Med Surg 2 Test 3- Reproductive

A patient who came to the clinic after finding a mass in her breast is scheduled for a diagnostic breast biopsy. During the nurses admission assessment, the nurse observes that the patient is distracted intense. What is it important for the nurse to do? a. Acknowledge the fear the patient is likely experiencing b. Describe the support groups that exist in the community c. Assess the patient's stress management skills d. Document a nursing diagnosis of ineffective coping

a

A public health nurse is teaching health class for the male students at the local high school. The nurse is teaching the boys to perform monthly testicular self examination's. What point would be appropriate to emphasize? a. Testicular cancer is a highly curable type of cancer b. Testicular cancer is very difficult to diagnose c. Testicular cancer is the number one cause of cancer death in males d. Testicular cancer is more common in older men

a

The best prognosis is indicated in the patient with breast cancer when diagnostic Studies reveal a. Negative axillary lymph nodes b. Aneuploid DNA tumor content c. Cells with high S phase fractions d. And estrogen receptor and progesterone receptor negative tumor

a

When teaching a 24-year-old woman who desires to learn BSC, the nurse knows that it is important to do what? a. Provide time for a return demonstration b. Emphasize the statistics related to breast cancer survival in mortality c. Have the woman said a consistent monthly date for performing the examination d. Inform the woman that professional examinations are not necessary unless she finds an abnormality

a

A 52-year-old woman has just been told she has breast cancer and is scheduled for a modified mastectomy the following week. The nurse caring for this patient knows that she is anxious and fearful about the upcoming procedure and the newly diagnosed malignancy. How can the nurse most likely alleviate this patient's fears? a. Provide written material and the procedure that has been scheduled for the patient b. Provide the patient with relevant information about expected recovery c. Give the patient current information on breast cancer survival rates d. Offer the patient alternative treatment options

b

A patient has been diagnosed with cancer of the ovary. In planning care for the patient, what does the nurse recognize that treatment of the patient depends on? a. Results of a direct needle biopsy of the ovary b. Results of a laparoscopy with multiple biopsies c. Whether the patient desires to maintain fertility d. The findings of metastasis by ultrasound or CT scan

b

The nurse is performing a comprehensive health history of a patient who is in her 50s. The nurse should identify what risk factor that may increase the patient's risk for breast cancer? a. The patient breast-fed each of her children b. The patient gave birth to her first child at age 38 c. The patient experienced perimenopausal symptoms starting at age 46 d. The patient experience menarche at age 13

b

A 48-year-old woman presenting for care is seeking information about hormone therapy for the treatment of her perimenopausal symptoms. The patient's need for relief from hot flashes and other symptoms will be weighed carefully gets the increased risk of what complications of hormone therapy? Select all that apply a. Anaphylaxis b. Osteoporosis c. Breast cancer d. Cardiovascular disease e. Venus thromboembolism

c,d,e

A patient undergoing either a mastectomy or Olympic to me for treatment of breast cancer can also usually expect to undergo what other treatment? a. Chemotherapy b. Radiation c. Hormonal therapy d. Sentinel lymph node dissection

d

It woman is being treated for a tumor of the left breast. If the patient and her physician opt for prophylactic treatment, the nurse should prepare the woman for what intervention? a. More aggressive chemotherapy b. Left mastectomy c. Radiation therapy d. Bilateral mastectomy

d

The nurse is teaching breast self examination to a group of women. The nurse should recommend that the women perform BSE at what time? a. At the time of menses b. At any convenient time, regardless of cycles c. Weekly d. Between days five and seven after menses

d

A 72-year-old man is in the emergency department because he has been unable to void for the past 12 hours. The best method for the nurse to use when assessing for bladder distention and a mail client is to check for: a. A rounded swelling above the pubis b. Dullness in the lower left quadrant c. Rebound tenderness below the symphysis d. You're a discharge from the urethral meatus

a

A priority nursing diagnosis for the client who has been discharged to home three days after TURP is a. Deficient fluid volume b. Imbalanced nutrition: less than body requirements c. Impaired tissue integrity d. Ineffective airway clearance

a

When teaching a client to perform testicular self examination, the nurse explains that the examination should be performed a. After intercourse b. At the end of the day c. After a warm bath or shower d. After exercise

c

When caring for a client with a history of benign prosthetic hypertrophy the nurse should do which of the following? Select all that apply a. Provide privacy and time for the client to void b. Monitor intake and output c. Catheterized a client for post void residual urine d. Ask the client if he has urinary retention e. Test the urine for hematuria

a,b,d,e

In discussing home care with a client after TURP, the nurse should teach the mail client that dribbling of urine a. Can be a chronic problem b. Can persist for several months c. Is an abnormal sign that requires intervention d. It's a sign of healing within the prostate

b

Risk factors associated with testicular malignancies include a. African-American race b. Residing in a rural area c. Lower socioeconomic status d. Age older than 40 years

b

The client states that she has noticed that her bra fits more snuggly at certain times of the month. She asked the nurse if this is a sign of breast disease. The nurse should be still reply to this client on the knowledge that: a. Benign cysts tend to cause the breast to vary in size b. It is normal for the breast to increase in size before menstruation begins c. A change in breast size warrants further investigation d. Differences in breast size are related to normal growth and development

b

A client with a testicular malignancy undergoes a radical orchiectomy. In the immediate post operative. The nurse should particularly assess the client for a. Bladder spasms b. Urine output c. Pain d. Nausea

c

A client is to have radiation therapy after a modified radical mastectomy. The nurse should teach the client to care for the skin at the side of therapy by a. Washing the area with water b. Exposing the area to dry heat c. Applying anointment to the area d. Using talcum powder on the area

a

The nurse is working with a patient who expects to begin menopause in the next few years. What educational topic should the nurse prioritize when caring for a healthy woman approaching menopause? a. Patient teaching and counseling regarding healthy lifestyles b. Referrals to local support groups c. Nutritional counseling regarding osteoporosis prevention d. Drug therapy options

a

During the clients urinary bladder catheterization, the nurse ensures that the bladder is empty gradually. The best rationale for the nurses action is that completely emptying and over distended bladder at one time tends to cause: a. Renal failure b. Abdominal cramping c. Possible shock d. Atrophy of bladder musculature

c

The nurse is reviewing the medication history of a client with BPH. Which medication would likely aggravate BPH? a. MetForman/glucophage b. Buspirone/Buspar c. Inhaled ipratropium/ atrovent d. Ophthalmic timolol/Timoptic

c

A client returned to the recovery room after a dilation and curettage has the postoperative medication ordered shown in the chart what should the nurse do next? a. Ask the client to write the intensity of her pain on a scale of 1 to 10 and administer the analgesia according to the intensity of the pain b. Administer the dimmer off first because the client had surgery today c. Administer the Tylenol three first, and if it does not relieve the pain in two hours administer the Demirel d. Administer the Motrin first and if it does not relieve the pain administer the Demerol

a

A post menopausal woman is worried about pain in the upper outer quadrant of her left breast. The nurses first course of action is to: a. Do breast examination and report the results to the physician b. Explain that pain is caused by hormonal fluctuations c. Reassure the client that pain is not a symptom of breast cancer d. Teach the client the correct procedure for breast self examination

a

A school nurse is presenting information on human development and sexuality. When describing the role of hormones in sexual development, which hormone does the nurse teach the class is the most important one for developing and maintaining the female reproductive organs? a. Estrogen b. Progesterone c. Androgens d. Follicle stimulating hormone

a

The client is being admitted from the emergency department with a nursing home acquired pneumonia. The unit has four empty beds in semi private rooms. The room that would be most suitable for this client is the one with a a. 60 year old client admitted for investigation of transient ischemic attack b. 45-year-old client with an abdominal hysterectomy c. 24-year-old client with non-Hodgkin's lymphoma d. A 55-year-old client with alcoholic cirrhosis

a

The husband of a client with cervical cancer says to the nurse, "The doctor told my wife that her cancer is curable. Is he just trying to make us feel better?" Which would be the nurse's most accurate response? A. "When cervical cancer is detected early and treated aggressively, the cure rate is almost 100%" B. "The 5-year survival rate is about 75%, which makes the odds pretty good." C. "Saying a cancer is curable means that 50% of all women with the cancer survive at least 5 years." D. "Cancers of the female reproductive tract tend to be slow-growing and respond well to treatment."

a

The nurse is providing a community presentation about ovarian cancer. Which topic should receive priority attention in the lesson plan? a. Ovarian cancer signs and symptoms are often vague until late in development b. Ovarian cancer should be considered in any Woman older than 30 years of age c. A rigid board like abdomen is the most common sign d. Methods for early detection have made a dramatic reduction in the mortality rate due to ovarian cancer

a

The nursery for a client who had a mastectomy to "reach to recovery" the primary purpose of the American cancer society reach to recovery program is to: a. Foster rehabilitation in women who have had mastectomies b. Raise funds to support early breast cancer detection programs c. Provide free dressings for women who have had radical mastectomies d. Collect statistics for research from women who have had mastectomies

a

The primary reason for taping an indwelling catheter laterally to the thigh of a mail client is to a. Illuminate pressure on the penoscrotal angle b. Prevent the catheter from kinking in the urethra c. Prevent accidental catheter removal d. Allow the client to turn without kicking the catheter

a

A 28-year-old female without health insurance is receiving treatment for cervical cancer. She's a single parent of two young children and is referred to the social worker. The client states to the nurse "I feel overwhelmed and beyond help. What can a social worker do to help me?" Which responses by the nurse about the role of a social worker or most appropriate? Select all that apply a. The social worker is part of a multidisciplinary team that provides care for clients with cancer b. The social worker can explain federal, state, and not-for-profit resources and programs to you c. Based on your income and family situation, the social worker will help you in applying for various assistance programs d. Your entire family will be included in the treatment plan. Your needs and those of your children will be assessed and determined so that referrals can be made to appropriate resources e. As the client, you will not have choices about the programs and resources you utilize

a,b,c,d

The nurse is teaching a client newly diagnosed with prostate cancer. Which of the following points should be included in the instructions? Select all that apply a. Prostate cancer is usually Multi focal and slow growing b. Most prostate cancer's are adenocarcinoma c. The incidence of prostate cancer is higher in African-American men, and the onset is earlier d. A prostate specific antigen or PSA lab test greater than 4 will need to be monitored e. Cancer cells are detected in the urine

a,b,c,d

The nurse is assessing a 53-year-old woman who has been experiencing dysmenorrhea. What question should the nurse include in an assessment of the patient's menstrual history? Select all that apply a. Do you ever experience bleeding after intercourse b. How long is your typical cycle c. Did you have any sexually transmitted infections in early adulthood d. When did your mother and sisters get their first periods e. Do you experience cramps or pain during your cycle.

a,b,e

A client is undergoing a total prostate ectomy for prostate cancer. The client asks questions about his sexual function. The best response by the nurse is which of the following a. Loss of the prostate gland means that you will be impotent b. Loss of the prostate gland means you will be in fertile and there will be no ejaculation. You can still experience this sensations of orgasm c. Last of the prostate gland means that you will have no loss of sexual function and drive d. Loss of prostate gland means that your erectile capability will return immediately after surgery

b

A female with bilateral breast implants ask if she still needs to do breast examinations because she does not know what to feel for. Which of the following is the nurses best response? a. "Have your partner access your breast on a regular basis." b. "I will show you the correct technique as I do a breast examination" c. "A breast examination is very difficult when you have had implant surgery" d. "You need to have a mammogram instead"

b

A pre-menopausal patient is complaining of vaginal spotting and sharp, colicky lower abdominal pain. She informs the nurse that her period is two weeks late. The nurse should recognize the need for this patient to be investigated for what health problem? a. Trichomonas vaginalis b. Ectopic pregnancy c. Cervical cancer d. Fibromyalgia

b

A priority nursing diagnosis for a client with cervical cancer who has an internal radium implant is a. Pain related to cervical tumor b. Anxiety related to self-care deficit from imposed immobility during radiation c. Ineffective health maintenance related to surgery d. Insomnia related to interruptions by healthcare personnel

b

A right orchiectomy is performed on a client with a testicular malignancy. The client expressed his concerns regarding his sexuality. The nurse should base the response on the knowledge that the client a. Is not a candidate for sperm banking b. Should retain normal sexual drive and function c. Will be impotent d. Will have a change in secondary sexual characteristics

b

Many older man with prosthetic hypertrophy do not seek medical attention until urinary obstruction is almost complete one reason for this delay in seeking attention is that these men may a. Feel too self-conscious to seek help when reproduction organs are involved b. Expect that it is normal to live with some urinary problems as they grow older c. Fear that sexual indiscretions in earlier life may be the cause of their problem d. Have a little discomfort in relation to the amount of pathology because responsive to pain stimuli fade with age

b

The UAP reports to the nurse that the client with an abdominal hysterectomy who returned from the recovery room one hour earlier has saturated the blue pad with bright red blood. The nurse should a. Call the surgeon to report the bleeding b. Ask the UAP to obtain vital signs while the nurse calls the surgeon c. Ask the UAP to increase the flow of IV fluids to prevent shock d. Ask the client again and 15 minutes before the nurse takes any further action

b

The client with suspected cervical cancer is undergoing a colposcopy with conization. The nurse gives instructions to the client about her menstrual periods, emphasizing that a. Her periods will return to normal after six months b. Her next two or three periods may be heavier and more prolonged than usual c. Her next two or three. Will be lighter than normal d. She may skip her next two periods

b

A client with BPH has an elevated prostate specific antigen PSA level. The nurse should? a. Instruct the client to have a colonoscopy b. Instruct the client that a urologist will monitor the PSA level biannually when elevated c. Determine if the prosthetic palpation was done before or after the blood sample was drawn d. Ask the client if he emptied his bladder before the blood sample was obtained

c

A client with BPH is being treated with teraZosin/Hytrin 2 mg at bedtime. The nurse should monitor the clients a. Urine nitrates b. White blood cell count c. Blood pressure d. Pulse

c

A nurse on the gynecological surgery unit observes a respiratory therapist take a medication cup with pills that was sitting in the medication room. What course of action should the nurse take? a. Report the situation to the supervisor of respiratory therapy b. Tell the RT that you saw him take the pills from the medication room c. Report the situation to the nursing supervisor d. Tell the nurse who is administering medications not to leave pills out

c

A nursing assistant tells the nurse, "I think the client is confused. He keeps telling me he hast to avoid, but that is impossible because he has a catheter in place that is draining well." Which of the following responses would be most appropriate for the nurse to make? a. His catheter is probably clogged. I'll irrigate it in a few minutes b. That's a common complaint after prostate surgery. The client only imagines the urge to void c. The urge to void is usually created by the large catheter, and he may be having some bladder spasms d. I think he may be somewhat confused

c

A patient in her late 50s has expressed to the nurse her desire to explore hormone replacement therapy. Based on what aspect of the patient's health history is this contraindicated? a. History of vaginal dryness b. History of hot flashes and night sweats c. History of vascular thrombosis d. Family history of osteoporosis

c

During the postoperative period after modified radical mastectomy, the client confides in the nurse that she think she got breast cancer because she had an abortion and she did not tell her husband. The best response by the nurse is which of the following? a. Cancer is not a punishment, it is a disease b. You might feel better if you confided in your husband c. Tell me more about your feelings on this d. I can have the social worker talk to you if you would like

c

On the second day following an abdominal hysterectomy, a client reports she has had three brown, loose stools in moderate amount. The morning medications include an order for 100 mg of docusate sodium daily or as needed. What should the nurse do next? a. Administer the Colace according to the physicians order b. Ask the client if she is having gas pains or hunger c. Withhold the medication and document with holding the medication on the medical record d. Administer the Colace and instruct the client to avoid high fiber foods

c

On the second postoperative day after an abdominal hysterectomy, the client develops a temperature of 100.4°. The nurses first action should be to a. Increase the number of wound changes to minimize infection b. Obtain a culture and sensitivity study of the urine to determine the source of infection c. Ensure that the client takes at least 10 deep breath's every hour d. Change the site of the clients IV fluid catheter to reduce the risk of infection

c

Postoperatively after I modified radical mastectomy, a client has an incisional drainage tube attached to Hemovac section. The nurse determines the section is affective when: a. The intrathoracic pressure is decreased and the client breathes easier b. There is an increased collateral lymphatic flow toward the operative area c. Accumulated serum and blood in the operative area are removed d. No adhesions are formed between the skin and chest wall in the operative area

c

The nurse is assessing a patient who believes that she has recently begun menopause. What principle should inform the nurses interactions with this patient? a. The nurse should express empathy for the patient's difficult health situation b. The nurse should begin by assuring the patient that her health will be much better in a few years c. The nurse should carefully assess the patient's feelings and beliefs surrounding menopause d. The nurse should encourage the patient to celebrate this life milestones and it's accompanying benefits

c

The nurse is changing the dressing up a client after an abdominal hysterectomy. Which of the following nursing measures would be most appropriate if the dressing adheres to the clients incisional area? a. Pull off the dressing quickly and then apply slight pressure over the area b. Lift an easily moved portion of the dressing and then remove it slowly c. Moisten the dressing with sterile normal saline solution and then remove it d. Remove part of the dressing and then remove the remainder gradually over a period of several minutes

c

The nurse should teach a client that a normal local tissue response to radiation is: a. Atrophy of the skin b. Scattered pustule formation c. Redness of the surface tissue d. Sloughing of two layers of skin

c

The nurse teaches a female client at the best time in the menstrual cycle to examine the breast is during the: a. Weeks that ovulation occurs b. Week that menstruation occurs c. First week after menstruation d. Week before menstruation occurs

c

When preparing a client for discharge two days after an abdominal hysterectomy, the nurse should instruct the client to avoid which activities until recovery is complete? a. Swimming in a pool treated with chlorine for six weeks after surgery b. Walking at a leisurely pace for 30 minutes at least once a day c. Driving until the client can push the brake pedal without pain d. Lifting greater than 2 pounds until the abdominal incision has healed

c

When a client is receiving hormone replacement for prostate cancer, the nurse should do which of the following? Select all that apply a. Informed the client that increased libido is expected with hormone therapy b. Reassure the client and his significant other that erectile dysfunction will not occur as a consequence of hormone therapy c. Provide the client with the opportunity to communicate concerns and needs d. Utilize communication strategies that enable to client to gain some feeling of control e. Suggest that an appointment be made to see a psychologist

c,d

A patient with ovarian cancer is admitted to the hospital for surgery and the nurse is completing the patient's health history. What clinical manifestations with the nurse expect to assess? a. Fish like vaginal odor b. Increased abdominal girth c. Fever and chills d. Lower abdominal pelvic pain

b

A public health nurse has been asked to provide a health promotion session for men at wellness center. What should the nurse inform the participants about testicular cancer? a. It is most common among men over 55 b. It is one of the least curable solid tumors c. It is typically not metastasized d. It is highly responsive to treatment

d

The nurse would be the most concerned with the patient's breast examination when it reveals what a. A large, tender, movable mass in the upper inner quadrant b. And immobile, hard, nontender lesion in the upper outer quadrant c. A 2 to 3 cm firm, defined, mobile mass in the lower outer quadrant d. A painful, immobile mass with red and skin in the upper outer quadrant

b

The patient's breast cancer has metastasized. Which medication for metastasis is better tolerated and has fewer and milder side effects than other chemotherapy medications? a. Xeloda b. Navelbine c. Adriamycin d. Alaven

b

The nurse is caring for a client who will have a bilateral orchiectomy. That client ask what is involved with this procedure. The nurse is most appropriate response would be? a. Removes the entire prostate gland, prostatic capsule, and seminal vesicles b. Tends to cause urinary incontinence and impotence c. Freezes prostate tissue, killing cells d. Results and reduction of the major circulating androgen, testosterone

d

What is the most common screening intervention for detecting BPH in men over 50? a. PSA level b. Urinalysis c. Cystoscopy d. Digital rectal examination

d

When teaching a patient testicular self examination, the nurse instruct the patient to report which finding? a. an irregular feeling epididymis b. One testis larger than the other c. The spermatic cord within the testicle d. A firm, nontender nodule on the testes

d

A client with prostate cancer is treated with hormone therapy consisting of diethylstilbestrol (DES; Stilphostrol) 2 mg daily. The nurse should instruct the client to expect to have a. Tenderness of the scrotum b. Tenderness of the breasts c. Loss of pubic hair d. Decreased blood pressure

b

Before undergoing a TURP, what should the patient be taught? a. Some degree of urinary incontinence is likely to occur b. This surgery results and some degree of retrograde ejaculation c. Erectile dysfunction is a common complication of this prostate surgery d. An indwelling catheter will be used to maintain urinary output until healing is complete

b

Following a modified radical mastectomy, a patient develops lymphedema of the affected arm. What does the nurse teach the patient to do? a. Avoid skin softening agent on the arm b. Protect the arm from any type of trauma c. Abduct and adduct the arm at the shoulder hourly d. Keep the arm positioned so that it is in a straight independent alignment

b

The healthcare provider of a patient with a positive biopsy of a 2 cm breast tumor has recommended a lumpectomy with radiation therapy or modified radical mastectomy as treatment. The patient says that she does not know how to choose and ask the female nurse what she would do if she had to make the choice. What is the best response by the nurse to this patient? a. It doesn't matter what I would do. It is a decision you have to make for yourself b. There are advantages and disadvantages of both procedures. What do you know about these procedures? c. I would choose the modified radical mastectomy because it would ensure that the entire tumor was removed d. The lumpectomy maintains a nearly normal breast but the survival rate is not as good as it is with a mastectomy

b

The nurse provides discharge teaching to a patient following a TURP and determines that the patient understands the instructions when he makes which statement? a. I should use daily enemas to avoid straining until healing is complete b. I should avoid heavy lifting, climbing, and driving until my follow up visit c. At least I don't have to worry about developing cancer of the prostate now d. Every day I should drink 10 to 12 glasses of liquids such as coffee, tea, or soft drinks

b

Which cancer is associated with intrauterine exposure to DES or metastasis from another gynecologic cancer? a. Vaginal b. Ovarian c. Cervical d. Endometrial

b

A patient is being discharged home from the ambulatory surgery center after an incisional biopsy of a mass in her left breast. What are the criteria for discharging this patient home? Select all that apply a. Patient must understand when she can begin ambulating b. Patient must have someone to accompany her home c. Patient must understand activity restrictions d. Patient must understand care of the biopsy site e. Patient must understand which when she can safely remove her urinary catheter

b,c,d

A 23-year-old woman comes to the free clinic stating I think I have a lump in my breast. Do I have cancer? The nurse instruct the patient that a diagnosis of breast cancer is confirmed by what? a. Supervised breast self examination b. Mammography c. Fine needle aspiration d. Chest x-ray

c

A 30-year-old patient has come to the clinic for her yearly examination. The patient asked the nurse about ovarian cancer. What should the nurse state when describing risk factors for ovarian cancer? a. Use of oral contraceptives increases the risk of ovarian cancer b. Most cases of ovarian cancer are attributed to tobacco use c. Most cases of ovarian cancer are considered to be random, with no obvious causation d. The majority of women who get ovarian cancer have a family history of the disease

c

A 44-year-old woman undergoing a total abdominal hysterectomy asks whether she will need to take estrogen until she reaches the age of menopause. What is the best response by the nurse? a. Yes it will help to prevent the more intense symptoms caused by surgically induced menopause b. You are close enough to normal menopause that you probably won't need additional estrogen c. Because your ovaries won't be removed, they will continue to secrete estrogen until your normal menopause d. There are so many risks associated with estrogen replacement therapy that is best to begin menopause now

c

A 45-year-old woman has just undergone a radical hysterectomy for invasive cervical cancer. Prior to the surgery the physician explained to the patient after the surgery a source of radiation will be placed near the tumor site to aid in reducing recurrence. What is the placement of the source of radiation called? a. Internal beam radiation b. Trachelectomy c. Brachytherapy d. External radiation

c

A 55-year-old man with a history of prostate cancer in his family asked the nurse what he can do to decrease the risk of prostate cancer. What should the nurse teach him about prostate cancer risks? a. Nothing can decrease the risk because prostate cancer is primarily a disease of aging b. Treatment of any enlargement of the prostate gland will help to prevent prostate cancer c. Substituting fresh fruits and vegetables for high fat foods in the diet may lower the risk of prostate cancer d. Using a natural herb, saw palmetto, has been found to be effective protection against prostate cancer

c

A 29-year-old patient has just been told that he has testicular cancer and needs to have surgery. During a pre-surgical appointment, the patient admits to feeling devastated that he requires surgery, stating that it will leave him emasculated in the shell of a man. The nurse should identify what nursing diagnosis when planning patient subsequent care? a. Disturbed body image related to effects of surgery b. Spiritual distress related to the effects of cancer surgery c. Social isolation related to the effects of surgery. d. Risk for loneliness related to changes in self-care

a

A man tells the nurse that his father died of prostate cancer and he is concerned about his own risk of developing the disease, having heard that prostate cancer has a genetic link. What aspect of the pathophysiology of prostate cancer what underlie the nurses response? a. A number of studies have identified an association of BRCA2 mutation with an increased risk of prostate cancer b. HNPCC is a mutation of two genes that causes prostate cancer in men and is autosomal dominant c. Studies have shown that the presence of the TP53 Gene strongly influences the incidence of prostate cancer d. Recent research has demonstrated that prostate cancer is the result of lifestyle factors and that genetics are unrelated

a

A nurse is providing care for a patient who has been recently admitted to the post surgical unit from PACU following a transurethral resection of the prostate. The nurse is aware of the nursing diagnosis of risk for imbalanced fluid volume. In order to assess for this risk, the nurse should prioritize what action? a. closely monitoring the input and output of the bladder irrigation system b. Administering parenteral nutrition and fluids as ordered c. monitoring the patient's level of consciousness and skin turgor d. Scanning the patient's bladder for retention every two hours

a

A nurse is teaching a 53-year-old man about prostate cancer. What information should the nurse provide the best facilitate the early identification of prostate cancer? a. Have a digital rectal examination and prostate specific antigen (PSA) test done yearly b. Have a transrectal ultrasound every five years c. Perform monthly testicular self examination's especially after age 60 d. Have a CBC, BUN and creatinine assessment performed annually

a

A nurse is teaching a group of women about the potential benefits of BSE. The nurse should teach the women that effective BSE is dependent on what factor? a. Women's knowledge of how their breasts normally look and feel b. The rapport that exist between the woman and her primary care provider c. Synchronizing women's routines around BSC with the performance of mammograms d. Women's knowledge of the pathophysiology of breast cancer

a

A patient has been referred to the breast clinic after her most recent mammogram revealed the presence of a lump. The lump is found to be a small, well-defined nodule in the right breast. The oncology nurse should recognize the likelihood of what treatment? a. Lumpectomy and radiation b. Partial mastectomy and radiation c. Partial mastectomy and chemotherapy d. Total mastectomy and chemotherapy

a

A patient has experienced occasional urinary incontinence in the week since his prostatectomy. In order to promote continents, the nurse should encourage which of the following? a. Pelvic floor exercises b. Intermittent urinary catheterization c. Reduced physical activity d. Active range of motion exercises

a

A patient has had a total mastectomy with immediate reconstruction. The patient ask the nurse when she can take a shower. What should the nurse respond a. Not until the drain is removed b. On the second postoperative day c. Now, if you wash gently with soap and water d. Seven days after your surgery

a

A patient has just been told that she needs to have an incisional biopsy of her right breast mass. During preoperative teaching, how could the nurse best assess this patient for specific educational, physical or psychosocial needs she might have? a. By encouraging her to verbalize her questions and concerns b. By discussing the possible findings of the biopsy c. By discussing possible treatment options if the diagnosis is cancer d. By reviewing her medical history

a

A patient has just returned to the floor following a transurethral resection of the prostate. A triple lumen indwelling urinary catheter has been inserted for continuous bladder irrigation. What, in addition to balloon inflation, are the functions of the three lumens? a. Continuous influence outflow of irrigation solution b. Intermittent inflow and continuous outflow of irrigation solution c. Continuous inflow and intermittent outflow of irrigation solution d. Intermittent flow of irrigation solution and prevention of hemorrhage

a

A patient has just returned to the post surgical unit from post anesthetic recovery after breast surgery for removal of a malignancy. What is the most likely major nursing diagnosis to include in this patient's immediate plan of care? a. Acute pain related to tissue manipulation and incision b. Ineffective coping related to surgery c. Risk for trauma related to post surgical injury d. Chronic sorrow related to change in body image

a

A patient is to undergo an ultrasound guided core biopsy. The patient tells the nurse that a friend of hers had a stereotactic core biopsy. She wants to understand the differences between the two procedures. What would the nurses best response be? a. And ultrasound guided core biopsy is faster, less expensive, and does not use radiation b. And ultrasound guided core biopsy is a little more expensive, but it doesn't use radiation and it is faster c. And ultrasound guided core biopsy is a little more expensive, and it also uses radiation but it is faster d. And ultrasound guided core biopsy takes more time, and it also uses radiation but it is less expensive.

a

A patient undergoing a modified radical mastectomy for cancer of the breast is going to use tissue expansion and an implant for breast reconstruction. What should the nurse teach the patient about tissue expansion? a. Weekly injections of water or saline into the expander will be required b. The expander cannot be placed until healing from the mastectomy is complete c. This method of breast reconstruction uses the patient's own tissue to replace breast tissue d. The nipple from the effective breast will be saved to be grafted onto the reconstructed breast

a

A patient who has had a lump ectomy calls the clinic to talk to the nurse. The patient tells the nurse that she has developed a tender area in her breast that is red and warm and looks like someone drew a line with a red marker what should the nurse suspect is the woman's problem a. Mondor disease b. DVT of the breast c. Recurrent malignancy d. An area of fat necrosis

a

A patient who is postoperative day 12 and recovering at home following a laparoscopic prostatectomy has reported that he is experiencing occasional dribbling of urine. How should the nurse best respond to this patient's concern? a. Inform the patient that urinary control is likely to return gradually b. Arrange for the patient to be assessed by his urologist c. Facilitate the insertion of an indwelling urinary catheter by the home care nurse d. Teach the patient to perform intermittent self-catheterization

a

The nurse is caring for a 63-year-old patient with ovarian cancer. The patient is to receive chemotherapy consisting of Taxol and Paraplatin. For what adverse effect of this treatment should the nurse monitor the patient? a. Leukopenia b. Metabolic acidosis c. Hyperphosphatemia d. Respiratory alkalosis

a

The nurse is caring for a patient who has just been told that her ovarian cancer is terminal and that no curative options remain. What would be the priority nursing care for this patient at this time? a. Provide emotional support to the patient and her family b. Implement distraction and relaxation techniques c. Offer to inform the patient's family of this diagnosis d. Teach the patient about the importance of maintaining a positive attitude

a

The nurse is reviewing the physicians notes for the patient who has just left the clinic. The nurse learns that the physician suspects a malignant breast tumor. On palpation, the mass will most likely have what characteristic? a. Non-tenderness b. A size of 5 mm c. Sofness and a regular shape d. Mobility

a

To decrease glandular cellular activity and prostate size, and 83 year old patient has been prescribed Proscar. When performing patient education with this patient, the nurse should be sure to tell the patient what? a. Report the planned use of dietary supplements to the physician b. Decrease the intake of fluids to prevent urinary retention c. Abstain from sexual activity for two weeks following the initiation of treatment d. Anticipate a temporary worsening of urinary retention before symptoms subside

a

What is the effect of finasteride (Proscar) in the treatment of BPH a. A reduction in the size of the prostate gland b. Relaxation of the smooth muscle of the urethra c. Increased bladder tone that promotes bladder emptying d. Relaxation of the bladder detrusor muscle promoting urine flow

a

When teaching a patient to perform Kegel exercises, what should the nurse tell the patient to do? a. Contract her muscles as if trying to stop the flow of urine b. Tighten the lower abdominal muscles over the bladder area c. Squeeze all of the peroneal muscles as if trying to close the vagina d. Lying on the floor and do leg lifts to strengthen the abdominal muscles

a

a 22 year old male is being discharged home after surgery for testicular cancer. The patient is scheduled to begin chemotherapy in 2 weeks. The patient tells the nurse that he doesn't think he can take weeks or months of chemotherapy, stating that he has researched the adverse effects online. What is the most appropriate nursing action for this patient at this time? a. provide empathy and encouragement in an effort to foster a positive outlook b. Tell the patient it is his decision whether to except or reject chemotherapy c. Report the patient's statement to members of his support team d. Refer the patient to social work

a

A patient has been discharged home after a total mastectomy without reconstruction. The patient lives alone and has home health referral. When the home care nurse performs the first scheduled visit this patient, what should the nurse assess? Select all that apply a. Adherence to the exercise plan b. Overall psychological functioning c. Integrity of surgical drains d. Understanding of cancer e. Use of the breast prosthesis

a,b,c

A public health nurse is participating in a campaign aimed at preventing cervical cancer. What strategies should the nurse include in this campaign? Select all that apply a. Promotion of HPV immunization b. Encouraging young women to delay first intercourse c. Smoking cessation d. Vitamin D and calcium supplementation e. Using safer for sex practices

a,b,c,e

What accurately describes prostate cancer detection and or treatment? Select all that apply a. The symptoms of pelvic or perineal pain, fatigue, and malaise may be present b. Palpation of the prostate reveals hard and asymmetric enlargement with areas of induration or nodules c. Orchiectomy is a treatment option for all patients with prosthetic cancer except those with stage IV tumors d. The preferred hormonal therapy for treatment of prostate cancer include estrogen and androgen receptor blockers e. Early detection of cancer of the prostate is increased with annual rectal examinations and serum prostate acid phosphatase measurements f. An annual prostate examination is recommended starting at age 45 for African-American men because of the increased mortality rate for prostatic cancer in this population

a,b,f

Which factors are associated with endometrial cancer? Select all that apply a. Obesity b. Smoking c. Family history d. Early sexual activity e. Early menarche and late menopause f. Unopposed estrogen only replacement therapy

a,b,f

What describes the use of high-dose brachytherapy radiation? Select all that apply a. May be completed in five days b. Follows local excision of tumor c. Alternative to traditional radiation therapy for early stage breast cancer d. Used to treat possible local residual cancer cells following a mastectomy e. Used to reduce tumor size and stabilize metastatic lesions for pain relief

a,c

Which manifestations of menopause are related to estrogen deficiency? Select all that apply a. Cessation of menses b. Breast engorgement c. Vasomotor instability d. reduction of bone fractures e. decreased cardiovascular risk

a,c

831-year-old patient has returned to the post surgical unit following a hysterectomy. The patient's care plan address is the risk of hemorrhage. How should the nurse best monitor the patient's postoperative blood loss? a. Have a patient void and have bowel movements using a commode rather than toilet b. Count and inspect each peroneal pad that the patient uses c. Swab the patient perineum for the presence of blood at least once per shift d. Leave the patient's perineum open to air to facilitate inspection

b

A 42-year-old man came to the clinic for an annual physical. The nurse notes in the patient's history that his father was treated for breast cancer. What should the nurse provide to the patient before he leaves the clinic? a. A referral for a mammogram b. Instructions about breast self examination c. A referral to a surgeon d. A referral to a support group

b

A 42-year-old patient tells the nurse that she has found a painless lump in her right breast during her monthly self examination. She says that she is afraid that she has cancer. Which assessment finding would most strongly suggest that this patient's lump is cancerous? a. A version of the right nipple and mobile mass b. A non-mobile mask with irregular edges c. A mobile mass that is soft and easily delineated d. Nonpalpable right axillary lymph nodes

b

A 45-year-old woman comes into the health clinic for her annual check up. She mentions to the nurse that she has noticed dimpling of the right breast that has occurred in a few months. What assessment would be most appropriate for the nurse to make? a. Evaluate the patient's milk production b. Palpate the area for a breast mass c. Assess the patient's knowledge of breast cancer d. Assure the patient that this likely is an age related change

b

A 56-year-old patient is undergoing a mammoplasty for breast reconstruction following a mastectomy one year ago. During the preoperative preparation of the patient, what is important for the nurse to do? a. Determine why the patient is choosing reconstruction surgery rather than the use of external prosthesis b. Ensure that the patient has realistic expectations about the outcome and possible complications of the surgery c. Inform the patient that implants use for breast reconstruction have been chose to cause immune related diseases d. Let the patient know that although the shape will be different from the other breast, the nipple can be reconstructed from other erectile tissue

b

A 60-year-old man presents at the clinic complaining that his breasts are tender and enlarging. The patient is subsequently diagnosed with gynecomastia. The patient be should be assessed for the possibility of white causative factor? a. Age related physiologic changes b. Medication adverse effects c. Poor nutrition d. Fluid overload

b

The nurse is assigning tasks to the unlicensed assistive personnel UAP for a client with an abdominal hysterectomy on the first postoperative day. Which of the following cannot be delegated to the UAP a. Taking vital signs b. Recording intake and output c. Giving perineal care d. Assessing the incision site

d

A man comes to the clinic complaining that he is having difficulty obtaining an erection. When reviewing the patient's history, what might the nurse notes that contributes to erectile dysfunction? a. The patient has been treated for a UTI twice in the past year b. The patient has a history of hypertension c. The patient is 66 years old d. The patient leads a sedentary lifestyle

b

A patient at high risk for breast cancer is scheduled for an incisional biopsy in the outpatient surgery department. When the nurse is providing preoperative education, the patient asks wine incisional biopsy is being done instead of just removing the mass. What were the nurses best response be? a. And incisional biopsy is performed because it's known to be less painful and more accurate than other forms of testing b. An incisional biopsy is performed to confirm diagnosis so that special studies can be done that will help determine the best treatment c. An incisional biopsy is performed to assess the potential for recovery from a mastectomy d. An incisional biopsy is performed on patients who are younger than age of 40 and who are otherwise healthy

b

A patient has been diagnosed with endometriosis. When planning the patient's care, the nurse should prioritize what nursing diagnosis? a. Anxiety related to risk of transmission b. Acute pain related to misplaced endometrial tissue c. Ineffective tissue perfusion related to hemorrhage d. Excess fluid volume related to abdominal distention

b

A patient has returned to the floor from the PACU after undergoing a suprapubic prostatectomy. The nurse notes significant urine leakage around the suprapubic tube. What is the nurse is most appropriate action? a. Cleanse the skin surrounding the suprapubic tube b. Informed the urologist of this finding c. Remove the suprapubic tube and apply a wet to dry dressing d. Administer anti-spasmodic drugs as ordered

b

A patient is 51 years old and suffered a wrist fracture when she slipped on the ice. She has her uterus and is interested in starting hormone therapy as she is also experiencing menopause symptoms. What should the nurse include when discussing the risks and benefits of hormone therapy with this patient? a. Taking only progestin is suggested for a woman with a uterus b. Taking both estrogen and progesterone may decrease her bone loss c. The risk of breast cancer and cardiovascular disease is decreased with hormone therapy d. Taking estrogen and progesterone will increase the risk of endometrial cancer

b

A patient is postoperative day one following vaginal hysterectomy. The nurse notes an increase in patients abdominal girth and the patient complains of bloating. What is the nurse is most appropriate action? a. Provide the patient with an unsweetened carbonated beverage b. Apply warm compresses to the patient's lower abdomen c. Provide an ice pack to apply to the perineum and supra pubic region d. Assist the patient into a prone position

b

A patient who is scheduled for a prostatectomy is concerned about the potential effects of the surgery on his sexual function. What aspect of prostate surgery should inform the nurses response? a. Erectile dysfunction is commonly after prostatectomy as a result of hormonal changes b. I'll prostatectomies carry a risk of nerve damage and consequently erectile dysfunction c. Erectile dysfunction after prostatectomy as expected, but normally resolves within several months d. Modern surgical techniques have illuminated the risk of erectile dysfunction following prostatectomy

b

A patient with a continuous bladder irrigation following a prostatectomy tells the nurse that he has bladder spasms and leaking of urine around the catheter. What should the nurse do first? a. Slow the rate of the irrigation b. Assess the patency of the catheter c. Encourage the patient to try to urinate around the catheter d. Administer a belladonna and opium suppository as prescribed

b

A patient with stage 0 cervical cancer identified from a Pap test ask the nurse what this finding means. The nurses response should include which information? a. Malignant cells have extended beyond the cervix to the upper vagina b. Abnormal cells are present but are combined to the epithelial layer of the cervix c. Atypical cells characteristic of inflammation but not necessarily malignancy are present d. This is a common finding on PAP testing and she will be examined frequently to see whether the abnormal cells spread beyond the cervix

b

A physician explains to the patient that he has an inflammation of the Cowper glands. Where are the Cowper glands located? a. Within the epididymis b. Below the prostate within the posterior aspect of the urethra c. On the inner epithelium lining of the scrotum lateral to the testes d. Medial to the vas deferens

b

A woman at the health clinic tells the nurse that she does not do breast self examinations because it just seems too much of a bother. What is the best response by the nurse about BSE a. It reduces mortality from breast cancer in women under the age of 50 b. It is useful to help women learn how their breasts normally look and feel c. BSE has little detection of cancer and is not recommended anymore d. BSE is the most common way that malignant tumors of the breasts are discovered

b

A woman who has been postmenopausal for 10 years cause the clinic because of vaginal bleeding. The nurse schedules a visit for the patient and informed her to expect to have which diagnostic procedure? a. An endometrial biopsy b. Abdominal radiography c. A laser treatment to the cervix d. Only a routine pelvic examination and Pap test

b

A nurse is caring for a 33-year-old male who has come to the clinic for a physical examination he states he has not had a routine physical in five years. During the examination, the physician finds that digital rectal examination reveals stony hardening in the posterior lobe of the prostate gland that is not mobile the nurse recognizes that the observation typically indicates what? a. A normal finding b. A sign of early prostate cancer c. Evidence of a more advanced lesion d. Metastatic disease

c

A nurse is explaining that each breast contains 12 to 20 cone shaped loaves. The nurse should explain that each lobe consists of what elements a. Modified tendons and ligaments b. Connective tissue and smooth muscle c. Lobules and ducts d. Endocrine glands and sebaceous glands

c

A nurse is performing an admission assessment on a 40-year-old man who has been admitted for outpatient surgery on his right knee. While taking the patient's family history, he states, my father died of prostate cancer at age 48. The nurse should extract him on which of the following health promotional activities? a. The patient on the PSA levels drawn starting at age 55 b. The patient should have tested for presents of the CDHI and STKII genes c. The patient should have PSA levels drawn regularly d. The patient should limit alcohol use due to the risk of malignancy

c

A nurse is providing an educational event to a local men's group about prostate cancer. The nurse should cite an increased risk of prostate cancer in which ethnic group? a. Native Americans b. Caucasian Americans c. African Americans d. Asian Americans

c

A nurse practitioner is assessing a 55-year-old male patient who is complaining of peroneal discomfort, burning, urgency, and frequency with urination. The patient states that he has pain with ejaculation. The nurse knows that the patient is exhibiting symptoms of what? a. Varicocele b. Epididymitis c. Prostatitis d. Hydrocele

c

A patient diagnosed with cervical cancer when planning the patient subsequent care, the nurse should prioritize actions with what goal? a. Preventing hemorrhage b. Ensuring the patient knows the treatment is palliative not curative c. Protecting the safety of the patient, family, and staff d. Ensuring that the patient adheres to dietary restrictions during treatment

c

A patient has been diagnosed with breast cancer and the nurse is performing a patient interview. In assessing this patient's ability to cope with the diagnosis, what would be an appropriate question for the nurse to ask this patient? a. What is your level of education b. Are you feeling all right these days c. Is there someone you trust to help you make treatment choices? d. Are you concerned about receiving this diagnosis?

c

A patient has fibrocystic changes in her breast. The nurse explains to the patient that this condition is significant because it a. Commonly becomes malignant over time b. Can be controlled with hormone therapy c. Makes it more difficult to examine the breasts d. Will eventually cause atrophy of normal breast tissue

c

A patient is being discharged home after a hysterectomy. When providing discharge education for this patient, the nurse has cautioned the patient against sitting for long periods of time. This advice addresses the patient's risk of what surgical complication? a. Pudendal nerve damage b. Fatigue c. Venous thromboembolism d. Hemorrhage

c

A patient undergoing surgery and radiation for treatment of breast cancer has a nursing diagnosis of disturbed body image related to absence of the breast. What is an appropriate nursing intervention for this patient? a. Provide the patient with information about surgical breast reconstruction b. Restrict visitors and phone calls until the patient feels better about herself c. Arrange for a reach to recovery visitor or similar resource available in the community d. Encourage the patient to obtain a permanent breast prosthesis as soon as she is discharged from the hospital

c

A patient with a positive breast biopsy tells the nurse that she read about tamoxifen on the Internet and asked about its use. The best response by the nurse include which information? a. Tamoxifen is the primary treatment for breast cancer if axillary lymph nodes are positive for cancer b. Tamoxifen is used only to prevent the development of new primary tumors in women with high risk for breast cancer c. Tamoxifen is the treatment of choice after surgery if the tumor has receptors for estrogen and progesterone on its cells d. Because tamoxifen has been shown to increase the risk for uterine cancer, it is used only when other treatment has not been successful

c

A woman age 48 years comes to the clinic because she has discovered a lump in her breast. After diagnostic testing, the woman receives a diagnosis of breast cancer. The woman asked the nurse when her teenage daughter should begin mammography. What is the nurses best advice? a. Age 28 b. Age 35 c. Age 38 d. Age 48

c

A woman scheduled for a simple mastectomy in one week is having her preoperative education provided by the clinic nurse. What educational intervention will be of primary importance to prevent hemorrhage in the postoperative period? a. Limit her intake of green, leafy vegetables b. Increase her water intake to eight glasses per day c. Stop taking aspirin d. Have nothing by mouth for six hours before surgery

c

During a recent visit to the clinic a woman presents with erythema of the nipple and Ariola on the right breast. She states this started several weeks ago and she was fearful of what would be found. The nurse should probably refer the patient to her primary care provider because the patient's signs and symptoms are suggestive of what health problem? a. Peau Dorange b. Nipple inversion c. Paget's disease d. Acute mastitis

c

During the immediate postoperative period following a mastectomy, the nurse initially institute which exercises for the affected arm? a. Having the patient brush or comb her hair with the affected arm b. Performed full passive range of motion exercises to the affected arm c. Ask the patient to flex and extend the fingers and wrist of the affected arm d. Have the patient crawl her fingers of the wall raising her arm above her head

c

Following a TURP, a patient has continuous bladder irrigation. Four hours after surgery, the catheter is draining thick, bright red clots and tissue. What should the nurse do? a. Release the traction on the catheter. b. Manually irrigate the catheter until the drainage is clear. c. Increase the rate of the irrigation and take the patient's vital signs. d. Clamp the drainage tube and notify the patient's health care provider.

c

For which of the following population groups would an annual breast examination be recommended? a. Women over age 21 b. Women over age 25 c. Women over age 40 d. I'll post pubescent females with a family history of breast cancer

c

Lymphatic mapping with sentinel lymph node dissection is planned for a patient undergoing a modified radical mastectomy for breast cancer. What does the nurse teach the patient and her family? a. If one sentinel lymph node is positive for malignant cells, all of the sentinel lymph nodes will be removed b. If malignant cells are found in any sentinel lymph node, a complete axillary lymph node dissection will be done c. Lymphatic mapping indicates which lymph nodes are most likely to have metastasis and all of those notes are removed d. Lymphatic mapping with SLND provides metastatic lymph nodes to test for responsiveness to chemotherapy

c

On admission to the ambulatory surgical center, a patient with BPH informs the nurse that he is going to have a laser treatment of his enlarged prostate. The nurse plans patient teaching with the knowledge that the patient will need to know what? a. The effects of general anesthesia b. The possibility of short-term incontinence c. Home management of an indwelling catheter d. Monitoring for postoperative urinary retention

c

The extent of urinary obstruction caused by BPH can be determined by which diagnostic study? a. A cystometrogram b. Transrectal ultrasound c. Urodynamic flow studies d. Postvoiding catheterization

c

The nurse is caring for a patient who has just had a radical mastectomy an axillary node dissection. When providing patient education regarding rehabilitation, what should the nurse recommend? a. Avoid exercise of the arm for the next two months b. Keep cuticles clipped neatly c. Avoid lifting objects heavier than 10 pounds d. Use a sling until healing is complete

c

The nurse leaving an educational session is describing self examination of the breast. The nurse tells the women's group to raise their arms and inspect their breasts in a mirror. A member of the women's group asked the nurse why raising her arms is necessary. What is the nurses best response? a. It helps to spread out the fat that makes up your breasts b. It allows you to simultaneously assess for pain c. It will help to observe for dimpling more closely d. This is the American Cancer Society recommendation

c

The patient is describing a feeling of something coming down her vagina and having a back ache. What is most likely the cause of this discomfort? a. Cystocele b. Dysmenorrhea c. Uterine prolapse d. Abdominal distention

c

The patient is suspected of having endometriosis and or uterine leiomyoma. What best describes what is found with these conditions? a. Endometriosis and uterine leiomyoma are to gynecologic conditions that increase with the onset of menopause b. Danocrine and GNRH analog are used to treat endometriosis and leiomyomas to create as pseudo pregnancy c. Treatment of endometriosis and leiomyomas depends on the severity of symptoms in the women's desire to maintain fertility d. The presence of ectopic uterine tissue that bleeds and causes pelvic and abdominal adhesions, cysts, and pain is known as uterine leiomyoma`

c

When planning discharge teaching with a patient who has undergone a total mastectomy with axillary dissection, the nurse knows to instruct the patient that she should report what sign or symptom to the physician immediately? a. Fatigue b. Temperature greater than 98.5° c. Sudden cessation of output from the drainage device d. Gradual decline in output from the drain

c

When taking a nursing history from a patient with BPH, the nurse would expect the patient to report a. Nocturia, dysuria, and bladder spasms b. Urinary frequency, hematuria, and perineal pain c. Urinary hesitancy, post void dribbling, and weak urinary stream d. Urinary urgency with a forceful urinary stream and cloudy urine

c

A 25-year-old patient diagnosed with invasive cervical cancer expresses a desire to have children. What procedure might decision offer as treatment? a. Radical hysterectomy b. Radical colposcopy c. Radical trabeculectomy d. Radical trachelectomy

d

A 27-year-old female patient is diagnosed with invasive cervical cancer and is told she needs to have a hysterectomy. One of the nursing diagnoses for this patient is disturbed body image related to perception of femininity. What intervention would be most appropriate for this patient? a. Reassured the patient that she will still be able to have children b. Reassured the patient that she does not have to have sex to be feminine c. Reassured the patient that you know how she is feeling and that you feel her anxiety and pain d. Reassured the patient that she will still be able to have intercourse with sexual satisfaction and orgasm

d

A nurse has a cyst that a patient is not yet willing to view her mastectomy site? how should the nurse best assist the patient in developing a positive body image? a. As the woman to describe the current appearance of her breast b. Help the patient to understand that many women have gone through the same unpleasant experience c. Explain to the patient that her body image does not have to depend on her physical appearance d. Provide the patient with encouragement in an empathetic and thoughtful manner

d

A nurse is planning the postoperative care of a patient who is scheduled for radical prostatectomy. What intraoperative position will place the patient at particular risk for the development of deep vein thrombosis postoperatively? a. Fowlers position b. Prone position c. Supine position d. Lithotomy position

d

A patient asked the nurse what the difference is between BPH and prostate cancer. The best response by the nurse include what information about the BPH? a. BPH is a benign tumor that does not spread beyond the prostate gland b. BPH is a precursor to prostate cancer but does not yet show any malignant changes c. BPH is an enlargement of the gland caused by increased size of the existing cells d. BPH is a benign enlargement of the gland caused by an increase in the number of normal cells

d

A patient has just been diagnosed with prostate cancer and is scheduled for Brekke therapy next week. The patient and his wife are unsure of having the procedure because their daughter is three months pregnant. What is the most appropriate teaching the nurse should provide to this family? a. The patient should not be in contact with the baby after delivery b. The patient's treatment poses no risk to his daughter or her infant c. The patient's Breaky therapy may be contra indicated for safety reasons d. The patient should avoid close contact with his daughter for two months

d

A patient has presented at the clinic with symptoms of BPH. What diagnostic findings would suggest that the patient has chronic urinary retention? a. Hypertension b. Peripheral edema c. Tachycardia and other dysrhythmias d. Increased BUN

d

A patient has presented for her annual mammogram. The patient voices concerns related to exposure to radiation. What should the nurse teach the patient about a mammogram? a. It does not use radiation b. Radiation levels are safe as long as mammograms are performed only once per year c. The negative effects of radiation do not accumulate until late in life d. Radiation from a mammogram is equivalent to an hour of sunlight

d

A patient has returned to the floor after undergoing a transurethral resection of the prostate (TURP). The patient has a continuous bladder irrigation system in place. The patient tells you he is experiencing bladder spasm and ask what you can do to relieve his discomfort. What is the most important nursing action to relieve the discomfort of the patient? a. Apply a cold compress to the pubic area b. Notify the urologist promptly c. Irrigate the catheter with 30 to 50 mL of normal saline as ordered d. Administer a smooth muscle relaxant as ordered

d

A patient in her 30s has two young children and has just had a modified radical mastectomy with immediate reconstruction. The patient shares with her nurse that she is somewhat worried about her future, but she appears to be adjusting well to her diagnosis in surgery. What nursing intervention is most appropriate to support this patient's coping? a. Encouraged the patient's spouse or partner to be supportive while she recovers b. Encourage the patient to proceed with the next phase of treatment c. Recommend that the patient remain optimistic for the sake of her children d. Arrange a referral to a community-based support program

d

A patient is 24 hours postoperative following prostatectomy and the urologist has ordered continuous bladder irrigation. What color of output should the nurse expect to find in the drainage bag? a. Red wine colored b. Tea colored c. Amber d. Light pink

d

A patient newly diagnosed with breast cancer states that her physician suspects regional lymph node involvement and told her that there are signs of metastatic disease. The nurse learns that the patient has been diagnosed with stage for breast cancer. What is an implication of this disease? a. The patient is not a surgical candidate b. The patient's breast cancer is considered highly treatable c. There is a 10% chance that the patient's cancer will self resolve d. The patient has a 15% chance of a five-year survival

d

A woman called the clinic and tells the nurse that she has her bloody discharge from her right nipple. The nurse makes an appointment for this patient, expecting a physician or practitioner to order what diagnostic test on this patient? a. Breast ultrasound b. Radiography c. Pet scan d. Galactography

d

The nurse is caring for a 52-year-old woman whose aunt and mother died of breast cancer. The patient states, my doctor and I talked about tamoxifen to help prevent breast cancer. Do you think it will work? What would be the nurses best response? a. Yes, it's known to have a slight protective effect b. Yes, but studies also show an increased risk of osteoporosis c. You won't need to worry about getting cancer as long as you take tamoxifen d. Tamoxifen is known to be highly effective protective measure

d

Which diagnostic test is most accurate and advantageous in terms of time and expense and diagnosing malignant breast disorders? a. Surgical biopsy b. Mammography c. Fine needle aspiration d. Core needle biopsy

d

Which patient probably has the highest risk of breast cancer? a. 60-year-old obese man b. A 58-year-old woman with sedentary lifestyle c. 55-year-old woman with fibrocystic breast changes d. Hey 65-year-old woman with a sister diagnosed with breast cancer

d

While examining a patient's breast, the nurse notes multiple bilateral mobile lumps. To assess the patient further, what is the most appropriate question by the nurse? a. Do you have a high caffeine intake? b. When did you last have a mammogram c. Is there a history of breast cancer in your mothers or sisters d. Do the size and tenderness of the lambs change with your menstrual cycle

d

a 35-year-old mother of three young children has been diagnosed with stage to breast cancer. After discussing treatment options with her physician, the woman goes home to talk to her husband, later calling the nurse for vacation of some points. The patient tells the nurse that the physician has recommended Breast conservation surgery following followed by radiation the patient's husband has done some online research and is asking why his wife does not have a modified radical mastectomy to be sure all of the cancer is gone. What would be the nurses best response? a. Modified radical mastectomy's are very hard on a patient, both physically and emotionally and they really aren't necessary anymore b. According to current guidelines, having a modified radical mastectomy is no longer seen as beneficial c. Modified radical mastectomy's have a poor survival rate because of the risk of cancer risk recurrenced. d. According to current guidelines, breast conservation combined with radiation are aseffective modified radical mastectomy

d

Which characteristics describe transurethral resection of the prostate (TURP)? Select all that apply a. Best used for very large prostate gland b. Inappropriate for men with rectal problems c. Involves an external incision prostatectomy d. Uses transurethral incisions into the prostate e. Most common surgical procedure to treat BPH f. Receptoscopic excision and cauterization of prostate tissue

e,f

A client is to receive belladonna and opium suppositories, as needed, post operatively after TURP. The nurse should give the client these drugs when he demonstrates signs of a. A urinary tract infections. b. Urinary retention c. Frequent urination d. Pain from bladder spasms

d

A 76-year-old client tells the nurse that she has lived long and does not need mammograms. Which is the nurses best response? a. "Having a mammogram when you are older is less painful." b. The incidence of breast cancer increases with age c. We need to consider your family history of breast cancer first d. It will be sufficient if you perform breast examinations monthly

b

Which should the nurse include when teaching a 55-year-old woman in the beginning of menopause? Select all that apply a. The average age of onset for menopause is 50 - 52 years b. Follicle-stimulating hormone and lutenizing hormone levels elevate c. Depression is a very common as a result of menopause d. Hot flashes, especially at night, can occur in a about 80% of women e. When periods become irregular, contraception is unnecessary

a,b,d

A physician has ordered amoxicillin 100 PO BID (ampicillin). The nurse should teach the client to: select all that apply a. Drink 2500 mL of fluid daily b. Void frequently, at least every 2 to 3 hours c. Take time to empty the bladder completely d. Take the last dose of the anabiotic for the day at bedtime e. Take the antibiotic with food

a,b,c,d

After the surgeons meeting with a client to obtain the clients informed consent for a modified radical mastectomy, the client asked the nurse many questions about breast reconstruction that the nurse finds difficult to answer. The nurse should: a. Inform the surgeon that the client has questions about reconstruction before she signs the consent b. Informed the client that she should concentrate on recovering from the mastectomy first c. Inform the client that she can have a consultation with the plastic surgeon in a few weeks d. Informed the client that she can ask the surgeon these questions later when the surgeon makes rounds

a

Although the cause of testicular cancer is unknown, it is associated with a history of a. Undescended testes b. Sexual relations at an early age c. Seminole vesiculitis d. Epididymitis

a

During the admission work up for a modified radical mastectomy, the client is extremely anxious and asked many questions. Which of the following approaches would offer the best guide for the nurse to answer question raised by this apprehensive preoperative client? a. Tell the client as much as she wants to know and is able to understand b. Delay discussing the clients questions with her until she is convalescing c. Delay discussing the clients questions with her until her apprehension subsides d. Explain to the client that she should discuss her questions first with the physician

a

The nurse is performing a digital rectal examination. Which of the following finding is a key sign for prostate cancer a. A hard prostate, localized or diffuse b. Abdominal pain c. A boggy, tender prostate d. A non-indurated prostate

a

The nurse is developing a program about prostate cancer for a health fair. The nurse should provide information about which of the following topics a. The prostate specific antigen or PSA test is reliable for detecting the presence of prostate cancer. b. For all man, age 50 and older, the American Cancer Society recommends an annual rectal examination c. Avoid lifting more than 20 pounds aids and prevention of prostate cancer d. Regular sexual activity promotes health of the prostate gland to prevent cancer

b

The nurse is preparing a 45-year-old female for a vaginal examination. The nurse should place the client in which position? a. Sims position b. Lithotomy position c. Genupectoral position d. Dorsal recumbent position

b

The nurse is witnessing the client signature on the informed surgical consent for an abdominal hysterectomy. It is important to ascertain that the client understands that with this surgical procedure she will have: a. Decreased libido b. Infertility c. Depression d. Weight gain

b

The nurse should specifically assess a client with prostatic hypertrophy for which of the following? a. Voiding Atlas frequent intervals b. Difficulty starting the flow of urine c. Painful urination d. Increased force of the urine stream

b

The primary reason for lubricating the urinary catheter generously before inserting it into the mail client is that this technique helps reduce: a. Spasms at the orifice of the bladder b. Friction along the urethra when the catheter is being inserted c. The number of organisms gaining entrance to the bladder d. The formation of encrustations that may occur at the end of the catheter

b

When preparing discharge instructions for a client after an abdominal hysterectomy, the nurse should first: a. Have the client watch an educational video b. Assess the clients available social supports c. Call the social worker to evaluate the client d. Read the discharge instructions to the client

b

When teaching patients about the risk factors of cervical cancer, what would the nurse identify as most common risk factor? a. Late childbearing b. Human papilloma virus c. Postmenopausal bleeding d. Tobacco use

b

Which of the following physical sensations with a client who has had an abdominal hysterectomy most likely experience if she hyperventilates while performing deep breathing exercises? a. Dyspnea b. Dizziness c. Blurred vision d. Mental confusion

b

Inter-disciplinary management of ovarian cancer include which of the following? Select all that apply a. Combination therapy to cure the cancer b. Bilateral salpingo-oophorectomy to remove diseased organs c. Radiation therapy to eliminate all cancer cells d. Referral to social services for supportive care e. Nutrition therapy for parenteral lipids

b,d

The mother of a client who has a radium implant ask why so many nurses are involved in her daughters care. She states "the doctor said I can be in the room for up to two hours each day, but the nurses say they're restricted to 30 minutes." The nurse explains that this variation is based on the fact that nurses a. Touch the client, which increases their exposure to radiation b. Work with many clients who could carry infection to a client receiving radiation therapy, if exposure is prolonged c. Work with radiation on an ongoing basis while visitors have in frequent exposure to radiation Are at greater risk from the radiation because they are younger than my mother

c

A 30-year-old female client asked the nurse about douching. What information should the nurse include in the teaching plan? a. Douching during menstruation is safe b. Daily douching will decrease vaginal odor c. Perfume dishes are recommended to decrease odors d. Douching removes natural mucus and changes the balance of normal vaginal flora

d

A client is scheduled to undergo transurethral resection of the prostate. The procedure is to be done under spinal anesthesia. Postoperatively, the nurse should assess the client for a. Seizures b. Cardiac arrest c. Renal shutdown d. Respiratory paralysis

d

A 65-year-old client has been told by the physician that his prostate cancer was graded at stage 11B. The client inquiries if this means he is going to die soon. The best response by the nurse is which of the following a. Prostate cancer at this stage is very slow growing b. Prostate cancer at this stage is very fast growing c. Prostate cancer at this stage has spread to the bone d. Prostate cancer at this stage is difficult to predict

a

A client asked the nurse, "where is cancer usually found in the breast?" When responding to the client, the nurse uses a diagram of a left breast and indicates that most malignant tumors occur in which quadrant of the breast? a. Upper outer quadrant b. Upper inner quadrant c. Lower outer quadrant d. Lower inner quadrant

a

A client undergoing chemotherapy after a modified radical mastectomy ask the nurse questions about breast prosthesis and wigs. After answering the questions directly, the nurse should also: a. Provide a list of resources, including the local breast cancer support group b. Offer a referral to the social worker c. Call the home healthcare agency d. Contact the plastic surgeon

a

A client diagnosed with seminomatous testicular cancer expresses fear and questions to the nurse about his prognosis. The nurse should base the response on the knowledge that a. Testicular cancer is almost always fatal b. Testicular cancer has a cure rate of 90% when diagnosed early c. Surgery is the treatment of choice for testicular cancer d. Testicular cancer has a 50% cure rate when diagnosed early

b

A client with cervical cancer is undergoing internal radium implant therapy. A lead lined container and a pair of long forceps are kept in the clients hospital room for a. Disposal of emesis or other bodily secretions b. Handling of the dislodged radiation source c. Disposal of the clients eating utensils d. Storage of the radiation dose

b

The client will be admitted tomorrow for an abdominal hysterectomy. Which of the following information will be most important for the nurse to give the client prior to admission? a. What to wear to the hospital b. What she can eat and drink before admission c. The type of pain medication that will be prescribed postoperatively d. The amount of activity she can have after surgery

b

The client with an abdominal hysterectomy is being prepared for discharge in the morning. The client has a mentally retarded adult son who she cares for at home. The nurse should discuss with the physician the need for a referral to which of the following departments? a. Home health care b. Social work c. Pastoral care d. Volunteer services

b

The client with breast cancer is prescribed tamoxifen 20 mg daily. The client states that she does not like taking medicine and ask the nurse if the tamoxifen is really worth taking. The nurses best response as which of the following? a. This drug is part of your chemotherapy program b. This drug has been found to decrease metastatic breast cancer c. This drug will act as an estrogen in your breast tissue d. This drug will prevent hot flashes since you cannot take hormone replacement

b

The nurse is assessing a clients testes. Which of the following findings indicate the testes are normal? a. Soft b. Egg shaped c. Spongy d. Lumpy

b

When teaching a client about ovarian cancer, the nurse should include which of the following? Select all that apply a. Details about the prognosis b. Staging and grading of cancer c. Need for a routine colonoscopy beginning at age 30 d. Procedures for diagnosis if there is a pelvic mass e. Symptoms occur early in the disease process

b,d

A nurse is reviewing the physicians admitting orders on a 52-year-old client scheduled for a dilation and curettage. The nurse is unable to decipher the handwriting and determines the medication order reads either met a metoprolol succinate (Toprol) or topiramate (Topamax) a. Ask the client if she has hypertension b. Ask the client if she has migraines c. Call the physician to clarify the order d. Ask the pharmacist to interpret the order

c

A 51-year-old woman is experiencing perimenopausal symptoms and expresses confusion around the possible use of hormone therapy. She explains that her mother and aunts used hormone therapy and she is unsure why few of her peers have been prescribed this treatment. What should the nurse explain to the patient? a. Large, long term health studies have revealed that hormone therapy is minimally effective b. Hormone therapy has been largely replaced by other non-pharmacological interventions c. Research has shown that significant health risks are associated with hormone therapy d. Hormone therapy has been shown to exacerbate symptoms of menopause in a minority of women

c

A client asked the nurse why the prostate specific antigen or PSA level is determined before the digital rectal examination. The nurses best response is which of the following a. It is easier for the client b. A prostate examination can possibly decrease the PSA c. A prostate examination can possibly increase the PSA d. If the PSA is normal, the client will not have to undergo the rectal examination

c

A client underwent transurethral resection of the prostate/TURP and a large three-way indwelling urinary catheter was inserted in the bladder with continuous bladder irrigation. In which of the following circumstances should the nurse increase the flow rate of the continuous bladder irrigation? a. Wind drainage is continuous but slow b. Wind drainage appears cloudy and dark yellow c. When drainage becomes bright red d. When there is no drainage of urine and irrigating solution

c

A 51-year-old woman has come to the OB/GYN clinic for her annual physical. She tells the nurse that she has been experiencing severe hot flashes, but she is reluctant to begin hormone therapy. What potential solution should the nurse discuss with the patient? a. Sodium restriction b. Adopting a vegan diet c. Massage therapy d. Vitamin supplements

d

A client has a testicular nodule that is highly suspicious for testicular cancer. A laboratory test that supports this diagnosis is a. Decreased AFP b. Decreased hCG c. Increased testosterone d. Increased AFP

d

A client with ovarian cancer ask the nurse, "what is the cause of this cancer?" The most accurate response by the nurse is? a. Use of oral contraceptives increases the risk of ovarian cancer b. Women who have had at least to live births are protected from ovarian cancer c. There is less chance of developing ovarian cancer when one lives in an industrialized country d. The risk of developing ovarian cancer is related to environmental, endocrine, and genetic factors

d

A community health nurse is leading a health education session addressing menopause in other aspects of women's health. What dietary supplements should the nurse recommend to prevent morbidity associated with osteoporotic fractures? a. Vitamin B 12 and vitamin C b. Vitamin A and potassium c. Vitamin B6 and phosphorus d. Calcium and vitamin D

d

A woman tells the nurse that "there's been a lot of cancer in my family." The nurse should instruct the client to report which possible sign of cervical cancer? a. Pain b. Leg edema c. Urinary and rectal symptoms d. Light bleeding or watery vaginal discharge

d

Atropine sulfate is included in the preoperative orders for a client undergoing a modified radical mastectomy. The expected outcome is to: a. Promote general muscular relaxation b. Decreased pulse in respiratory rates c. Decrease nausea d. Inhibit oral and respiratory secretions

d

The client asks the nurse to explain the meaning of her abnormal Pap smear result of atypical squamous cells. Which of the following concepts should the nurse include in the response? a. An atypical pat smear means that abnormal viral cells were found in a smear b. An atypical Pap smear means that cancer cells were found in the smear c. A positive Pap smear alone is not very important diagnostically because there are many false positive results d. Abnormal cells in a Pap smear may be caused by various conditions that help identify a problem early

d

The nurse is providing preoperative education for a patient diagnosed with endometriosis. A hysterectomy has been scheduled. What education topic should the nurse be sure to include for this patient? a. Menstrual periods will continue to occur for several months, some of them heavy b. Normal activity will be permitted within 48 hours following surgery c. After a hysterectomy, hormone levels remain largely unaffected d. The bladder must be emptied prior to surgery and the catheter may be placed during surgery

d

The nurse manager on a gynecologic surgical unit is addressing reports from clients that they have to wait too long on the Night Shift for the pain medication. Which course of action should the nurse manager take first? a. Change the staffing schedule on nights to include a medication nurse b. Consult the nursing supervisor c. Consult the nurses on the evening shift about their evaluation of the night nurses regarding these complaints d. Complete a quality improvement study with the night nurse is to document the waiting times for pain medication and other data including staffing and client acuity

d

The nurse should carefully observe a client with internal radium implants for typical adverse effects associated with radiation therapy to the cervix. These effects include a. Severe vaginal itching b. Confusion c. High fever in the afternoon or evening d. Nausea in a foul vaginal discharge

d

Which nursing measure would most likely relieve Post operative gas pains after abdominal hysterectomy? a. Offering the client a hot beverage b. Providing extra warmth c. Applying a tight fitting abdominal binder d. Helping the client walk

d

Which of the following is a respecter for cervical cancer? a. Sexual experiences with one partner b. Sedentary lifestyle c. Obesity d. Adolescent pregnancy

d

Which of the following positions would be best for a clients right arm when she returns to her room after a right modified radical mastectomy with multiple lymph node excision's? a. Across her chest wall b. At her side at the same level as her body c. In the position that affords her the greatest comfort without placing pressure on the incision d. On pillows with her hand higher than her elbow and her elbow higher than her shoulder

d

Which of the following would be standard nursing care for a client with cervical cancer who has an internal radium implant in place? a. Offer the bedpan every two hours b. Provide perineal care twice daily c. Check the position of the applicator hourly d. Offer a low residue diet

d

Which is the correct order from first to last, for proper placement of a urinary catheter? a. Lubricate the catheter adequately with a water soluble lubricant b. Insure free flow of urine c. Insert the catheter far enough into the bladder to prevent trauma to the urethral tissue d. Prepare a sterile field

d,a,c,b