PrepU chapters 43, 52, 54, 55

The nurse is assessing a woman's risk for breast cancer. Which of the following places the woman at the greatest risk?

Late menopause

Acute overdistention of the bladder can occur in anyone with a neurogenic bladder that does not empty. What is the maximum amount of urine should a nurse empty out of a neurogenic bladder at one time?

No more than 1000 cc of urine at one time

A female patient is being seen in the ED with complaints of lower abdominal pain, dyspareunia, back pain, purulent cervical discharge, and the presence of adnexal tenderness and painful cervix on bimanual pelvic examination. The nurse suspects the patient has pelvic inflammatory disease (PID), and will assess the patient for which of the following?

Number of sexual partners

A female patient reports to the nurse that she has noticed a release of urine when she laughs or sneezes. Which of the following interventions should the nurse implement first?

Obtain a clean catch urine specimen

A female patient presents to her primary care physician with a report of very heavy bleeding during menstrual cycles. Tests indicate the condition is not from a hormone imbalance. Which of the following intervention options is least invasive?

Oral contraceptives

A client asks the nurse there is anything that would greatly increase her risk of acquiring human papillomavirus (HPV). The best response by the nurse would be:

Oral-genital sex

Which of these complications does the nurse recognize may occur after illness with parotitis (mumps)in young men?

Orchitis with residual sterility

A patient has been diagnosed with a Bartholin gland cyst. The nurse expects the patient may experience which symptoms if this becomes infected?

Pain, tenderness, and dyspareunia

The nursing instructor who is teaching about disorders of the lower urinary tract realizes a need for further instruction when one of the students makes which of the following statements?

"Alterations in bladder function can only occur when there is incontinence."

The nurse assesses a patient and finds a foul odor coming from the vaginal area when assisting with perineal care. What is the best statement for the nurse to make?

"Do you have any other symptoms?"

A patient informs the nurse that he has been having difficulty sustaining an erection. Which of the following statements made by the patient demonstrates to the nurse that the patient understands what a contributing factor to his erectile dysfunction is?

"I should stop smoking cigarettes. I have been smoking for 20 years."

The nursing instructor who is teaching about incontinence in the elderly recognizes a need for further instruction when one of the students makes which of the following statements?

"Frequency is not a major problem for the elderly."

A patient was diagnosed with human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS). The nurse realizes that the patient needs further teaching about the disease process based on which of the following statements made by the patient?

"HIV only infects B cells."

A client is admitted with secondary orchitis. Which assessment question is most relevant?

"Have you ever had mumps?"

A client diagnosed with endometriosis asks the nurse how it is that she did not know about this when she had it for so long. What is the nurse's best response?

"Its symptoms mimic those of other disorders "

A public health nurse is conducting a health promotion class for a group of older adults. Which of the participants' following statements demonstrates an accurate understanding of the risk factors for bladder cancer?

"More than ever, I guess it would worthwhile for me to quit smoking."

What should the nurse teach the client about assessing for possible breast cancer?

"Perform monthly self-breast exams after menses."

What will the nurse teach the client who has a cervical polyp?

"Polyps typically are asymptomatic"

A patient states "I'm not getting this sexually transmitted infection (STI) treated. It doesn't bother me!" Which of the following is the nurse's best response?

"Sexually transmitted infections can spread to other organs. It needs to be treated."

In teaching a patient about genital warts, which of the following statements is correct for the nurse to say?

"The incubation period is 6 weeks to 3 months."

A mother asks, "why can't my 1 year old go to the bathroom by himself?" Which of the following is the nurse's best response?

"Your child is too young to begin toilet training."

There is no known cure for genital herpes, and methods of treatment are often symptomatic. Pharmacologic management of genital herpes includes which drugs?

Acyclovir

It is important to test anyone who has had sex with an individual tests positive for gonorrhea, within how many days of the diagnosis?

60 days

Which of the following patients is at greatest risk for the impairment of spermatogenesis?

A 15-year-old male who is diagnosed with mumps orchitis

Which sexually active woman most likely faces the highest risk of developing an ectopic pregnancy?

A 42 year old who has decided to try to have one more child and has had her tubal ligation reversed

The patient has a Bartholin cyst that has developed into an abscess. The nurse explains to the patient the plan of care including which of the following treatments?

A catheter may be inserted to drain the cyst for several weeks.

What will the nurse assess in a client diagnosed with Paget disease as a cause of breast cancer?

A lesion of the nipple on the affected breast

Which of the following patients is at highest risk of developing trichomoniasis?

A patient who is sexually active

Which of the following information is essential for a nurse to include in the teaching plan for a patient receiving metronidazole for trichomoniasis?

Abstinence is recommended until the therapy is completed.

A 40-year-old man presents at the clinic complaining of painful urination and rectal pain. His vital signs are temperature, 101.7°F; blood pressure, 105/74; pulse, 98; respiration, 22. While taking a history, the nurse notes the client has had chills, malaise, and myalgia. What would the nurse suspect as a diagnosis?

Acute bacterial prostatitis

A warehouse worker is experiencing trouble with incontinence, especially when lifting heavy objects. What intervention is most appropriate for this client's needs?

Administration of a-adrenergic agonistic drugs as ordered

A client has been diagnosed with syphilis after seeking care for a penile lesion. The nurse should anticipate which intervention?

Administration of injectable penicillin

While the cause of BPH is unknown, we do know that the incidence of BPH increases with age. What ethnic group is BPH highest in?

African American

When caring for the client with acute bacterial prostatitis, the nurse plans for which of these interventions?

Antibiotics

Which of the following types of pharmacological therapy does the nurse anticipate administering to a patient for treatment of a spastic bladder in order to decrease bladder hyperactivity?

Anticholinergic medications

A client who has a history of untreated cervicitis tells the nurse that she is concerned about the risk of experiencing problems with fertility. The nurse explains that problems may result from:

Ascending infection of the fallopian tubes

Which of the following diagnoses is most likely to require surgical correction?

Hypospadias

The nursing instructor, while teaching about renal function and disorders, informs the students that the most frequent form of urinary tract cancer is which of the following?

Bladder

A sexually active female presents to the clinic with white copious vaginal discharge, itch, swelling, and dysuria. The nurse anticipates the client will be treated for the overgrowth of which of the following organisms?

Candida albicans

Epididymitis can be sexually transmitted, or it can be caused by a variety of other reasons, including abnormalities in the genitourinary tract. What are the most common causes of epididymitis in young men without underlying genitourinary disease?

Chlamydia trachomatis and Neisseria gonorrhoeae

The pediatric nurse is caring for a newborn with hypospadias. The mother requests that a circumcision be performed prior to discharge. Which information related to treatment of hypospadias should the nurse convey?

Circumcision is avoided as the foreskin will be used to repair the urinary opening.

A patient arrives in the emergency department complaining of severe pain in the left testicular area with nausea and vomiting for 2 hours. The left testicle is large and tender to palpation and radiating to the inguinal area. Which of the following reflexes can the nurse assess the absence of to indicate testicular torsion?

Cremasteric reflex

A 45-year-old client reports "needing to bear down with urination," frequency, and occasional loss of urine when coughing. Based on symptoms, which diagnosis is most appropriate for this client?

Cystocele

A 65-year-old Caucasian female who smokes presents with increased urinary frequency, dysuria, and sporadic, painless hematuria. The client's follow-up will likely include:

Cystoscopy

Which physiologic change in the elderly population contributes to urinary incontinence?

Decline in detrusor muscle function

The gerontology nurse recognizes that aging male clients may enter a stage referred to as andropause. Which of these does the nurse recognize as characteristic of this stage?

Decline in sexual function

What are the central nervous symptoms associated with tertiary stage syphilis? Select all that apply.

Dementia Blindness Ataxia

Erectile dysfunction is the inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse. The nurse knows that there may be many causes of erectile dysfunction, and a psychogenic cause would include which of the following?

Depression

The nurse is conducting a staff development program on urinary disorders. The nurse evaluates that the participants are understanding the information when they identify that disruption of which muscle's contraction can lead to the inability to expel urine from the bladder.

Detruser

While studying about the process of urination, the nursing student learns that which of the following is known as the "muscle of micturition"?

Detrusor

A client who has been diagnosed with premenstrual syndrome (PMS) asks if there is anything to help alleviate the symptoms. The best response would be:

Eat a diet low in simple sugars and high in protein

An older male comes to the clinic with the chief complaint of having difficulty voiding. The physician diagnoses him with a lower urinary tract obstruction and stasis. Which of the following should the nurse suspect to be the most frequent cause of this client's problem?

Enlargement of prostate gland

In assessing a client with a fibroadenoma of the breast, what will the nurse find?

Firm, rubbery masses

Which of the following events is associated with the primary stage of syphilis?

Genital chancres

A client informs the nurse that she is afraid of developing bladder cancer because her mother had it. She asks the nurse what signs and symptoms are present with this cancer. What does the nurse tell the client is the most common sign of bladder cancer?

Gross hematuria

A school nurse is providing an informational session about the prevention of cervical cancer in young girls and women. The most important information for the nurse to present would be:

HPV vaccine before becoming sexually active

A patient comes to the clinic and informs the nurse that he was playing soccer and was kicked in the scrotal area on the right side. The nurse observes that the scrotal skin on the right side is dark red. Which of the following should the nurse suspect this patient may have?

Hematocele

The nurse is assessing a client with a collection of blood in the tunica vaginalis of the scrotum. How does the nurse correctly document this in the medical record?

Hematocele

Testicular cancer is highly curable if found and treated early in the disease. What are signs of metastatic spread of testicular cancer? (Select all that apply.)

Hemoptysis Neck mass Back pain

There are two types of vulvar cancer. One type is found in older women, and one type is found in younger women, generally less than 40 years of age. What is the type found in younger women thought to be caused by?

Human papillomavirus

A patient is admitted with a prolonged and painful erection that has lasted longer than four hours. The nurse knows that this is a true urologic emergency, and that the cause is which of the following?

Impaired blood flow in the corpora cavernosa of the penis

A female patient with blocked fallopian tubes seeks assistance at a fertility clinic. Which of the following assisted reproductive technologies will bring the greatest chance for conception?

In vitro fertilization (IVF)

A client is experiencing oligomenorrhea. The nurse interprets this as:

Infrequent menstruation with periods more than 35 days apart

The parents of a 9-year-old child ask the nurse for information about quadrivalent human papillomavirus recombinant vaccine (Gardasil) vaccine. Which of the following instructions are appropriate for the nurse to provide? Select all that apply.

It can be given to boys and girls. It should be given before the child is sexually active. It prevents a common cause of cervical cancer.

Testicular torsion, a serious disorder affecting young males, causes which of the following?

Loss of testicular perfusion

The ovaries have a dual function. The nurse is able to explain to the patient that any problems with the ovaries frequently cause which of the following problems?

Menstrual and fertility problems

A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last 6 months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms?

Metronidazole

A patient is diagnosed with vulvar carcinoma, which appears as an inconspicuous thickening of the skin resembling eczema or dermatitis and may produce few symptoms other than pruritus, local discomfort, and exudation. The nurse understands that the cancer metastasizes readily through which mode?

Multiple lymph channels

The nurse is teaching the client about risk factors for cervical cancer. What will be included in the plan of care? Select all that apply.

Multiple sexual partners History of sexually transmitted infections Smoking First intercourse at an early age Multiple sexual partners Smoking History of sexually transmitted infections

Select the correct statement regarding Herpes simplex virus.

Only two strains of the virus are considered sexually transmittable.

A nurse is caring for a patient in spinal shock. Which of the following interventions is appropriate in relation to the patient's urinary status?

Perform intermittent catheterization

Which of the following disorders of the female genitourinary system is most likely to result from a disruption in normal endocrine function?

Polycystic ovary syndrome (PCOS)

The nurse in the urology unit teaches is teaching about medication to treat erectile dysfunction. The nurse teaches the client that the mechanism of action of most of these medications is which of these?

Promotes increase in blood flow to the corporus cavernosa

A 71-year-old client reports to the nurse that he often notices a pink tinge to his urine. Upon further questioning, he states that he experiences no pain when voiding and has not noticed any change in the frequency of his voiding. Which response by the nurse is best?

Promptly report this finding to the client's primary care provider.

Which of the following assessment findings helps the nurse confirm that the patient has genital warts?

Soft, raised lesions on external genitalia

A 42-year-old man reports testicular tenderness. He is concerned also because he found a mass that moves around within the scrotal sack. Upon examination, the physician determines that the mass is near the end of the epididymis, lights up uniformly when illuminated, and is above the testes. Which condition does this client most likely have?

Spermatocele

The nurse is caring for a client with significant benign prostatic hyperplasia (BPH)and hydronephrosis who is fearful of having corrective surgery. Which of these is important for the nurse to convey?

The obstruction is causing urine to flow backward and cause kidney dysfunction.

The pediactric nurse is teaching the mother of a newborn with hypospadias about this disorder. Which of these does the nurse convey?

The opening of the urethra is found on the underside of the penis.

A pregnant patient presents with bacterial vaginosis. Which of the following is the nurse's primary concern?

The patient has an increased risk of preterm labor.

A patient has been diagnosed with candidiasis. Which of the following symptoms was present to diagnose this condition?

Thick white secretions

A client tells the nurse that he is experiencing involuntary loss of urine associated with a strong desire to void (urgency). The nurse would recognize this as:

Urge incontinence

The nurse understands that medications although very beneficial to clients can also have harmful effects. When working with elderly clients the nurse should recognize which of the following is a common result of potent, fast-acting diuretics?

Urge incontinence

A patient is admitted with lower urinary tract obstruction and stasis. Which of the following is the primary intervention?

Urinary catheterization

Men older than age 50 are at high risk for prostatic hypertrophy with complications that include:

Urine retention

Which of the following organisms might be responsible for a patient's sexually transmitted infection (STI)?

Virus Chlamydia Parasite Bacteria

Select the option that best describes the sensory process involved in the inhibition of micturition.

When the bladder is distended to 150 to 250 mL in the adult, the sensation of fullness is transmitted to the spinal cord and then to the cerebral cortex, allowing for conscious inhibition of the micturition reflex.

A nurse is examining an aging male, which of the following would the nurse recognize as normal changes due to age? (Select all that apply)

enlargement of prostate gland small testes enlargement of prostate gland decreased penis size

A nurse is performing a genital examination on a male client who develops an erection. Which of the following is the nurse's most appropriate intervention?

reassure the client that this is a normal response and continue with the examination

A client asks the nurse what the most common sign/symptom of bladder cancer is. Which is the best response by the nurse?

Painless hematuria

Gonorrhea is caused by Neisseria gonorrhoeae, a gram-negative diplococcus. Which is a characteristic of gonorrhea?

Purulent exudates

The nurse is caring for a client with acute superficial balanitis. The nurse assesses for which of these signs or symptoms, consistent with the diagnosis?

Redness of the glans penis and malodorous discharge

A patient presents with gonorrhea. Which of the following is a primary nursing action?

Reporting the case to the Centers for Disease Control and Prevention

For a woman, what is the most serious long term outcome of an infection resulting from exposure to the N. gonorrhea bacteria?

Sterility

A 56-year-old client complains of urinary incontinence when she laughs. The nurse documents this as which type of incontinence?

Stress

A 40-year-old mother of three reports incontinence. Her physician suggests Kegel exercises, because they strengthen the pelvic floor muscles. Kegel exercises are most likely to help which type of incontinence?

Stress incontinence

The client has just been diagnosed with bladder cancer and asks the nurse what causes it. Which of the following would be the nurse's best response to the client?

"The cause is unknown"

After an office visit with her primary health provider, a female patient with an elevated CA-125 test result asks the nurse if that means she has ovarian cancer. Which of the following is the nurse's best response?

"The test is not specific for ovarian cancer but suggests further evaluation to find the cause of the elevation."

Which of the following is essential for the nurse to include in the care plan for a patient with herpes simplex virus-1 (HSV-1)?

"This disease is transmitted by oral secretions."

A patient has a postvoid residual (PVR) volume of 40 mL. Which of the following information would the nurse teach the patient?

"This is a normal value."

A bladder cancer client asks the nurse, "What did the doctor mean by intravesicular chemotherapy? Am I going to lose all my hair and have to do for treatments over months and months?" The best response would be:

"This is when they put the chemotherapy directly into the bladder to kill any cancer cells."

A patient with vulvodynia tells the nurse, "This is not getting better. I just can't live like this." What is the best response by the nurse?

"What bothers you the most about your condition?"

A male client is diagnosed with gonococcal urethritis. He tells the nurse he had recent sexual contact with a woman but states she did not appear to have any disease. Which of the following is the nurse's best response to the client?

"Women may not know they have gonorrhea because they may not have symptoms."

A patient asks "How could I have chlamydia? I feel fine!" Which of the following is the nurse's best response?

"Women with this condition are often asymptomatic."

A nurse who works in a fertility clinic is conducting a program on options for various fertility issues. The nurse judges that the participants are understanding the education when they identify that donor eggs are the best option for which one of the following women?

A 42-year-old

The nurse is re-enforcing information given to the client who is asking about screening for prostrate cancer. Which of these will be nurse teach the client about the PSA test?

An elevated score on a PSA test does not necessarily indicate the presence of cancer.

A 22-year-old client has presented to her primary care provider for her scheduled Pap smear. Abnormal results of this diagnostic test may imply infection with:

Human papillomavirus (HPV)

Which of the following factors in a patient's history is most likely related to the diagnosis of cervical squamous dysplasia?

Human papillomavirus (HPV) infection

A female client presents to the clinic with a rash on the palms of her hands, symptoms of hair loss, and the development of elevated, red-brown lesions that have begun to ulcerate and produce a foul discharge. Based on these symptoms, the nurse plans to test the client for which of the following sexually transmitted disease?

Syphilis

A patient presents with a rash on the palms of his hands, mucous membranes, and stomach. He is complaining of a sore throat and nausea. Which of the following conditions is the nurse concerned about?

Syphilis

Which of the following is the most important discharge instruction for a female patient with pelvic inflammatory disease (PID)?

Take all of the antibiotic

Leiomyomas are smooth-muscle fibroid tumors usually develop in which of the following?

The corpus of the uterus

A patient has been diagnosed with candidiasis. Which of the following symptoms were present to diagnose this condition?

Thick white secretions.

A patient has a postvoid residual (PVR) volume of 250 mL. Which of the following information would the nurse tell the patient?

This value indicates you are having difficulty emptying your bladder."

The nurse is caring for a baby with phimosis. Which of these does the nurse explain to the mother is the key feature of this disorder?

Tightening of the foreskin preventing full retraction over the penis

A client who had been utilizing pharmacologic management for BPH is now experiencing severe signs of obstruction. The client would most likely require:

Transurethral prostatectomy

Which of the following assessment findings would the nurse expect in a patient with chronic urinary obstruction

Urinary frequency

The nursing instructor, while teaching about incontinence in older adults, informs the students that which of the following is true?

Urinary incontinence is a common problem in older adults, both male and female.

A 52-year-old male diagnosed with erectile dysfunction (ED) asks the nurse what will be implemented as a first option for treatment. The best response would be:

Psychosexual counseling and PDE-5 inhibitor medications

Which of the following patients should have a feeling of bladder fullness?

The patient with 200 mL of urine in their bladder