Med Surg - Exam 4

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

56. A nurse is collecting assessment data from a premenopausal patient who states that she does not have menses. What term should the nurse use to document the absence of menstrual flow? A) Amenorrhea B) Dysmenorrhea C) Menorrhagia D) Metrorrhagia

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

When teaching a patient infected with HIV regarding transmission of the virus to others, which of the following statements made by the patient would identify a need for further education? a) "I will need to isolate any tissues I use so as not to infect my family." b) "I will notify all of my sexual partners so they can get tested for HIV." c) "Unprotected sexual contact is the most common mode of transmission." d) "I do not need to worry about spreading this virus to others by sweating at the gym."

56. The nurse is planning the sexual assessment of a new adolescent patient. The nurse should include what assessment components? Select all that apply. A) Physical examination findings B) Laboratory results C) Health history D) Interpersonal skills E) Understanding of menopause

a,b,c

56. A new patient has come to the clinic seeking an appropriate method of birth control. What would the nurse teach this patient about a diaphragm? A) One size fits all females. B) The diaphragm may be cleaned with soap and water after use. C) A diaphragm eliminates the need for spermicidal jelly. D) The diaphragm should be removed 1 hour following intercourse.

59. A clinic nurse is providing preprocedure education for a man who will undergo a vasectomy. Which of the following measures will enhance healing and comfort? Select all that apply. A) Abstaining from sexual intercourse for at least 14 days postprocedure B) Wearing a scrotal support garment C) Using sitz baths D) Applying a heating pad intermittently E) Staying on bed rest for 48 to 72 hours post procedure

b,c

56. The nurse is taking the sexual history of an adolescent who has come into the free clinic. What question best assesses the patients need for further information? A) Are you involved in an intimate relationship at this time? B) How many sexual partners have you had? C) What questions or concerns do you have about your sexual health? D) Have you ever been diagnosed with a sexually transmitted infection?

A 30-year-old female patient has sought care because of the recent appearance of itchy lesions on her vulva, some of which have recently burst. The patient's description of her problem would lead you to first suspect a) HIV. b) Gonorrhea. c) Chlamydia. d) Genital herpes.

71. A nurse who provides care in a busy ED is in contact with hundreds of patients each year. The nurse has a responsibility to receive what vaccine? A) Hepatitis B vaccine B) Human papillomavirus (HPV) vaccine C) Clostridium difficile vaccine D) Staphylococcus aureus vaccine

57. A patient with ovarian cancer is admitted to the hospital for surgery and the nurse is completing the patients health history. What clinical manifestation would the nurse expect to assess? A) Fish-like vaginal odor B) Increased abdominal girth C) Fever and chills D) Lower abdominal pelvic pain

71. A nurse is caring for a child who was admitted to the pediatric unit with infectious diarrhea. The nurse should be alert to what assessment finding as an indicator of dehydration? A) Labile BP B) Weak pulse C) Fever D) Diaphoresis

A patient comes to the free clinic complaining of urethral discharge. On assessment, the nurse notes that the patient is feverish. During the assessment, the patient admits to having unprotected sex. The nurse suspects the patient may have a diagnosis of what? a) HIV b) Chlamydia c) Syphilis d) Gonorrhea

After teaching a group of students about sexually transmitted infections (STIs), the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment? a) Syphillis b) Gonorrhea c) Chlamydia d) Genital herpes

59. A 35-year-old man is seen in the clinic because he is experiencing recurring episodes of urinary frequency, dysuria, and fever. The nurse should recognize the possibility of what health problem? A) Chronic bacterial prostatitis B) Orchitis C) Benign prostatic hyperplasia D) Urolithiasis

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

58. The nurse is caring for a patient who has just had a radical mastectomy and axillary node dissection. When providing patient education regarding rehabilitation, what should the nurse recommend? A) Avoid exercise of the arm for next 2 months. B) Keep cuticles clipped neatly. C) Avoid lifting objects heavier than 10 pounds. D) Use a sling until healing is complete.

59. A nurse is performing an admission assessment on a 40-year-old man who has been admitted for outpatient surgery on his right knee. While taking the patients family history, he states, My father died of prostate cancer at age 48. The nurse should instruct him on which of the following health promotion activities? A) The patient will need PSA levels drawn starting at age 55. B) The patient should have testing for presence of the CDH1 and STK11 genes. C) The patient should have PSA levels drawn regularly. D) The patient should limit alcohol use due to the risk of malignancy.

59. A nurse is providing an educational event to a local mens group about prostate cancer. The nurse should cite an increased risk of prostate cancer in what ethnic group? A) Native Americans B) Caucasian Americans C) African Americans D) Asian Americans

59. A nursing student is learning how to perform sexual assessments using the PLISSIT model. According to this model, the student should begin an assessment by doing which of the following? A) Briefly teaching the patient about normal sexual physiology B) Assuring the patient that what he says will be confidential C) Asking the patient if he is willing to discuss sexual functioning D) Ensuring patient privacy

A client is diagnosed as being in the primary stage of syphilis? Which of the following would the nurse expect as a finding? a) Development of gummas b) Palmar rash c) Genital chancres d) Development of central nervous system lesions

56. A female patient who has cognitive and physical disabilities has come into the clinic for a routine checkup. When planning this patients assessment, what action should the nurse take? A) Ensure that a chaperone is available to be present during the assessment. B) Limit the length and scope of the health assessment. C) Avoid health promotion or disease prevention education. D) Avoid equating the patient with her disabilities.

58. The nurse is reviewing the physicians notes from the patient who has just left the clinic. The nurse learns that the physician suspects a malignant breast tumor. On palpation, the mass most likely had what characteristic? A) Nontenderness B) A size of 5 mm C) Softness and a regular shape D) Mobility

57. A female patient with HIV has just been diagnosed with condylomata acuminata (genital warts). What information is most appropriate for the nurse to tell this patient? A) This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually. B) The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days. C) The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse. D) The human papillomavirus (HPV), which causes condylomata acuminata, cannot be transmitted during oral sex.

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

59. To decrease glandular cellular activity and prostate size, an 83-year-old patient has been prescribed finasteride (Proscar). When performing patient education with this patient, the nurse should be sure to tell the patient what? A) Report the planned use of dietary supplements to the physician. B) Decrease the intake of fluids to prevent urinary retention. C) Abstain from sexual activity for 2 weeks following the initiation of treatment. D) Anticipate a temporary worsening of urinary retention before symptoms subside.

A 22-year-old patient has presented to her primary care provider for her scheduled Pap smear. Abnormal results of this diagnostic test may imply infection with: a) human papillomavirus (HPV). b) Chlamydia trachomatis. c) Candida albicans. d) Trichomonas vaginalis.

A client with a history of HSV-2 infection asks the nurse about future sexual activity. Which of the following responses would be most appropriate? a) "Inform all potential sexual partners about the infection, even if it is inactive.". b) "Use a condom during sexual activity if the infection becomes active again." c) "If the infection has healed, you probably don't have to use a condom." d) "Refrain from all sexual activity until you don't have another outbreak for a year."

A group of students are reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which of the following as the cause of condylomata? a) Human papilloma virus b) Haemophilus ducreyi bacillus c) Herpes virus d) Treponema pallidum

57. Following a recent history of dyspareunia and lower abdominal pain, a patient has received a diagnosis of pelvic inflammatory disease (PID). When providing health education related to self-care, the nurse should address which of the following topics? Select all that apply. A) Use of condoms to prevent infecting others B) Appropriate use of antibiotics C) Taking measures to prevent pregnancy D) The need for a Pap smear every 3 months E) The importance of weight loss in preventing symptoms

a,b

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

a,b,c

56. By initiating an assessment about sexual concerns what does the nurse convey to the patient? Select all that apply. A) That sexual issues are valid health issues B) That it is safe to talk about sexual issues C) That sexual issues are only a minor aspect a persons identity D) That changes or problems in sexual functioning should be discussed E) That changes or problems in sexual functioning are highly atypical

a,b,d

56. The nurse is assessing a 53-year-old woman who has been experiencing dysmenorrhea. What questions should the nurse include in an assessment of the patients menstrual history? Select all that apply. A) Do you ever experience bleeding after intercourse? B) How long is your typical cycle? C) Did you have any sexually transmitted infections in early adulthood? D) When did your mother and sisters get their first periods? E) Do you experience cramps or pain during your cycle?

a,b,e

A nurse is teaching a health class to a group of clients likely to be at highest risk for gonorrhea. What is the age range of the clients? a) 60 to 70 years b) 15 to 24 years c) 25 to 29 years d) 30 to 45 years

A patient has herpes simplex 2 viral infection (HSV-2). The nurse recognizes that which of the following should be included in teaching the patient? a) The virus causes "cold sores" of the lips. b) Treatment is focused on relieving symptoms. c) The virus may be cured with antibiotics. d) The virus when active may not be contracted during intercourse.

A patient with ovarian cancer is admitted to the hospital for surgery and the nurse is completing the patients health history. What clinical manifestation would the nurse expect to assess? A) Fish-like vaginal odor B) Increased abdominal girth C) Fever and chills D) Lower abdominal pelvic pain

A student nurse is caring for a male patient diagnosed with gonorrhea. The patient is receiving ceftriaxone and doxycycline. The nursing instructor asks the student why the patient is receiving two antibiotics. What is the student nurse's best response? a) "This combination of medications will eradicate the infection faster than a single antibiotic." b) "Many people infected with gonorrhea are infected with chlamydia as well." c) "The combination of these two antibiotics reduces the risk of reinfection." d) "There are many resistant strains of gonorrhea, so more than one antibiotic may be required for successful treatment."

CH44S. The nurse is instructing a client to perform a testicular self-examination (TSE). The nurse should provide the client with which information about the procedure? a. to examine the testicles while lying down b. that the best time for the examination is after a shower c. to gently feel the testicle with one finger to feel for a growth that TSEs should be done at least every 6 months

58. During a recent visit to the clinic a woman presents with erythema of the nipple and areola on the right breast. She states this started several weeks ago and she was fearful of what would be found. The nurse should promptly refer the patient to her primary care provider because the patients signs and symptoms are suggestive of what health problem? A) Peau dorange B) Nipple inversion C) Pagets disease D) Acute mastitis

58. For which of the following population groups would an annual clinical breast examination be recommended? A) Women over age 21 B) Women over age 25 C) Women over age 40 D) All post-pubescent females with a family history of breast cancer

58. The nurse leading an educational session is describing self-examination of the breast. The nurse tells the womens group to raise their arms and inspect their breasts in a mirror. A member of the womens group asks the nurse why raising her arms is necessary. What is the nurses best response? A) It helps to spread out the fat that makes up your breast. B) It allows you to simultaneously assess for pain. C) It will help to observe for dimpling more closely. D) This is what the American Cancer Society recommends.

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

56. A 48-year-old woman presenting for care is seeking information about hormone therapy (HT) for the treatment of her perimenopausal symptoms. The patients need for relief from hot flashes and other symptoms will be weighed carefully against the increased risks of what complications of HT? Select all that apply. A) Anaphylaxis B) Osteoporosis C) Breast cancer D) Cardiovascular disease E) Venous thromboembolism

c,d,e

56. A 17-year-old girl has come to the free clinic for her annual examination. She tells the nurse she uses tampons and asks how long she may safely leave her tampon in place. What is the nurses best response? A) You may leave the tampon in overnight. B) The tampon should be changed at least twice per day. C) Tampons are dangerous and, ideally, you should not be using them. D) Tampons need to be changed every 4 to 6 hours.

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

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

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

71. A male patient comes to the clinic and is diagnosed with gonorrhea. Which symptom most likely prompted him to seek medical attention? A) Rashes on the palms of the hands and soles of the feet B) Cauliflower-like warts on the penis C) Painful, red papules on the shaft of the penis D) Foul-smelling discharge from the penis

A 16-year-old patient comes to the free clinic and is diagnosed with primary syphilis. The patient states that she contracted this disease by holding hands with someone who has syphilis. What is the most appropriate nursing diagnosis for this patient? a) Alteration in comfort related to impaired skin integrity b) Fear related to complications c) Noncompliance with treatment regimen related to age d) Knowledge deficit related to modes of transmission

A nurse is providing care to a client with chlamydia. The nurse anticipates that the client will also receive treatment for which of the following? a) Mycoplasma b) Trichomoniasis c) Human papillomavirus d) Gonorrhea

The nurse is preparing a presentation for a local community group about sexually transmitted infections (STIs). Which of the following would the nurse expect to include as the most common STI in the United States? a) Chlamydia b) Syphilis c) Genital herpes d) Gonorrhea

59. The nurse is leading a workshop on sexual health for men. The nurse should teach participants that organic causes of erectile dysfunction include what? Select all that apply. A) Diabetes B) Testosterone deficiency C) Anxiety D) Depression E) Parkinsonism

a,b,e

A male patient comes to the clinic and is diagnosed with gonorrhea. Which symptom most likely prompted him to seek medical attention? a) Painful red papules on the shaft of the penis b) Foul-smelling discharge from the penis c) Rashes on the palms of the hands and soles of the feet d) Cauliflower-like warts on the penis

58. A woman is considering breast reduction mammoplasty. When weighing the potential risks and benefits of this surgical procedure, the nurse should confirm that the patient is aware of what potential consequence? A) Chronic breast pain B) Unclear mammography results C) Increased risk of breast cancer D) Decreased nipple sensation

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

56. A 15-year-old girl is brought to the clinic by her mother to see her primary care provider. The mother states that her daughter has not started to develop sexually. The physical examination shows that the patient has no indication of secondary sexual characteristics. What diagnosis should the nurse suspect? A) Primary amenorrhea B) Dyspareunia C) Vaginal atrophy D) Secondary dysmenorrhea

56. A 21-year-old woman has sought care because of heavy periods and has subsequently been diagnosed with menorrhagia. The nurse should recognize which of the following as the most likely cause of the patients health problem? A) Hormonal disturbances B) Cervical or uterine cancer C) Pelvic inflammatory disease D) A sexually transmitted infection (STI)

57. You are caring for a patient who has been diagnosed with genital herpes. When preparing a teaching plan for this patient, what general guidelines should be taught? A) Thorough handwashing is essential. B) Sun bathing assists in eradicating the virus. C) Lesions should be massaged with ointment. D) Self-infection cannot occur from touching lesions during a breakout.

58. A new mother who is breastfeeding calls the clinic to speak to a nurse. The patient is complaining of pain in her left breast and describes her breast as feeling doughy. The nurse tells her to come into the clinic and be checked. The patient is diagnosed with acute mastitis and placed on antibiotics. What comfort measure should the nurse recommend? A) Apply cold compresses as ordered. B) Avoid wearing a bra until the infection clears. C) Avoid washing the breasts. D) Perform gentle massage to stimulate neutrophil migration.

58. A nurse is teaching a group of women about the potential benefits of breast self-examination (BSE). The nurse should teach the women that effective BSE is dependent on what factor? A) Womens knowledge of how their breasts normally look and feel B) The rapport that exists between the woman and her primary care provider C) Synchronizing womens routines around BSE with the performance of mammograms D) Womens knowledge of the pathophysiology of breast cancer

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

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

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

58. A patient is to undergo an ultrasound-guided core biopsy. The patient tells the nurse that a friend of hers had a stereotactic core biopsy. She wants to understand the differences between the two procedures. What would be the nurses best response? A) An ultrasound-guided core biopsy is faster, less expensive, and does not use radiation. B) An ultrasound-guided core biopsy is a little more expensive, but it doesnt use radiation and it is faster. C) An ultrasound-guided core biopsy is a little more expensive, and it also uses radiation but it is faster. D) An ultrasound-guided core biopsy takes more time, and it also uses radiation, but it is less expensive.

58. A patient who came to the clinic after finding a mass in her breast is scheduled for a diagnostic breast biopsy. During the nurses admission assessment, the nurse observes that the patient is distracted and tense. What is it important for the nurse to do? A) Acknowledge the fear the patient is likely experiencing. B) Describe the support groups that exist in the community. C) Assess the patients stress management skills. D) Document a nursing diagnosis of ineffective coping.

58. A patient who has had a lumpectomy calls the clinic to talk to the nurse. The patient tells the nurse that she has developed a tender area on her breast that is red and warm and looks like someone drew a line with a red marker. What would the nurse suspect is the womans problem? A) Mondor disease B) Deep vein thrombosis (DVT) of the breast C) Recurrent malignancy D) An area of fat necrosis

59. A 22-year-old male is being discharged home after surgery for testicular cancer. The patient is scheduled to begin chemotherapy in 2 weeks. The patient tells the nurse that he doesnt think he can take weeks or months of chemotherapy, stating that he has researched the adverse effects online. What is the most appropriate nursing action for this patient at this time? A) Provide empathy and encouragement in an effort to foster a positive outlook. B) Tell the patient it is his decision whether to accept or reject chemotherapy. C) Report the patients statement to members of his support system. D) Refer the patient to social work.

59. A 29-year-old patient has just been told that he has testicular cancer and needs to have surgery. During a presurgical appointment, the patient admits to feeling devastated that he requires surgery, stating that it will leave him emasculated and a shell of a man. The nurse should identify what nursing diagnosis when planning the patients subsequent care? A) Disturbed Body Image Related to Effects of Surgery B) Spiritual Distress Related to Effects of Cancer Surgery C) Social Isolation Related to Effects of Surgery D) Risk for Loneliness Related to Change in Self-Concept

59. A man tells the nurse that his father died of prostate cancer and he is concerned about his own risk of developing the disease, having heard that prostate cancer has a genetic link. What aspect of the pathophysiology of prostate cancer would underlie the nurses response? A) A number of studies have identified an association of BRCA-2 mutation with an increased risk of prostate cancer. B) HNPCC is a mutation of two genes that causes prostate cancer in men and it is autosomal dominant. C) Studies have shown that the presence of the TP53 gene strongly influences the incidence of prostate cancer. D) Recent research has demonstrated that prostate cancer is the result of lifestyle factors and that genetics are unrelated.

59. A nurse is providing care for a patient who has recently been admitted to the postsurgical unit from PACU following a transuretheral resection of the prostate. The nurse is aware of the nursing diagnosis of Risk for Imbalanced Fluid Volume. In order to assess for this risk, the nurse should prioritize what action? A) Closely monitoring the input and output of the bladder irrigation system B) Administering parenteral nutrition and fluids as ordered C) Monitoring the patients level of consciousness and skin turgor D) Scanning the patients bladder for retention every 2 hours

59. A nurse is teaching a 53-year-old man about prostate cancer. What information should the nurse provide to best facilitate the early identification of prostate cancer? A) Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly. B) Have a transrectal ultrasound every 5 years. C) Perform monthly testicular self-examinations, especially after age 60. D) Have a complete blood count

59. A patient has experienced occasional urinary incontinence in the weeks since his prostatectomy. In order to promote continence, the nurse should encourage which of the following? A) Pelvic floor exercises B) Intermittent urinary catheterization C) Reduced physical activity D) Active range of motion exercises

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

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

59. A public health nurse is teaching a health class for the male students at the local high school. The nurse is teaching the boys to perform monthly testicular self-examinations. What point would be appropriate to emphasize? A) Testicular cancer is a highly curable type of cancer. B) Testicular cancer is very difficult to diagnose. C) Testicular cancer is the number one cause of cancer deaths in males. D) Testicular cancer is more common in older men.

71. A nursing home patient has been diagnosed with Clostridium difficile. What type of precautions should the nurse implement to prevent the spread of this infectious disease to other residents? A) Contact B) Droplet C) Airborne D) Positive pressure isolation

CH54S. A client is admitted to the emergency department following a fall from a horse, and the PHCP prescribes insertion of a urinary catheter. While preparing for the procedure, the nurse notes blood at the urinary meatus. The nurse should take which action? a. notify the PHCP before performing the catheterization b. use a small-sized catheter and an anesthetic gel as a lubricant c. administer parenteral pain medication before inserting the catheter d. clean the meatus with soap and water before opening the catheterization kit

59. A 76-year-old with a diagnosis of penile cancer has been admitted to the medical floor. Because the incidence of penile cancer is so low, the staff educator has been asked to teach about penile cancer. What risk factors should the educator cite in this presentation? Select all that apply. A) Phimosis B) Priapism C) Herpes simplex infection D) Increasing age E) Lack of circumcision

a,d,e

56. A newly pregnant patient is being assessed in an obstetric clinic. The patient states that she has been experiencing intense abdominal pain and the nurse anticipates that the patient will be assessed for ectopic pregnancy. In addition to ultrasonography, what diagnostic test should the nurse anticipate? A) Computed tomography B) Human chorionic gonadotropin (hCG) testing C) Estrogen and progesterone testing D) Abdominal x-ray

56. A nurse presenting an educational event for a local community group is addressing premenstrual syndrome (PMS). What treatment guideline should the nurse teach this group? A) Avoid excessive fluid intake. B) Increase the frequency and intensity of exercise. C) Limit psychosocial stressors in order to reduce symptoms. D) Take opioid analgesics as ordered.

56. A patient calls the clinic and tells the nurse she has thick white, curd-like discharge from her vagina. How should the nurse best interpret this preliminary data? A) The drainage is physiologic and normal. B) The patient may have a Candida species infection. C) The patient needs a Pap smear as soon as possible. D) The patient may have a Trichomonas infection.

56. A premenopausal patient is complaining of vaginal spotting and sharp, colicky lower abdominal pain. She informs the nurse that her period is 2 weeks late. The nurse should recognize a need for this patient to be investigated for what health problem? A) Trichomonas vaginalis B) Ectopic pregnancy C) Cervical cancer D) Fibromyalgia

56. A womans current health complaints are suggestive of a diagnosis of premenstrual dysphoric disorder (PMDD). The nurse should first do which of the following? A) Assess the patients understanding of HT. B) Assess the patient for risk of suicide. C) Assure the patient that the problem is self-limiting. D) Suggest the use of St. Johns wort.

56. The nurse is being trained to perform assessment screenings for abuse on patients who come into the walk-in clinic where the nurse works. Which of the following assessment questions is most appropriate? A) Would you describe your relationship as healthy and functional? B) Have you ever been forced into sexual activity? C) Do you make your husband uncontrollably angry? D) How is conflict usually handled in your home?

58. A 42 year-old patient tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. She says that she is afraid that she has cancer. Which assessment finding would most strongly suggest that this patients lump is cancerous? A) Eversion of the right nipple and mobile mass B) A nonmobile mass with irregular edges C) A mobile mass that is soft and easily delineated D) Nonpalpable right axillary lymph nodes

58. A 42-year-old man has come to the clinic for an annual physical. The nurse notes in the patients history that his father was treated for breast cancer. What should the nurse provide to the patient before he leaves the clinic? A) A referral for a mammogram B) Instructions about breast self-examination (BSE) C) A referral to a surgeon D) A referral to a support group

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

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

58. A nurse is examining a patient who has been diagnosed with a fibroadenoma. The nurse should recognize what implication of this patients diagnosis? A) The patient will be scheduled for radiation therapy. B) The patient might be referred for a biopsy. C) The patients breast mass is considered an age-related change. D) The patients diagnosis is likely related to her use of oral contraceptives.

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

58. The nurse is performing a comprehensive health history of a patient who is in her 50s. The nurse should identify what risk factor that may increase this patients risk for breast cancer? A) The patient breastfed each of her children. B) The patient gave birth to her first child at age 38. C) The patient experienced perimenopausal symptoms starting at age 46. D) The patient experienced menarche at age 13.

59. A 55-year-old man presents at the clinic complaining of erectile dysfunction. The patient has a history of diabetes. The physician orders tadalafil (Cialis) to be taken 1 hour before sexual intercourse. The nurse reviews the patients history prior to instructing the patient on the use of this medication. What disorder will contraindicate the use of tadalafil (Cialis)? A) Cataracts B) Retinopathy C) Hypotension D) Diabetic nephropathy

59. A 75-year-old male patient is being treated for phimosis. When planning this patients care, what health promotion activity is most directly related to the etiology of the patients health problem? A) Teaching the patient about safer sexual practices B) Teaching the patient about the importance of hygiene C) Teaching the patient about the safe use of PDE-5 inhibitors D) Teaching the patient to perform testicular self-examination

59. A man comes to the clinic complaining that he is having difficulty obtaining an erection. When reviewing the patients history, what might the nurse note that contributes to erectile dysfunction? A) The patient has been treated for a UTI twice in the past year. B) The patient has a history of hypertension. C) The patient is 66 years old. D) The patient leads a sedentary lifestyle.

59. A patient has returned to the floor from the PACU after undergoing a suprapubic prostatectomy. The nurse notes significant urine leakage around the suprapubic tube. What is the nurses most appropriate action? A) Cleanse the skin surrounding the suprapubic tube. B) Inform the urologist of this finding. C) Remove the suprapubic tube and apply a wet-to-dry dressing. D) Administer antispasmodic drugs as ordered.

59. A patient presents to the emergency department with paraphimosis. The physician is able to compress the glans and manually reduce the edema. Once the inflammation and edema subside, what is usually indicated? A) Needle aspiration of the corpus cavernosum B) Circumcision C) Abstinence from sexual activity for 6 weeks D) Administration of vardenafil

59. A patient who is scheduled for an open prostatectomy is concerned about the potential effects of the surgery on his sexual function. What aspect of prostate surgery should inform the nurses response? A) Erectile dysfunction is common after prostatectomy as a result of hormonal changes. B) All prostatectomies carry a risk of nerve damage and consequent erectile dysfunction. C) Erectile dysfunction after prostatectomy is expected, but normally resolves within several months. D) Modern surgical techniques have eliminated the risk of erectile dysfunction following prostatectomy.

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

b,c,d

56. A 36-year-old woman comes to the clinic complaining of premenstrual syndrome (PMS) that is disrupting her quality of life. What signs and symptoms are associated with this health problem? Select all that apply. A) Loss of appetite B) Breast tenderness C) Depression D) Fluid retention E) Headache

b,c,d,e

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

56. A nurse practitioner is preparing to perform a patients scheduled Pap smear and the patient asks the nurse to ensure that the speculum is well-lubricated. How should the nurse proceed with assessment? A) Reassure the patient that ample petroleum jelly will be used. B) Reassure that patient that a water-based lubricant will be used. C) Explain to the patient that water is the only lubricant that can be used. D) Explain to the patient why the speculum must be introduced dry.

56. The nurse is assessing a patient who believes that she has recently begun menopause. What principle should inform the nurses interactions with this patient? A) The nurse should express empathy for the patients difficult health situation. B) The nurse should begin by assuring the patient that her health will be much better in a few years. C) The nurse must carefully assess the patients feelings and beliefs surrounding menopause. D) The nurse should encourage the patient to celebrate this life milestone and its accompanying benefits.

56. The nurse is utilizing the PLISSIT model of sexual health assessment during an interaction with a new patient. According to this model, the nurse should begin with what action? A) Conducting a preliminary assessment B) Addressing the patients psychosocial status C) Asking the patients permission to discuss sexuality D) Assessing for physiologic problems

56. The school nurse is presenting a class on female reproductive health. The nurse should describe what aspect of Pap smears? A) The test may be performed at any time during the patients menstrual cycle. B) The smear should be done every 2 years. C) The test can detect early evidence of cervical cancer. D) False positive Pap smear results occur mostly from not douching before the examination.

58. A nurse is explaining that each breast contains 12 to 20 cone-shaped lobes. The nurse should explain that each lobe consists of what elements? A) Modified tendons and ligaments B) Connective tissue and smooth muscle C) Lobules and ducts D) Endocrine glands and sebaceous glands

58. A patient has just been diagnosed with breast cancer and the nurse is performing a patient interview. In assessing this patients ability to cope with this diagnosis, what would be an appropriate question for the nurse to ask this patient? A) What is your level of education? B) Are you feeling alright these days? C) Is there someone you trust to help you make treatment choices? D) Are you concerned about receiving this diagnosis?

58. A woman aged 48 years comes to the clinic because she has discovered a lump in her breast. After diagnostic testing, the woman receives a diagnosis of breast cancer. The woman asks the nurse when her teenage daughters should begin mammography. What is the nurses best advice? A) Age 28 B) Age 35 C) Age 38 D) Age 48

58. A woman scheduled for a simple mastectomy in one week is having her preoperative education provided by the clinic nurse. What educational intervention will be of primary importance to prevent hemorrhage in the postoperative period? A) Limit her intake of green leafy vegetables. B) Increase her water intake to 8 glasses per day. C) Stop taking aspirin. D) Have nothing by mouth for 6 hours before surgery.

59. A nurse is caring for a 33-year-old male who has come to the clinic for a physical examination. He states that he has not had a routine physical in 5 years. During the examination, the physician finds that digital rectal examination (DRE) reveals stoney hardening in the posterior lobe of the prostate gland that is not mobile. The nurse recognizes that the observation typically indicates what? A) A normal finding B) A sign of early prostate cancer C) Evidence of a more advanced lesion D) Metastatic disease

56. A clinic nurse is meeting with a 38-year-old patient who states that she would like to resume using oral contraceptives, which she used for several years during her twenties. What assessment question is most likely to reveal a potential contraindication to oral contraceptive use? A) Have you ever had surgery? B) Have you ever had a sexually transmitted infection? C) When did you last have your blood sugar levels checked? D) Do you smoke?

56. A 27-year-old primipara presents to the ED with vaginal bleeding and suspected contractions. The woman relates that she is 14 weeks pregnant and she thinks she is losing her baby. Diagnostic testing confirms a spontaneous abortion. What nursing action would be a priority at this time? A) Leave the patient alone so she can grieve in private. B) Teach the patient that this will not affect her future chance of conception. C) Take the patient off the obstetric floor so she will not hear a baby cry. D) Provide opportunities for the patient to talk and express her emotions.

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

56. During the nurses assessment of a female patient, the patient reveals that she experienced sexual abuse when she was a young woman. What is the nurses most appropriate response to this disclosure? A) Reassure her that this information will be kept a secret. B) Begin the process of intensive psychotherapy. C) Encourage the patient to phone 911. D) Facilitate appropriate resources and referrals.

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

58. A nurse has assessed that a patient is not yet willing to view her mastectomy site. How should the nurse best assist the patient is developing a positive body image? A) Ask the woman to describe the current appearance of her breast. B) Help the patient to understand that many women have gone through the same unpleasant experience. C) Explain to the patient that her body image does not have to depend on her physical appearance. D) Provide the patient with encouragement in an empathic and thoughtful manner.

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

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

58. A patient newly diagnosed with breast cancer states that her physician suspects regional lymph node involvement and told her that there are signs of metastatic disease. The nurse learns that the patient has been diagnosed with stage IV breast cancer. What is an implication of this diagnosis? A) The patient is not a surgical candidate. B) The patients breast cancer is considered highly treatable. C) There is a 10% chance that the patients cancer will self-resolve. D) The patient has a 15% chance of 5-year survival.

58. A woman calls the clinic and tells the nurse she has had bloody drainage from her right nipple. The nurse makes an appointment for this patient, expecting the physician or practitioner to order what diagnostic test on this patient? A) Breast ultrasound B) Radiography C) Positron emission testing (PET) D) Galactography

58. A woman is being treated for a tumor of the left breast. If the patient and her physician opt for prophylactic treatment, the nurse should prepare the woman for what intervention? A) More aggressive chemotherapy B) Left mastectomy C) Radiation therapy D) Bilateral mastectomy

58. The nurse is caring for a 52-year-old woman whose aunt and mother died of breast cancer. The patient states, My doctor and I talked about Tamoxifen to help prevent breast cancer. Do you think it will work? What would be the nurses best response? A) Yes, its known to have a slight protective effect. B) Yes, but studies also show an increased risk of osteoporosis. C) You wont need to worry about getting cancer as long as you take Tamoxifen. D) Tamoxifen is known to be a highly effective protective measure.

58. The nurse is teaching breast self-examination (BSE) to a group of women. The nurse should recommend that the women perform BSE at what time? A) At the time of menses B) At any convenient time, regardless of cycles C) Weekly D) Between days 5 and 7 after menses

59. A 57-year-old male comes to the clinic complaining that when he has an erection his penis curves and becomes painful. The patients diagnosis is identified as severe Peyronies disease. The nurse should be aware of what likely treatment modality? A) Physical therapy B) Treatment with PDE-5 inhibitors C) Intracapsular hydrocortisone injections D) Surgery

59. A patient confides to the nurse that he cannot engage in sexual activity. The patient is 27 years old and has no apparent history of chronic illness that would contribute to erectile dysfunction. What does the nurse know will be ordered for this patient to assess his sexual functioning? A) Sperm count B) Ejaculation capacity tests C) Engorgement tests D) Nocturnal penile tumescence tests

59. A patient has been diagnosed with erectile dysfunction; the cause has been determined to be psychogenic. The patients interdisciplinary plan of care should prioritize which of the following interventions? A) Penile implant B) PDE-5 inhibitors C) Physical therapy D) Psychotherapy

CH54S. A client complains of fever, perineal pain, and urinary urgency, frequency, and dysuria. To assess whether the client's problem is related to bacterial prostatitis, the nurse reviews the results of the prostate examination for which characteristics of this disorder? a. soft and swollen prostate gland b. swollen and boggy prostate gland c. tender and edematous prostate gland d. tender, indurated prostate gland that is warm to the touch

57. A female patient tells the nurse that she thinks she has a vaginal infection because she has noted inflammation of her vulva and the presence of a frothy, yellow-green discharge. The nurse recognizes that the clinical manifestations described are typical of what vaginal infection? A) Trichomonas vaginalis B) Candidiasis C) Gardnerella D) Gonorrhea

57. A nurse is caring for a pregnant patient with active herpes. The teaching plan for this patient should include which of the following? A) Babies delivered vaginally may become infected with the virus. B) Recommended treatment is excision of the herpes lesions. C) Pain generally does not occur with a herpes outbreak during pregnancy. D) Pregnancy may exacerbate the mothers symptoms, but poses no risk to the infant.

57. A nurse practitioner is examining a patient who presented at the free clinic with vulvar pruritus. For which assessment finding would the practitioner look that may indicate the patient has an infection caused by Candida albicans? A) Cottage cheese-like discharge B) Yellow-green discharge C) Gray-white discharge D) Watery discharge with a fishy odor

57. A patient comes to the free clinic complaining of a gray-white discharge that clings to her external vulva and vaginal walls. A nurse practitioner assesses the patient and diagnoses Gardnerella vaginalis. What would be the most appropriate nursing action at this time? A) Advise the patient that this is an overgrowth of normal vaginal flora. B) Discuss the effect of this diagnosis on the patients fertility. C) Document the vaginal discharge as normal. D) Administer acyclovir as ordered.

57. A patient with trichomoniasis comes to the walk-in clinic. In developing a care plan for this patient the nurse would know to include what as an important aspect of treating this patient? A) Both partners will be treated with metronidazole (Flagyl). B) Constipation and menstrual difficulties may occur. C) The patient should perform Kegel exercises 30 to 80 times daily. D) Care will involve hormone therapy to control the pain.

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

57. You are caring for a patient who has been diagnosed with genital herpes. When preparing a teaching plan for this patient, what general guidelines should be taught? A) Thorough hand washing is essential. B) Sun bathing assists in eradicating the virus. C) Lesions should be massaged with ointment. D) Self-infection cannot occur from touching lesions during a breakout.

A female client with an anal gonorrheal infection experiences painful bowel elimination and a purulent rectal discharge. The nurse would expect to find which of the following once the microorganism disseminates throughout the body? a) Painful joints b) Intermenstrual bleeding c) Sore throat d) Painful urination

A male client reports urethral pain and a creamy yellow, bloody discharge from the penis. The nurse associates these characteristics with which of the following sexually transmitted infections? a) Gonorrhea b) Candidiasis c) Chancroid d) Trichomoniasis

A nurse is developing a plan of care for a female client experiencing her first outbreak of genital herpes. Which nursing diagnosis would the nurse most likely identify as the priority? a) Acute pain related to the development of the genital lesions b) Deficient knowledge related to the disease and its transmission c) Ineffective coping related to the increased stress associated with the infection d) Hyperthermia related to body's response to an infectious process

A patient comes to the clinic after being informed by a sexual partner of possible recent exposure to syphilis. The nurse will examine the patient for which of the following characteristic findings of syphilis in the primary clinical stage? a) Chancre b) Alopecia c) Condylomata lata d) Regional adenopathy

A student nurse is doing clinical hours at an OB/GYN clinic. The student is helping to develop a plan of care for a patient with gonorrhea has presented at the clinic. The student knows that the care plan for this patient should be include what in the treatment of gonorrhea? a) Concurrent treatment for chlamydia b) Avoidance of the use of tampons c) Vaginal smears every 6 months d) Radiation therapy to destroy cancerous cells

An instructor is teaching a group of students about the incidence of sexually transmitted infections (STIs) and those that must be reported by law. The instructor determines that the students have understood the information when they state that which STI must be reported? a) Syphilis b) Condylomata acuminata c) Genital herpes d) Hepatitis B

Katrina Sterrett, a 26-year-old preschool teacher, is being seen by a physician who is part of the internist group where you practice nursing. She is undergoing her annual physical and is having many lab tests done as a condition of her employment and upcoming wedding. She is returning for her results and is devastated to learn that she has the sexually-transmitted infection, gonorrhea. What would contribute to her ignorance of her condition? a) Being asymptomatic b) All options are correct c) Being sexually inactive d) Knowing the signs and symptoms of STIs

The nurse is giving a presentation about chlamydia to a group of adult women. The nurse would emphasize the need for annual screening for this infection in all sexually active women younger than which age? a) 26 b) 35 c) 18 d) 32

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

a,b,c,e

Teaching for patients with a sexually transmitted disease (STD) would include (select all that apply) a) Treatment of sexual partner is important. b) Douching may help provide relief of itching. c) Cotton undergarments are preferred over synthetic materials. d) Sexual abstinence is indicated during the communicable phase of the disease. e) Condoms should be used during as well as after treatment during sexual activity.

a,c,d,e

57. A student nurse is caring for a patient who has undergone a wide excision of the vulva. The student should know that what action is contraindicated in the immediate postoperative period? A) Placing patient in low Fowlers position B) Application of compression stockings C) Ambulation to a chair D) Provision of a low-residue diet

57. The nurse is caring for a patient with a diagnosis of vulvar cancer who has returned from the PACU after undergoing a wide excision of the vulva. How should this patients analgesic regimen be best managed? A) Analgesia should be withheld unless the patients pain becomes unbearable. B) Scheduled analgesia should be administered around-the-clock to prevent pain. C) All analgesics should be given on a PRN, rather than scheduled, basis. D) Opioid analgesics should be avoided and NSAIDs exclusively provided.

57. When teaching patients about the risk factors of cervical cancer, what would the nurse identify as the most important risk factor? A) Late childbearing B) Human papillomavirus (HPV) C) Postmenopausal bleeding D) Tobacco use

59. A patient has been prescribed sildenafil. What should the nurse teach the patient about this medication? A) Sexual stimulation is not needed to obtain an erection. B) The drug should be taken 1 hour prior to intercourse. C) Facial flushing or headache should be reported to the physician immediately. D) The drug has the potential to cause permanent visual changes.

57. A 14-year-old is brought to the clinic by her mother. The mother explains to the nurse that her daughter has just started using tampons, but is not yet sexually active. The mother states I am very concerned because my daughter is having a lot of stabbing pain and burning. What might the nurse suspect is the problem with the 14-year-old? A) Vulvitis B) Vulvodynia C) Vaginitis D) Bartholins cyst

57. A 31-year-old patient has returned to the post-surgical unit following a hysterectomy. The patients care plan addresses the risk of hemorrhage. How should the nurse best monitor the patients postoperative blood loss? A) Have the patient void and have bowel movements using a commode rather than toilet. B) Count and inspect each perineal pad that the patient uses. C) Swab the patients perineum for the presence of blood at least once per shift. D) Leave the patients perineum open to air to facilitate inspection.

57. A middle-aged female patient has been offered testing for HIV/AIDS upon admission to the hospital for an unrelated health problem. The nurse observes that the patient is visibly surprised and embarrassed by this offer. How should the nurse best respond? A) Most women with HIV dont know they have the disease. If you have it, its important we catch it early. B) This testing is offered to every adolescent and adult regardless of their lifestyle, appearance or history. C) The rationale for this testing is so that you can begin treatment as soon as testing comes back, if its positive. D) Youre being offered this testing because you are actually in the prime demographic for HIV infection.

57. A patient comes to the clinic complaining of a tender, inflamed vulva. Testing does not reveal the presence of any known causative microorganism. What aspect of this patients current health status may account for the patients symptoms of vulvitis? A) The patient is morbidly obese. B) The patient has type 1 diabetes. C) The patient has chronic kidney disease. D) The patient has numerous allergies.

57. A patient has been diagnosed with endometriosis. When planning this patients care, the nurse should prioritize what nursing diagnosis? A) Anxiety related to risk of transmission B) Acute pain related to misplaced endometrial tissue C) Ineffective tissue perfusion related to hemorrhage D) Excess fluid volume related to abdominal distention

57. A patient is post-operative day 1 following a vaginal hysterectomy. The nurse notes an increase in the patients abdominal girth and the patient complains of bloating. What is the nurses most appropriate action? A) Provide the patient with an unsweetened, carbonated beverage. B) Apply warm compresses to the patients lower abdomen. C) Provide an ice pack to apply to the perineum and suprapubic region. D) Assist the patient into a prone position.

57. A patient with a genital herpes exacerbation has a nursing diagnosis of acute pain related to the genital lesions. What nursing intervention best addresses this diagnosis? A) Cover the lesions with a topical antibiotic. B) Keep the lesions clean and dry. C) Apply a topical NSAID to the lesions. D) Remain on bed rest until the lesions resolve.

A 22-year-old male is being treated at a college health care clinic for gonorrhea. Which of the following teaching points should the nurse include in patient teaching? a) "While being treated for the infection, you will not be able to pass this infection on to your sexual partner." b) "While you're taking your antibiotics, you will need to abstain from participating in sexual activity or drinking alcohol." c) "It's important to complete your full course of antibiotics in order to ensure that you become resistant to reinfection." d) "The symptoms of gonorrhea will resolve on their own, but it is important for you to abstain from sexual activity while this is occurring."

A client is being treated for gonorrhea. Which agent would the nurse expect the physician to prescribe? a) Tetracycline b) Ceftriaxone c) Penicillin d) Levofloxacin

A client is diagnosed with chlamydia and is distraught. "How can I have this problem? I don't have any symptoms!" she says. The nurse teaches the client that the percentage of women with chlamydia who are asymptomatic is as high as a) 100% b) 75% c) 50% d) 25%

A client with primary syphilis is allergic to penicillin. The nurse would expect the physician to order which agent? a) Podophyllum resin b) Tetracycline c) Ceftriaxone d) Acyclovir

A hospital has seen a recent increase in the incidence of hospital-acquired infections (HAIs). Which of the following measures should be prioritized in the response to this trend? a) Use of gloves during patient contact b) Frequent and thorough hand washing c) Prophylactic, broad-spectrum antibiotics d) Fitting and appropriate use of N95 masks

A nurse is assessing a woman with vaginal discharge. The nurse suspects bacterial vaginosis when the client states which of the following? a) "The discharge is yellowish but thin." b) "I noticed a strange fishy odor during my period." c) "The discharge looks almost like cottage cheese." d) "I've been experiencing some really intense itching."

A nurse is caring for a client diagnosed with a chlamydia infection. The nurse teaches the client about disease transmission and advises the client to inform his sexual partners of the infection. The client refuses, stating, "This is my business and I'm not telling anyone. Beside, chlamydia doesn't cause any harm like the other STDs." How should the nurse proceed? a) Do nothing because the client's sexual habits place him at risk for contracting other STDs. b) Educate the client about why it's important to inform sexual contacts so they can receive treatment. c) Inform the health department that this client contracted an STD. d) Inform the client's sexual contacts of their possible exposure to chlamydia.

Max Thornton, a 24-year-old chef, is being seen by a physician at the urology group where you practice nursing. He has developed a painless ulcer on his penis and is rather concerned about his health. The urologist will be communicating his diagnosis of syphilis and prescribing treatment. What is the typical span of time between infection and developing symptoms with syphilis? a) 14 days b) 21 days c) 35 days d) 28 days

Within the free clinic where you practice nursing, you hold weekly sexual education classes open to the public. Within the classroom, you communicate the CDC's numbers for the incidence of STIs and their impact upon public health. Which is the fastest-spreading bacterial STI in the United States? a) Gonorrhea b) Chlamydia c) Herpes simplex 1 d) HPV

CH44S. When caring for a client with an internal radiation implaint, the nurse should observe which principles? Select all that apply. a. Limiting the time with the client to 1 hr per shift b. keeping pregnany women out of the client's room c. placing the client in a private room with a private bath d. wearing a lead shield when providing direct client care e. removing the dosimeter film badge when entering the clients room f. allowing individuals younger than 16 years olf in the room as long as they are 6 feet away from the client

b,c,d

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

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

57. A patient diagnosed with cervical cancer will soon begin a round of radiation therapy. When planning the patients subsequent care, the nurse should prioritize actions with what goal? A) Preventing hemorrhage B) Ensuring the patient knows the treatment is palliative, not curative C) Protecting the safety of the patient, family, and staff D) Ensuring that the patient adheres to dietary restrictions during treatment

57. A patient has been diagnosed with polycystic ovary syndrome (PCOS). The nurse should encourage what health promotion activity to address the patients hormone imbalance and infertility? A) Kegel exercises B) Increased fluid intake C) Weight loss D) Topical antibiotics as ordered

57. A patient has returned to the post-surgical unit after vulvar surgery. What intervention should the nurse prioritize during the initial postoperative period? A) Placing the patient in high Fowlers position B) Administering sitz baths every 4 hours C) Monitoring the integrity of the surgical site D) Avoiding analgesics unless the patients pain is unbearable

57. A patient is being discharged home after a hysterectomy. When providing discharge education for this patient, the nurse has cautioned the patient against sitting for long periods. This advice addresses the patients risk of what surgical complication? A) Pudendal nerve damage B) Fatigue C) Venous thromboembolism D) Hemorrhage

57. The nurse is planning health education for a patient who has experienced a vaginal infection. What guidelines should the nurse include in this program regarding prevention? A) Wear tight-fitting synthetic underwear. B) Use bubble bath to eradicate perineal bacteria. C) Avoid feminine hygiene products, such as sprays. D) Restrict daily bathing.

57. When reviewing the electronic health record of a female patient, the nurse reads that the patient has a history of adenomyosis. The nurse should be aware that this patient experiences symptoms resulting from what pathophysiologic process? A) Loss of muscle tone in the vaginal wall B) Excessive synthesis and release of unopposed estrogen C) Invasion of the uterine wall by endometrial tissue D) Proliferation of tumors in the uterine wall

57. While taking a health history on a 20-year-old female patient, the nurse ascertains that this patient is taking miconazole (Monistat). The nurse is justified in presuming that this patient has what medical condition? A) Bacterial vaginosis B) Human papillomavirus (HPV) C) Candidiasis D) Toxic shock syndrome (TSS)

59. An uncircumcised 78-year-old male has presented at the clinic complaining that he cannot retract his foreskin over his glans. On examination, it is noted that the foreskin is very constricted. The nurse should recognize the presence of what health problem? A) Bowens disease B) Peyronies disease C) Phimosis D) Priapism

A client is prescribed didanosine (Videx) as part of his highly active antiretroviral therapy (HAART). Which instruction would the nurse emphasize with this client? a) "You should take the drug with an antacid." b) "It doesn't matter if you take this drug with or without food." c) "Be sure to take this drug about 1/2 hour before or 2 hours after you eat." d) "When you take this drug, eat a high-fat meal immediately afterwards."

A client with genital herpes asks the nurse about what to expect with the infection. Which of the following responses would be most appropriate? a) Once you take the medication, the infection will be gone for good. b) You might have to try several different medications before finding one that works. c) Even though you don't have symptoms, you could still spread the infection. d) You can expect other outbreaks, each of which will be longer than the first.

A female college student is distressed at the recent appearance of genital warts, an assessment finding that her care provider has confirmed as attributable to human papillomavirus (HPV) infection. Which of the following information should the nurse give the patient? a) "It's important to start treatment soon, so you will be prescribed pills today." b) "I'd like to give you an HPV vaccination if that's okay with you." c) "There is a chance that these will clear up on their own without any treatment." d) "Unfortunately, this is going to greatly increase your chance of developing pelvic inflammatory disease."

A nurse is teaching a community health class of women and explains that a sexually transmitted infection (STI) is associated with an increased risk of infertility in women. Which of the following STIs would the nurse identify? a) Herpes simplex b) Syphilis c) Chlamydia d) Gonorrhea

CH54S. The nurse is assessing a client with epididymitis. The nurse anticipates which findings on physical examination? a. fever, diarrhea, groin pain, and ecchymosis b. Nausea, painful scrotal edema, and ecchymosis c. fever, nausea, vomiting, and painful scrotal edema d. diarrhea, groin pain, testicular torsion, and scrotal edema

Screening for chlamydia is recommended for young women because a) Chlamydia is frequently comorbid with HIV. b) Chlamydial infections may progress to sepsis. c) Untreated chlamydial infections can lead to infertility. d) Chlamydial infections are treatable only in the early stages of infection.

The nurse is gathering data from a male client who is suspected of having gonorrhea. Which of the following would the nurse most likely find? a) Testicular pain b) Purulent rectal discharge c) Pain on urination d) Skin rash

The physical assessment and history of a 29-year-old female patient are indicative of human papillomavirus (HPV) infection. You would perform patient teaching related to a) Gardasil. b) Antibiotic therapy. c) Wart removal options. d) Treatment with antiviral drugs.

57. A 25-year-old patient diagnosed with invasive cervical cancer expresses a desire to have children. What procedure might the physician offer as treatment? A) Radical hysterectomy B) Radical culposcopy C) Radical trabeculectomy D) Radical trachelectomy

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

57. A nurse providing prenatal care to a pregnant woman is addressing measures to reduce her postpartum risk of cystocele, rectocele, and uterine prolapse. What action should the nurse recommend? A) Maintenance of good perineal hygiene B) Prevention of constipation C) Increased fluid intake for 2 weeks postpartum D) Performance of pelvic muscle exercises

57. A patient has herpes simplex 2 viral infection (HSV2). The nurse recognizes that which of the following should be included in teaching the patient? A) The virus causes cold sores of the lips. B) The virus may be cured with antibiotics. C) The virus, when active, may not be contracted during intercourse. D) Treatment is aimed at relieving symptoms.

57. A patient with genital herpes is having an acute exacerbation. What medication would the nurse expect to be ordered to suppress the symptoms and shorten the course of the infection? A) Clotrimazole (Gyne-Lotrimin) B) Metronidazole (Flagyl) C) Podophyllin (Podofin) D) Acyclovir (Zovirax)

57. A student nurse is doing clinical hours at an OB/GYN clinic. The student is helping to develop a plan of care for a patient with gonorrhea who has presented at the clinic. The student should include which of the following in the care plan for this patient? A) The patient may benefit from oral contraceptives. B) The patient must avoid use of tampons. C) The patient is susceptible to urinary incontinence. D) The patient should also be treated for chlamydia.

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

57. The nurse is teaching a patient preventative measures regarding vaginal infections. The nurse should include which of the following as an important risk factor? A) High estrogen levels B) Late menarche C) Nonpregnant state D) Frequent douching

57. The nurse notes that a patient has a history of fibroids and is aware that this term refers to a benign tumor of the uterus. What is a more appropriate term for a fibroid? A) Bartholins cyst B) Dermoid cyst C) Hydatidiform mole D) Leiomyoma

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

59. A patient has just been diagnosed with prostate cancer and is scheduled for brachytherapy next week. The patient and his wife are unsure of having the procedure because their daughter is 3 months pregnant. What is the most appropriate teaching the nurse should provide to this family? A) The patient should not be in contact with the baby after delivery. B) The patients treatment poses no risk to his daughter or her infant. C) The patients brachytherapy may be contraindicated for safety reasons. D) The patient should avoid close contact with his daughter for 2 months.

59. A patient has presented at the clinic with symptoms of benign prostatic hyperplasia. What diagnostic findings would suggest that this patient has chronic urinary retention? A) Hypertension B) Peripheral edema C) Tachycardia and other dysrhythmias D) Increased blood urea nitrogen (BUN)

A client is diagnosed as being in the primary stage of syphilis? Which of the following would the nurse expect as a finding? a) Palmar rash b) Development of gummas c) Development of central nervous system lesions d) Genital chancres

A client with genital herpes simplex infection asks the nurse, "Will I ever be cured of this infection?" Which response by the nurse would be most appropriate? a) "All you need is a dose of penicillin and the infection will be gone." b) "There is a new vaccine available that prevents the infection from returning." c) "Once you have the infection, you develop an immunity to it." d) "There is no cure, but drug therapy helps to reduce symptoms and recurrences."

A nurse is assisting with a physical examination of a male client. Which of the following signs and symptoms is most clearly suggestive of primary genital herpes? a) Emergence of hard, painless nodules on the shaft of the penis b) Presence of purulent, whitish discharge from the penis c) Production of cloudy, foul-smelling urine d) Itching, pain, and the emergence of pustules on the penis

A nurse is teaching a client with genital herpes. Education for this client should include an explanation of: a) why the disease is transmittable only when visible lesions are present. b) the need for the use of petroleum products. c) the option of disregarding safer-sex practices now that he's already infected. d) the importance of informing his partners of the disease.

CH44S. During the admission assessment of a client with advanced ovarian cancer, the nurse recognizes which manifestation as typical of the disease? a. diarrhea b. hypermenorrhea c. abnormal bleeding d. abdominal distention

CH44S. While giving care to a client with an internal cervical radiation implant, the nurse finds the implant in the bed. The nurse should take which initial action? a. call the PHCP b. reinsert the implant into the vagina c. pick up the implant with gloved hands and flush it down the toilet d. puck up the implant with long-handled forceps and place it in a lead container

CH44S.The community health nurse is instructing a group of young female clients about breast self-examination. The nurse should instruct the clients to perform the examination at which time? a. at the onset of menstruation b. every month during ovulation c. weekly at the same time of day d. one week after menstruation begins

CH54S. A client is admitted to the hospital with a diagnosis of benign prostatic hyperplasia, and a transurethral resection of the prostate is performed. Four hours after surgery, the nurse takes the client's vital signs and empties the urinary drainage bag. Which assessment finding indicated the need to notify the PHCP? a. red, bloody urine b. pain rated as 2 on a 0 to 10 pain scale c. urinary output of 200 mL higher than intake d. blood pressure-100/50 mmHg, pulse-130 bpm

CH54S. The nurse is collecting data from a client. Which symptom described by the client is characteristic of an early symptom of benign prostatic hyperplasia? a. nocturia b. scrotal edema c. occasional constipation d. decreased force in the stream of urine

When obtaining the health history from a client, which factor would lead the nurse to suspect that the client has an increased risk for sexually transmitted infections (STIs)? a) Hive-like rash for the past 2 days b) Clear vaginal discharge c) Weight gain of 5 lbs in one year d) Five different sexual partners

Med Surg - Exam 4

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