Health Promotion/Men & Womens Health NCLEX questions

During the initial interview, the client reports that she has a lesion on the perineum. Further investigation reveals a small blister on the vulva that is painful to touch. The nurse is aware that the most likely source of the lesion is: A.Syphilis B.Herpes C.Gonorrhea

B.Herpes

Instructions to pt scheduled for computerized tomography (CT) scan with contrast media?

Need to be NPO 8 hrs before procedure. Hold metformin for 48 hrs before procedure *risk for lactic acidosis*

The nurse determines that a woman with genital herpes understands her infection when she states: "I can have sex when all the herpes sores have healed." "When I finish the acyclovir prescription, I will be cured." "I must be careful when I have sex because herpes is a lifelong problem."

"I must be careful when I have sex because herpes is a lifelong problem." -Genital herpes (HSV-2) is characterized by remissions and exacerbations; it cannot be cured. Clients should abstain from sex until 10 days after the lesions heal. *Herpes can be controlled, not cured.*

What are the two most common sti's that lead to PID?

(1) Chlamydia (2) Gonorrhea

Vaginitis - client teaching

- wear cotton underwear - avoid sitting in wet bathing suit in warm weather for long periods - prompt attention @ 1st sign of infect - EAT 8-oz of yogurt w/active cultures daily while taking antibiotics -AVOID hygeine sprays and douches!!

What affect do alpha adrenergic blockers (doxazosin, prazosin, terazosin are examples) have that might help a client with BPH? What side effects whould we monitor?

-AABlockers (end with -sin) prevent excessive smooth muscle contraction so they increase flow of urine; relieve obstruction s/e: orthostatic hypertension, tachycardia

Most common causes of vulvovaginitis:

1. Bacterial vaginosis 2. candidiasis (yeast infection) 3. STDs-Trichomoniasis 4. change in vaginal PH

The nurse works at an outpatient health center and receives a call from an adolescent girl who was recently prescribed the birth control pill. She describes "an awful leg cramp that turned the skin red." Which of the following statements, if made by the nurse to the patient, is CORRECT? 1. "Has this happened before?" 2. "We'll need you to come in to the clinic to be evaluated immediately." 3. "This is a normal side effect with the pill and should go away after the first month." 4. "Do you play any sports where you could have injured yourself?"

2. "We'll need you to come in to the clinic to be evaluated immediately." This is a most-feared complication of birth control pills: a DVT. The girl needs immediate evaluation and treatment.

A client who has had a prostatectomy is complaining of pain from bladder spasms. The nurse checks the health care provider's prescription sheet and expects to see which medication prescribed to treat the problem? 1. Morphine sulfate 2. Oxybutynin (Ditropan) 3. Hydromorphone (Dilaudid) 4. Meperidine hydrochloride (Demerol)

2. Oxybutynin (Ditropan)

A student nurse interns at an outpatient health center. Which of the following responsibilities of the student nurse are considered tertiary prevention strategies? SELECT ALL THAT APPLY: 1. The student nurse administers a flu vaccine. 2. The student nurse administers a PPD test for employment. 3. The student nurse administers Acyclovir to a patient diagnosed with hepatitis C. 4. The student nurse prepares a sterile field before cleaning the inner cannula of a tracheostomy. 5. The student nurse gives a presentation on diet and exercise. 6. The student nurse gives Bactrim to a patient with a UTI.

3 & 6 Giving Bactrim and giving Acyclovir are examples of tertiary prevention. The flu vaccine, the sterile field, and the presentation on diet/exercise are examples of primary prevention. The PPD test is secondary prevention.

The nurse teaches a 20-year-old female how to perform SBE. Which of the following instructions, if given by the nurse, is INCORRECT? 1. "The first position you will use to inspect your breasts is to stand with your arms at your sides." 2. "Use your index, pointer, and ring fingers to firmly palpate the breast in a circular motion." 3. "The best time to perform your SBE is at the end of the month." 4. "Remember that breast tissue may feel tender at times, and this is normal."

3. "The best time to perform your SBE is at the end of the month." The best time to perform SBE is one week after the onset of the woman's menstrual period, when hormones are at the lowest. It is normal for hormonal changes during the month to make breast tissue tender or enlarged. The other options are correct as well.

Tamsulosin hydrochloride (Flomax) has been prescribed for a client with benign prostatic hypertrophy (BPH). How should the nurse instruct the client to take the medication? 1. With breakfast 2. With a glass of milk 3. 30 minutes after a meal 4. With the lunchtime meal

3. 30 minutes after a meal

A client passes a urinary stone, and laboratory analysis of the stone indicates that it is composed of calcium. On the basis of this analysis, which option should the nurse specifically include in the dietary instructions? 1. Increase intake of dairy products. 2. Avoid citrus fruits and citrus juices. 3. Avoid green, leafy vegetables such as spinach. 4. Increase intake of meat, fish, plums, and cranberries.

3. Avoid green, leafy vegetables such as spinach.

A client arrives at the emergency department with complaints of low abdominal pain and hematuria. The client is afebrile. The nurse next assesses the client to determine a history of which condition? 1. Pyelonephritis 2. Glomerulonephritis 3. Trauma to the bladder or abdomen 4. Renal cancer in the client's family

3. Trauma to the bladder or abdomen *know anatomy keyword was LOW ABDOMINAL PAIN*

Oxybutynin is prescribed for a client. Based on this prescription, the nurse suspects that the client has which condition? 1. Gastritis 2. Renal calculi 3. Ulcerative colitis 4. Overactive bladder

4. Overactive bladder *INSTRUCT PT TO REPORT S/E OF DRY MOUTH ON THIS MEDICATION*

A triple-lumen indwelling urinary catheter is inserted for continuous bladder irrigation following a transurethral resection of the prostate. In addition to balloon inflation, the nurse is aware that the functions of the three lumens include: A Continuous inflow and outflow of irrigation solution B Intermittent inflow and continuous outflow of irrigation solution C Continuous inflow and intermittent outflow of irrigation solution

A Explanation: When preparing for continuous bladder irrigation, a triple-lumen indwelling urinary catheter is inserted. The three lumens provide for balloon inflation and continuous inflow and outflow of irrigation solution.

If a patient is undergoing a right nephrectomy for a right renal tumor, the position is

A left lateral kidney

A patient is devastated to learn that she has the sexually-transmitted infection, gonorrhea. What would contribute to her ignorance of her condition? a) Being asymptomatic b) All options are correct c) Being sexually inactive d) Knowing the signs and symptoms of STIs

A) Being asymptomatic Many women who have gonorrhea are asymptomatic, a factor that contributes to the spread of the disease.

A male client reports urethral pain and a creamy yellow, bloody discharge from the penis. The nurse associates these characteristics with which of the following sexually transmitted infections? a) Gonorrhea b) Candidiasis c) Chancroid d) Trichomoniasis

A) Gonorrhea In men, the initial symptoms of gonorrhea include urethral pain and a creamy, yellow, sometimes bloody discharge. Candidiasis, trichomoniasis, and bacterial vaginosis are vaginal infections that can be sexually transmitted, and the male partner usually is asymptomatic.

A 22-year-old patient has presented to her primary care provider for her scheduled Pap smear. Abnormal results of this diagnostic test may imply infection with: a) human papillomavirus (HPV). b) Chlamydia trachomatis. c) Candida albicans. d) Trichomonas vaginalis.

A) human papillomavirus (HPV) Although a Pap smear does not test directly for HPV, dysplasia of cervical cells is strongly associated with HPV infection. An abnormal Pap smear is not indicative of chlamydial infection, trichomoniasis, or candidiasis.

Which nursing action will be most helpful in decreasing the risk for hospital-acquired infection (HAI) of the urinary tract in patients admitted to the hospital? a.Avoid unnecessary catheterizations. b.Encourage adequate oral fluid intake. c.Test urine with a dipstick daily for nitrites. d.Provide thorough perineal hygiene to patients.

ANS: A Since catheterization bypasses many of the protective mechanisms that prevent urinary tract infection (UTI), avoidance of catheterization is the most effective means of reducing HAI. The other actions will also be helpful, but are not as useful as decreasing urinary catheter use.

Which information will the nurse plan to include when teaching a 19-year-old to perform testicular self-examination? a.Testicular self-examination should be done in a warm area. b.The only structure normally felt in the scrotal sac is the testis. c.Testicular self-examination should be done at least every week. d.Call the health care provider if one testis is larger than the other.

ANS: A The testes will hang lower in the scrotum when the temperature is warm (e.g., during a shower), and it will be easier to palpate. The epididymis is also normally palpable in the scrotum. One testis is normally larger. The patient should perform testicular self-examination monthly.

A client has returned from the PACU after a vaginoplasty. What comfort measure does the nurse provide? a. Apply ice to the perineum. b. Elevate the legs on pillows. c. Position the client on the left side. d. Raise the head of the bed.

ANS: A Ice is applied to the perineum to reduce pain and discomfort. Elevating the legs on pillows is not recommended after a lengthy procedure in the lithotomy position, which predisposes the client to venous thromboembolism. Positioning the client on the left side and raising the head of the bed are not comfort measures related to this procedure.

After a vaginoplasty, what instruction by the nurse is most important? a. "You must dilate the vagina several times a day for months." b. "Do not have sexual intercourse for at least 6 months." c. "Use oil-based lubricants with the vaginal dilators."

ANS: A Self-care management for this client includes instructions to dilate the new vagina several times a day for months after the procedure, using water-based lubricant. Sexual intercourse is another way to keep the vagina dilated.

A nurse is providing health teaching to a 48 year old male-to-female (MtF) client who has undergone gender reassignment surgery. What information is most important to this client? a. "Be sure to have an annual prostate examination." b. "Continue your normal health screenings." c. "Try to avoid being around people who are ill." d. "You should have an annual flu vaccination."

ANS: A The MtF client retains the prostate, so annual screening examinations for prostate cancer remain important. The other statements are good general health teaching ideas for any client.

The nurse is reviewing a patient's medication history and notes that the patient is taking the cholinergic blocker tolterodine (Detrol). Which is an indication for this medication? a.Irritable bowel disease b.BPH c.Urge incontinence

ANS: C Tolterodine (Detrol) is used for urinary frequency, urgency, and urge incontinence caused by bladder (detrusor) overactivity.

A 48-year-old woman tells the nurse, "I missed my period last month. Am I in menopause?" The nurse would respond that a woman is considered to be menopausal when: a. her periods have stopped for 1 year. b. her periods have been irregular and light for 12 months. c. she has symptoms of vasomotor instability. d. she experiences symptoms of decreased estrogen, such as dyspareunia.

ANS: A When a woman's menstrual periods have stopped for 1 year, she is considered menopausal.

A nurse sees clients with sexually transmitted diseases. Which clients would the nurse be required to report to the local authority in every state, according to the Centers for Disease Control and Prevention? (Select all that apply.) a. Client with Chlamydia b. Woman with gonorrhea c. Man with syphilis d. Client with human immune deficiency virus e. Female with pelvic inflammatory disease

ANS: A, B, C, D Chlamydia, gonorrhea, syphilis, human immune deficiency virus (HIV), and acquired immune deficiency syndrome (AIDS) are all reportable to local authorities in every state. Pelvic inflammatory disease does not need to be reported.

The nurse advises the woman with pelvic floor dysfunction that she can do what for relief of the associated discomfort? Select all that apply. a. Lie down with feet elevated. b. Practice Kegel exercises. c. Assume knee-chest position periodically. d. Perform leg lift exercises. e. Prevent constipation.

ANS: A, B, C, E Elevating the feet, performing Kegel exercises, assuming the knee-chest position, and preventing constipation will reduce the pelvic discomfort of pelvic floor dysfunction.

A patient is receiving finasteride (Proscar) for treatment of benign prostatic hyperplasia. The nurse will tell him that a possible effect of this medication is a. alopecia. b.increased hair growth. c.urinary retention. d.increased prostate size.

ANS: B Finasteride is given to reduce prostate size in men with benign prostatic hyperplasia. It has been noted that men taking this medication experience increased hair growth. The other options are incorrect.

During the administration of finasteride (Proscar), the nurse must remember which important precaution? a.It must be taken on an empty stomach. b.It must not be handled by pregnant women. c.It is given by deep intramuscular injection to avoid tissue irritation. d.The patient needs to be warned that alopecia is a common adverse effect.

ANS: B Finasteride must not be handled by pregnant women because of its teratogenic effects. It is taken orally and without regard to meals. The other options are incorrect.

A 75-year-old male patient is in the clinic for a yearly physical and is asking for a prescription for sildenafil (Viagra). He has listed on his health history that he is taking a nitrate for angina, which problem may occur if sildenafil is taken with a nitrate? a.Significant increase in pulse rate b.Significant decrease in blood pressure c.Increased risk of bleeding d.Reduced effectiveness of the sildenafil

ANS: B In patients with preexisting cardiovascular disease, especially those on nitrates, erectile dysfunction drugs such as sildenafil lower blood pressure substantially, potentially leading to more serious adverse events. The other options are incorrect.

Following discharge teaching for a patient who has had a transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH), the nurse determines that additional instruction is needed when the patient says, a."I will avoid driving until I get approval from my doctor." b."I should call the doctor if I have any incontinence at home." c."I will increase fiber and fluids in my diet to prevent constipation."

ANS: B Since incontinence is common for several weeks after a TURP, the patient does not need to call the health care provider if this occurs. The other patient statements indicate that the patient has a good understanding of post-TURP instructions.

A patient with benign prostatic hyperplasia (BPH) is admitted to the hospital with urinary retention and new onset elevations in the blood urea nitrogen (BUN) and creatinine. Which of these prescribed therapies should the nurse implement first? a. Schedule an abdominal computed tomography (CT) scan. b. Insert a urinary retention catheter. c. Draw blood for a complete blood count.

ANS: B The patient data indicate that the patient may have acute renal failure caused by the BPH. The initial therapy will be to insert a catheter. The other actions also are appropriate, but they can be implemented after the acute urinary retention is resolved.

A woman is diagnosed with bacterial vaginosis and will begin taking metronidazole (Flagyl). What will the nurse teach the patient about this medication? a. "Abstain from sexual intercourse while taking this medication." b. "Do not consume alcohol while taking this drug and for 48 hours after stopping." c. "Take this medication on an empty stomach to increase absorption." d. "Topical preparations are ineffective for treating bacterial vaginosis."

ANS: B Metronidazole can cause a disulfiram-like reaction when taken with alcohol, so patients should be cautioned against using foods or drug products that contain alcohol. There is no need to abstain from sexual intercourse. Metronidazole should be taken with food. The topical preparation is effective against bacterial vaginosis.

A woman asks the nurse, "How do oral contraceptives prevent pregnancy?" The nurse explains that the combination of estrogen and progesterone in oral contraceptives: a. makes cervical mucus hostile to sperm. b. prevents ovul ation. c. prohibits implantation of the egg. d. acts as a barrier by destroying sperm.

ANS: B Oral contraceptives contain a combination of estrogen and progesterone that suppress ovulation.

A client is diagnosed with syphilis. Which question by the nurse is a priority at this time? a. "Have you been using latex condoms?" b. "Are you allergic to penicillin?" c. "When was your last sexual encounter?" d. "Do you have a history of sexually transmitted disease?"

ANS: B Penicillin is the treatment for syphilis. The other questions would be helpful in the client's history of sexually transmitted diseases but not as important as knowing whether the client is allergic to penicillin.

Which information will the nurse include when teaching a patient who has a diagnosis of chronic prostatitis? a.Ibuprofen (Motrin) should provide good pain control. b.Prescribed antibiotics should be taken for 7 to 10 days. c.Sexual intercourse and masturbation will help relieve symptoms. d.Cold packs should be used every 4 hours to reduce inflammation.

ANS: C Ejaculation helps drain the prostate and relieve pain. Warm baths are recommended to reduce pain. Nonsteroidal antiinflammatory drugs (NSAIDs) are frequently prescribed but usually do not offer adequate pain relief. Antibiotics for chronic prostatitis are taken for 4 to 12 weeks

A transgender client is taking transdermal estrogen (Climara). What assessment finding does the nurse report immediately to the provider? a. Breast tenderness b. Headaches c. Red, swollen calf d. Swollen ankles

ANS: C A red, swollen calf could be a manifestation of a deep vein thrombosis, a known side effect of estrogen. The nurse reports this finding immediately. The other manifestations are also side effects of estrogen, but do not need to be reported as a priority.

When a woman asks what she can do to reduce the discomfort of hot flashes, the nurse advises: a. "Aerobic exercise helps control hot flashes." b. "Increase the amount of calcium and vitamin D in your diet." c. "Dress in layers of cotton clothing." d. "Drink plenty of fluids, particularly caffeinated beverages."

ANS: C Cotton allows easier passage of air than synthetic fabrics. Layering allows the woman to take off or put on clothes when symptoms occur.

The nurse planning to teach a woman about perimenopause would include that lowered estrogen levels: a. prevent osteoporosis. b. decrease vaginal lubrication. c. raise the level of low-density lipoproteins. d. raise the level of high-density lipoproteins.

ANS: C Estrogen increases the amount of high-density lipoproteins that carry cholesterol from body cells to the liver for excretion. With lowered levels of estrogen, low-density lipoproteins increase, causing an increase in the incidence of heart attacks and strokes.

A woman who has menorrhagia is prescribed ibuprofen, and she asks the nurse how a pain medication can decrease uterine bleeding. The nurse will explain that this is most likely explained by ibuprofen's effects on a. estrogen levels. b. platelet aggregation. c. prostaglandin production. d. uterine endometrium.

ANS: C Ibuprofen blocks prostaglandin production, which decreases uterine bleeding and cramps. Ibuprofen does not affect estrogen levels. Its effects on platelet aggregation would most likely increase bleeding. It does not have effects on the uterine endometrium.

A nurse is reviewing the chart of a new client in the family medicine clinic and notes the client is identified as "Kevin Jones." The nurse enters the room and finds a woman in a skirt. What action by the nurse is best? a. Apologize and declare confusion about the client. b. Ask Mrs. Jones where her husband is right now. c. Ask the client about preferred forms of address. d. Explain that the chart must contain an error.

ANS: C The nurse may encounter transgender clients whose outward appearance does not match their demographic data. In this case, the nurse should greet the client and ask the client to explain his or her preferred forms of address. Lengthy apologies can often create embarrassment. The nurse should not assume the client is not present in the room. The chart may or may not contain errors, but that is not related to determining how the client prefers to be addressed.

A pt is admitted to the hospital with chills, fever, and vomiting. Which finding by the nurse will be most helpful in determining whether the patient has an upper urinary tract infection (UTI)? a.Suprapubic pain b.Bladder distention c.Foul-smelling urine d.Costovertebral tenderness

ANS: D Costovertebral tenderness is characteristic of pyelonephritis. The other symptoms are characteristic of lower UTI and are likely to be present if the patient also has an upper UTI.

When obtaining a focused health history for a patient with possible testicular cancer, the nurse will ask the patient about any history of a.sexually transmitted disease (STD) infection. b.testicular trauma. c.testicular torsion. d. undescended testicles.

ANS: D Cryptorchidism (undescended testicles.) is a risk factor for testicular cancer if it is not corrected before puberty. STD infection, testicular torsion, and testicular trauma are risk factors for other testicular conditions but not for testicular cancer.

A patient who has been recently diagnosed with benign prostatic hyperplasia (BPH) tells the nurse that he does not want to have a transurethral resection of the prostate (TURP) because he is afraid it might affect his ability to have intercourse. Which action should the nurse take? a. Offer reassurance that sperm production is not affected by TURP. b. Discuss alternative methods of sexual expression besides intercourse. c. Provide education about the use of medications for erectile dysfunction (ED) occurring after TURP. d. Teach that ED is not a common complication following a TURP.

ANS: D ED is not a concern with TURP, although retrograde ejaculation is likely and the nurse should discuss this with the patient. Erectile function is not usually affected by a TURP, so the patient will not need information about penile implants or reassurance that other forms of sexual expression may be used. Because the patient has not asked about fertility, reassurance about sperm production does not address his concerns.

The nurse is reviewing instructions for vaginal antifungal drugs with a patient. Which statement by the nurse is an appropriate instruction regarding these drugs? a."The medication can be stopped when your symptoms are relieved." b."Discontinue this medication if menstruation begins." c."Daily douching is part of the treatment for vaginal fungal infections." d."Abstain from sexual intercourse until the treatment has been completed and the infection has resolved."

ANS: D Female patients taking antifungal medications for the treatment of vaginal infections need to abstain from sexual intercourse until the treatment has been completed and the infection has resolved. The medication needs to be taken for as long as prescribed. Instruct patients to continue to take the medication even if they are actively menstruating. Douching is not an appropriate intervention.

A patient has an enlarged prostate detected by digital rectal examination (DRE) and an elevated prostate specific antigen (PSA) level. The nurse will anticipate that the patient will need teaching about a. cystourethroscopy. b. uroflowmetry studies. c. magnetic resonance imaging (MRI). d. transrectal ultrasonography (TRUS).

ANS: D In a patient with an abnormal DRE and elevated PSA, transrectal ultrasound is used to visualize the prostate for biopsy. Uroflowmetry studies help determine the extent of urine blockage and treatment, but there is no indication that this is a problem for this patient. Cystoscopy may be used before prostatectomy but will not be done until after the TRUS and biopsy. MRI is used to determine whether prostatic cancer has metastasized but would not be ordered at this stage of the diagnostic process.

To determine the severity of the symptoms for a patient with benign prostatic hyperplasia (BPH) the nurse will ask the patient about a.blood in the urine. b.lower back or hip pain. c.erectile dysfunction (ED). d.strength of the urinary stream.

ANS: D The American Urological Association (AUA) Symptom Index for a patient with BPH asks questions about the force and frequency of urination, nocturia, etc. Blood in the urine, ED, and back or hip pain are not typical symptoms of BPH.

After a transurethral resection of the prostate (TURP), a patient with continuous bladder irrigation complains of painful bladder spasms. The nurse observes a decrease in urine output and clots in the urine. Which action should the nurse take first? a.Increase the flow rate of the bladder irrigation. b.Administer the prescribed IV morphine sulfate. c.Give the patient the prescribed belladonna and opium suppository. d.Manually instill and then withdraw 50 mL of saline into the catheter.

ANS: D The assessment suggests that obstruction by a clot is causing the bladder spasms, and the nurse's first action should be to irrigate the catheter manually and to try to remove the clots. IV morphine will not decrease the spasm, although pain may be reduced. Increasing the flow rate of the irrigation will further distend the bladder and may increase spasms. The belladonna and opium suppository will decrease bladder spasms but will not remove the obstructing blood clot.

A 17-year-old female is asking the nurse about the vaccine for human papilloma virus (HPV). Which statement by the nurse is accurate? a. "Gardasil protects against all HPV strains." b. "You are too young to receive the vaccine." c. "Only females can receive the vaccine." d. "This will lower your risk for cervical cancer."

ANS: D Gardasil is used to provide immunity for HPV that are high risk for cervical cancer and warts. The vaccine is recommended for people ages 10 to 26 years.

The nurse is preparing a community education program on preventive health care for women and teaches that a screening test used to detect breast cancer is? a. breast examination by a health professional. b. breast self-examination. c. breast biopsy. d. mammography.

ANS: D Mammography is a screening test used to detect breast cancer.

The nurse is caring for a postmenopausal patient taking estrogen to reduce signs and symptoms of menopause. What other benefit will result from this medication? A)Reduced risk of endometriosis B)Reduced risk of dysfunctional uterine bleeding C)Reduced risk of osteoporosis D)Reduced risk of uterine cancer

Ans: C Estrogen slows the bone loss seen with osteoporosis so this will be an added benefit of the drug. Observe for improved bone density tests and absence of fractures. Endometriosis and dysfunctional uterine bleeding do not occur in postmenopausal women who no longer menstruate. Estrogen does not prevent uterine cancer and screening for cancer should be performed before prescribing this drug.

Hot flashes that occur during menopause are thought to be related to: a. Low estrogen levels. b. Low progesterone levels. c. Fluctuating progesterone levels. d. Fluctuating estrogen levels.

Answer: d. Low estrogen levels alone do not produce hot flashes. The fluctuation in estrogen levels produces vasomotor symptoms referred to as hot flashes.

A student nurse is caring for a male patient diagnosed with gonorrhea. The patient is receiving ceftriaxone and doxycycline. The nursing instructor asks the student why the patient is receiving two antibiotics. What is the student nurse's best response? a) "This combination of medications will eradicate the infection faster than a single antibiotic." b) "Many people infected with gonorrhea are infected with chlamydia as well." c) "The combination of these two antibiotics reduces the risk of reinfection." d) "There are many resistant strains of gonorrhea, so more than one antibiotic may be required for successful treatment."

B) *Many people infected with gonorrhea are infected with chlamydia as well* Treatment of gonorrhea includes the antibiotic ceftriaxone. Because many people with gonorrhea have a coexisting chlamydial infection, doxycycline or azithromycin is prescribed as well. There has been an increase in the number of resistant strains of gonorrhea, but that isn't the reason for this dual therapy. This combination of antibiotics doesn't reduce the risk of reinfection or provide a faster cure.

A nurse is teaching a health class to a group of clients likely to be at highest risk for gonorrhea. What is the age range of the clients? a) 60 to 70 years b) 15 to 24 years c) 25 to 29 years d) 30 to 45 years

B) 15 to 24 years Gonorrhea is the second most frequently reported communicable disease in the United States. Its highest incidence occurs in the 15- to 24-year-old age group.

Which is the fastest-spreading bacterial STI in the United States? a) Gonorrhea b) Chlamydia c) Herpes simplex 1 d) HPV

B) Chlamydia Chlamydia is the most common and fastest-spreading bacterial STI in the United States.

A male patient comes to the clinic and is diagnosed with gonorrhea. Which symptom most likely prompted him to seek medical attention? a) Painful red papules on the shaft of the penis b) Foul-smelling discharge from the penis c) Rashes on the palms of the hands and soles of the feet d) Cauliflower-like warts on the penis

B) Foul smelling discharge from the penis Signs and symptoms of gonorrhea in men include purulent, foul-smelling drainage from the penis and painful urination. Rashes on the palms of the hands and soles of the feet are a sign of the secondary stage of syphilis. Cauliflower-like warts on the penis are a sign of human papillomavirus. Painful red papules on the shaft of the penis may be a sign of the first stage of genital herpes.

A client is being treated for gonorrhea. Which agent would the nurse expect the physician to prescribe? a) Tetracycline b) Ceftriaxone c) Penicillin d) Levofloxacin

B. ceftriaxone (*Rocephin*) Gonorrhea has become resistant to penicillin and tetracyclines, and fluoroquinolones (such as levofloxacin). Therefore, the current CDC (2006) recommendation for treating gonorrhea is a single intramuscular dose of a broad-spectrum cephalosporin such as ceftriaxone (*Rocephin*)

A client is receiving Pyridium (phenazopyridine) for a urinary tract infection. The client should be taught that the medication may: A.Cause diarrhea B.Change the color of her urine C. cause mental confusion D.Cause changes in taste

B.Change the color of her urine

A nurse is writing a plan of care for a patient who is taking bethanechol (Urecholine). What would be an appropriate outcome for this patient? A)Reduction in size of prostate B) Increased libido C)Improved bladder function D)Decreased urine

C Feedback: Bethanechol is prescribed for nonobstructive urinary retention and neurogenic bladder. The appropriate outcome for this patient would be improved bladder function. It could cause hypotension in the older patient, so monitor BP

A client with primary syphilis is allergic to penicillin. The nurse would expect the physician to order which agent? a) Podophyllum resin b) Tetracycline c) Ceftriaxone d) Acyclovir

C) Tetracycline Clients who are allergic to penicillin are given a 14-day regimen of tetracycline or doxycycline. Acyclovir is used to treat genital herpes. Ceftriaxone may be used for gonorrhea. Podophyllum resin is used to treat genital warts.

Because of an unexpected emergency case, a client is scheduled for surgery at 8 AM has been rescheduled for 11 AM. What is the nurse's best action related to the preoperative prophylactic antibiotic administration according to the Surgical Care Improvement Project (SCIP) guidelines? A. Administer the preoperative antibiotic at 7 AM as originally prescribed. B. Administer the antibiotic at the same time as the other prescribed preoperative drugs. C. Adjust the antibiotic administration time to be within 1 hour before the surgical incision. D. Hold the preoperative antibiotic until the client is actually in the operating room and has been anesthetized

C. Adjust the antibiotic administration time to be within 1 hour before the surgical incision.

A practitioner orders azithromycin for a sexually active woman with a history of a mucopurulent discharge and bleeding associated with cervical dysplasia, dysuria, and dyspareunia. Which sexually transmitted infection are these clinical findings is this medication commonly associated?

Chlamydial infection -The signs and symptoms listed and the treatment ordered azithromycin indicate that the client has a chlamydial infection.

The physician has ordered several diagnostic measures for a client with suspected renal calculi. Which diagnostic measure has the highest sensitivity for detecting renal calculi? Ultrasonography Magnetic resonance imaging Computerized Tomography X-ray of the kidneys, ureter, and bladder

Computerized Tomography is the most sensitive means for diagnosing renal calculi. Magnetic resonance imaging, ultrasonography, and x-ray of the kidneys, ureters, and bladder are not as sensitive; therefore, they are incorrect.

The nurse is caring for a female patient who would like to start taking oral contraceptives. What assessment finding may indicate the patient is not a good candidate for these drugs? A)Decreased appetite B)Dehydration C)Occasional headaches D)History of deep vein thrombosis

D Feedback: Estrogens are contraindicated in the presence of a history of thromboembolic disorders because of the increased risk of thrombus and embolus development.

A nurse is teaching a client with genital herpes. Education for this client should include an explanation of: a) why the disease is transmittable only when visible lesions are present. b) the need for the use of petroleum products. c) the option of disregarding safer-sex practices now that he's already infected. d) the importance of informing his partners of the disease.

D) Importance of informing his partners of the disease. Clients with genital herpes should inform their partners of the disease to help prevent transmission. Petroleum products should be avoided because they can cause the virus to spread. The notion that genital herpes is only transmittable when visible lesions are present is false. Anyone not in a long-term, monogamous relationship, regardless of current health status, should follow safer-sex practices.

A client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia (BPH), the nurse questions the client about use of which medication? Maalox Decongestants Aspirin Antibiotics

Decongestants *(anticholinergics dry you up!)*

The nurse is speaking with a client who underwent a minimally invasive procedure treatment for recurrent urolithiasis. Which instructions are appropriate to reinforce in the teaching plan?

Drink at least 3000 mL of fluid each day Complete the full course of prescribed antibiotics Filter urine and collect any stones to take to the urological health care provider

A patient has been diagnosed with primary syphilis. When assessing the patient, which of these findings will the healthcare provider anticipate? Firm and painless genital ulcers Reddish rash on the palms of the hands Sore throat and swollen lymph glands Muscle weakness and visual changes

Firm and painless genital ulcers

Distress caused by incongruence between natal sex and gender identity

Gender dysphoria

High _____ and low ______ values are suggestive of menopause but not confirmatory

High FSH and Low Estrogen

The sex one is born with or is assigned to at birth

Natal sex

Removal of a testis is called

Orchiectomy

The nurse is urging a client to cough and deep breathe after a nephrectomy. The client tells the nurse, "That's easy for you to say! You don't have to do this." The client's statement is likely a result of which contributing factor?

Pain that is intensified because the location of the incision is near the diaphragm

The nurse is caring for a pt following prostatectomy. The client has a three-way Foley catheter with continuous bladder irrigation. The nurse should maintain the flow rate of the continuous bladder infusion to maintain which urine output characteristic?

Pale yellow or slightly pink

An umbrella term for a variety of infections of the inner reproductive organs, including the ovaries, the fallopian tubes, the endometrial lining of the uterus, the uterine wall, the ligaments that support the uterus, and even the lining of the uterus.

Pelvic inflammatory disease

Differences between primary, secondary and tertiary syphilis.

Primary syphilis is characterized by the appearance of a chancre at the site of exposure. A rash on the palms is associated with secondary syphilis, whereas gummas and central nervous system (CNS) lesions are indicative of tertiary syphilis.

Although commonly thought of as a medication used to treat enlarged prostate, tamsulosin can also be prescribed for??

Pts with bladder blockages or obstruction to help them urinate more easily. Doctors may also *prescribe tamsulosin to help the body clear or pass kidney stones.* Tamsulosin is an alpha-adrenergic receptor antagonist that relaxes the bladder outlet and the prostate gland, which improves urinary flow.

A 74 year-old male is admitted due to inability to void. He has a history of an enlarged prostate and has not voided in 14 hours. When assessing for bladder distention, the BEST method for the nurse to use is to assess for? Urinary discharge Rebound tenderness Rounded swelling above the pubis Left lower quadrant dullness

Rounded swelling above the pubis is the correct option. Swelling above the pubis is representative of a distended bladder in the male client.

A client with a chronic urinary tract infection (UTI) is scheduled for a number of laboratory tests. The nurse would note which test results to best evaluate whether the kidneys are being adversely affected? Urinalysis specific gravity 1.015 Urine culture negative Serum potassium 3.8 mEq/L Serum creatinine 2.0 mg/dL

Serum creatinine measures the amount of creatinine and indicates renal function (normal 0.8-1.6 mg/dL). Urinalysis is a gross and microscopic view of the urine that can indicate such disorders as urinary tract infection and dehydration. The specific gravity of 1.015 is within normal limits (1.010-1.025). Urine culture specifically examines the type and amount of microscopic organisms present in the urine and should be negative. Serum potassium may be increased in renal failure as well as other disorders, so it is not a definitive diagnostic test for renal function; this value is normal (range 3.5-5.1 mEq/L).

You're developing a nursing care plan for a patient with a kidney stone. Which of the following nursing interventions will you include in the patient's plan of care? A. Restrict food intake B. Strain urine with every void C. Keep patient in supine position to alleviate pain D. Maintain fluid restriction of 1-2 Liter per day

The answer is B. It is vital the nurse strains every void and assesses the urine very closely for stones. This is crucial so it can be determined what type of kidney stone is causing the problem, therefore, appropriate treatment can be ordered. It is important to avoid placing the patient in the supine position for long periods because this impedes the flow of urine and the patient's ability to pass the stone. Fluid should not be restricted because this concentrates the urine...hence increases the chances of another stone developing.

You're providing discharge teaching to a patient who was hospitalized for the treatment of a kidney stone. The type of kidney stone the patient experienced was a uric acid type stone. What type of foods will you educate the patient to avoid? A. Cabbage, spinach, tomatoes, strawberries B. Ice cream, milk, pork, cheese C. Beans, potatoes, corn, peas D. Liver, scallops, anchovies, sardines, pork

The answer is D. The patient should avoid foods high in purine and foods high in animal proteins. Foods that are high in purine or animal proteins breakdown into uric acid. Foods high in purine are any type of organ meats (liver), most seafood (scallops, anchovies, sardines), pork, red meats, wine, beer etc.

Your patient arrives back to their room after having lithotripsy for treatment of a kidney stone. What will be included in the patient's plan of care? SELECT-ALL-THAT-APPLY: A. Keep the patient in bed B. Encourage fluid intake of 3-4 liters per day C. Maintain nephrostomy tube D. Strain urine E. Keep dressing dry and intact

The answers are B and C. lithotripsy is NONINVASIVE (no incisions...no dressings or nephrostomy tubes are placed). Shockwaves are created to penetrate though the skin and body tissue. Shockwaves will hit the stone and break it down into grain of sand like particles which will be passed out by the patient. Option A is wrong because the patient should be kept mobile (as tolerated) to assist the passage of the kidney stone fragment. **only STONES LARGER THAN 5mm in size, lithotripsy should be considered.**

The nurse is teaching a 50-year-old client about the scheduled screening colonoscopy. Which of the following statements would be correct for the nurse to make? a. "Before the test begins, an intravenous catheter will be placed into your arm." b. "You will be able to return home after the test is completed and you are able to urinate." c. "A full liquid diet is permitted the night before the test." d. "The test will be rescheduled if you have any rectal itching."

The correct answer is A. A client who is scheduled for a colonoscopy is advised that a intravenous catheter will be inserted before the test so that medications can be given as needed prior to and during the procedure. The client is discharged when fully awake and when the vital signs are stable.

The nurse is conducting a community-based health fair. The nurse should recognize that which of the following is an appropriate age-based screening? a. breast cancer screening for a 16-year-old female who has anorexia nervosa b. skin cancer screening for a 27-year-old female who is a bridge construction worker c. prostate cancer screening for a 30-year-old male who is Asian d. colorectal cancer screening for a 35-year-old male who is Caucasian

The correct answer is B. Cancer screening is an important role for the nurse in the community. Skin cancer screening is appropriate for a 27-year-old female construction worker since the client works outdoors. Prostate cancer screening begins between 45 and 50 years of age, colorectal cancer screening begins at 50 years of age and breast cancer screening begins at 18 years of age

The nurse is confirming an appointment with a client who is scheduled for her first Papanicolaou smear. Which of the following statements would be appropriate for the nurse to make? a. "This test will help to determine if you have any sexually transmitted diseases." b. "A vaginal irrigation can be done the morning of the test." c. "Do not use any vaginal medications for at least twenty-four hours before the test." d. "An over-the-counter analgesic will help minimize cramping during the test."

The correct answer is C. A client who is scheduled for a Papanicolaou smear is instructed to not douche or use any vaginal medications prior to the test to help ensure reliability of the results.

if you suspect a client might have BPH what medications would you tell them to avoid

anticholinergic medications such as OTC cold medications, decongestants

A patient passing bloody urine is scheduled for a cystoscopy with cystogram. Which description of the procedure by the nurse is accurate? a. "Your doctor will place a catheter into an artery in your groin and inject a dye that will visualize the blood supply to the kidneys." b. "Your doctor will insert a lighted tube into the bladder, and little catheters will be inserted through the tube into your kidney." c. "Your doctor will insert a lighted tube into the bladder through your urethra, inspect the bladder, and instill a dye that will outline your bladder on x-ray." d. "Your doctor will inject a radioactive solution into a vein in your arm and the distribution of the isotope in your kidneys and bladder will be checked

c. "Your doctor will insert a lighted tube intothe bladder through your urethra, inspect the bladder, and instill a dye that will outline your bladder on x-ray." In a cystoscope and cystogram procedure, a cystoscope is inserted into the bladder for direct visualization, and then contrast solution is injected through the scope so that x-rays can be taken. *Checks for bladder trauma & can identify causes of a UT obstruction*

Your patient has just had transurethral resection of the prostate gland (TURP) which type of preventative therapies do you expect them to have?

continuous bladder irrigation (prevents the formation of blood clots)

8 hours after surgery, a postoperative client reports that the antiembolism stockings and sequential compression devices itch and are too hot. The client asks the nurse to remove them. What response by the nurse is best? a. "Let me call the surgeon to see if you really need them." b. "No, you have to use those for 24 hours after surgery." c. "OK, we can remove them since you are stable now." d. "To prevent blood clots you need them a few more hours."

d. "To prevent blood clots you need them a few more hours." According to the Surgical Care Improvement Project (SCIP), any prophylactic measures to prevent thromboembolic events during surgery are continued for 24 hours afterward. The nurse should explain this to the client. Calling the surgeon is not warranted. Simply telling the client he or she has to wear the hose and compression devices does not educate the client. The nurse should not remove the devices.

Both Estrogen and Progesterone are produced by?

ovarian follicles

_____ uses a wire loop of resectoscope to remove obstructing tissue of the prostate gland

transurethral resection of the prostate (TURP)