ASSESSMENT PRACTICE QUESTIONS FINAL CHAPTERS

The nurse is examining the glans and knows which finding is normal for this area?

Smegma may be present under the foreskin of an uncircumcised male.

A patient has had three pregnancies and two live births. The nurse would record this information as grav _____, para _____, AB _____.

3; 2; 1

The nurse is reviewing risk factors for breast cancer. Which of these women have risk factors that place them at a higher risk for breast cancer?

65 year old whose mother had breast cancer

When performing a genitourinary assessment, the nurse notices that the urethral meatus is ventrally positioned. This finding is:

Called hypospadias.

During an examination of a woman, the nurse notices that her left breast is slightly larger than her right breast. Which of these statements is true about this finding?

Asymmetry is not unusual, but the nurse should verify that this change is not new.

Which of these clinical situations would the nurse consider to be outside normal limits?

A patient has had two pregnancies, and she breastfed both of her children. Her youngest child is now 10 years old. Her breast examination reveals breast tissue that is somewhat soft, and she has a small amount of thick yellow discharge from both nipples.

During a health history interview, a female patient states that she has noticed a few drops of clear discharge from her right nipple. What should the nurse do next?

Ask the patient some additional questions about the medications she is taking.

A patient contacts the office and tells the nurse that she is worried about her 10-year-old daughter having breast cancer. She describes a unilateral enlargement of the right breast with associated tenderness. She is worried because the left breast is not enlarged. What would be the nurses best response? Tell the mother that:

Although an examination of her daughter would rule out a problem, her breast development is most likely normal.

The uterus is usually positioned tilting forward and superior to the bladder. This position is known as:

Anteverted and anteflexed.

The nurse is preparing for a class in early detection of breast cancer. Which statement is true with regard to breast cancer in black women in the United States?

Black women are more likely to die of breast cancer at any age.

The nurse is preparing to teach a woman about BSE. Which statement by the nurse is correct?

BSE on a monthly basis will help you become familiar with your own breasts and feel their normal variations.

During an annual physical examination, a 43-year-old patient states that she does not perform monthly breast self-examinations (BSEs). She tells the nurse that she believes that mammograms do a much better job than I ever could to find a lump. The nurse should explain to her that:

BSEs may detect lumps that appear between mammograms.

A 43-year-old woman is at the clinic for a routine examination. She reports that she has had a breast lump in her right breast for years. Recently, it has begun to change in consistency and is becoming harder. She reports that 5 years ago her physician evaluated the lump and determined that it was nothing to worry about. The examination validates the presence of a mass in the right upper outer quadrant at 1 oclock, approximately 5 cm from the nipple. It is firm, mobile, and nontender, with borders that are not well defined. The nurse replies: a.

Because of the change in consistency of the lump, it should be further evaluated by a physician.

A woman is in the family planning clinic seeking birth control information. She states that her breasts change all month long and that she is worried that this is unusual. What is the nurses best response? The nurse should tell her that:

Because of the changing hormones during the monthly menstrual cycle, cyclic breast changes are common.

A 55-year-old man is in the clinic for a yearly checkup. He is worried because his father died of prostate cancer. The nurse knows which tests should be performed at this time? Select all that apply.

Blood test for prostate-specific antigen (PSA), Digital rectal examination (DRE)

In performing an assessment of a womans axillary lymph system, the nurse should assess which of these nodes?

Central, lateral, pectoral, and subscapular

The nurse is performing a genital examination on a male patient and notices urethral drainage. When collecting urethral discharge for microscopic examination and culture, the nurse should:

Compress the glans between the examiners thumb and forefinger, and collect any discharge.

While inspecting a patients breasts, the nurse finds that the left breast is slightly larger than the right with the bilateral presence of Montgomery glands. The nurse should:

Consider these findings as normal, and proceed with the examination.

When performing a genital examination on a 25-year-old man, the nurse notices deeply pigmented, wrinkled scrotal skin with large sebaceous follicles. On the basis of this information, the nurse would:

Consider this finding as normal, and proceed with the examination.

During an examination of an aging man, the nurse recognizes that normal changes to expect would be:

Decrease in the size of the penis.

During an examination of an aging man, the nurse recognizes that normal changes to expect would be:

Decreased penis size.

A 55-year-old postmenopausal woman is being seen in the clinic for her annual examination. She is concerned about changes in her breasts that she has noticed over the past 5 years. She states that her breasts have decreased in size and that the elasticity has changed so that her breasts seem flat and flabby. The nurses best reply would be:

Decreases in hormones after menopause causes atrophy of the glandular tissue in the breast and is a normal process of aging.

When the nurse is performing a genital examination on a male patient, which action is correct?

Having the patient shift his weight onto the left (unexamined) leg when palpating for a hernia on the right side

Which of these statements is most appropriate when the nurse is obtaining a genitourinary history from an older man?

Do you need to get up at night to urinate?

A nurse is assessing a patients risk of contracting a sexually transmitted infection (STI). An appropriate question to ask would be:

Do you use a condom with each episode of sexual intercourse?

A 59-year-old patient has been diagnosed with prostatitis and is being seen at the clinic for complaints of burning and pain during urination. He is experiencing:

Dysuria

During the interview, a patient reveals that she has some vaginal discharge. She is worried that it may be a sexually transmitted infection. The nurses most appropriate response to this would be:

Id like some information about the discharge. What color is it?

A 55-year-old man is experiencing severe pain of sudden onset in the scrotal area. It is somewhat relieved by elevation. On examination the nurse notices an enlarged, red scrotum that is very tender to palpation. Distinguishing the epididymis from the testis is difficult, and the scrotal skin is thick and edematous. This description is consistent with which of these?

Epididymitis

During a discussion about BSEs with a 30-year-old woman, which of these statements by the nurse is most appropriate?

Examine your breasts shortly after your menstrual period each month.

A 62-year-old man states that his physician told him that he has an inguinal hernia. He asks the nurse to explain what a hernia is. The nurse should:

Explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscles.

In examining a 70-year-old male patient, the nurse notices that he has bilateral gynecomastia. Which of the following describes the nurses best course of action

Explain that this condition may be the result of hormonal changes, and recommend that he see his physician.

Which of the following statements is true regarding the internal structures of the breast? The breast is made up of:

Fibrous, glandular, and adipose tissues.

The nurse is describing how to perform a testicular self-examination to a patient. Which statement is most appropriate?

If you notice an enlarged testicle or a painless lump, call your health care provider.

During a genital examination, the nurse notices that a male patient has clusters of small vesicles on the glans, surrounded by erythema. The nurse recognizes that these lesions are:

Genital herpes.

When performing a genital assessment on a middle-aged man, the nurse notices multiple soft, moist, painless papules in the shape of cauliflower-like patches scattered across the shaft of the penis. These lesions are characteristic of:

Genital warts.

When the nurse is discussing sexuality and sexual issues with an adolescent, a permission statement helps convey that it is normal to think or feel a certain way. Which statement is the best example of a permission statement?

Girls your age often have questions about sexual activity. Do you have any questions?

A 50-year-old woman calls the clinic because she has noticed some changes in her body and breasts and wonders if these changes could be attributable to the hormone replacement therapy (HRT) she started 3 months earlier. The nurse should tell her:

HRT has several side effects, including fluid retention, breast tenderness, and vaginal bleeding.

. During the interview with a female patient, the nurse gathers data that indicate the patient is perimenopausal. Which of these statements made by this patient leads to this conclusion?

I have been noticing that I sweat a lot more than I used to, especially at night.

A 9-year-old girl is in the clinic for a sport physical examination. After some initial shyness she finally asks, Am I normal? I dont seem to need a bra yet, but I have some friends who do. What if I never get breasts? The nurses best response would be:

I understand that it is hard to feel different from your friends. Breasts usually develop between 8 and 10 years of age.

During a breast health interview, a patient states that she has noticed pain in her left breast. The nurses most appropriate response to this would be:

I would like some more information about the pain in your left breast.

A 22-year-old woman has been considering using oral contraceptives. As a part of her health history, the nurse should ask:

If you smoke, how many cigarettes do you smoke per day?

When performing a genitourinary assessment on a 16-year-old male adolescent, the nurse notices a swelling in the scrotum that increases with increased intra-abdominal pressure and decreases when he is lying down. The patient complains of pain when straining. The nurse knows that this description is most consistent with a(n) ______ hernia.

Indirect inguinal

A patient is newly diagnosed with benign breast disease. The nurse recognizes which statement about benign breast disease to be true? The presence of benign breast disease:

Makes it hard to examine the breasts.

A new mother calls the clinic to report that part of her left breast is red, swollen, tender, very hot, and hard. She has a fever of 38.3 C. She also has had symptoms of influenza, such as chills, sweating, and feeling tired. The nurse notices that she has been breastfeeding for 1 month. From her description, what condition does the nurse suspect?

Mastitis

The nurse is aware of which statement to be true regarding the incidence of testicular cancer?

Men with a history of cryptorchidism are at the greatest risk for the development of testicular cancer.

A woman is in the clinic for an annual gynecologic examination. The nurse should plan to begin the interview with the:

Menstrual history, because it is generally nonthreatening.

The nurse is assessing the breasts of a 68-year-old woman and discovers a mass in the upper outer quadrant of the left breast. When assessing this mass, the nurse is aware that characteristics of a cancerous mass include which of the following? Select all that apply.

Non tender mass, Hard, dense, and immobile, Irregular, poorly delineated border

When the nurse is conducting sexual history from a male adolescent, which statement would be most appropriate to use at the beginning of the interview?

Often adolescents your age have questions about sexual activity.

The nurse is discussing BSEs with a postmenopausal woman. The best time for postmenopausal women to perform BSEs is:

On the same day every month.

A 54-year-old man comes to the clinic with a horrible problem. He tells the nurse that he has just discovered a lump on his breast and is fearful of cancer. The nurse knows which statement about breast cancer in men is true?

One percent of all breast cancers occurs in men.

A patient states during the interview that she noticed a new lump in the shower a few days ago. It was on her left breast near her axilla. The nurse should plan to:

Palpate the unaffected breast first.

While examining a 75-year-old woman, the nurse notices that the skin over her right breast is thickened and the hair follicles are exaggerated. This condition is known as:

Peau dorange.

The nurse is providing patient teaching about an erectile dysfunction drug. One of the drugs potential side effects is prolonged, painful erection of the penis without sexual stimulation, which is known as:

Priapism

The nurse is performing a breast examination. Which of these statements best describes the correct procedure to use when screening for nipple and skin retraction during a breast examination? Have the woman:

Slowly lift her arms above her head, and note any retraction or lag in movement.

When the nurse is performing a genital examination on a male patient, the patient has an erection. The nurses most appropriate action or response is to:

Reassure the patient that this is a normal response and continue with the examination.

The nurse has palpated a lump in a female patients right breast. The nurse documents this as a small, round, firm, distinct, lump located at 2 oclock, 2 cm from the nipple. It is nontender and fixed. No associated retraction of the skin or nipple, no erythema, and no axillary lymphadenopathy are observed. What information is missing from the documentation?

Size of the lump

During a breast examination on a female patient, the nurse notices that the nipple is flat, broad, and fixed. The patient states it started doing that a few months ago. This finding suggests:

Retracted nipple.

The nurse is inspecting the scrotum and testes of a 43-year-old man. Which finding would require additional follow-up and evaluation?

Skin on the scrotum is taut.

When assessing the scrotum of a male patient, the nurse notices the presence of multiple firm, nontender, yellow 1-cm nodules. The nurse knows that these nodules are most likely:

Sebaceous cysts.

A 54-year-old woman who has just completed menopause is in the clinic today for a yearly physical examination. Which of these statements should the nurse include in patient education? A postmenopausal woman:

Should be aware that she is at increased risk for dyspareunia because of decreased vaginal secretions.

An older man is concerned about his sexual performance. The nurse knows that in the absence of disease, a withdrawal from sexual activity later in life may be attributable to:

Side effects of medications.

A 45-year-old mother of two children is seen at the clinic for complaints of losing my urine when I sneeze. The nurse documents that she is experiencing:

Stress incontinence.

The nurse is palpating a female patients breasts during an examination. Which of these positions is most likely to make significant lumps more distinct during breast palpation?

Supine with the arms raised over her head

When performing a scrotal assessment, the nurse notices that the scrotal contents show a red glow with transillumination. On the basis of this finding the nurse would:

Suspect the presence of serous fluid in the scrotum.

A 16-year-old boy is brought to the clinic for a problem that he refused to let his mother see. The nurse examines him, and finds that he has scrotal swelling on the left side. He had the mumps the previous week, and the nurse suspects that he has orchitis. Which of the following assessment findings support this diagnosis? Select all that apply.

Swollen testis, mass that does not transilluminate, scrotum that is tender upon palpation, scrotal skin that is reddened.

During an examination, the nurse notices that a male patient has a red, round, superficial ulcer with a yellowish serous discharge on his penis. On palpation, the nurse finds a nontender base that feels like a small button between the thumb and fingers. At this point the nurse suspects that this patient has:

Syphilitic chancre.

A 14-year-old girl is anxious about not having reached menarche. When taking the health history, the nurse should ascertain which of the following? The age that:

The girl began to develop breasts.

When a breastfeeding mother is diagnosed with a breast abscess, which of these instructions from the nurse is correct? The mother needs to:

Temporarily discontinue nursing on the affected breast, and manually express milk and discard it.

When the nurse is performing a testicular examination on a 25-year-old man, which finding is considered normal?

Testes that feel oval and movable and are slightly sensitive to compression

A male patient with possible fertility problems asks the nurse where sperm is produced. The nurse knows that sperm production occurs in the:

Testes.

The nurse is conducting a class on BSE. Which of these statements indicates the proper BSE technique?

The best time to perform a BSE is 4 to 7 days after the first day of the menstrual period.

Which of these statements is true regarding the penis?

The corpus spongiosum expands into a cone of erectile tissue called the glans.

Which statement concerning the testes is true?

The cremaster muscle contracts in response to cold and draws the testicles closer to the body.

The mother of a 10-year-old boy asks the nurse to discuss the recognition of puberty. The nurse should reply by saying: a

The first sign of puberty is an enlargement of the testes.

A 65-year-old patient remarks that she just cannot believe that her breasts sag so much. She states it must be from a lack of exercise. What explanation should the nurse offer her? After menopause:

The glandular and fat tissue atrophies, causing breast size and elasticity to diminish, resulting in breasts that sag.

In performing a breast examination, the nurse knows that examining the upper outer quadrant of the breast is especially important. The reason for this is that the upper outer quadrant is:

The location of most breast tumors.

The nurse is preparing to interview a postmenopausal woman. Which of these statements is true as it applies to obtaining the health history of a postmenopausal woman?

The nurse should ask a postmenopausal woman if she has ever had vaginal bleeding.

During a health history, a 22-year old woman asks, Can I get that vaccine for human papilloma virus (HPV)? I have genital warts and Id like them to go away! What is the nurses best response?

The vaccine cannot protect you if you already have an HPV infection.

. During an examination, the nurse notes a supernumerary nipple just under the patients left breast. The patient tells the nurse that she always thought it was a mole. Which statement about this finding is correct?

This variation is normal and not a significant finding.

During a physical examination, a 45-year-old woman states that she has had a crusty, itchy rash on her breast for approximately 2 weeks. In trying to find the cause of the rash, which question would be important for the nurse to ask?

Where did the rash first appear on the nipple, the areola, or the surrounding skin?

A woman states that 2 weeks ago she had a urinary tract infection that was treated with an antibiotic. As a part of the interview, the nurse should ask, Have you noticed any:

Unusual vaginal discharge or itching?

During an examination, the nurse observes a female patients vestibule and expects to see the:

Urethral meatus and vaginal orifice.

The nurse is reviewing the changes that occur with menopause. Which changes are associated with menopause?

Uterine and ovarian atrophy, along with a thinning of the vaginal epithelium

. A 15-year-old boy is seen in the clinic for complaints of dull pain and pulling in the scrotal area. On examination, the nurse palpates a soft, irregular mass posterior to and above the testis on the left. This mass collapses when the patient is supine and refills when he is upright. This description is consistent with:

Varicocele.

When the nurse is interviewing a preadolescent girl, which opening question would be least threatening?

When did you notice that your body was changing?

During the physical examination, the nurse notices that a female patient has an inverted left nipple. Which statement regarding this is most accurate?

Whether the inversion is a recent change should be determined.

The nurse is assisting with a BSE clinic. Which of these women reflect abnormal findings during the inspection phase of breast examination?

Woman whose nipples are in different planes (deviated).

Which statement would be most appropriate when the nurse is introducing the topic of sexual relationships during an interview?

Women often have questions about their sexual relationship and how it affects their health. Do you have any questions?

The nurse is reviewing statistics regarding breast cancer. Which woman, aged 40 years in the United States, has the highest risk for developing breast cancer?

black

During a speculum inspection of the vagina, the nurse would expect to see what at the end of the vaginal canal?

cervix

The nurse is performing a genitourinary assessment on a 50-year-old obese male laborer. On examination, the nurse notices a painless round swelling close to the pubis in the area of the internal inguinal ring that is easily reduced when the individual is supine. These findings are most consistent with a(n) ______ hernia.

direct inguinal

Generally, the changes normally associated with menopause occur because the cells in the reproductive tract are:

estrogen dependent

During a health history, a patient tells the nurse that he has trouble in starting his urine stream. This problem is known as:

hesitancy

The nurse is examining a 62-year-old man and notes that he has bilateral gynecomastia. The nurse should explore his health history for which related conditions? Select all that apply.

hyperthyroidism, liver disease, hx of alc disease.

If a patient reports a recent breast infection, then the nurse should expect to find ________ node enlargement.

ipsilateral axillary

During a physical examination, the nurse finds that a male patients foreskin is fixed and tight and will not retract over the glans. The nurse recognizes that this condition is:

phimosis

An accessory glandular structure for the male genital organs is the:

prostate

The external male genital structures include the:

scrotum

A 52-year-old patient states that when she sneezes or coughs she wets herself a little. She is very concerned that something may be wrong with her. The nurse suspects that the problem is:

stress incontinence

An 11-year-old girl is in the clinic for a sports physical examination. The nurse notices that she has begun to develop breasts, and during the conversation the girl reveals that she is worried about her development. The nurse should use which of these techniques to best assist the young girl in understanding the expected sequence for development? The nurse should:

use the TANNER SCALE on the five stages of sexual development