NUR 222 - Test 1 PrepU super set
A client is scheduled for a transurethral rescection of the prostate {TURP}. Which statement demonstrates that the expected outcome of "client demonstrates understanding of the surgical procedure and aftercare" has been met?
"The surgeon is going to insert a scope through my urethra to remove a portion of the gland." (p. 958, 960)
A client undergoes extracorporeal shock wave lithotripsy. Before discharge, the nurse should provide which instruction?
"Increase your fluid intake to 2 to 3 L per day." (Page 793)
Which of the following is an expected outcome for a client 24 hours after an abdominal hysterectomy?
The client will perform leg exercises hourly. (Page 947)
Which of the following would be most important to include in a teaching plan for a client who has had a vasectomy?
Using a reliable method of contraception for several weeks.
A nurse is using a diagram to educate a client with a pelvic organ prolapse. Which condition would the client have based on the illustration?
Uterine prolapse (Page 936)
A group of students are reviewing the female reproductive system in preparation for a test. Which of the following if identified by the students as an internal structure indicates successful learning?
Vagina
The nurse is caring for a male patient with gonorrhea. The patient asks how he can reduce his risk of contracting another sexually transmitted infection (STI). The nurse should instruct the patient to do which of the following?
Wear a condom every time he has intercourse. (Page 972)
During a follow-up visit, a female client who underwent a mastectomy presents with an infection that requires an antibiotic. She admits she has been doing some gardening. What further instruction and reinforcement of teaching is needed?
Wear gloves and protective clothing to avoid any injuries.
A patient reports to the nurse that she has a sense of pelvic pressure and urinary problems such as incontinence, frequency, and urgency. The problem has gotten much worse since the birth of her third child. What does the nurse suspect the patient is experiencing?
A cystocele (Page 935)
Which information would be most appropriate for a nurse to provide to a client who has never used a condom?
A new condom should be used for each sex act. (Page 972)
A group of students are reviewing material in preparation for a test on the male and female breasts. The students demonstrate understanding of the material when they identify which of the following?
A primary function of the female breast is to produce milk. (Page 889)
A client is considering use of *chemo-prevention* because she is at *high risk for* developing *breast cancer*. What can the nurse do to assist the patient with her decision?
Provide the patient with information regarding the benefits, risks, and possible side effects. (Page 913)
Which term refers to inflammation of the renal pelvis?
Pyelonephritis (Page 772)
A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms?
Pyridium (Page 776)
Which laboratory value supports a diagnosis of pyelonephritis?
Pyuria (Page 777)
A nurse is reviewing the history of a client who is suspected of having glomerulonephritis. Which of the following would the nurse consider significant?
Recent history of streptococcal infection (Page 741)
A 32-year-old client has been admitted to the renal unit with acute pyelonephritis. She is undergoing parenteral antibiotic treatment. As her nurse, what would be a significant aspect of your discharge education?
Recurring infection prevention
Hydrocele can be differentiated from a hernia by transillumination. The hydrocele will glow which of the following colors?
Red (Page 967)
Erythropoietin growth factor increases production of which of the following?
Red blood cells (Page 924)
A female patient visits her primary health care provider with a complaint of *frequency of urination and incontinence when she sneezes*. The health care provider suspects the patient is experiencing *cystitis*. The nurse knows that this is most likely due to which of the following?
Reflux of urine from the urethra into the bladder (Page 773)
The nurse recognizes which statement as accurately reflecting a risk factor for breast cancer?
Mother affected by cancer before 60 years of age (Page 913)
A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate I can't control it, and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence?
Urge (Page 780)
Within the free clinic where you practice nursing, you hold weekly sexual education classes open to the public. Within the classroom, you communicate the CDC's numbers for the incidence of STIs and their impact upon public health. Which is the fastest-spreading bacterial STI in the United States?
Chlamydia (Page 974)
Behavioral interventions for urinary incontinence can be coordinated by a nurse. A comprehensive program that incorporates timed voiding and urinary urge inhibition is referred to as what?
Bladder retraining (Page 782)
The nurse is providing care to a client who has had a renal *biopsy*. The nurse would need to be alert for signs and symptoms of which of the following?
Bleeding
A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF?
Blood urea nitrogen (BUN) 100 mg/dL and serum creatinine 6.5 mg/dL (Page 752)
Which treatment involves implantation of interstitial radioactive seeds under anesthesia to treat prostate cancer?
Brachytherapy (Page 957)
After teaching a group of students about the signs and symptoms of breast cancer, the instructor determines that additional teaching is needed when the group identifies which of the following?
Breast symmetry
A client with Stage IV prostate cancer is to receive hormone therapy. The nurse would inform the client about possible adverse effects including which of the following?
Breast tenderness
Assessment of a client reveals evidence of a *cystocele*. The nurse interprets this as which of the following?
Bulging of the bladder into the vagina (Page 935)
A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea?
Burning on urination (Page 974)
A 42-year-old client is being seen by an urologist in the group where you practice nursing. She is experiencing some secretion abnormalities, for which diagnostics are being performed. Which of the following substances are typically *reabsorbed and not secreted in urine*?
Glucose (Page 727)
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?
Gonorrhea
Which of the following may result if prostate cancer invades the urethra or bladder?
Hematuria
The nurse is preparing a presentation for a local community group about prostate cancer and possible dietary risk factors. Which of the following would the nurse most likely include?
High-fat diet (Page 956)
The diagnosis of prostate cancer is confirmed by which of the following?
Histologic exam of tissue (Page 956)
The nurse is educating a patient with urolithiasis about preventive measures to avoid another occurrence. What should the patient be encouraged to do?
Increase fluid intake so that the patient can excrete 2,500 to 4,000 mL every day, which will help prevent additional stone formation. (Page 794)
The nurse advises the patient with *chronic pyelonephritis* that he should:
Increase fluids to 3 to 4 Liters per 24 hours to dilute the urine. (Page 778)
The nurse is assessing the breast of a female patient and observes a prominent venous pattern on the left breast. What does the nurse understand that this can be indicative of?
Increased blood supply required by a tumor
The examiner is preparing to perform a pelvic examination. Which of the following would be done first?
Inspection of the external genitalia
A patient presents with vulvar itching and diffuse green vaginal discharge. Upon evaluation, she is prescribed metronidazole (Flagyl). What is the paramount nursing intervention in discharge planning?
Instruct the patient not to drink alcohol with this treatment. (Page 978)
The treatment of choice for a spinal cord-injured patient with impaired bladder emptying would include which of the following?
Intermittent self-catheterization (Page 788)
A nurse caring for a postmastectomy patient should not perform which of the following on the operative side? Select all that apply.
Intravenous sticks; Blood pressure; Injections; Blood draws (Page 918)
A group of students is reviewing for a test on the urinary and renal system. The students demonstrate understanding of the information when they identify which of the following as part of the upper urinary tract?
Ureters
A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate, I can't control it and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence?
Urge
A client complains of a sudden onset of sharp, severe flank pain. the client indicates that the pain, which comes in waves, travels to the supra-pubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect?
Urinary calculi
An elderly client, who can void only while standing and pushing upward on the vagina, is ordered a pessary. Which comment from the client indicates a need for further teaching about this device?
"I will remove and clean it every day."
A client who has been treated for chronic renal failure (CRF) is ready for discharge. The nurse should reinforce which dietary instruction?
"Increase your carbohydrate intake." (Page 754)
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?
"Many people infected with gonorrhea are infected with chlamydia as well." (Page 974)
The nurse is caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective?
"My urine will be eliminated through a stoma." (Page 797)
A client who wishes to preserve childbearing asks the nurse to explain how taking oral contraceptives will work in the management of endometriosis. Which is the best response by the nurse?
"Symptoms of endometriosis are increased during normal menstrual cycle."
An adolescent informs the school nurse that she is afraid of contracting an STI but her boyfriend does not want to use condoms. What is the best response by the nurse?
"The use of condoms is one of the best ways to reduce the risk of acquiring an STI." (Page 971)
A client with erectile dysfunction is prescribed sildenafil {Viagra}. Which of the following would the nurse include in the teaching plan for this client?
"You may experience headache and some flushing with this drug." (Page 954)
The wall of the *bladder* is comprised of *four layers*. Which of the following is the layer responsible for *micturition*?
*Detrusor* muscle (Page 726)
When fluid intake is *normal*, the *specific gravity of urine* should be which of the following?
1.010 to 1.025 (Page 737)
Following a post void bladder scan, straight catheterization is performed if the bladder has how many milliliters left in it?
100 (Page 787-788)
A male client has undergone a semen analysis for evaluation of fertility. The nurse understands that a sperm count of which of the following would suggest infertility?
18 million/mL
A client has developed a painless ulcer on the penis. The urologist suspects that the client has syphilis. When reviewing the client's health history, how many days ago would the nurse expect the client to report that he had unprotected sexual intercourse that may have led to his condition?
21 (Page 972)
Max has developed a painless ulcer on his penis and is rather concerned about his health. The urologist will be communicating his diagnosis of syphilis and prescribing treatment. What is the typical span of time between infection and developing symptoms with syphilis?
21 days (Page 972)
The nurse is caring for a client with chronic kidney disease. The patient has gained 4 kg in the past 3 days. In milliliters, how much fluid retention does this equal?
4000
The nurse is educating a patient about the best time to perform breast self-examination (BSE). When does the nurse inform her is the best time after menses to perform BSE?
5 to 7 days
A client is diagnosed with *chlamydia* and is distraught. "How can I have this problem? I don't have any symptoms!" she says. The nurse teaches the client that the percentage of women with chlamydia who are *asymptomatic* is as high as:
75% (Page 974)
A routine serum glucose analysis indicated the presence of *renal glycosuria*. The nurse knew that the serum glucose level was:
>180 mg/dL (Page 727)
The nurse is completing a full exam of the renal system. Which *assessment finding* best documents the need to offer the use of the bathroom {*full bladder*}?
A *dull* sound when percussing over the bladder
Which client would the nurse identify as being at highest risk for the development of testicular cancer?
A 25-year-old male with a history of cryptorchidism
A nurse is caring for the following clients who have a history of genital herpes infection. Which client is most at risk for an outbreak of genital herpes?
A client who complains of genital pruritus and paresthesia (Page 976)
During a breast examination, which finding most strongly suggests that a client has breast cancer?
A fixed nodular mass with dimpling of the overlying skin (Page 914)
The nurse observes a client's uric acid level of 9.3 mg/dL. When teaching the client about ways to decrease the uric acid level, which diet would the nurse suggest?
A low-purine diet
A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis?
A painless genital ulcer that appeared about 3 weeks after unprotected sex (Page 972)
Which is part of the education for a client undergoing a stereotactic core biopsy?
A small titanium clip is placed at the biopsy site.
While reviewing the history of a client diagnosed with cancer of the vagina, the nurse would expect the client to report which of the following as the major complaint?
Abnormal vaginal bleeding
A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client's care, the nurse should assign the highest priority to which nursing diagnosis?
Acute pain (Page 790)
The history of a female patient reveals the following: First coitus at age 16 years; First pregnancy at age 28 years; Sexual intercourse with circumcised partner; Weight appropriate for height. Which of the following would alert the nurse to a *possible risk factor for developing cervical cancer?*
Age at first coitus (Page 942)
Which of the following would be most important for the nurse to include to ensure a thorough baseline history related to the reproductive system?
Age of menarche
Which drugs, originally developed for hypertension, relax smooth muscle tissue found in the prostate?
Alpha blockers (Page 785)
A patient with chronic kidney failure experiences decreased levels of erythropoietin. What serious complication related to those levels should the nurse assess for when caring for this client?
Anemia (Page 752)
The nurse is employed in a urologist's office. Which classification of *medication* is anticipated for clients having difficulty with *urinary incontinence*?
Anticholinergic
A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program?
Assessing present voiding patterns (Page 779)
A female client is diagnosed with breast abscess. She would like to continue to breast-feed her newborn. Which of the following would be most appropriate in this situation?
Assist the client to pump the breasts to remove breast milk.
Which of the following is a term used to describe excessive nitrogenous waste in the blood, as seen in acute glomerulonephritis?
Azotemia (Page 742)
Katrina is undergoing her annual physical and is having many lab tests done as a condition of her employment and upcoming wedding. She is devastated to learn that she has the sexually-transmitted infection, *gonorrhea*. What would contribute to her ignorance of her condition?
Being asymptomatic (Page 974)
Which is inconsistent with a digital rectal examination {DRE}?
Can reveal a hydrocele (Page 956)
Diet modifications are part of nutritional therapy for the management of ARF. Select the high-potassium food that should be restricted.
Citrus fruits (Page 750)
The nurse is educating a client who is required to restrict potassium intake. What foods would the nurse suggest the client eliminate that are rich in potassium?
Citrus fruits (Page 750)
In which group is it most important for the client to understand the importance of an annual Papanicolaou test?
Clients infected with the human papillomavirus {HPV} (Page 975)
The nurse is encouraging the client with recurrent urinary tract infections to increase his fluid intake to 8 large glasses of fluids daily. The client states he frequently drinks water and all of the following. Which of the following would the nurse *discourage* for this client?
Coffee in the morning
The client is admitted to the hospital with a diagnosis of acute glomerulonephritis. Which clinical manifestation would the nurse expect to find?
Cola-colored urine (Page 742)
Which of the following describes microorganisms present without host interference or interaction?
Colonization (Page 970)
The nurse is assessing a client at the diagnostic *imaging* center. For which diagnostic test would the client assess for an *allergy to shellfish*?
Computed tomography with *contrast*
A student nurse is doing clinical hours at an OB/GYN clinic. The student is helping to develop a plan of care for a patient with gonorrhea who has presented at the clinic. The student knows that the care plan for this patient should be include what in the treatment of gonorrhea?
Concurrent treatment for chlamydia (Page 974)
Which term describes a procedure in which cervical tissue is removed because abnormal cells are detected?
Cone biopsy (conization) (p. 902)
The following outcome appears on the plan of care for a client with genital herpes: "Client demonstrates knowledge about measures to reduce the risk of transmission and recurrences." Which of the following, if reported by the client, would support achievement of this outcome?
Consistently uses condoms with sexual activity (Page 976)
Which of the following would a nurse include in the teaching plan for a client who has had surgery for cancer of the testes?
Consuming a well-balanced diet with adequate fluids.
A client develops decreased renal function and requires a change in *antibiotic dosage*. On which factor should the physician base the dosage change?
Creatinine clearance (Page 738)
A patient is being seen in the clinic for possible kidney disease. What *major sensitive indicator of kidney disease* does the nurse anticipate the patient will be tested for?
Creatinine clearance level (Page 730)
After teaching a group of student about structural abnormalities of the male reproductive system, the instructor determines that the teaching was successful when the students identify which of the following as an example?
Cryptorchidism (Page 966)
Which term refers to a failure of one or both or both of the testes to descend into the scrotum?
Cryptorchidism (Page 966)
Which of the following is the gold standard for herpes simplex virus {HSV} diagnosis?
Culture (Page 976)
A 32-year-old client is concerned with the lumps that have developed in her breasts and is fearful of cancer. She reports variability in the size of the lumps. What could be causing her condition?
Cyclical hormonal changes (Page 912)
Which condition is a downward displacement of the bladder toward the vaginal orifice?
Cystocele (Page 935)
A client has undergone diagnostic testing that involved the *insertion of a lighted tube with a telescopic lens*. The nurse identifies this test as which of the following?
Cystoscopy (Page 738)
Which of the following *vitamin* is necessary for maintenance of *normal calcium levels*?
D (Page 730)
A client who suffered hypovolemic shock during a cardiac incident has developed acute renal failure. Which is the best nursing rationale for this complication?
Decrease in the blood flow through the kidneys
An older adult client is being evaluated for suspected pyelonephritis and is ordered *kidney, ureter, and bladder (KUB) x-ray*. The nurse understands the significance of this order is related to which rationale?
Detects calculi, cysts, or tumors
How can breast cancer prevention programs best serve at-risk women from lower socioeconomic backgrounds?
Develop screening and educational programs. (Page 913)
Which of the following is the most common cause of nephrotic syndrome?
Diabetic nephropathy (Page 746)
A nurse practitioner is conducting a history and physical on a 42-year-old woman. One of the questions asked of someone in this age group is the *type of medications that the patient's mother took during her pregnancy*. The nurse is assessing for a past history of ______ use.
Diethylstilbestrol {DES} (Page 893)
Which of the following diagnostic tests {procedures} is used as a therapeutic measure for incomplete miscarriage?
Dilation and curettage (D & C)
The client with chronic renal failure is exhibiting signs of anemia. Which is the best nursing rationale for this symptom?
Diminished erythropoietin production
A patient experiences hypotension, lethargy, and muscle spasms while receiving bladder irrigations after a transurethral resection of the prostate {TURP}. What is the first action the nurse should take?
Discontinue the irrigations (Page 961)
A patient is planning to use a negative-pressure {vacuum} device to maintain and sustain an erection. What should the nurse caution the patient about with the use of this device?
Do not leave the constricting band in place for longer than 1 hour to avoid penile injury (Page 953)
The nurse is caring for a group of breast cancer survivors post mastectomy. Which teaching point should the nurse include?
Do not lift objects greater than 15 lb
A client has a *full bladder*. Which *sound* would the nurse expect to hear *on percussion*?
Dullness (Page 735)
The nurse is preparing a patient for a gynecologic examination when the patient says, "I hope the exam doesn't hurt as much as intercourse with my husband does." What should the nurse document this finding as?
Dyspareunia (Page 892)
Symptoms of pelvic infection usually begin with which of the following?
Dyspareunia (Page 977)
Menopause marks the end of a woman's reproductive capacity. Which of the following is a common complaint that may be due to a cystocele?
Dyspareunia (p. 891)
Which of the following would lead a nurse to suspect that a client is experiencing acute prostatitis? Select all that apply.
Dysuria; Nocturia; Perineal pain (Page 954)
Patients who have had pelvic inflammatory disease {PID} are prone to which of the following complications?
Ectopic pregnancy (Page 978)
A nurse identifies a nursing diagnosis of risk for ineffective breathing pattern related to incisional pain and restricted positioning for a client who has had a nephrectomy. Which of the following would be most appropriate for the nurse to include in the client's plan of care?
Encourage use of incentive spirometer every 2 hours.
A nurse is caring for a client who had a stroke. Which nursing intervention promotes urinary continence?
Encouraging intake of at least 2 Liters of fluid daily (Page 781)
Which of the following recommendations would a nurse advocate during infancy and childhood to help reduce potential adult complications such as orchitis?
Ensure immunizations against infectious diseases such as mumps.
A client is preparing for his annual prostate digital examination. He asks what role the prostate has. What would the nurse identify as the function of the prostatic fluid?
Ensures sperm survival (Page 906)
Which of the following is the *descent of the small intestine into the vaginal vault*?
Enterocele (Page 935)
After teaching a group of students about erectile dysfunction, the instructor determines that the teaching was successful when the students identify which of the following as true?
Erectile dysfunction may be due to testosterone insufficiency.
A client who comes to the clinic complaining of perineal pain, dysuria and fever is diagnosed with prostatitis. The nurse understands that which of the following organisms would be the most likely cause?
Escherichia coli (Page 954)
A client with genital herpes asks the nurse about what to expect with the infection. Which of the following responses would be most appropriate?
Even though you don't have symptoms, you could still spread the infection. (Page 976)
A nurse, when caring for a client, notes that the *specific gravity* of the client's urine is low. *What could have led to the low specific gravity* of urine?
Excess fluid intake (Page 737)
Which of the following is a cause of a calcium renal stone?
Excessive intake of vitamin D (Page 792)
The nurse is monitoring a client with metastatic breast cancer who is receiving morphine for pain control. The nurse would be alert for which of the following?
Excessive sedation, confusion, and weakness
Which is a risk factor for cervical cancer?
Exposure to HPV (Page 942)
As a school nurse, you discuss female anatomy and the appropriate titles and functions of each structure. Which of the following structures are referred to as the vulva?
External female genitalia (p. 888)
Which hormone increases during the premenstrual phase?
FSH (p. 891)
A group of nursing students are reviewing information about the structure and function of the female reproductive system in preparation for an examination. The students demonstrate understanding when they identify which of the following as an internal structure?
Fallopian tube (Page 889)
When describing the process of fertilization, the nurse would explain that it normally occurs in which structure?
Fallopian tube (p. 890)
Medical management for Herpes Simplex Virus {HSV-2} is aimed at relieving symptoms because there is no cure. The nurse is aware that antiviral agents can prevent the spread of the infection. Select all the antiviral medications that could be used.
Famvir; Valtrex; Zovirax (Page 976)
A 13-year-old asks the N.P. how frequently her "period" should come. Her last period started on January 7. The nurse then circles when her next period should start based on the average number of days in a normal cycle. What date did the nurse circle?
February 5 (ref page 889)
When obtaining the health history from a client, which factor would lead the nurse to suspect that the client has an increased risk for sexually transmitted infections (STIs)?
Five different sexual partners (Page 972)
A patient informs the nurse that she believes she has premenstrual syndrome and is having physical symptoms as well as moodiness. What physical symptoms does the nurse recognize are consistent with PMS? Select all that apply.
Fluid retention, Low back pain, Headache
A male patient comes to the clinic and is diagnosed with *gonorrhea*. Which symptom most likely prompted him to seek medical attention?
Foul-smelling discharge from the penis
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?
Gonorrhea (Page 974)
A nurse is providing care to a client with chlamydia. The nurse anticipates that the client will also receive treatment for which of the following?
Gonorrhea (Page 974)
Hematoma and seroma formation are complications of breast surgery. Which of the following is the indicator that should be reported to the surgeon?
Gross swelling (Page 918)
A client is receiving leuprolide as part of his treatment for prostate cancer. The nurse would be alert for which of the following as a possible adverse effect?
Gynecomastia (Page 956)
A nurse practitioner assessed a patient's complaints about a vaginal discharge and prescribed Flagyl. The nurse was able to diagnose *bacterial vaginosis* because of this defining characteristic, a discharge that:
Has a fish-like odor. (Page 978)
What should a male client older than age 50 do to help ensure early identification of prostate cancer?
Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly (Page 956)
The nurse is obtaining a health history from a client describing urinary complications. Which assessment finding is most suggestive of a malignant tumor of the bladder?
Hematuria
A nurse provided health teaching to a patient with a STI. The nurse advised her patient that *transmission* of the organism was by three routes: *sexual, percutaneous, and perinatal*. Choose the STI that was diagnosed.
Herpes simplex
Which of the following sexually transmitted infections (STIs) could be transmitted perinatally?
Herpes simplex (Page 972)
A nursing midwife delivered a baby whose mother had a sexually transmitted disease. The nurse knows that of the six sexually transmitted diseases, only two can be transmitted via the perinatal route. What are those two diseases?
Herpes simplex and syphilis (Page 972)
A nurse is caring for a client diagnosed with a chlamydia infection. The nurse advises the client to inform his sexual partners of the infection. The client refuses, stating, "This is my business and I'm not telling anyone. Beside, chlamydia doesn't cause any harm like the other STDs."
How should the nurse proceed? Educate the client about why it's important to inform sexual contacts so they can receive treatment. (Page 974)
Which of the following should nurses teach all men, especially those who have had cryptorchidism?
How to perform a testicular self-examination (Page 967)
The nurse is instructing an adolescent female on potential vaccinations available. Which vaccination would the nurse state that decreases the risk of cervical cancer?
Human papilloma viral {HPV}
A client, age 42, visits the gynecologist. After examining the client, the physician suspects cervical cancer. The nurse reviews the client's history for risk factors for this disease. Which history finding is a risk factor for cervical cancer?
Human papillomavirus infection at age 32 (Page 942)
Which of the following is the most common sexually transmitted infection {STI} among young, sexually active people?
Human papillomavirus {HPV} (Page 975)
A nurse practitioner who works for Planned Parenthood is responsible for health education seminars. During these presentations, the nurse always discusses the symptoms of the most common STI among young, sexually active people. This is:
Human papillomavirus. (Page 975)
A group of students are reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which of the following as the cause of condylomata?
Humanpapilloma virus (Page 975)
Regulation of *electrolyte balance* is a management goal for patients suffering from renal disease. Which of the following lab results is considered the *most life-threatening effect of renal failure*?
Hyperkalemia (Page 729)
A 65-year-old man complains to his health care provider that, when he urinates, he has to *start and stop several times over a period of minutes in order to fully empty his bladder*. The nurse is aware that this is not uncommon in men over the age of 60. This *"double voiding"* is directly related to which of the following?
Hyperplasia of the prostate gland
According to Healthy People 2010, which of the following is a major cause of chronic renal failure?
Hypertension (Page 751-752)
An 80-year-old client is being seen by the urologist because of erectile dysfunction. This client has a history of hypertension. Which of the following would be the most likely cause of his erectile dysfunction?
Hypertension medication (Page 950-951)
The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for?
Hypovolemic shock caused by hemorrhage
Which test is an x-ray study of the uterus and the fallopian tubes after injection of a contrast agent?
Hysterosalpingography
Which test is an x-ray study of the uterus and the fallopian tubes after injection of a contrast agent?
Hysterosalpingography (Page 903)
A client with genital warts is receiving treatment with a local application of trichloroacetic acid. Which client statement indicates adequate understanding of the procedure?
I'm temporarily not contagious once the warts are destroyed. (Page 975)
Max has developed a painless ulcer on his penis and is rather concerned about his health. The urologist will be communicating his diagnosis of syphilis and prescribing treatment. What would you expect the physician prescribe as treatment?
IV Penicillin G - single dose (Page 973-974)
The nurse is caring for a client with genital herpes experiencing a reoccurrence. Which nursing diagnosis would be the priority?
Impaired Skin Integrity
The nurse is relating health education to male students when asked where sperm is actually made. Which location is most correct?
In the testes within the scrotum {not the seminiferous tubules}
Nursing students are reviewing information about the age-related changes in the reproductive system and their effects. The students demonstrate a need for additional study when they identify which of the following as an expected change?
Increased labial thickness (Page 892)
A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find?
Increased serum creatinine (Page 730)
A female patient comes to the clinic with the complaint that she is having a *greenish-colored discharge from the nipple and the breast feels warm to touch*. What does the nurse suspect these symptoms may indicate?
Infection
A client reports urinary *frequency, urgency, and dysuria*. Which of the following would the nurse most likely suspect?
Infection (Page 734)
A young client presenting at the health clinic with *fever and mucopurulent vaginal drainage* is diagnosed with *acute pelvic inflammatory disease (PID)*. Which long-term affect is of greatest concern in the care of this client?
Infertility
A nurse is assisting with a physical examination of a male client. Which of the following signs and symptoms is most clearly suggestive of primary genital herpes?
Itching, pain, and the emergence of pustules on the penis (Page 976)
Which statement is accurate regarding sildenafil?
Its side effects include headache, flushing, and dizziness. (Page 952)
Following prostatectomy, the nurse monitors the patient for indicators of fluid volume excess {FVE}. Which of the following are positive indicators? Select all that apply.
Jugular vein distention; An S3 gallop heart sound; Pulmonary crackles; Dyspnea and wheezing. (Page 962)
After a radical prostatectomy for prostate cancer, a client has an indwelling catheter removed. The client then begins to have periods of incontinence. During the postoperative period, which intervention should be implemented first?
Kegel exercises (Page 965)
The nurse reviews a client's history and notes that the client has a history of *hyperparathyroidism*. The nurse would identify that this client most likely would be *at risk for* which of the following?
Kidney stones
The expert nurse is assisting a novice nurse insert a Foley catheter. The novice nurse has tried unsuccessfully to insert the catheter, and the expert nurse is providing verbal guidance while spreading which area to reveal the urethral opening?
Labia majora and minora
Which stage or period of syphilis occurs when the infected person has no signs or symptoms of syphilis?
Latency (Page 973)
Which drug is the most effective treatment for trichomoniasis?
Metronidazole (Page 933)
Which of the following is the most effective treatment for trichomoniasis?
Metronidazole {Flagyl} (Page 979)
A patient has had surgery to create an ileal conduit for urinary diversion. What is a priority intervention by the nurse in the postoperative phase of care?
Monitor urine output hourly and report output less than 30 mL/hr.
The nurse is preparing a presentation for a men's community group about health promotion. Which of the following would the nurse include as a current recommendation for screening?
Monthly testicular self-examination {TSE} (Page 966)
Carlos Gutierrez, an 80-year-old retired farmer, is being seen by the urologist due to his erectile dysfunction. How many men, 75 years of age and older, have chronic erectile dysfunction?
More than half (Page 950)
Breast cancer is the most commonly diagnosed malignancy in women, except for which of the following?
Non-melanoma skin cancer (Page 912)
Which term refers to the surgical removal of one or both testes?
Orchiectomy (Page 957)
The nurse is completing the admission history for a client who is admitted for a reduction mammoplasty. Which of the following client statements is uncommon when explaining the rationale for the procedure?
Others disapprove
A female client with an anal gonorrheal infection experiences painful bowel elimination and a purulent rectal discharge. The nurse would expect to find which of the following once the microorganism disseminates throughout the body?
Painful joints (Page 974)
Which of the following is the most common symptom of bladder cancer?
Painless gross hematuria (Page 796)
A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom?
Painless hematuria (Page 796)
Which finding is an early indicator of bladder cancer?
Painless hematuria (Page 796)
A 32-year-old woman has had three consecutive normal Pap tests. Which of the following recommendations for screening would be appropriate?
Pap testing every 2 to 3 years
When assessing the impact of medications on the etiology of acute renal failure, the nurse recognizes which of the following as the drug that is not nephrotoxic?
Penicillin (Page 749)
Culture and sensitivity testing of a swab taken from a chancre on the penis of a 27-year-old man has confirmed the presence of Treponema pallidum. The nurse providing care for the patient should anticipate administering which of the following drugs?
Penicillin (Page 973-974)
Which of the following is the medication of choice for early syphilis?
Penicillin G benzathine (Page 973-974)
A patient is suspected to have prostate cancer related to observed clinical symptoms. What definitive test can the nurse assist with to confirm a diagnosis of prostate cancer?
Prostate biopsy (Page 956)
A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client?
Risk for infection (Page 762)
As glomerular filtration decreases, which of the following occurs? Select all that apply.
Serum creatinine increases; Blood urea nitrogen (BUN) increases; Creatinine clearance decreases (Page 752)
Pelvic infection is most commonly caused by which of the following?
Sexual transmission (Page 977)
A woman at an employee health fair informs the nurse that she has had vaginal bleeding for the past several days. She is postmenopausal and has not had a menstrual period for the past 4 years. What should the nurse instruct the woman to do?
She should see her gynecologist or physician as soon as possible. (Page 892)
A client has just been diagnosed with acute pyelonephritis. What education would the nurse offer this client regarding fluids?
Significantly increase fluid intake.
What is used to decrease potassium level seen in acute renal failure?
Sodium polystyrene sulfonate (Page 750)
Which type of biopsy is used for nonpalpable lesions found on mammography?
Stereotactic (Page 915)
Which of the following nursing actions is most important in caring for the client following lithotripsy?
Strain the urine carefully for stone fragments.
Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing?
Stress (Page 779)
A client expresses concerns about future reproduction after a surgery to correct the cancer of the testes. For this client, treatment proceeded without first collecting and storing sperm. Which alternative should the nurse suggest to the client?
Suggest donor insemination or adoption (Page 967)
Which of the following positions is commonly used for a pelvic examination?
Supine lithotomy
Which positions is used for a pelvic examination?
Supine lithotomy (Page 896)
An instructor is teaching a group of students about the incidence of sexually transmitted infections (STIs) and those that must be reported by law. The instructor determines that the students have understood the information when they state that which STI must be reported?
Syphilis (Page 974)
A patient is having a DRE in the physician's office and the nurse is to assist in the examination. What can the nurse instruct the client to do to decrease the discomfort from the exam?
Take a deep breath and exhale when the physician inserts a gloved finger into the rectum.
Which should be included as part of the home care instructions for a client with epididymitis and orchitis?
Take prescribed antibiotics (Page 965)
A client with *vaginitis* complains of *itching and burning of the perineum*. Which suggestion would be most appropriate to relieve the client's symptoms?
Take sitz baths frequently (Page 938)
The nurse is educating a female patient with a UTI on the pharmacologic regimen for treatment. What is important for the nurse to instruct the patient to do?
Take the antibiotic for 3 days as prescribed. (Page 776)
A patient comes to the emergency department and tells the nurse, "I took a pill to help me perform and then passed out." The nurse is assessing the patient and finds a nitroglycerin patch on his back. What is the first intervention the nurse must perform?
Take the patient's blood pressure (Page 953)
Hyperkalemia is a serious side effect of acute renal failure. Identify the electrocardiogram (ECG) tracing that is diagnostic for hyperkalemia.
Tall, peaked T waves (Page 749)
Students are reviewing information about the use of adjuvant hormonal therapy for breast cancer. They demonstrate understanding of this information when they identify which of the following as an example of a *selective estrogen receptor modulator {SERM}*?
Tamoxifen (Page 913)
Which nursing intervention should the nurse caring for the client with pyelonephritis implement?
Teach client to increase fluid intake up to 3 liters per day.
A client has undergone a renal transplant and returns to the health care agency for a follow-up evaluation. Which finding would lead to the suspicion that the client is experiencing rejection?
Tenderness over transplant site (Page 767)
A nurse is teaching a male client to perform monthly testicular self-examinations. Which point is appropriate to make?
Testicular cancer is a highly curable type of cancer (Page 965-966)
A client with primary syphilis is allergic to penicillin. The nurse would expect the physician to order which agent?
Tetracycline (Page 974)
An expected outcome for the hemodialysis client is:
The client explains how to assess the venous access site. (Page 757)
The nurse is providing supportive care to a client receiving hemodialysis in the management of acute renal failure. Which statement from the nurse best reflects the ability of the kidneys to recover from acute renal failure?
The kidneys can improve over a period of months.
The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Which action made by the nursing assistant would require instruction?
The nursing assistant places the drainage bag on the client's abdomen for transport.
Which of the following is the only definitive test that can determine if cancer of the testis is present?
Tissue biopsy (Page 966)
A nurse practitioner provided health information to a young woman diagnosed with HPV who had genital warts. Select the teaching points that should be provided.
Warts usually appear within weeks or months after exposure, so recent sexual partners should be notified; Annual Pap smears should be scheduled because HPV can cause dysplasia; Symptoms can be relieved, and the spread of infection decreased, by using an antiviral drug. (Page 975)
A postmenopausal patient is experiencing dyspareunia. What methods can the nurse recommend she use to diminish the discomfort?
Water-based lubricant
The nurse is discussing contraception with a patient interested in transdermal contraceptives. What should the nurse inform the client is the most common side effect of transdermal contraceptives?
Withdrawal bleeding
Which group of clients is at high risk of developing breast cancer?
Women who are obese (Page 913)
How often should women diagnosed with human papillomavirus {HPV} have Pap smears?
Yearly (Page 975)
A patient has been diagnosed with a Trichomoniasis vaginal infection. The nurse would expect which color of discharge?
Yellow-green
A gynecologist told a patient that she had Chlamydia. The nurse expected the health care provider to prescribe a single dose of which of the following medications?
Zithromax (Page 974)
A gynecologist told a patient that she had chlamydia. The nurse expected the health care provider to prescribe a single dose of which of the following medications?
Zithromax (Page 974)
A 23-year-old sexually active woman is having a yearly check-up. The nurse advises the client that she should be screened for chlamydia:
annually (Page 974)
The nurse needs to assess the fluid volume status of a client with chronic glomerulonephritis. To accurately assess the client's fluid volume status, the nurse should weigh the client daily:
at the same time, on the same scale, with similar clothing. (Page 742)
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 functions of the three lumens include:
continuous inflow and outflow of irrigation solution. (Page 964)
A client is undergoing a diagnostic workup for suspected testicular cancer. When obtaining the client's history, the nurse checks for known risk factors for this type of cancer. Testicular cancer has been linked to:
cryptorchidism (Page 966)
When the bladder contains 400 to 500 mL of urine, this is referred to as
functional capacity (Page 730)
Hormone therapy decreases the risk of
hot flashes.
Sentinel lymph node mapping is done to validate the lack of lymph node metastasis. Which complication does this technique help avoid?
lymphedema (Page 918)
The term used to describe total urine output less than *0.5 mL/kg/hour* is
oliguria (Page 733)
A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client's risk of:
water and sodium retention secondary to a severe decrease in the glomerular filtration rate. (Page 747)
A nurse receives her client care assignment. Following the report, she should give priority assessment to the client:
who, following a kidney transplant, has returned from hemodialysis with a sodium level of 110 mEq/L and a potassium level of 2.0 mEq/L. (Page 755)
What is the main cause of anemia in a client with active uterine leiomyoma?
menorrhagia (Page 930-931)
Bladder retraining following removal of an indwelling catheter begins with
instructing the client to follow a 2- to 3-hour timed voiding schedule. (Page 787)
The nurse is aware, when caring for patients with renal disease, that which *substance made in the glomeruli directly controls blood pressure*?
Renin (Page 726)
Which of the following *hormone*s is secreted by the *juxtaglomerular apparatus*?
Renin (Page 726)
A patient admitted with electrolyte imbalance has carpopedal spasm, ECG changes, and a positive Chvostek sign. What deficit does the nurse suspect the patient has?
Calcium (Page 745)
A woman comes to the clinic complaining of vaginal itching and a discharge. Inspection reveals a *thick curdlike white discharge*. The nurse suspects which of the following?
Candida infection
Which type of yeast infection is manifested by *white, cheeselike discharge*?
Candidiasis (Page 934)
A client is being treated for gonorrhea. Which agent would the nurse expect the physician to prescribe?
Ceftriaxone (Page 974)
A nurse has been asked to speak to a local women's group about preventing cystitis. Which of the following would the nurse include in the presentation?
Need to urinate after engaging in sexual intercourse
A nurse has been asked to speak to a local women's group about preventing cystitis. Which of the following would the nurse include in the presentation?
Need to urinate after engaging in sexual intercourse (Page 775)
A woman with a 3-cm breast tumor is scheduled for a lumpectomy followed by 5 to 7 weeks of radiation therapy. The patient asks the nurse if this procedure would cure her. What is the nurse's best response?
"Lumpectomy, followed by radiation, has the same predicted long-term survival rates as a mastectomy." (Page 917)
A client with urinary incontinence asks the nurse for suggestions about managing this condition. Which suggestion would be most appropriate?
"Make sure to eat enough fiber to prevent constipation." (Page 781)
A 32-year-old client has been diagnosed with an ovarian cyst and asks the nurse, "Should I be worried about cancer?" Which response by the nurse would be most appropriate?
"Most cysts are benign in younger women, but it's good to have it checked out." (Page 938)
Which of the following medications are used to suppress viral load of the HSV-2 infection?
Acyclovir {Zovirax} (Page 976)
A 67-year-old client underwent a lumpectomy for a breast lesion determined to be malignant. Which of the following are factors in the client's history that may have increased her risk of breast cancer?
All options are correct
What is included in the home care instructions for a client with epididymitis and orchitis?
All options are correct (Page 965)
The nurse is preparing a presentation for a local community group about sexually transmitted infections (STIs). Which of the following would the nurse expect to include as the most common STI in the United States?
Chlamydia (Page 974)
Which hormone is primarily responsible for stimulating the production of progesterone?
Luteinizing hormone (Page 890)
Which term refers to breast pain?
Mastalgia (Page 910)
A woman comes to her health care provider's office with signs and symptoms of *kidney stones*. Which of the following should be the primary medical management goal?
Relieve the pain. (Page 790)
The nurse is preparing a client for a pelvic examination. The client asks the nurse, "Why do I need to urinate and empty my bladder?" Which response by the nurse would be most appropriate?
"It helps make you more comfortable and the exam easier."
Which stage of syphilis occurs when the infected person has no signs or symptoms of syphilis?
Primary (Page 972)
A nurse who works at a college health center frequently treats *female athletes* for this type of *menstrual disorder*. What is the disorder?
Secondary amenorrhea (Page 929)
The nurse encourages a female client with human papillomavirus {HPV} to receive continued follow-up care because she is at risk for:
Cervical cancer (Page 975)
What is the most common presenting objective symptom of a urinary tract infection in older adults, especially in those with dementia?
Change in cognitive functioning (Page 780)
A 24-year-old patient was admitted to the emergency room after a water skiing *accident*. The X-rays revealed two fractured vertebrae, T-12 and L1. Based on this information, the nurse would know to perform which of the following actions?
Check the patient's urine for *hematuria*. (Page 724)
Which condition of generally requires the identification and treatment of sexual partners?
Chlamydia trachomatis infection (Page 974)
A client is diagnosed as being in the primary stage of syphilis. Which of the following would the nurse expect as a finding?
Genital chancres (Page 973)
After teaching a group of students about sexually transmitted infections {STIs}, the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment?
Genital herpes (Page 976)
The most frequent reason for *admission to skilled care facilities* includes which of the following?
Urinary incontinence (Page 732)
Which of the following are risk factors for the development of a sexually transmitted disease (STD)? Select all that apply.
Multiple partners; Unprotected sex; Prostitution (Page 972)
A patient with an indwelling catheter after a radical prostatectomy is having bladder spasms. What medication prescribed by the physician can the nurse administer to help alleviate the discomfort?
Oxybutynin {Ditropan}
The nurse is gathering data from a male client who is suspected of having gonorrhea. Which of the following would the nurse most likely find?
Pain on urination (Page 974)
A 64-year-old man is seeing his urologist for an annual check-up, post prostatectomy. The health care provider is concerned with the symptom he finds because it is considered diagnostic for bladder cancer. Which of the following signs/symptoms is diagnostic for bladder cancer?
Painless, gross hematuria (Page 796)
The nurse is providing instruction for testicular self-examination to a group of young adolescents. Which is the most correct examination technique?
Palpate each testicle separately, following a warm shower.
A nurse practitioner examines a 23-year-old woman from the Middle East. She documents that the patient has type I female genital mutilation (FGM) and examines her for signs of *vaginal cellulitis and infection*. Type I FGM refers to which of the following?
Partial or total removal of the clitoris (p. 894)
The nurse is providing an education program for the nursing assistants in a long-term care facility in order to decrease the number of UTIs in the female population. What interventions should the nurse introduce in the program? Select all that apply.
Perform hand hygiene prior to patient care; Assist the patients with frequent toileting; Provide careful perineal care. (Page 777)
If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection?
Perform meticulous perineal care daily with soap and water (Page 788)
The nurse is preparing a discharge teaching plan for a client who has had a prostatectomy. Which of the following would be appropriate to include?
Performing perineal exercises frequently throughout the day (Page 964)
Which of the following is the period of transition from normal periods to the complete cessation of menses for 1 year?
Perimenopause (Page 890)
Which medication may be ordered to relieve discomfort associated with a urinary tract infection?
Phenazopyridine (Page 776)
An 82-year-old client experiences urinary incontinence. Which factor should the nurse assess before beginning a bladder training program for this client?
Physical and environmental conditions (Page 784)
The nurse has received several laboratory studies back at the clinic. Which of these results should be reported to the local health department?
Positive gonorrhea (Page 974)
A client comes to the emergency department complaining of sudden, sharp testicular pain. Further examination reveals torsion of the spermatic cord. Which of the following would the nurse expect to do next?
Prepare the client for surgery
As a school nurse, you discuss male anatomy and the appropriate titles and functions of each structure. You discuss the procedure of circumcision and how it is viewed by different ethnicities. Which external reproductive structure is removed by circumcision?
Prepuce
A patient comes to the clinic with complaints of a painless sore on her lip 2 weeks after she had oral sex with her boyfriend. The nurse observes a chancre on the lips and the physician orders testing for syphilis. If results are positive, what is the likely stage the patient is in?
Primary (Page 972)
Ovulation occurs midway between days 17 and 22 {usually at day 14} in a normal 28-day menstrual cycle. Conception occurs during ovulation. If an egg is fertilized, this hormone will continue to be produced to protect the egg until the placenta takes over. Which of the following is the correct hormone?
Progesterone
What is a hallmark of the diagnosis of nephrotic syndrome?
Proteinuria (Page 746)
When the nurse places the patient in the stirrups for a pelvic exam she observes a bulge caused by *rectal cavity protrusion*. What does the nurse know this protrusion is called?
Rectocele (Page 896)
A nurse is using a diagram to educate a client with a pelvic organ prolapse. Which condition would the client have based on the illustration?
Rectocele (Page 936)
*Common tests of renal function* include which of the following? Select all that apply.
Renal concentration test; Creatinine clearance; Serum creatinine; Blood urea nitrogen {BUN} (Page 738)
An ileal conduit is created for a client after a *radical cystectomy*. Which of the following would the nurse expect to include in the client's plan of care?
Application of an ostomy pouch
A sexually active male presented to a clinic concerned about a round, painless sore on the shaft of his penis that had appeared 2 days prior to his visit. The nurse practitioner recognized the lesion as a "chancre," an indicator of primary syphilis. The nurse should tell the patient:
"An antibiotic injection is the best treatment since the lesion has just occurred." (Page 973)
The nurse is conducting a health history when the client states that her last menstrual period was 6 months ago. Upon further questioning, the client also states that symptoms of hot flashes and mood fluctuations. Which question should the nurse ask next?
"Are you taking any hormone replacement therapy?"
*Sympathomimetics* have which of the following effects on the body?
Relaxation of bladder wall (Page 783)
The nurse recognizes that urinalysis results that most likely indicate a urinary tract infection include:
WBC 50 (Page 775)
A client presents at the clinic with reports of urinary retention. What question should the nurse ask to obtain additional information about the client's report?
"When did you last urinate?" (Page 783)
A client with urinary tract infection is prescribed phenazopyridine (Pyridium). Which of the following instructions would the nurse give the client?
"This medication will relieve your pain." (Page 776)
An 56-year-old menopausal client comes to the clinic reporting painful intercourse. Her pelvic examination reveals vaginal dryness. Which suggestion would be most appropriate?
"Try using a water-soluble lubricant before intercourse." (Page 891)
A client with newly diagnosed renal cancer is questioning why detection was delayed. Which is the best response by the nurse?
"Very few symptoms are associated with renal cancer."
A patient who is scheduled for a gynecologic examination and Pap smear informs the nurse that she just began her menstrual cycle. What is the best response by the nurse?
"We will reschedule your examination when you have finished menstruating."
A client asks the nurse why a *creatinine clearance test* is accurate. The nurse is most correct to reply which of the following?
"Creatinine is broken down at a constant rate, and the total amount is excreted by the kidney."
A female college student is distressed at the recent appearance of genital warts, an assessment finding that her care provider has confirmed as attributable to human papillomavirus (HPV) infection. Which information should the nurse give the patient?
"There is a chance that these will clear up on their own without any treatment." (Page 975)
A client has been diagnosed with an enlarged prostate. What information should the nurse explain to the client about the effects of an enlarged prostate?
Retention of urine
Following percutaneous nephrolithotomy, the client is at greatest risk for which nursing diagnosis?
Risk for infection (Page 791)
A woman receives news that her Pap test results indicate atypical squamous cells. She is at high-risk for HPV because of her habit of frequent, unprotected sex with multiple partners. When the woman calls her provider, she is advised to do which of the following?
Schedule a colposcopy within a month. (Page 902)
A 73-year-old client has been diagnosed with epididymitis after examination and diagnostic tests ordered by a physician with the urology group where you practice nursing. What treatment would you expect the physician to order? Choose all correct options.
Scrotal elevation, Comfort measures (Page 965)
As a school nurse, you discuss male anatomy and the appropriate titles and functions of each structure. Which structure is involved in keeping the testes at the necessary degrees cooler to facilitate sperm production?
Scrotum
A perimenopausal woman informs the nurse that she is having irregular vaginal bleeding. What should the nurse encourage the patient to do?
See her gynecologist as soon as possible. (Page 944)
A group of students are reviewing information related to the male reproductive system structures. The students demonstrate understanding of the information when they identify which structure as an accessory organ?
Seminal vesicles
A child is brought into the clinic with symptoms of periorbital edema and dark brown rusty urine. Which nursing assessment finding would best assist in determining the cause of this problem?
Sore throat 2 weeks ago
After having transurethral resection of the prostate {TURP}, a client returns to the unit with a three-way indwelling urinary catheter and continuous closed bladder irrigation. Which finding suggests that the client's catheter is occluded?
The client reports bladder spasms and the urge to void (Page 964)
The nurse is caring for a client who has presented to the walk-in clinic. The client verbalizes pain on urination, feelings of fatigue, and diffuse back pain. When completing a head-to-toe assessment, at which specific location would the nurse *assess the client's kidneys for tenderness*?
The costovertebral angle
A patient is having a fine-needle biopsy (FNB) for a mass in the left breast. When the needle is inserted and the mass is no longer palpable, what does the nurse know has most likely occurred?
The mass may be cystic and was ruptured when the needle was inserted. (Page 915)
When developing an educational program for a group of adolescents about sexually transmitted infections {STIs}, what should the nurse inform the group about the single greatest risk factor for contracting an STI?
The number of sexual partners
The nurse practitioner performing a physical assessment on an 80-year-old woman is looking for which of the following functional changes in the reproductive system? Select all that apply.
Thickening and stiffness of the vaginal wall; Uterine prolapse; Vulvar dystrophy; Vaginal dryness (p. 891, 901-2)
A female client has just been diagnosed with condylomata acuminata {genital warts}. What information is appropriate to tell this client?
This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou {Pap} smear annually. (Page 942)
The client states to the nurse that he is very anxious about having prostate cancer ever since his prostate-specific antigen (PSA) test came back elevated. The client asks, "Which diagnostic test produces definitive results if cancer is present?" The nurse is most correct to state which of the following?
Tissue biopsy
Which of the following is the only definitive way to diagnose testicular cancer?
Tissue biopsy (Page 966)
A client with benign prostatic hyperplasia doesn't respond to medical treatment and is admitted to the facility for prostate gland removal. What is the most widely used procedure for prostate gland removal?
Transurethral resection of the prostate {TURP} (Page 959)
A patient has herpes simplex 2 viral infection {HSV-2}. The nurse recognizes that which of the following should be included in teaching the patient?
Treatment is focused on relieving symptoms. (Page 976)
During an internal vaginal examination, the nurse practitioner notes a *frothy and malodorous discharge*. What bacteria does the practitioner suspect is causing this disorder?
Trichomonas
During an internal vaginal examination, the nurse practitioner notes a frothy and malodorous discharge. The nurse suspects the odor is caused by which bacteria?
Trichomonas
Which of the following female genital mutilation (FGM) types is described as partial or total removal of the clitoris?
Type I
During a teaching demonstration on breast self-examination (BSE), the nurse should always explain that the majority of breast cancers are found in the:
Upper, outer quadrant.
A client reports loss of interest in sexual relations and discomfort during intercourse. Which is the best response by the nurse?
"These are normal, manageable symptoms of menopause."
A client is scheduled for a renal ultrasound. Which of the following would the nurse include when explaining this procedure to the client?
"You don't need to do any fasting before this noninvasive test." (Page 739)
A nurse measures a patient's urinary output every 8 hours. The nurse weighs the importance of these results by comparing the normal 24-hour urinary output with the patient's condition and medication. The *normal 24-hour output* should be:
1 to 2 L/day (Page 728)
A client with end-stage renal disease is scheduled to undergo a kidney transplant using a sibling donated kidney. The client asks if immunosuppressive drugs can be avoided. Which is the best response by the nurse?
"Even a perfect match does not guarantee organ success."
Which statement made by a client with a chlamydial infection indicates understanding of the potential complications?
"I need to treat this infection so it doesn't spread into my pelvis because I want to have children some day." (Page 974)
A client has had a right modified radical mastectomy and axillary lymph node dissection. The nurse is teaching the client about measures to reduce the risk of complications. The client demonstrates understanding of the instructions when she states which of the following?
"I need to use an electric shaver when shaving my right armpit."
Which statement demonstrates that a client has understood instructions about breast self-examination?
"I need to use the pads of three fingers to apply pressure when checking each breast."
A nurse is assessing a woman with vaginal discharge. The nurse suspects *bacterial vaginosis* when the client states which of the following?
"I noticed a strange fishy odor during my period." (Page 978)
A client comes to the clinic reporting urinary symptoms. Which statement would most likely alert the nurse to suspect benign prostatic hyperplasia (BPH)?
"I've had trouble getting started when I urinate, often straining to do so."
A client with a history of HSV-2 infection asks the nurse about future sexual activity. Which of the following responses would be most appropriate?
"Inform all potential sexual partners about the infection, even if it is inactive." (Page 976)
The nurse is providing care to a client who has had a kidney *biopsy*. The nurse would need to be alert for signs and symptoms of which of the following?
Bleeding
A client has undergone a total abdominal hysterectomy and bilateral salpingo-oopherectomy as treatment for endometrial cancer. When providing postoperative care to this client the nurse would be alert for signs and symptoms of which of the following?
Bladder dysfunction (Page 947)
A clinical manifestation related to metastasis from prostate cancer is
hip pain. (Page 956)
The nurse is demonstrating the technique for performing a testicular self examination {TSE} to a group of men for a company health fair. One of the men asks the nurse at what age a man should begin performing TSE. What is the best answer by the nurse?
"It should begin in adolescence." (Page 966)
The nurse is completing community education when asked by a client without health insurance why a mammogram is needed if the women are completing breast self-examinations at home. The nurse is most correct to respond stating which of the following?
"Mammograms can detect cysts or tumors too small to palpate."
The nurse is teaching a young adult male how to perform testicular self-examination {TSE}. The nurse determines that the client has understood the instructions when he states which of the following?
"The best time to do it is once a month after I take my warm morning shower." (Page 967)
The nurse weighs a patient daily and measures urinary output every hour. The nurse notices a weight gain of 1.5 kg in a 74-kg patient over 48 hours. The nurse is aware that this weight gain is equivalent to the retention of:
1,500 mL of fluid (Page 742)
A client who is diagnosed with *calcium oxalate stones* is instructed to limit calcium intake. The client is instructed to *consume ______ mg of calcium per day, or less*, as part of dietary treatment.
1000
The nurse is giving a presentation about chlamydia to a group of adult women. The nurse would emphasize the need for annual screening for this infection in all sexually active women younger than which age?
26 (Page 972)
A male patient comes to the clinic and is diagnosed with gonorrhea. Which symptom most likely prompted him to seek medical attention?
Foul-smelling discharge from the penis (Page 974)
In a client with benign prostatic hyperplasia {BPH}, which assessment finding provides the best indication of urinary retention?
Frequency
A patient has stage 3 chronic kidney failure. What would the nurse expect the patient's glomerular filtration rate (GFR) to be?
A GFR of 30-59 (mL/min/1.73 m2 ) (Page 751)
A nurse is developing a plan of care for a female client experiencing her first outbreak of genital herpes. Which nursing diagnosis would the nurse most likely identify as the priority?
Acute pain related to the development of the genital lesions (Page 976)
The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention does the nurse anticipate the physician will order to reduce the potassium level?
Administration of sodium polystyrene sulfonate [Kayexalate] (Page 750)
The nurse explained the difference between the herpes simplex viruses (HSV-1 and HSV-2). One characteristic of HSV-1 is that it:
Affects the mouth and lips (Page 976)
The nurse explained the difference between the herpes simplex viruses (HSV-1 and HSV-2). One characteristic of HSV-1 is that it:
Affects the mouth and lips.
A nurse is reviewing a female client's history, which includes the following information: Age at menarche: 14 years, Cesarean delivery: 2 pregnancies, Age at first pregnancy: 35 years, Alcohol use: approximately 1 to 2 glasses of wine/month. The nurse identifies which as a possible *risk factor for the client to develop breast cancer*?
Age at first pregnancy (Page 913)
Which of the following *diagnostic tests* would the nurse expect to be ordered to determine the details of the *arterial supply to the kidneys*?
Angiography (Page 739)
The nurse is providing information at the local YMCA about screenings for breast and cervical cancer. The nurse should inform young women that they should begin their screenings at what time?
Annual breast and pelvic examinations are important for all women 21 years of age or older and for those who are sexually active, regardless of age.
Which type of medication may be used to inhibit bladder contraction in a client with incontinence?
Anticholinergic agent (Page 779)
The nurse is obtaining a history from a male client who states having difficulty achieving and sustaining an erection. When reviewing the medication history, which medication classification does the nurse anticipate?
Antihypertensives
Bright red bleeding following prostate surgery indicates which of the following?
Arterial bleed (Page 963)
As women age, many experience an *increased sense of urgency* to void, as well as an *increased risk of incontinence*. This is usually the result of *age-related changes* in which part of the renal system?
Bladder
The nurse is discussing nutritional needs for a postmenopausal patient. What dietary increase should the nurse recommend to the patient?
Calcium
Which of the following is an age-related functional change of the female reproductive system?
Decreased ovulation
The nurse expects which of the following assessment findings in the client in the diuretic phase of acute renal failure?
Dehydration (Page 748)
Which of the following antibiotics are prescribed for the treatment of gonorrhea? Select all that apply.
Deoxycycline; Ceftriaxone; Azithromycin (Page 974)
As a grade school nurse, you speak to the sixth grade girls regarding their physical maturation and body changes during puberty. In your client education sessions, you explain when reproductive systems form and become functional. When do reproduction systems form?
During embryonic development (p. 904)
An adolescent patient comes to the clinic with complaints of "terrible pain" during menstruation. What should the nurse document this subjective data as?
Dysmenorrhea
Which term refers to difficult or painful sexual intercourse?
Dyspareunia
The client with benign prostatic hyperplasia {BPH} is considering use of medication in the management of symptoms. Which of the following drugs reduces the size of the prostate without lowering circulating levels of testosterone?
Finasteride {Proscar}
A nurse is reviewing a client's history for possible *risk factors* associated with *breast cancer*. Which of the following would the nurse identify as increasing the client's risk?
First full-term pregnancy at age 34 years (Page 913)
The nurse is assessing an older adult female who has not seen her physician in 2 years. The nurse is assisting the patient into a gown and notices that the patient has *edema and pitting of the skin on the right breast*. What does the nurse understand is the significance of this finding?
It may result from a neoplasm blocking lymphatic drainage, giving the skin an orange-peel appearance, a classic sign of advanced breast cancer.
The clinical manifestations of primary syphilis can be diagnostic. Select all the symptoms consistent with this diagnosis.
It occurs 2 to 3 weeks after initial inoculation with the organism; a painless lesion forms at the site of infection; the lesion resolves in 2 months. (Page 972)
The nurse is preparing the female client for a pelvic examination. In which position will the nurse assist the client?
Lithotomy position
Examination of a client's *bladder stones* reveal that they are primarily composed of *uric acid*. The nurse would expect to provide the client with which type of diet?
Low purine
Examination of a client's bladder stones reveals that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?
Low purine (Page 792)
A patient who has been treated for uric acid stones is being discharged from the hospital. What type of diet does the nurse discuss with the patient?
Low-purine diet (Page 792)
The nurse is providing care to a client who has had surgery as treatment for breast cancer. The nurse would be alert for the development of which of the following?
Lymphedema (Page 918)
A client undergoes surgery to remove a malignant tumor, followed by a urinary diversion procedure. Which postoperative procedure should the nurse perform?
Maintain skin and stoma integrity (Page 797)
A client is considering breast augmentation. Which of the following would the nurse recommend to the client to ensure that there are no malignancies?
Mammogram (Page 913)
A 30-year-old woman comes to the clinic for a routine examination. During the visit, the nurse would least likely recommend which of the following as important for health screening?
Mammography (Page 893)
Which nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction?
Medication use
Which of the following is a term used to describe excessive menstrual bleeding?
Menorrhagia (Page 929)
Which is the main cause of anemia in a client with active uterine leiomyoma?
Menorrhagia (Page 939)
A client is diagnosed with *vaginitis due to trichomonasis*. Which of the following agents would the nurse expect the physician to prescribe?
Metronidazole (Page 933)
A patient asks the nurse if there are any available nonsurgical options to terminate a pregnancy if she is only 2 weeks pregnant. What information should the nurse provide to the patient about a medication that blocks progesterone?
Mifepristone {RU-486, Mifeprex} is used only in early pregnancy to terminate a pregnancy nonsurgically.
A client is scheduled for a *renal angiography*. Which of the following would be appropriate before the test?
Monitor the client for an allergy to *iodine contrast* material.
A N.P. was preparing a health education program for college students. The nurse mentioned that C. trachomatis and N. gonorrhoeae are the two most common infections in sexually active young women under the age of 25. The nurse told the students that the most common finding for these infections is:
Mucopurulent cervicitis. (Page 974)
The wall of the *bladder has four layers*. Which of the following layers contains a *membrane* that *prevents reabsorption* of urine stored in the bladder?
Mucosal (Page 726)
The nurse is caring for a client who is describing urinary symptoms of *needing to go to the bathroom with little notice*. When the nurse is documenting these symptoms, which medical term will the nurse document?
Urinary urgency
A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. I.V. fluid is being infused at 150 mL/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)?
Urine output of 250 ml/24 hours (Page 747)
Following a vasectomy, which is the most important instruction to provide to the client?
Use another form of birth control until further notice.
A nurse is reviewing a client's medical history. Which factor indicates the client is at risk for candidiasis?
Use of corticosteroids (Page 934)
A client diagnosed with prostate cancer is to receive brachytherapy. Which of the following would the nurse include when discussing this therapy with the client?
Use of radioactive seeds implanted into the prostate
A client underwent a transurethral resection of the prostate gland 24 hours ago and is on continuous bladder irrigation. Which nursing intervention is appropriate?
Use sterile technique when irrigating the catheter (Page 964)
A nurse who works in a gynecologist's office frequently cares for patients who are diagnosed with *vulvovaginal candidiasis*. The nurse should teach the patients how to manage and treat the most common symptom of:
Vulvar pruritus. (Page 935)
A patient taking an *alpha-adrenergic medication for* the treatment of *hypertension* is having a problem with *incontinence*. What does the nurse tell the patient?
When the medication is discontinued or changed, the incontinence will resolve. (Page 780)
The nurse is assigned to care for a patient in the *oliguric phase* of kidney failure. When does the nurse understand that *oliguria* is said to be present?
When the urine output is less than 30 mL/h (Page 733)
A client is ordered continuous bladder irrigation at a rate of 60 gtt/minute. The nurse hangs a 2 L bag of sterile solution with tubing on a three-legged IV pole. She then attaches the tubing to the client's three-way urinary catheter, adjusts the flow rate, and leaves the room.
Which important procedural step did the nurse fail to follow? Evaluating patency of the drainage lumen (Page 964)
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:
human papillomavirus {HPV} (Page 975)
A client presents to the emergency department complaining of a *dull, constant ache* along the right costovertebral angle along with *nausea and vomiting*. The most likely cause of the client's symptoms is:
renal calculi. (Page 733)