NCA Test #5

After discussing the various methods of contraception with a nurse, a client decides on the contraceptive sponge as her method of choice. Which of the following would the nurse include in the teaching plan for the client about this contraceptive method?

"Keep the sponge in place for at least 6 hours after intercourse."

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.

The nurse is caring for a client scheduled for a transrectal ultrasonography. Which instruction is essential in obtaining an accurate test?

Administer an enema prior to arrival.

The nurse is preparing a client for repair of a rectovaginal fistula. Which of the following would the nurse include?

Administering antibiotic to cleanse the bowel

The nurse is performing the Rinne test on a client with a sensorineural hearing loss. Which of the following would the nurse expect?

Air-conducted sound heard longer than bone-conducted sound

A client is diagnosed with uveitis. Which assessment finding is most important in determining likelihood of recurrence?

Although the cause of uveitis is unknown, it is detected with frequency among clients with autoimmune disorders (such as ankylosing spondylitis)

A health care provider recommends that a patient with breast cancer undergo a modified radical mastectomy. The nurse explains that this procedure involves removal of the entire breast:

And the nipple-areola complex along with the axillary node dissection.

punctal occlusion

Applies gentle pressure bilaterally on the bridge of the nose to the inner canthus of each eye

A patient is being treated for prostatitis and the nurse is providing education about the treatment. What should the nurse include in the education of this patient?

Avoid foods and liquids with diuretic action or that increase prostatic secretions.

A woman visits her primary health care provider with a complaint of pain and swelling in the vaginal area. The pain is present when she sits and walks; intercourse is painful. The nurse prepares the patient for an examination. The nurse and health care provider suspect that the patient may have an inflammation or infection of the

Bartholin glands

Which of the following medications decreases the production of aqueous humor

Beta blockers

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 of the following nursing intervention should be included during the assessment of a client with an eye disorder?

Check the extraocular muscles by instructing the client to keep his or her head still when following an object.

tamoxifen (Soltamox)

Chemoprevention

A nurse practitioner examines a patient suspected of having endometriosis. The nurse knows that although a definitive diagnosis could not be made without diagnostic treating (transvaginal ultrasound), the most frequent symptom is:

Chronic pelvic pain

The nurse uses the otoscope to assess the ear canal and tympanic membrane and notes a significant accumulation of cerumen. Which documentation of hearing loss type would be most accurate?

Conductive

Which of the following terms is used to describe a procedure in which cervical tissue is removed as result of detection of abnormal cells?

Cone biopsy (Conization)

A patient with an abnormal Pap test has a colposcopy. The test indicates small areas of mild to moderate dysplasia. The nurse advises the patient that the next procedure that should be done is a:

Cryotherapy.

A nurse is reviewing a client's medication history. Which drug would the nurse identify as placing the client at risk for ototoxicity

Erythromycin

ketoconazole (Nizoral)

Decreasing the endocrine production of androgen.

Which of the following would the nurse expect to be done to assess the size of the prostate?

Digital rectal examination

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.

When a female patient reports profuse purulent discharge, dysuria, and bleeding, the advance practice nurse is most likely to prescribe which of the following medications to treat this condition?

Doxycycline (Vibramycin) for 1 week

Which of the following instructions would be appropriate to include when preparing a woman for an abdominal ultrasound?

Drink at least 1 quart of water an hour before the test.

Which type of biopsy would the nurse tell the patient is a usual procedure for any palpable breast mass found on mammography?

Excisional

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

A client has undergone a transverse rectus abdominis myocutaneous (TRAM) flap procedure for breast reconstruction immediately following a mastectomy. Which of the following would be most appropriate to include in the client's postoperative plan of care?

Encouraging coughing and deep breathing exercises

Which of the following diagnostic tests is used for severe bleeding that is unresponsive to other therapies?

Endometrial ablation

Which diagnostic is indicated for postmenopausal bleeding?

Endometrial biopsy

A nurse educator is giving a lecture to a group of boys about normal male reproductive structures. Which of the following male structures collects the spermatocytes and nourishes them until they are able to spontaneously move about?

Epididymis

When describing the process of fertilization, the nurse would explain that it normally occurs in which structure?

Fallopian tube

A 48-year-old man recently diagnosed with benign prostatic hyperplasia (BPH), reports taking Serenoa repens (saw palmetto berry). The nurse needs to intervene if the physician orders which of the following treatments?

Finasteride (Proscar)

Gardnerella vaginalis

Fishy smelling watery discharge

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

Which of the following is the leading cause of blindness in the United States?

Glaucoma

open-angle glaucoma

Gradual loss of peripheral vision, usually in both eyes, and tunnel vision

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

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

What to monitor for after undergoing LASIK

Halos and glare

A client is prescribed a combination hormonal contraceptive. The nurse would instruct the client to report which of the following immediately?

Headaches

Which type of benign tumor of the eyelids is characterized by superficial, vascular capillary lesions that are strawberry red in color?

Hemangioma

The diagnosis of prostate cancer is confirmed by which of the following?

Histologic exam of tissue

Cone biopsy is a term used to describe a procedure in which cervical tissue is removed as result of detection of abnormal cells. Which of the following statements made by the patient demonstrates that the patient undergoing a cone biopsy understands the discharge instructions?

I will avoid having sexual relations until I see the doctor again

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

Which of the following is true regarding hormonal contraception?

Increases the risk for venous thromboembolism

The nurse is caring for a client who is beginning doxorubicin (Adriamycin) therapy for breast cancer. When preparing the client for probable side effects, which would the nurse include?

Information regarding wigs from the American Cancer Society

Which of the following is true regarding endometriosis?

It affects women of reproductive age.

A client has a routine Papanicolaou (Pap) test during a yearly gynecologic examination. The result reveals a class V finding. What should the nurse tell the client about this finding?

It calls for a biopsy as soon as possible.

A patient is diagnosed with the most common type of uterine fibroid, an intramural fibroid. The nurse includes which of the following information in teaching the patient about this type of fibroid

It grows within the wall of the uterine muscle

The nurse in the gynecology clinic is interviewing a patient who informs the nurse that her mother and aunt had carcinoma of the cervix. What does the nurse recognize are two chief symptoms of early carcinoma that the patient should be questioned about?

Leukorrhea and irregular vaginal bleeding or spotting

Which one of the following options is available to women with an increased risk of developing breast cancer?

Long-term follow-up

The menstrual cycle is dependent on the interplay among a number of hormones. The hormone(s) responsible for stimulation of progesterone is (are):

Luteinizing hormone.

Sentinel lymph node mapping is done to validate the lack of lymph node metastasis. Which of the following complications does this technique help avoid?

Lymphedema

Which part of the retina is responsible for central vision

Macula

In educating a patient with PMS about changing her dietary practices, what would the nurse recommend that she increase her intake of?

Magnesium

Typical clinical manifestations of bacterial vaginosis (BV)

Malodorous, gray vaginal discharge Explanation: BV has a characteristic gray vaginal discharge with a "fishy" odor.

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.

Which group of medications causes pupillary constriction?

Miotics cause pupillary constriction

Which of the following would be inconsistent as a risk factor for breast cancer?

Multiparity

Cycloplegics

Mydriasis, or pupil dilation, is the main objective of the administration of mydriatics and cycloplegics (Table 63-3). These two types of medications function differently and are used in combination to achieve the maximal dilation that is needed during surgery and fundus examinations to give the ophthalmologist a better view of the internal eye structures

The nurse is reviewing the medical record of a client diagnosed with uterine cancer. Which of the following, if noted, would the nurse identify as a risk factor?

Nulliparity

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)

Which of the following would be an inaccurate clinical manifestation of a retinal detachment?

Pain

During physical examination of the male reproductive system, which method would best provide the nurse information about the prostate for size as well as evidence of tumor?

Performing digital rectal examination

Which of the following is associated with buildup of fibrous plaques in the sheath of the corpus cavernosum causing curvature of the penis when it is erect?

Peyronie's disease Explanation: Peyronie's disease may require surgical removal of the plaques when the disease makes sexual intercourse painful, difficult, or impossible

proparacaine hydrochloride (Ophthaine 0.5%)

Prescriptions of this medication are generally not given because it can cause corneal problems

In the menstrual cycle, every month the female reproductive system generates an ovum. When the ovum is not fertilized, production of which of the following leads to menstruation?

Progesterone by the corpus luteum beginning to decrease

A patient is diagnosed with hypertension. In addition, the patient reports skin discoloration, weight gain, and nausea. Which of the following contraceptive preparations would the nurse practitioner recommend for this patient?

Progestin-only

A patient is newly diagnosed with otitis externa. Which of the following should the nurse teach the patient before the patient leaves the clinic?

Proper instillation of prescribed ear drops Explanation: Otitis externa is usually treated with antimicrobial otic drops. The nurse should anticipate teaching the patient how to instill the ear drops properly

Which of the following is an early symptom of vulvar cancer

Pruritus with genital burning

Erythropoietin growth factor increases production of which of the following?

Red blood cells

What is the most widely used procedure for prostate gland removal?

Transurethral resection of the prostate (TURP)

The nurse is caring for a client ordered multiple eye screening. Following which procedure will the nurse instruct the client on a yellow coloring to the skin and urine as being normal?

Retinal Angiography Explanation: The nurse is most correct to instruct the client that his skin and urine may turn yellow following a retinal angiography. Sodium fluorescein is a water-soluble dye that is injected into a vein. The dye then travels to the retinal arteries and capillaries, where pictures are obtained of the vascular supply. The other options do not include a dye injection.

Upon examination, the nurse practitioner notes a backward positioning of the patient's uterus. How would the nurse document this finding?

Retroversion

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.

Which structure is involved in keeping the testes at the necessary temperature to ensure sperm production?

Scrotum

A patient has had a pessary inserted for long-term treatment of a prolapsed uterus. As part of the teaching plan, what should the nurse advise the patient to do?

See her gynecologist to remove and clean the pessary at regular intervals.

The nurse is caring for a client who states having an irregular menstrual period. Which diagnostic test provides information of the body's ability to ovulate?

Serum follicle-stimulating hormone

Which of the following positions may be utilized for a patient who is unable to maintain the supine lithotomy position?

Sims'

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

The nurse is aware that a diagnostic sign of age-related dry macular degeneration is:

The appearance of tiny, yellow spots in the field of vision

dutasteride (Avodart)

The drug interferes with testosterone, which causes the prostate to shrink in size.

fibrocystic disease

The lump is round and movable

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

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 with breast cancer is scheduled to undergo chemotherapy with aromatase inhibitors. Which of the following best reflects the rationale for using this group of drugs?

They lower the level of estrogen in the body blocking the tumor's ability to use it.

visual field examination

This test measures peripheral vision and detects gaps in the visual field

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

A patient diagnosed with endometriosis asks for an explanation of the disease. What should the nurse explain to the patient?

Tissue from the lining of the uterus has implanted in areas outside the uterus.

A client is prescribed androgen therapy. Which of the following would the nurse explain as a possible adverse effect?

Weight gain

A 15-year-old high student reports to the school nurse with complaints of cramping, nausea, diarrhea, and backache. Which of the following assessment questions by the nurse is most appropriate in this situation

When was your last period

A patient has been diagnosed with genital herpes. Knowing patient education is an essential part of nursing care of the patient with a genital herpes infection, the nurse plans to include which of the following methods to minimize HIV transmission? Select all that apply.

a) Avoiding IV drug use c) Avoiding unprotected sexual intercourse d) Avoiding multiple partners for sexual intercourse

The nurse is caring for a patient who had a 1-day postoperative transurethral resection of the prostate (TURP). Which of the following assessment findings does the nurse expect? Select all that apply.

a) Drainage tube secured to the inner thigh b) Reports of the urge to void from the patient c) Large amounts of amber-colored urine in the drainage bag

do to reduce her risk for osteoporosis

a) Try to decrease or stop smoking. c) Avoid caffeine-containing food and drink. d) Engage in regular weight-bearing exercise. e) Take a calcium supplement daily.

What interventions for the relief of pain and discomfort can the nurse educate the patient with a vulvovaginal infection about using? (Select all that apply.)

a) Warm perineal irrigations b) Sitz baths c) Cornstarch for chafed inner thighs

A 25-year-old sales manager with a financial firm reports to the health care unit with high stress levels and a BP reading of 130/80 mm Hg. She admits that her life has been stressful as she is unable to meet sales targets and is going through a financial crisis. She suffers from frequent headaches and blurred vision. She currently uses a cervical ring for contraception. Which of the following additional assessment questions related to the patient's choice of contraception does the nurse need to ask? Select all that apply.

b) "Describe any abdominal pain you may be experiencing." d) "Have you noticed any episodes of chest pain?" e) "Tell me about the last time you had leg pain."

A patient reports intermittent pelvic pain that does not appear to have a predictable occurrence. She recalls these episodes began approximately 8 months ago. Following months of physical and diagnostic tests, the physician diagnoses the patient with chronic pelvic pain. Which of the following choices should be used as possible treatment options? Select all that apply.

b) Antidepressants d) Oral contraceptives e) Analgesics

A nurse who will be working at a health fair is preparing a presentation on reproductive health and contraception. Which of the following would the nurse expect to include as advantages of combined hormonal contraception? Select all that apply.

b) Improved acne control c) Reduced incidence of benign breast disease d) Decreased risk of anemia e) Reduced risk of ovarian cancer

Which of the following would the nurse include as associated with the male reproductive system? Select all that apply.

b) Loss of testicular firmness c) Thickening of the seminiferous tubules e) Decrease in sexual energy level

occurring during the proliferative phase

b) Rise in follicle-stimulating hormone secretion d) Increasing estrogen secretion

Which of the following are methods of removing foreign bodies from the ear?

b) Suction c) Irrigation e) Instrumentation

Which of the following STDs appears to accelerate in HIV-positive patients?

b) Syphilis

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.

b) Uterine prolapse c) Vulvar dystrophy d) Thickening and stiffness of the vaginal wall e) Vaginal dryness

A patient has been diagnosed with a Trichomoniasis vaginal infection. The nurse would expect which color of discharge?

b) Yellow-green

Mydriatics

cause pupillary dilation

A 21-year-old female is talking with a nurse at her gynecologist's office. She is scheduled to have her first Pap test and she asks the nurse why she needs to have this test done. Which of the following is the nurse's best response?

d) The test is used to detect early cancer of the cervix and to determine estrogen activity as it relates to menopause or endocrine abnormalities.

Beta-blockers

decrease aqueous humor production

perimetry test

during the examination, she will be asked to fix her gaze on a stationary point while an object is moved from a point on the side, where it can't be seen, toward the center. The client will indicate when she can see the object

Adrenergic agonists

increase aqueous outflow, but primarily decrease aqueous production with an action similar to beta-blockers and carbonic anhydrase inhibitors

Cholinergics

increases aqueous fluid outflow in the patient with glaucoma

If the health care provider wants to inspect the optic nerve, the nurse would prepare the patient for

ophthalmoscopy to inspect the optic nerve

perimetry

to assess the visual fields

gonioscopy

to examine the filtration angle of the anterior chamber

tonometry

to measure the IOP

A nurse is providing breast cancer education at a community facility. The American Cancer Society recommends that women get mammograms:

yearly starting at age 40.

acute angle-closure glaucoma

• Severe eye pain • Reddening of the eye • Sudden onset of visual disturbance • Nausea and vomiting