Med Surg: Chapter 33: Nursing Management: Patients With Breast and Female Reproductive Disorders: PREPU
A 32-year-old client has been diagnosed with an ovarian cyst and asks the nurse, "Should I be worried about cancer?" Which response by the nurse would be most appropriate? A. "Ovarian cysts can be malignant but this is a rare occurrence." B. "Most cysts are benign in younger women, but it's good to have it checked out." C. "Since you don't have any symptoms, the chances of having cancer are really remote." D. "Ovarian cysts are just that, cysts and not a cause for concern."
B
A client is being treated for trichomoniasis. The client has received instructions about the prescribed drug therapy. The nurse determines that the client needs additional teaching when she states which of the following? A. "I might notice a metallic taste in my mouth while I'm taking the drug." B. "My partner will not need any treatment." C. "I need to take the medication three times a day for a week." . D. "I need to avoid drinking any alcohol with this drug."
B
A female patient experienced a severe reduction in body fat by extreme caloric restriction and exercise. Which of the following female reproductive abnormalities could she acquire as a result of the reduction in body fat? A. Higher risk of fibrocystic breast disease B. Cessation of menstruation C Underdeveloped breasts D. Polycystic ovarian syndrome
B
A patient is diagnosed with the most common type of uterine fibroid, an intramural fibroid. The nurse includes which information in teaching the patient about this type of fibroid? A. It grows below the inner uterine surface. B. It grows within the wall of the uterine muscle. C. It lies underneath the outermost layer of the uterus. D. It arises from inside or outside the surface of the uterine muscle.
B
Based on her knowledge of the most common site of metastatic spread for breast cancer, the nurse would recommend periodic assessments of the: A. Lungs B. Bone C. Brain D. Liver
B
The nurse is providing care to a client who has had surgery as treatment for breast cancer. The nurse would be alert for the development of which of the following? A. Breast abscess B. Lymphedema C Fibrocystic breast disease D. Fibroadenoma
B
The nurse working on a cancer treatment floor assesses her assigned clients. It is most important for the nurse to report which assessment finding? A. Temperature 99.2°F, pulse 72, respirations 18, blood pressure 130/80 B. Coolness and mottling of a newly constructed breast site C. Immediate postoperative report of throat tenderness D. Small amount of bloody drainage on surgical dressing 12 hours postoperatively
B
Which statement by the nurse demonstrates effective communication techniques when initiating a discussion about sex with a 25-year-old female client? A. "Why didn't you start receiving annual Pap tests at an earlier age?" B. "What questions do you have related to your sexual health?" C. "Do you know how to properly apply a male condom?" D. "Have you had sex with more than one partner?"
B
A 33-year-old female client with three children has had a follow-up mammogram after an abnormal BSE. Mammogram findings reveal incidental microscopic abnormal tissue growth in the left breast lobules. The physician orders tamoxifen for the client. The nurse understands that the physician is implementing which primary prevention modality to treat this client? A. Prophylactic mastectomy B. Radiation therapy C. Chemoprevention D. Long-term surveillance
C
A client with vaginitis complains of itching and burning of the perineum. Which suggestion would be most appropriate to relieve the client's symptoms? A. Avoid yogurt with active lactobacilli cultures. B. Use skin protectants containing zinc oxide. C. Take sitz baths frequently D. Use a pure vinegar douche daily.
C
A patient has a diagnosis of stage III ovarian cancer and wants to know what organs are involved. What information should be provided to the patient? A. The cancer involves distant metastases. B. The cancer involves only the ovaries. C. The cancer involves metastases outside the pelvis. D. The cancer involves the ovaries with pelvic extension.
C
During a follow-up visit, a female client who underwent a mastectomy presents with an infection that requires an antibiotic. She admits she has been doing some gardening. What further instruction and reinforcement of teaching is needed? A. Avoid household chores for at least 6 to 9 months. B. Avoid working in the garden or yard altogether. C. Wear gloves and protective clothing to avoid any injuries. D. Increase the frequency of follow-up visits if she does works.
C
The client arrives at a public health clinic worried that she has breast cancer since finding a lump in her breast. When assessing the breast, which assessment finding is characteristic of fibrocystic disease? A. The lump is firm and nonmovable. B. One breast is larger than the other. C. The lump is round and movable. D. Nipple retractions are noted.
C
While caring for a client who is being treated for severe PID, the nurse insists on keeping the client in a semisitting position. Which is the correct rationale for this positioning? A. To easily distract the client B. To prevent nosocomial infections to other clients C. To facilitate pelvic drainage and minimize the upward extension of infection D. To prevent movement, as it increases pain
C
The nurse is providing education regarding sexually transmitted infections. Which statement regarding herpes virus 2 (herpes genitalis) is accurate? A. Transmission of the virus requires sexual contact. B. Usually, the virus is killed at room temperature by drying. C. . In pregnant women with active herpes, babies delivered vaginally may become infected with the virus. D. The virus is very difficult to kill.
C
Which is a characteristic of a breast cancer mass? A. Occurs as disseminated masses B. Symmetrical mass C. Firm, hard, embedded in surrounding tissue D. Tender upon palpation
C
Which is a risk factor for cervical cancer? A. Underweight status B. Late childbearing C. Exposure to HPV D. Sex with circumcised males
C
A client has just had a left radical mastectomy, and the nurse is providing information on complications that may arise due to removing the axillary lymph nodes. Which would not be included? A. All would be included in the discussion. B. tissue necrosis C. reduced range of motion D. infection
A
A client who has had a left total mastectomy is about to view her surgical site for the first time. Which of the following would be most appropriate for the nurse to say? A "Do you feel like you're ready to look at your incision now?" B "You need to look at the incision so you can heal emotionally." C. Did you have reconstructive surgery when they removed your breast?" D. "Don't be afraid. Everybody feels the same way."
A
A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client? A. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually. B. The potential for transmission to her sexual partner will be eliminated if condoms are used every time she and her partner have sexual intercourse. C. The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days. D The human papillomavirus (HPV), which causes condylomata acuminata, can't be transmitted during oral sex.
A
A nurse is reviewing a female client's history, which includes the following information: Age at menarche: 14 years Cesarean delivery: 2 pregnancies Age at first pregnancy: 35 years Alcohol use: approximately 1 to 2 glasses of wine/month The nurse identifies which as a possible risk factor for the client to develop breast cancer? A. age at first pregnancy B. alcohol use C. age at menarche D. how many cesarean deliveries.
A
On discharge, a client who underwent left modified radical mastectomy expresses relief that "the cancer" has been treated. When discussing this issue with the client, the nurse should stress that she: A. should continue to perform breast self-examination on her right breast. B. will have irregular menses. C. Should schedule a follow-up appointment in 6 months. D. is lucky that the cancer was caught in time.
A
A 39-year-old woman with a diagnosis of endometriosis has met with her care provider to discuss treatment options. The nurse who is planning this woman's care should prioritize which of the following nursing diagnoses? A. Impaired adjustment related to complications of endometriosis B. Chronic low self-esteem related to complications of endometriosis C. Stress incontinence related to endometriosis D. Chronic pain related to endometriosis
D
A client has undergone a total abdominal hysterectomy and bilateral salpingo-oopherectomy as treatment for endometrial cancer. When providing postoperative care to this client the nurse would be alert for signs and symptoms of which of the following? A Leukopenia B. Neurotoxicity C. Clotting deficiencies D. Bladder dysfunction
D
A client with challenging menopausal symptoms has discussed treatment options with the physician and now has some questions for the nurse. The client asks, "What are the potential risks of hormone replacement therapy?" What is the best answer? A. stroke (CVA) B. breast cancer C. heart disease D. All options are correct.
D
A female client is diagnosed with breast abscess. She would like to continue to breast-feed her newborn. Which of the following would be most appropriate in this situation? A. Reduce the frequency of removing and reapplying the dressings. B. Instruct the client to wear a tight-fitting bra. C. Encourage the client to include protein content in the diet. D. Assist the client to pump the breasts to remove breast milk.
D
A female patient comes to the clinic with the complaint that she is having a greenish-colored discharge from the nipple and the breast feels warm to touch. What does the nurse suspect these symptoms may indicate? A. Cancer B. Blocked lymph duct C. A ruptured cyst D. Infection
D
A nurse is providing breast cancer education at a community facility. The American Cancer Society recommends that women get mammograms: A. after the birth of the first child and every 2 years thereafter. B. after the first menstrual period and annually thereafter. C. every 3 years between ages 20 and 44 and annually thereafter. D. yearly starting at age 45.
D
After teaching a group of students about the signs and symptoms of breast cancer, the instructor determines that additional teaching is needed when the group identifies which of the following? A. Nipple retraction B. Peau d'orange skin C. Painless mass D. Breast symmetry
D
An older client underwent a lumpectomy for a breast lesion that was determined to be malignant. Which factors in the client's history may have increased the risk of breast cancer? A. increased age B. obesity C not giving birth D. All options are correct.
D
Assessment of a client reveals evidence of a cystocele. The nurse interprets this as which of the following? A. Protrusion of intestinal wall into the vagina B.Downward displacement of the cervix C Herniation of the rectum into the vagina D. Bulging of the bladder into the vagina
D
At a follow-up visit, the client is informed that her breast cancer has recurred. The nurse knows that which situation places the client at risk for developing bone metastases? A. No maternal family history of breast cancer B. Previous therapeutic response to chemotherapy C. Aggressive treatment, including surgery, radiation, and hormonal therapy D. Recurrence within 2 years of the original diagnosis
D
The nurse is preparing a teaching plan for a client with a vulvovaginal infection. Which of the following would be least appropriate for the nurse to include? A. Maintaining a reclining position for 30 minutes after inserting vaginal medication B. Wearing cotton underwear that is loose-fitting and allows for air flow C. Refraining from unprotected sexual intercourse with partners D. Performing douching with a dilute vinegar solution twice a day
D
Which of the following is the extrusion of the rectum into the posterior vagina? A Enterocele B. Uterine prolapse C. Cystocele D. Rectocele
D
The nurse is caring for a group of breast cancer survivors post mastectomy. Which teaching point should the nurse include? A. Sleep on the affected side B. When using cream, be careful to avoid the affected breast C. Wear tight-fitting shirts D. Do not lift objects greater than 15 lb
D. The nurse should instruct post mastectomy clients to avoid lifting objects greater than 15 lb. Tight-fitting or constrictive clothing is to be avoided. The client is encouraged to place cream on any area of the breast which is dry, and discouraged to sleep on the affect side.
