloves 3. Using long-handled forceps to handle the implant 4. Enclosing the implant in a glass jar

3

A 16-year-old female client confides to the school nurse that she has cramps that accompany the onset of menstruation. Besides a mild analgesic such as ibuprofen (Motrin), which therapeutic interventions are most appropriate for the nurse to recommend? Select all that apply. 1. Obtain a prescription for an oral contraceptive 2. Switch from menstrual pads to tampons 3. Use local applications of heat 4. Reduce physical activity 5. Massage the lower abdomen when experiencing pam 6. Lie prone while sleeping or napping

34

The licensed practical nurse realizes that the nursing assistant requires further instruction when observing her performing which actions following the client's hysterectomy? Select all that apply. 1. Offering the client a variety of oral fluids frequently 2. Helping the client ambulate in the hall 3. Raising the knee-gatch on the hospital bed 4. Reporting to the physician that the client's dressing is loose 5. Massaging the calves when applying lotion 6. Changing the client's perinea!pad without using gloves

3456

The client's breast tumor is malignant and she undergoes a left modified radical mastectomy. Which nursing interventions are most appropriate to add to the client's immediate postoperative care plan? Select all that apply. 1. Maintain the client in a dorsal recumbent position. 2. Limit oral fluid intake to no more than 2,000 mL/day. 3. Use the right arm when assessing blood pressures. 4. Inspect the incision at least once each shift. 5. Advise client not to turn on to or sleep on the affected side. 6. Ask the client to report numbness or tingling in the chest wall.

356

When teaching a male client about how to use a condom, which instructions are correct? Select all that apply. 1. "Wait until your penis becomes limp before removing it from the vagina." 2. "You can reuse a condom as long as it is made of silicone." 3. "Leave a small space between the end of the condom and the penis." 4. "Apply spermicide to the penis before applying the condom." 5. " Unroll the condom over an erect penis." 6. " Store condoms in a cool, dry place."

356

A 53-year-old woman becomes symptomatic as a result of a cystocele. If this client is typical of others with this condition, she will most likely report to the nurse that she experiences urinary incontinence during which time? 1. When she awakens 2. As she walks 3. During sleep 4. Upon sneezing

4

A 68-year-old woman experiences painful intercourse and is concerned about possible reproductive disease. On the basis of this client's age, which statement by the nurse best explains the reason for the client's discomfort? 1. The pelvic muscles are more sensitive to pressure after menopause. 2. The clitoris is less responsive to sexual foreplay as women age. 3. The vagina atrophies if intercourse is infrequent. 4. The mucus-producing glands decrease with aging.

4

At the family planning class, the nurse describes to the participants the various barrier methods of contraception. Which statement made by a participant indicates the need for additional teaching about barrier methods of contraception? 1. "A diaphragm is refitted or replaced if there is a weight gain or loss of 10 lb or more." 2. "Use of the intrauterine device is not recommended for women who have never been pregnant." 3. "Toxic shock syndrome is a potential side effect associated with the use of the cervical cap." 4. "Use of the female condom is not recommended for women who are allergic to latex."

4

Because many anti-neoplastic drugs affect bone marrow function, which laboratory test is most important to monitor for client safety? 1. Mean cell volume 2. Total leukocyte count 3. Differential cell count 4. Complete blood count

4

If a culture is ordered to detect the causative organism, which body substance will the nurse collect? 1. Venous blood 2. Sterile urine 3. Ejaculated semen 4. Urethral drainage

4

If the client asks about long-term consequences that are associated with this disorder, the nurse accurately identifies which reproductive sequela? 1. Cancer of the cervix 2. Premature labors 3. Spontaneous abortions 4. Difficulty getting pregnant

4

If the nurse finds the radioactive insert in the client's bed, which nursing action is most appropriate? 1. Return it to the nuclear medicine department. 2. Discard it in the infectious waste receptacle. 3. Reinsert it immediately. 4. Place it in a lead container.

4

The client experiences almost total hair loss as anti-neoplastic drug therapy progresses. Which statement is most accurate when discussing hair loss with the client? 1. The hair loss is permanent, but attractive wigs are available. 2. The hair loss is permanent, but hair transplantation is a possible solution. 3. The hair loss is temporary; hair may grow back in several years. 4. The hair loss is temporary; hair will regrow after chemotherapy is finished.

4

The client is scheduled for a sonogram of his prostate. When the nurse provides the client with pretest instructions, which statement is most correct? 1. "You'll need to fast from midnight the night before the test." 2. "You'll need to empty your bladder just before the test begins." 3. "You 'll need to consume at least a quart of water an hour before the test." 4. "You'll need to self-administer an enema 1 hour before the test."

4

The client with trichomoniasis is treated with oral metronidazale (Flagyl). Which nursing instruction is essential for preventing a drug-food interaction while the client is taking metronidazole (Flagyl)? 1. Use plain salt rather than the iodized type. 2. Stop eating anything with aspartame (NutraSweet). 3. Eliminate sources of monosodium glutamate (MSG). 4. Avoid consuming alcohol in any form.

4

The nurse correctly places the client in which position when the physician is ready to perform the pelvic examination? 1. Sims' position 2. Trendelenburg's position 3. Fowler's position 4. Lithotomy position

4

The physician prescribes tamoxifen (Nolvadex) 10 mg P.O. b.i.d. for a client who underwent a modified radical mastectomy to treat her estrogen-sensitive breast cancer. The drug label indicates that there are 20 mg in each tablet. How many tablets should the nurse administer to the client? 1. 1 2. 2 3. 0.8 4. 0.5

4

The radiologist interprets the findings on the mammogram as benign fibrocystic disease. The nurse correctly informs the client that fibrocystic lesions may become larger and more tender at what time? I. After the menstrual cycle 2. Following sexual intercourse 3. Nearer to beginning menopause 4. Just before menstruation

4

What special instruction concerning the technique for taking vital signs is most important when assigning this task to a nursing assistant? 1. Count the client's respirations while he is resting. 2. Assess the client's pulse at the radial artery. 3. Take the client's blood pressure with an electronic machine. 4. Avoid taking a rectal temperature.

4

When managing the care of a client with acquired immunodeficiency syndrome (AIDS), which method best evaluates the effectiveness of zidovudine (AZT) therapy? 1. Assessing the client's vital signs 2. Assessing the client's blood counts 3. Monitoring the client's blood culture reports 4. Monitoring the client's viral load tests

4

Which breast palpation technique is most correct? 1. Examine the breast while using the heel of the hand. 2. Examine the breast while using the index finger only. 3. Examine the breast while using the index finger and thumb. 4. Examine the breast while using the pads of the fingertips.

4

Which comment indicates that the client lacks a clear understanding of this disease? 1. "I can be cured using antibiotic therapy." 2. "My sexual partner should be tested for the disease." 3. "Syphilitic lesions may be present in 1my partner' s vagina." 4. "One infection provides lifelong immunity."

4

Which statement made by the client best demonstrates that she understands how frequently to perform a BSE? 1. "I will perform a BSE on a weekly basis." 2. "I will perform a BSE every 6 months." 3. "I will perform a BSE 1 week before my period begins." 4. "I will perform a BSE 3 to 7 days after my period ends."

4

A nurse has been asked to teach ovulation and menstruation to a class of secondary school students. Place the events listed below in ascending chronologic order in the way that they occur during the menstrual cycle. Use all the options. 1. Ovum is released 2. Progesterone decreases 3. Endometrium begins to thicken 4. Ovarian follicle matures 5. Endometrium is shed 6. Corpus luteum forms

431625

The office manager schedules a mandatory staff meeting for all nursing personnel. As the nurse enters the room, several documents containing the client's name, medical records number, mammogram results, and diagnosis are found unattended on the table. What are the most appropriate nursing actions in this situation? Select all that apply. 1. Notify housekeeping to come and dispose of the papers. 2. Toss the papers in the trash. 3. Put the papers into the shredder bin. 4. Try to determine who left the papers unattended. 5. Stack the papers neatly placing them off to the side. 6. Notify the office manager of the confidentiality breach

46


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