nclex 10000 genitourinary disorders

A nurse is caring for a client diagnosed with ovarian cancer. Diagnostic testing reveals that the cancer has spread outside the pelvis. The client has previously undergone a right oophorectomy and received chemotherapy. The client now wants palliative care instead of aggressive therapy. The nurse determines that the care plan's priority nursing diagnosis should be: a) Impaired home maintenance. b) Knowledge deficit: Chemotherapy. c) Acute pain. d) Noncompliance.

Acute pain. Explanation: Palliative care for the client with advanced cancer includes pain management, emotional support, and comfort measures. The client is in the hospital, so home maintenance doesn't apply at this time. The client has chosen palliative care, so she isn't noncompliant. The client's decision is not based on a knowledge deficit about chemotherapy because she has previously had treatments with chemotherapy.

A client undergoes cystoscopy with bladder biopsy. After the procedure, which assessment is most appropriate for the nurse to make? a) Obtain a urine specimen for culture. b) Assess urine for excessive bleeding. c) Percuss the bladder for distention. d) Assess the patency of the Foley catheter.

Assess urine for excessive bleeding. Explanation: After cystoscopy with biopsy, the nurse would assess for excessive hematuria, which might indicate hemorrhage caused by the biopsy. Catheters are not routinely inserted after cystoscopy. The nurse would not assess for bladder distention unless the client was having difficulty voiding. Urine cultures are not routinely ordered after cystoscopy.

During a routine physical examination, a male client informs the nurse that he frequently participates in anal intercourse with his girlfriend. The nurse informs the client that: a) Condoms are recommended for anal intercourse. b) Anal intercourse should be avoided. c) Lubricants should be avoided during anal intercourse. d) The rectal mucosa is thick and can withstand vigorous activity.

Condoms are recommended for anal intercourse. Explanation: Condoms are recommended for anal and vaginal intercourse to prevent sexually transmitted diseases. Care should be used to avoid injury to the delicate rectal mucosa, and lubrication is necessary for comfort.

A client is diagnosed with pyelonephritis. Which nursing action is a priority for care now? a) Insert a urinary catheter. b) Stress the importance of the use of long-term antibiotics. c) Ensure sufficient hydration. d) Monitor hemoglobin levels.

Ensure sufficient hydration. Explanation: The nurse should ensure the client has adequate hydration. A urinary catheter is discouraged because of the risk of urinary tract infection. Monitoring of the hemoglobin level is not necessary for clients with pyelonephritis. Although antibiotics may be prescribed for long-term management and for chronic pyelonephritis, at this time the nurse should focus on helping the client maintain hydration.

A nurse is reviewing a client's medical history. Which factor indicates the client is at risk for candidiasis? a) Use of spermicidal jelly b) Nulliparity c) Menopause d) Use of corticosteroids

Use of corticosteroids Explanation: A small quantity of the fungus Candida albicans commonly exists in the vagina. Because corticosteroids decrease host defense, they increase the risk of candidiasis. Candidiasis is rare before menarche and after menopause. Using hormonal contraceptives, not spermicidal jelly, and pregnancy, not nulliparity, increase the risk of candidiasis.

The nurse is teaching a 17-year-old girl who has a severe gonorrheal infection. The nurse realizes that the girl understands the implications of her disease when she tells the nurse:

"I could have trouble getting pregnant." Explanation: With a severe gonorrheal infection, scarring of the fallopian tubes may occur, and becoming pregnant may be difficult or impossible. If the girl's partner is not treated, she can be reinfected. There is no immunity against gonorrhea and, if exposed again, the girl can again become infected. Although a condom may provide some protection against contracting gonorrhea, it is not an adequate protection against the condition and will not help clear up an existing infection. It is only with proper antibiotic administration that the condition can be eradicated.

Which statements by a female client would indicate that she is at high risk for a recurrence of cystitis? a) "I can usually go 8 to 10 hours without needing to empty my bladder." b) "I wipe from front to back after voiding." c) "I take a tub bath every evening." d) "I work out by lifting weights 3 times a week."

"I can usually go 8 to 10 hours without needing to empty my bladder." Explanation: Stasis of urine in the bladder is one of the chief causes of bladder infection, and a client who voids infrequently is at greater risk for reinfection. A tub bath does not promote urinary tract infections as long as the client avoids harsh soaps and bubble baths. Scrupulous hygiene and liberal fluid intake (unless contraindicated) are excellent preventive measures, but the client also should be taught to void every 2 to 3 hours during the day. Lifting weights is not a risk factor for cystitis.

The nurse is collecting data on a client with a urinary tract infection (UTI). Which statements should the nurse expect the client to make? Select all that apply.

"I need to urinate frequently." • "It burns when I urinate." • "I need to urinate urgently." Explanation: Typical data collection findings for a client with a UTI include urinary frequency, burning on urination, and urinary urgency. The client with a UTI typically reports that he voids frequently in small amounts, not large amounts. The client with a UTI complains of foul-smelling, not sweet-smelling, urine.

A male client enters the oncology clinic for an evaluation. The nurse explains that the healthcare provider has ordered a prostate-specific antigen (PSA) test. The client asks the nurse, "How will this test tell if I have prostate cancer?" Which of the following is the nurse's best response? a) "Individuals with a 2.5 ng/mL PSA and a mother who had breast cancer need to have a biopsy of the prostate gland." b) "If your level is between is between 6 and 8 ng/mL, you have nothing to worry about." c) "The evidence shows that individuals who have levels under 4 ng/mL need yearly follow-up." d) "Individuals who have a PSA higher than 10 have a 60-70% chance of having prostate cancer."

"Individuals who have a PSA higher than 10 have a 60-70% chance of having prostate cancer." Explanation: Most men have PSA levels under 4 ng/mL, which has traditionally been used as the cutoff for concern about the risk of prostate cancer. Men with prostate cancer often have PSA levels higher than 4. Those with a PSA between 4 and 10 have a 25% chance of having prostate cancer and if the PSA is higher than 10, the risk increases to 67%

After undergoing transurethral resection of the prostate to treat benign prostatic hyperplasia, a client returns to the room with continuous bladder irrigation. On the first day after surgery, the client reports bladder pain. What should the nurse do first?

Assess the irrigation catheter for patency and drainage. Explanation: Although postoperative pain is expected, the nurse should make sure that other factors, such as an obstructed irrigation catheter, aren't the cause of the pain. After assessing catheter patency, the nurse should administer an analgesic, such as morphine sulfate, as ordered. Increasing the I.V. flow rate may worsen the pain. Notifying the physician isn't necessary unless the pain is severe or unrelieved by the ordered medication.

A client has nephropathy. The health care provider (HCP) prescribes a 24-hour urine collection for creatinine clearance. Which action is necessary to ensure proper collection of the specimen? a) Collect the urine in a preservative-free container and keep it on ice. b) Request a prescription for insertion of an indwelling urinary catheter. c) Inform the client to discard the last voided specimen at the conclusion of urine collection. d) Determine the client's weight before beginning the collection of urine.

Collect the urine in a preservative-free container and keep it on ice. Explanation: All urine for creatinine clearance determination must be saved in a container with no preservatives and refrigerated or kept on ice. The first urine voided at the beginning of the collection is discarded, not the last. A self-report of weight may not be accurate. It is not necessary to have an indwelling urinary catheter inserted for urine collection

A client comes to the outpatient department complaining of vaginal discharge, dysuria, and genital irritation. Suspecting a sexually transmitted disease (STD), the physician orders diagnostic testing of the vaginal discharge. Which STD must be reported to the public health department? a) Bacterial vaginitis b) Gonorrhea c) Genital herpes d) Human papillomavirus (HPV)

Gonorrhea Correct Explanation: Gonorrhea must be reported to the public health department. Bacterial vaginitis, genital herpes, and HPV aren't reportable diseases.

The nurse collects a urine specimen from a client for a culture and sensitivity analysis. What should the nurse do next?

Send the specimen to the laboratory immediately. Explanation: A specimen for culture and sensitivity should be sent to the laboratory promptly so that a smear can be taken before organisms start to grow in the specimen.

A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client? a) The potential for transmission to her sexual partner will be eliminated if condoms are used every time she and her partner have sexual intercourse. b) This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually. c) The human papillomavirus (HPV), which causes condylomata acuminata, can't be transmitted during oral sex. d) The most common treatment is metronidazole, which should eradicate the problem within 7 to 10 days.

This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually. Explanation: Women with condylomata acuminata are at risk for cancer of the cervix and vulva. Yearly Pap smears are very important for early detection. Because condylomata acuminata is a virus, there is no permanent cure. Because condylomata acuminata can occur on the vulva, a condom won't protect sexual partners. HPV can be transmitted to other parts of the body, such as the mouth, oropharynx, and larynx.

Which factor should be checked when evaluating the effectiveness of an alpha-adrenergic blocker given to a client with benign prostatic hyperplasia (BPH)? a) Size of the prostate b) Serum testosterone level c) Creatinine clearance d) Voiding pattern

Voiding pattern Explanation: The client's voiding pattern should be checked to evaluate the effectiveness of alpha-adrenergic blockers. These drugs relax the smooth muscle of the bladder neck and prostate, so the urinary symptoms of BPH are reduced in many clients. These drugs don't affect the size of the prostate, production or metabolism of testosterone, or renal function

A female client with gonorrhea informs the nurse that she has had sexual intercourse with her boyfriend and asks the nurse, "Would he have any symptoms?" The nurse responds that in men the symptoms of gonorrhea include: a) dysuria. b) scrotal swelling. c) impotence. d) urine retention.

dysuria. Correct Explanation: Dysuria and a mucopurulent urethral discharge characterize gonorrhea in men. Gonococcal symptoms are so painful and bothersome for men that they usually seek treatment with the onset of symptoms. Impotence, scrotal swelling, and urine retention are not associated with gonorrhea

To prevent recurrence of cystitis, the nurse should plan to encourage the female client to include which measure in her daily routine? a) using vaginal sprays b) douching regularly with 0.25% acetic acid c) increasing citrus juice intake d) wearing cotton underpants

wearing cotton underpants Explanation: A woman can adopt several health-promotion measures to prevent the recurrence of cystitis, including avoiding too-tight pants, noncotton underpants, and irritating substances, such as bubble baths and vaginal soaps and sprays. Increasing citrus juice intake can be a bladder irritant. Regular douching is not recommended; it can alter the pH of the vagina, increasing the risk of infection.

A client presents to the emergency department complaining of a dull, constant ache along the right costovertebral angle along with nausea and vomiting. The most likely cause of the client's symptoms is: a) acute prostatitis. b) an overdistended bladder. c) renal calculi. d) interstitial cystitis.

renal calculi. Correct Explanation: Renal calculi usually presents as a dull, constant ache at the costovertebral angle. The client may also present with nausea and vomiting, diaphoresis, and pallor. The client with an overdistended bladder and interstitial cystitis presents with dull, continuous pain at the suprapubic area that's intense with voiding. The client also complains of urinary urgency and straining to void. The client with acute prostatitis presents with a feeling of fullness in the perineum and vague back pain, along with frequency, urgency, and dysuria

A client with a urinary tract infection is to take nitrofurantoin four times each day. The client asks the nurse, "What should I do if I forget a dose?" What should the nurse tell the client? a) "Double the amount prescribed with your next dose." b) "Take the prescribed dose as soon as you remember it, and if it is very close to the time for the next dose, delay that next dose." c) "You can wait and take the next dose when it is due." d) "Take a lot of water with a double amount of your prescribed dose."

"Take the prescribed dose as soon as you remember it, and if it is very close to the time for the next dose, delay that next dose." Explanation: Antibiotics have the maximum effect when the level of the medication in the blood is maintained. However, because nitrofurantoin is readily absorbed from the gastrointestinal tract and is primarily excreted in urine, toxicity may develop by doubling the dose. The client should not skip a dose, if one dose is missed. Additional fluids, especially water, should be encouraged, but not forced to promote elimination of the antibiotic from the body. Adequate fluid intake aids in the prevention of urinary tract infections, in addition to an acidic urine.

A woman is using progestin injections for contraception. The nurse instructs the client to return for an appointment in: a) 6 months. b) 4 months. c) 1 month. d) 3 months.

3 months. Explanation: At the time a client receives a progestin injection, a follow-up appointment should be made for 3 months later. The nurse should emphasize the need to adhere to the medication schedule to prevent an unplanned pregnancy. One of the most common reasons for failure of this contraceptive is lack of adherence to the appointment schedule for injections every 3 months.

The client asks the nurse, "Is it really possible to lead a normal life with an ileostomy?" Which action by the nurse would be the most effective to address this question? a) Have the client talk with a member of the clergy about these concerns. b) Arrange for a person with an ostomy to visit the client preoperatively. c) Notify the surgeon of the client's question. d) Tell the client to worry about those concerns after surgery.

Arrange for a person with an ostomy to visit the client preoperatively. Correct Explanation: If the client agrees, having a visit by a person who has successfully adjusted to living with an ileostomy would be the most helpful measure. This would let the client actually see that typical activities of daily living can be pursued postoperatively. Someone who has felt some of the same concerns can answer the client's questions. A visit from the clergy may be helpful to some clients but would not provide this client with the information sought. Disregarding the client's concerns is not helpful. Although the health care provider (HCP) should know about the client's concerns, this in itself will not reassure the client about life after an ileostomy

A client develops decreased renal function and requires a change in antibiotic dosage. On which factor should the physician base the dosage change?

Creatinine clearance Explanation: The physician should base changes to antibiotic dosages on creatinine clearance test results, which gauge the kidney's glomerular filtration rate; this factor is important because most drugs are excreted at least partially by the kidneys. The GI absorption rate, therapeutic index, and liver function studies don't help determine dosage change in a client with decreased renal function

A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client? a) Risk for infection b) Toileting self-care deficit c) Activity intolerance d) Impaired urinary elimination

Risk for infection Explanation: The peritoneal dialysis catheter and regular exchanges of the dialysis bag provide a direct portal for bacteria to enter the body. If the client experiences repeated peritoneal infections, continuous ambulatory peritoneal dialysis may no longer be effective in clearing waste products. Impaired urinary elimination, Toileting self-care deficit, and Activity intolerance may be pertinent but are secondary to the risk of infection

A school nurse is teaching a class about sexually transmitted infections (STIs). Which statement is correct regarding STIs? a) The incidence of STIs is decreasing due to limited sex partners. b) STIs are most prevalent among teenagers and young adults. c) STIs disproportionately affect people with a lower socioeconomic status and education. d) The signs and symptoms of an STI are obvious.

STIs are most prevalent among teenagers and young adults. Explanation: STIs are most prevalent among teenagers and young adults, and nearly two thirds of all STIs occur in people younger than 25 years. The incidence of STIs is increasing due to multiple sex partners and sexual activity at a younger age. STIs affect men and women of all backgrounds and economic levels.

Which client is at highest risk for developing a urinary tract infection?

a man with an indwelling urinary catheter Explanation: Indwelling catheters are considered to be a major contributor to nosocomial infections. Any client with an indwelling catheter is at high risk for developing a urinary tract infection. A history of previous childbirths does not necessarily predispose a client to urinary tract infections. Clients with a history of renal calculi are not necessarily at risk for developing urinary tract infections unless the renal calculi recur. Clients with diabetes mellitus are at a higher risk for developing urinary tract infections, but this risk can be decreased by maintaining good control over blood glucose levels.

A client is admitted to the hospital with a diagnosis of renal calculi. The client is experiencing severe flank pain and nausea; the temperature is 100.6° F (38.1° C). Which outcome would be a priority for this client? a) maintenance of fluid and electrolyte balance b) alleviation of pain c) alleviation of nausea d) prevention of urinary tract complications

alleviation of pain Correct Explanation: The priority nursing goal for this client is to alleviate the pain, which can be excruciating. Prevention of urinary tract complications and alleviation of nausea are appropriate throughout the client's hospitalization, but relief of the severe pain is a priority. The client is at little risk for fluid and electrolyte imbalance.

A nulliparous client tells the nurse that during her last pelvic examination, the health care provider (HCP) said that her uterus was in a severe retroverted position. The nurse determines that the client may experience:

difficulty conceiving a child. Explanation: Severe retroversion or anteversion may lead to infertility or difficulty conceiving a child because these positions can block the deposition or migration of sperm. The normal position of the uterus is tipped slightly forward. Frequent vaginal infections commonly are associated with diabetes or human immunodeficiency virus infection, not abnormal uterine positions. Pain from endometriosis (abnormal myometrial growth outside the uterus) is not associated with abnormal uterine positions. Severe menstrual cramping or dysmenorrhea (primary) is caused by increased prostaglandin production, not abnormal uterine positions. Secondary dysmenorrhea is associated with pelvic inflammatory disease or endometriosis

The nurse should specifically assess a client with prostatic hypertrophy for: a) increased force of the urine stream. b) difficulty starting the flow of urine. c) painful urination. d) voiding at less frequent intervals.

difficulty starting the flow of urine. Explanation: Signs and symptoms of prostatic hypertrophy include difficulty starting the flow of urine, urinary frequency and hesitancy, decreased force of the urine stream, interruptions in the urine stream when voiding, and nocturia. The prostate gland surrounds the urethra, and these symptoms are all attributed to obstruction of the urethra resulting from prostatic hypertrophy. Nocturia from incomplete emptying of the bladder is common. Straining and urine retention are usually the symptoms that prompt the client to seek care. Painful urination is generally not a symptom of prostatic hypertrophy.

A client with chronic renal failure who receives hemodialysis three times weekly has a hemoglobin (Hb) level of 7 g/dl (70mmol/L). The most therapeutic pharmacologic intervention would be to administer: a) enoxaparin. b) ferrous sulfate. c) filgrastim. d) epoetin alfa.

epoetin alfa. Explanation: Chronic renal failure diminishes the production of erythropoietin by the kidneys and leads to a subnormal Hb level. (Normal Hb level is 13 to 18 g/dl in men and 12 to 16 g/dl in women.) An effective pharmacologic treatment for this is epoetin alfa, a recombinant erythropoietin. Because the client's anemia is caused by a deficiency of erythropoietin and not a deficiency of iron, administering ferrous sulfate would be ineffective. Neither filgrastim, a drug used to stimulate neutrophils, nor enoxaparin (low-molecular-weight heparin) will raise the client's Hb level

A client is admitted to the recovery room after cystoscopy with biopsy. Before the nurse can discharge the client, the nurse should be sure the client: a) has no blood in the urine. b) has a bowel movement. c) has received the first dose of pain medication. d) has voided.

has voided. Explanation: The nurse should verify that the client has voided prior to discharge in order to evaluate bladder function. Bowel function is not expected to be affected by this procedure. There may not be a need for pain medication immediately postprocedure and before discharge, but the nurse should assess the client's pain status and inform the client about the use and side effects of the medication. It is normal for the client to have hematuria because of the procedure.

A client is to receive belladonna and opium suppositories, as needed, postoperatively after transurethral resection of the prostate (TURP). The nurse should give the client these drugs when he demonstrates signs of:

pain from bladder spasms. Explanation: Belladonna and opium suppositories are prescribed and administered to reduce bladder spasms that cause pain after TURP. Bladder spasms frequently accompany urologic procedures. Antispasmodics offer relief by eliminating or reducing spasms. Antimicrobial drugs are used to treat an infection. Belladonna and opium do not relieve urine retention or urinary frequency

During dialysis, the client has disequilibrium syndrome. The nurse should first? a) slow the rate of dialysis. b) place the client in Trendelenburg's position. c) administer oxygen per nasal cannula. d) reassure the client that the symptoms are normal.

slow the rate of dialysis. Explanation: If disequilibrium syndrome occurs during dialysis, the most appropriate intervention is to slow the rate of dialysis. The syndrome is believed to result from too-rapid removal of urea and excess electrolytes from the blood; this causes transient cerebral edema, which produces the symptoms. Administration of oxygen and position changes do not affect the symptoms. It would not be appropriate to reassure the client that the symptoms are normal.

A client asks the nurse to explain the meaning of her abnormal Papanicolaou (Pap) smear result of atypical squamous cells. The nurse should tell the client that an atypical Pap smear means that: a) cancer cells were found in the smear. b) the Pap smear alone is not very important diagnostically because there are many false-positive results. c) abnormal viral cells were found in the smear. d) the cells could cause various conditions and help identify a problem early.

the cells could cause various conditions and help identify a problem early. Explanation: The Pap smear identifies atypical cervical cells that may be present for various reasons. Cancer is the most common possible cause, but not the only one. The Pap smear does not show abnormal viral cells unless specific gene typing is done for human papillomavirus. An adequate smear provides accurate diagnostic data; the false-positive rate is only about 5%.

The nurse teaches the client with a urinary diversion to attach the appliance to a standard urine collection bag at night. The most important reason for doing this is to prevent: a) urine leakage. b) appliance separation. c) the need to restrict fluids. d) urine reflux into the stoma.

urine reflux into the stoma. Explanation: The most important reason for attaching the appliance to a standard urine collection bag at night is to prevent urine reflux into the stoma and ureters, which can result in infection. Use of a standard collection bag also keeps the appliance from separating from the skin and helps prevent urine leakage from an overly full bag, but the primary purpose is to prevent reflux of urine. A client with a urinary diversion should drink 2,000 to 3,000 mL of fluid each day; it would be inappropriate to suggest decreasing fluid intake.

The nurse caring for a client with stress incontinence who is ordered a cystometrography. The client inquires about the nature of the procedure.All options must be used.

Client is asked to void normally. Urinary catheter is inserted. Fluid is instilled into the urinary catheter. Urge to void is recorded. Client is asked to void following instillation. Any residual urine is noted. Explanation: A cystometrography is a urological procedure that measures the amount of pressure exerted on the bladder at various bladder volumes. First, the client is asked to void normally. Then a urinary catheter is inserted, and fluid is instilled. The first urge to void is recorded. Following the procedure, the client is instructed to void and any residual urine is noted. Finally, the catheter is removed.

The client asks the nurse, "How did I get this urinary tract infection?" The nurse should explain that in most instances, cystitis is caused by: a) an infection elsewhere in the body. b) congenital strictures in the urethra. c) urinary stasis in the urinary bladder. d) an ascending infection from the urethra.

an ascending infection from the urethra. Explanation: Although various conditions may result in cystitis, the most common cause is an ascending infection from the urethra. Strictures and urine retention can lead to infections, but these are not the most common cause. Systemic infections are rarely causes of cystitis.

A client who had transurethral resection of the prostate (TURP) 2 days earlier has lower abdominal pain. The nurse should first: a) have the client use a sitz bath for 15 minutes. b) administer an oral analgesic. c) auscultate the abdomen for bowel sounds. d) assess the patency of the urethral catheter.

assess the patency of the urethral catheter. The lower abdominal pain is most likely caused by bladder spasms. A common cause of bladder spasms after TURP is blood clots obstructing the catheter; therefore, the nurse's first action should be to assess the patency of the catheter. Auscultating the abdomen for bowel sounds would be appropriate after patency of the catheter has been established. The nurse should assess for bladder spasms before administering an analgesic. A sitz bath would not relieve bladder spasms that are caused by an obstructed catheter.

A client receiving dialysis directs profanities at the nurse and then abruptly hangs his head and pleads, "Please forgive me. Something just came over me. Why do I say those things?" The nurse interprets this as which finding? a) flight of ideas b) emotional lability c) neologism d) confabulation

emotional lability Explanation: This type of behavior illustrates emotional lability, which is a readily changeable or unstable emotional affect. Neologism is using a word when it can have two or more meanings, or a play on words. Confabulation involves replacing memory loss by fantasy to hide confusion; it is unconscious behavior. Flight of ideas refers to a rapid succession of verbal expressions that jump from one topic to another and are only superficially related.

A client has a ureteral catheter in place after renal surgery. A priority nursing action for care of the ureteral catheter is to: a) ensure that the catheter is draining freely. b) ensure that the catheter drains at least 30 mL/h. c) clamp the catheter every 2 hours for 30 minutes. d) irrigate the catheter with 30 ml of normal saline every 8 hours.

ensure that the catheter is draining freely. Explanation: The ureteral catheter should drain freely without bleeding at the site. The catheter is rarely irrigated, and any irrigation would be done by the health care provider (HCP). The catheter is never clamped. The client's total urine output (ureteral catheter plus voiding or indwelling urinary catheter output) should be at least 30 mL/h.

When educating a female client with gonorrhea, the nurse should emphasize that for women gonorrhea: a) can be treated but not cured. b) does not lead to serious complications. c) is often marked by symptoms of dysuria or vaginal bleeding. d) may not cause symptoms until serious complications occur.

may not cause symptoms until serious complications occur. Explanation: Many women do not seek treatment because they are unaware that they have gonorrhea. They may be symptom-free or have only very mild symptoms until the disease progresses to pelvic inflammatory disease. Dysuria and vaginal bleeding are not present in gonorrhea. Gonorrhea can lead to very serious complications. It can be cured with the proper treatment

A client is voiding small amounts of urine every 30 to 60 minutes. What should the nurse do first? a) Palpate for a distended bladder. b) Encourage an increased fluid intake. c) Obtain a urine specimen for culture. d) Catheterize the client for residual urine.

Palpate for a distended bladder. Explanation: When a client voids frequent, small amounts, the nurse should suspect that the client is retaining urine. Palpating for a distended bladder is the first assessment that the nurse should perform to verify this suspicion. Obtaining a prescription to catheterize for residual urine may be appropriate as a follow-up activity. Obtaining a urine specimen for culture is not a first priority. The nurse would not encourage an increased fluid intake until further assessment of the situation is completed.

A client with benign prostatic hypertrophy (BPH) has an elevated prostate-specific antigen (PSA) level. The nurse should: a) instruct the client to have a colonoscopy before coming to conclusions about the PSA results. b) determine if the prostatic palpation was done before or after the blood sample was drawn. c) ask the client if he emptied his bladder before the blood sample was obtained. d) instruct the client that a urologist will monitor the PSA level biannually when elevated.

determine if the prostatic palpation was done before or after the blood sample was drawn. Explanation: Rectal and prostate examinations can increase serum PSA levels. The prostatic palpation should be done after the blood sample is drawn. The PSA level must be monitored more often than biannually when it is elevated. Having a colonoscopy is not related to the findings of the PSA test. It is not necessary to void prior to having PSA blood levels tested

A nurse is teaching a client with genital herpes. Which of the following would indicate to the nurse that the client's teaching was successful? a) "I can use condoms made from animal skins." b) "I should inform my partners about the disease." c) "As long as I am in a monogamous relationship, I do not have to use safer-sex practices." d) "The disease is transmittable only when visible lesions are present."

"I should inform my partners about the disease." Explanation: Clients with genital herpes should inform their partners of the disease to help prevent transmission. Animal skin condom should be avoided because the products do not prevent virus transmission. The notion that genital herpes is only transmittable when visible lesions are present is false. Anyone not in a long-term, monogamous relationship, regardless of current health status, should follow safer-sex practices if having sex with an infected partner

When instructing a client about the proper use of condoms for pregnancy prevention, the nurse should include which instructions to ensure maximum effectiveness? a) Obtain a prescription for a condom with nonoxynol 9. b) Place the condom over the erect penis before coitus. c) Withdraw the condom after coitus when the penis is flaccid. d) Ensure that the condom is pulled tightly over the tip of the penis before coitus.

Place the condom over the erect penis before coitus. Explanation: To ensure maximum effectiveness, the condom should always be placed over the erect penis before coitus. Some couples find condom use objectionable because foreplay may have to be interrupted to apply the condom. The penis, covered by the condom, should be withdrawn before the penis becomes flaccid. Otherwise semen may escape from the condom, providing an opportunity for possible fertilization. Rather than having the condom pulled tightly over the penis before coitus, space should be left at the tip of the penis to allow the condom to hold the sperm. The client does not need a prescription for a condom with nonoxynol 9 because these are sold over the counter.