Module 2
The nurse will plan to teach the female patient with genital warts about the a. importance of regular Pap tests. b. increased risk for endometrial cancer. c. appropriate use of oral contraceptives. d. symptoms of pelvic inflammatory disease (PID).
A
Which patient statement indicates that the nurse's teaching about tamoxifen has been effective? a. "I can expect to have leg cramps." b. "I will call if I have any eye problems." c. "I should contact you if I have hot flashes." d. "I will be taking the medication for 6 to 12 months."
B
A 56-yr-old patient is concerned about having a moderate amount of vaginal bleeding after 5 years of menopause. The nurse will anticipate teaching the patient about a. endometrial biopsy. c. uterine balloon therapy. b. endometrial ablation. d. dilation and curettage (D&C).
A
A patient brought to the emergency department reports being sexually assaulted. The patient is confused about where she is and she has a laceration above the right eye. Which action should the nurse take first? a. Assess the patient's neurologic status. b. Assist the patient to remove her clothing. c. Ask the patient to describe what occurred during the assault. d. Ask the sexual assault nurse examiner (SANE) to assess the patient.
A
A patient diagnosed with breast cancer asks the nurse what "triple negative" means. An accurate response from the nurse about triple-negative breast cancer should include that a. the tumor is not likely to be responsive to hormone therapy. b. HER-2 receptor testing was repeated for a total of three samples. c. treatment with chemotherapy is not likely to be recommended. d. estrogen receptor testing identified the three hormones causing the cancer.
A
A patient in the emergency department reports that she has been sexually assaulted. Which action by the nurse will help to maintain the medicolegal chain of evidence? a. Labeling all specimens and other materials obtained from the patient b. Assisting the patient in filling out the application for financial compensation c. Discussing the availability of the "morning-after pill" for pregnancy prevention d. Educating the patient about baseline sexually transmitted infection (STI) testing
A
A patient is on the surgical unit after a radical abdominal hysterectomy. Which finding requires a report to the health care provider? a. Urine output of 125 mL in the first 8 hours after surgery b. Decreased bowel sounds in all four abdominal quadrants c. One-inch area of bloody drainage on the abdominal dressing d. Complaints of abdominal pain at the incision site with coughing
A
A patient who is scheduled for a lumpectomy and axillary lymph node dissection tells the nurse, "I would rather not know much about the surgery." Which response by the nurse is best? a. "Tell me what you think is important to know about the surgery." b. "It is essential that you know enough to provide informed consent." c. "Many patients do better after surgery if they have more information." d. "You can wait until after surgery for teaching about pain management."
A
A patient with endometriosis asks why she is being treated with medroxyprogesterone, a medication that she thought was a contraceptive. The nurse explains that this therapy a. suppresses the menstrual cycle by mimicking pregnancy. b. relieves symptoms such as vaginal atrophy and hot flashes. c. prevents a pregnancy that could worsen the menstrual bleeding. d. leads to permanent suppression of abnormal endometrial tissues.
A
After a 48-yr-old patient has had a modified radical mastectomy, the pathology report identifies the tumor as an estrogen-receptor positive adenocarcinoma. The nurse will plan to teach the patient about a. tamoxifen c. raloxifene (Evista). b. estradiol (Estrace). d. trastuzumab (Herceptin).
A
The nurse is assessing the sexual-reproductive functional health pattern of a 32-yr-old woman. Which question is most useful in determining the patient's sexual orientation and related risk factors? a. "Do you have sex with men, women, or both?" b. "Which gender do you prefer to have sex with?" c. "What types of sexual activities do you prefer?" d. "Are you heterosexual, homosexual, or bisexual?"
A
The nurse will anticipate teaching a patient who is diagnosed with lobular carcinoma in situ (LCIS) about a. tamoxifen c. lymphatic mapping. b. lumpectomy. d. MammaPrint testing.
A
Which information will the nurse include in patient teaching for a 36-yr-old patient who is scheduled for stereotactic core biopsy of the breast? a. A local anesthetic will be given before the biopsy specimen is obtained. b. You will need to lie flat on your back and lie very still during the biopsy. c. A thin needle will be inserted into the lump and aspirated to remove tissue. d. You should not have anything to eat or drink for 6 hours before the procedure.
A
Which topic will the nurse include in the preoperative teaching for a patient admitted for an abdominal hysterectomy? a. Purpose of ambulation and leg exercises b. Adverse effects of systemic chemotherapy c. Decrease in vaginal sensation after surgery d. Symptoms caused by the drop in estrogen level
A
Which nonhormonal therapies will the nurse suggest for a healthy perimenopausal patient who prefers not to use hormone replacement therapy (HRT) (select all that apply)? a. Reduce caffeine intake. b. Exercise several times a week. c. Take black cohosh supplements. d. Drink a glass of wine in the evening. e. Increase intake of dietary soy products.
A,B,C,E
A 22-yr-old patient reports her concern about not having a menstrual period for the past 7 months. Which statement by the patient indicates a possible related factor to the amenorrhea? a. "I drink at least 3 glasses of nonfat milk every day." b. "I run 7 to 8 miles every day to manage my weight." c. "I am not sexually active but currently I have an IUD." d. "I was treated for a sexually transmitted infection 2 years ago."
B
A 24-yr-old woman says she wants to begin using oral contraceptives. Which information from the nursing assessment is important to report to the health care provider before a prescription is considered? a. The patient quit smoking 5 months previously. b. The patient's blood pressure is 150/86 mm Hg. c. The patient has not been vaccinated for rubella. d. The patient has chronic iron-deficiency anemia.
B
A 31-yr-old patient who has been diagnosed with human papillomavirus (HPV) infection gives a health history that includes smoking tobacco, taking oral contraceptives, and having been treated twice for vaginal candidiasis. Which topic will the nurse include in patient teaching? a. Use of water-soluble lubricants b. Risk factors for cervical cancer c. Antifungal cream administration d. Possible difficulties with conception
B
A 34-yr-old patient who is discussing contraceptive options with the nurse says, "I want to have children but not for a few years." Which response by the nurse is accurate? a. "If you do not become pregnant within the next few years, you never will." b. "Women often have more difficulty becoming pregnant after about age 35." c. "Stop taking oral contraceptives several years before you want to have a child." d. "You have many more years of fertility left, so there is no rush to have children."
B
A 36-yr-old patient who has a diagnosis of fibrocystic breast changes calls the nurse in the clinic reporting symptoms. Which information is likely to change the treatment plan? a. There is yellow discharge from the patient's right nipple. b. An area on the breast is hot, pink, and tender to the touch. c. Firm, moveable lumps are in the upper outer breast quadrants. d. The lumps get more painful before the patient's menstrual period.
B
A 58-yr-old patient is on the medical-surgical unit after undergoing a radical vulvectomy for vulvar carcinoma. The greatest risk to the patient at this time is a. self-care deficit. c. inadequate nutrition. b. wound infection. d. ineffective sexual pattern.
B
A 58-yr-old woman tells the nurse, "I understand that I have stage II breast cancer and I need to decide on a surgery, but I feel overwhelmed. What do you think I should do?" Which response by the nurse is best? a. "I would have a lumpectomy, but you need to decide what is best for you." b. "Tell me what you understand about the surgical options that are available." c. "It would not be appropriate for me to make a decision about your health." d. "There is no need to make a decision rapidly; you have time to think about this."
B
A couple is scheduled to have a Huhner test for infertility. In preparation for the test, the nurse will instruct the couple about a. being sedated during the procedure. b. determining the estimated time of ovulation. c. experiencing shoulder pain after the procedure. d. refraining from intercourse before the appointment.
B
A healthy 24-yr-old patient who has been vaccinated against human papillomavirus (HPV) has a normal Pap test result. Which information will the nurse include in patient teaching when calling the patient with the results of the Pap test? a. You can wait until after age 30 before having another Pap test. b. Pap testing is recommended every 3 years for women your age. c. No further Pap testing is needed until you decide to become pregnant. d. Yearly Pap testing is suggested for women with multiple sexual partners.
B
A patient undergoes an anterior and posterior (A&P) colporrhaphy for repair of a cystocele and rectocele. Which nursing action will be included in the postoperative care plan? a. Encourage a high-fiber diet. b. Perform urinary catheter care. c. Repack the vagina with gauze daily. d. Teach the patient to insert a pessary.
B
A patient with pelvic inflammatory disease (PID) is being treated with oral antibiotics as an outpatient. Which instruction will be included in patient teaching? a. Abdominal pain may persist for several weeks. b. Return for a follow-up appointment in 2 to 3 days. c. Instruct a male partner to use a condom during sexual intercourse for the next week. d. Nonsteroidal antiinflammatory drug (NSAID) use may prevent pelvic organ scarring
B
A young patient who is trying to become pregnant asks the nurse how to determine when she is most likely to conceive. The nurse explains that a. ovulation is unpredictable unless there are regular menstrual periods. b. ovulation prediction kits can provide accurate information about ovulation. c. she will need to bring a specimen of cervical mucus to the clinic for testing. d. she should take her body temperature daily and have intercourse when it drops.
B
After a 26-yr-old patient has been treated for pelvic inflammatory disease, the nurse will plan to teach about the a. use of hormone therapy (HT). b. potential complication of infertility. c. irregularities in the menstrual cycle. d. changes in secondary sex characteristics.
B
After scheduling a patient with a possible ovarian cyst for ultrasound, the nurse will teach the patient that she should a. expect to receive IV contrast during the procedure. b. drink several glasses of fluids before the procedure. c. experience mild abdominal cramps after the procedure. d. discontinue taking aspirin for 7 days before the procedure.
B
An 18-yr-old female patient who has been admitted to the emergency department after a motor vehicle crash is scheduled for chest and abdominal x-rays. Which information may alter the plans for the x-rays? a. Report of abdominal pain b. Positive result of hCG test c. Blood pressure of 172/88 mm Hg d. Temperature of 102.1°F (38.9°C)
B
The nurse is providing preoperative teaching about the transverse rectus abdominis musculocutaneous (TRAM) procedure to a patient. Which information will the nurse include? a. Saline-filled implants are placed under the pectoral muscles. b. Recovery from the TRAM surgery takes at least 6 to 8 weeks. c. Muscle tissue removed from the back is used to form a breast. d. TRAM flap procedures may be done in outpatient surgery centers.
B
The nurse notes bilateral enlargement of the breasts during examination of a 62-yr-old male patient. Which action should the nurse take first? a. Refer the patient for mammography. b. Question the patient about current medications. c. Explain that this is temporary due to hormonal changes. d. Teach the patient how to palpate the breast tissue for lumps.
B
The nurse will plan to teach a 34-yr-old patient diagnosed with stage 0 cervical cancer about a. radiation. c. chemotherapy. b. conization. d. radical hysterectomy.
B
Which information should the nurse include in teaching a patient who is scheduled for external beam radiation to the breast? a. The radiation therapy will take a week to complete. b. Careful skin care in the radiated area will be necessary. c. Visitors are restricted until the radiation therapy is completed. d. Wigs may be used until the hair regrows after radiation therapy.
B
Which nursing assessment finding in a patient who recently started taking hormone replacement therapy (HRT) requires discussion with the health care provider about a change in therapy? a. Breast tenderness c. Weight gain of 3 lb b. Left calf swelling d. Intermittent spotting
B
Which statement by the patient indicates that the nurse's teaching about treating vaginal candidiasis was effective? a. "I will tell my partner that we cannot have intercourse for a month." b. "I should clean carefully after each urination and bowel movement." c. "I can douche with warm water if the itching continues to bother me." d. "I will insert the antifungal cream right before I get up in the morning."
B
Which nursing actions can the nurse working in a women's health clinic delegate to experienced unlicensed assistive personnel (UAP) (select all that apply)? a. Call a patient with the results of an endometrial biopsy. b. Assist the health care provider with performing a Pap test. c. Draw blood for CA-125 levels for a patient with ovarian cancer. d. Question a patient about use of medications that may cause amenorrhea. e. Teach the parent of a 10-yr-old about human papilloma virus (HPV) vaccine (Gardasil).
B,C
A 19-yr-old patient calls the school clinic and tells the nurse, "My menstrual period is very heavy this time. I have to change my tampon every 4 hours." Which action should the nurse take next? a. Tell the patient that her flow is not unusually heavy. b. Schedule the patient for an appointment later that day. c. Ask the patient how heavy her usual menstrual flow is. d. Have the patient call again if the heavy flow continues.
C
A 47-yr-old patient asks whether she is going into menopause if she has not had a menstrual period for 3 months. Which response by the nurse is appropriate? a. "Have you thought about using hormone replacement therapy?" b. "Most women feel a little depressed about entering menopause." c. "What was your menstrual pattern before your periods stopped?" d. "Because you are in your mid-40s, it is likely that you are menopausal."
C
A 49-yr-old man who has type 2 diabetes, high blood pressure, hyperlipidemia, and gastroesophageal reflux tells the nurse that he has had recent difficulty in achieving an erection. Which of the following drugs from his current medications list may cause erectile dysfunction (ED)? a. Ranitidine (Zantac) c. Propranolol (Inderal) b. Atorvastatin (Lipitor) d. Metformin (Glucophage)
C
A female patient tells the nurse that she has been having nightmares and acute anxiety around men since being sexually assaulted 3 months ago. The most appropriate nursing diagnosis for the patient is a. anxiety related to effects of being raped. b. sleep deprivation related to frightening dreams. c. rape-trauma syndrome related to rape experience. d. ineffective coping related to inability to resolve incident.
C
A patient requests a prescription for birth control pills to control severe abdominal cramping and headaches during her menstrual periods. Which action should the nurse take first? a. Determine whether the patient is sexually active. b. Teach about the side effects of oral contraceptives. c. Take the patient's personal and family health history. d. Suggest nonsteroidal antiinflammatory drugs (NSAIDs).
C
A patient tells the nurse that she would like a prescription for oral contraceptives to control her premenstrual dysphoric disorder (PMD-D) symptoms. Which patient information that contraindicates oral contraceptives should be communicated to the health care provider? a. Bilateral breast tenderness c. History of migraine headaches b. Frequent abdominal bloating d. Previous spontaneous abortion
C
During a well-woman physical examination, a 43-yr-old patient asks about her risk for breast cancer. Which question is most pertinent for the nurse to ask? a. "Do you currently smoke tobacco?" b. "Have you ever had a breast injury?" c. "At what age did you start having menstrual periods?" d. "Is there a family history of fibrocystic breast changes?"
C
Which information will the nurse include when teaching a patient who has developed a small vesicovaginal fistula 2 weeks into the postpartum period? a. Take stool softeners to prevent fecal contamination of the vagina. b. Limit oral fluid intake to minimize the quantity of urinary drainage. c. Change the perineal pad frequently to prevent perineal skin breakdown. d. Call the health care provider immediately if urine drains from the vagina.
C
Which nursing action should be included in the plan of care for a patient returning to the surgical unit after a left modified radical mastectomy with dissection of axillary lymph nodes? a. Obtain a permanent breast prosthesis before the patient is discharged from the hospital. b. Teach the patient to use the ordered patient-controlled analgesia (PCA) every 10 minutes. c. Post a sign at the bedside warning against venipunctures or blood pressures in the left arm. d. Insist that the patient examine the surgical incision when the initial dressings are removed.
C
Which patient in the women's health clinic will the nurse expect to teach about an endometrial biopsy? a. A 55-yr-old patient who has 3 to 4 alcoholic drinks each day b. A 35-yr-old patient who has used oral contraceptives for 15 years c. A 25-yr-old patient who has a family history of hereditary nonpolyposis colorectal cancer d. A 45-yr-old patient who has had six previous full-term pregnancies and two spontaneous abortions
C
Which question should the nurse ask when assessing a 60-yr-old patient who has a history of benign prostatic hyperplasia (BPH)? a. "Have you noticed any unusual discharge from your penis?" b. "Has there been any change in your sex life in the past year?" c. "Has there been a decrease in the force of your urinary stream?" d. "Have you been experiencing any difficulty in achieving an erection?"
C
A 19-yr-old patient has been diagnosed with primary dysmenorrhea. How will the nurse suggest that the patient manage discomfort? a. Avoid aerobic exercise during her menstrual period. b. Use cold packs on the abdomen and back for pain relief. c. Talk with her health care provider about beginning antidepressant therapy. d. Take nonsteroidal antiinflammatory drugs (NSAIDs) when her period starts.
D
A 49-yr-old patient tells the nurse that she is postmenopausal but has recently had occasional spotting. Which initial response by the nurse is appropriate? a. "A frequent cause of spotting is endometrial cancer." b. "How long has it been since your last menstrual period?" c. "Breakthrough bleeding is not unusual in women your age." d. "Are you using prescription hormone replacement therapy?"
D
A patient has had left-sided lumpectomy (breast-conservation surgery) and an axillary lymph node dissection. Which nursing intervention is appropriate to delegate to a licensed practical/vocational nurse (LPN/LVN)? a. Teaching the patient how to avoid injury to the left arm b. Assessing the patient's range of motion for the left arm c. Evaluating the patient's understanding of instructions about drain care d. Administering an analgesic 30 minutes before scheduled arm exercises
D
The nurse will plan to teach a 51-yr-old man who is scheduled for an annual physical examination about a(n) a. increased risk for testicular cancer. b. possible changes in erectile function. c. normal decreases in testosterone level. d. prostate specific antigen (PSA) testing.
D
The nurse will teach a patient with metastatic breast cancer who has a new prescription for trastuzumab (Herceptin) that a. hot flashes may occur with the medication. b. serum electrolyte levels will be drawn monthly. c. the patient will need frequent eye examinations. d. the patient should call if she notices ankle swelling.
D
The outpatient clinic receives telephone calls from four patients. Which patient should the nurse call back first? a. A 57-yr-old patient with ductal ectasia who has sticky multicolored nipple discharge and severe nipple itching b. A 21-yr-old patient with a family history of breast cancer who wants to discuss genetic testing for the BRCA gene c. A 40-yr-old patient who still has left side chest and arm pain 2 months after a left modified radical mastectomy d. A 50-yr-old patient with stage 2 breast cancer who is receiving doxorubicin and has ankle swelling and fatigue
D
To prevent pregnancy in a patient who has been sexually assaulted, the nurse in the emergency department will plan to teach the patient about the use of a. mifepristone . c. methotrexate with misoprostol. b. dilation and evacuation. d. levonorgestrel (Plan-B One-Step).
D
When caring for a patient who has a radium implant for treatment of cervical cancer, the nurse will a. assist the patient to ambulate every 2 to 3 hours. b. use gloves and gown when changing the patient's bed. c. flush the toilet several times right after the patient voids. d. encourage the patient to discuss any concerns by telephone.
D
When the nurse is working in the women's health care clinic, which action is appropriate to take? a. Teach a healthy 30-yr-old patient about the need for an annual mammogram. b. Discuss scheduling an annual clinical breast examination with a 22-year-old patient. c. Explain to a 60-yr-old patient that mammography frequency can be reduced to every 3 years. d. Teach a 28-yr-old patient with a BRCA-1 mutation about magnetic resonance imaging (MRI).
D
A 19-yr-old patient visits the health clinic for a routine checkup. Which question should the nurse ask to determine whether a Pap test is needed? a. "Have you had sexual intercourse?" b. "Do you use any illegal substances?" c. "Do you have cramping with your periods?" d. "At what age did your menstrual periods start?"
A
A 22-yr-old patient tells the nurse that she has not had a menstrual period for the past 3 months. Which action is most important for the nurse to take? a. Obtain a urine specimen for a pregnancy test. b. Ask about any recent stressful lifestyle changes. c. Measure the patient's current height and weight. d. Question the patient about prescribed medications.
A
A 28-yr-old patient reports anxiety, headaches with dizziness, and abdominal bloating occurring before her menstrual periods. Which action is best for the nurse to take at this time? a. Ask the patient to keep track of her symptoms in a diary for 3 months. b. Suggest that the patient try aerobic exercise to decrease her symptoms. c. Teach the patient about appropriate lifestyle changes to reduce premenstrual syndrome (PMS) symptoms. d. Advise the patient to use nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen to control symptoms.
A
A 50-yr-old patient is diagnosed with uterine bleeding caused by a leiomyoma. Which information will the nurse include in the patient teaching plan? a. The symptoms may decrease after the patient undergoes menopause. b. The tumor size is likely to increase throughout the patient's lifetime. c. Aspirin or acetaminophen may be used to control mild to moderate pain. d. The patient will need frequent monitoring to detect any malignant changes.
A
A 51-yr-old patient with a small immobile breast lump is considering having a fine-needle aspiration (FNA) biopsy. The nurse explains that an advantage to this procedure is that a. FNA is done in the outpatient clinic, and results are available in 1 to 2 days. b. only a small incision is needed, resulting in minimal breast pain and scarring. c. if the biopsy results are negative, no further diagnostic testing will be needed. d. FNA is guided by a mammogram, ensuring that cells are taken from the lesion.
A
A 32-yr-old patient has oral contraceptives prescribed for endometriosis. The nurse will teach the patient to a. expect to experience side effects such as facial hair. b. take the medication every day for the next 9 months. c. take calcium supplements to prevent developing osteoporosis during therapy. d. use a second method of contraception to ensure that she will not become pregnant.
B
A 33-yr-old patient has a saline breast implant inserted in the outpatient surgery area. Which instruction will the nurse include in the discharge teaching? a. Take aspirin every 4 hours to reduce inflammation. b. Check wound drains for excessive blood or a foul odor. c. Wear a loose-fitting bra to decrease irritation of the sutures. d. Resume normal activities 2 to 3 days after the mammoplasty.
B
A patient is scheduled for an induced abortion using instillation of hypertonic saline solution. Which information will the nurse plan to discuss with the patient before the procedure? a. The patient will require a general anesthetic. b. The expulsion of the fetus may take 1 to 2 days. c. There is a possibility that the patient may deliver a live fetus. d. The procedure may be unsuccessful in terminating the pregnancy.
B
A patient who was admitted to the emergency department with severe abdominal pain is diagnosed with an ectopic pregnancy. The patient begins to cry and asks the nurse to leave her alone to grieve. Which action should the nurse take next? a. Stay with the patient and encourage her to discuss her feelings. b. Explain the reason for taking vital signs every 15 to 30 minutes. c. Close the door to the patient's room and minimize disturbances. d. Provide teaching about options for termination of the pregnancy.
B
The nurse provides discharge teaching for a 61-yr-old patient who has had a left modified radical mastectomy and lymph node dissection. Which statement by the patient indicates that teaching has been successful? a. "I will need to use my right arm and to rest the left one." b. "I will avoid reaching over the stove with my left hand." c. "I will keep my left arm in a sling until the incision is healed." d. "I will stop the left arm exercises if moving the arm is painful."
B
When caring for a 58-yr-old patient with persistent menorrhagia, the nurse will plan to monitor the a. estrogen level. b. complete blood count (CBC). c. gonadotropin-releasing hormone (GNRH) level. d. serial human chorionic gonadotropin (hCG) results.
B
Which action will the nurse include in the plan of care for a patient with right arm lymphedema? a. Avoid isometric exercise on the right arm. b. Assist with application of a compression sleeve. c. Keep the right arm at or below the level of the heart. d. Check blood pressure (BP) on both right and left arms.
B
Which assessment finding in a 36-yr-old patient is most indicative of a need for further evaluation? a. Bilateral breast nodules that are tender with palpation b. A breast nodule that is 1 cm in size, nontender, and fixed c. A breast lump that increases in size before the menstrual period d. A breast lump that is small, mobile, with a rubbery consistency
B
A 53-yr-old woman who is experiencing menopause is discussing the use of hormone therapy (HT) with the nurse. Which information about the risk of breast cancer will the nurse provide? a. HT is a safe therapy for menopausal symptoms if there is no family history of BRCA genes. b. HT does not appear to increase the risk for breast cancer unless there are other risk factors. c. The patient and her health care provider must weigh the benefits of HT against the risks of breast cancer. d. Natural herbs are as effective as estrogen in relieving symptoms without increasing the risk of breast cancer.
C
A nursing diagnosis that is likely to be appropriate for a 67-yr-old patient who has just been diagnosed with stage III ovarian cancer is a. sexual dysfunction related to loss of vaginal sensation. b. risk for infection related to impaired immune function. c. anxiety related to cancer diagnosis and need for treatment decisions. d. situational low self-esteem related to guilt about delaying medical care.
C
A patient has an induced abortion with suction curettage at an ambulatory surgical center. Which instructions will the nurse include when discharging the patient? a. "Avoid contraceptives until your reexamination." b. "Heavy vaginal bleeding is expected for 2 weeks." c. "Abstain from sexual intercourse for the next 2 weeks." d. "Irregular menstrual periods are expected for a few months."
C
A patient is considering the use of combined estrogen-progesterone hormone replacement therapy (HRT) during menopause. Which information will the nurse include during their discussion? a. Use of estrogen-containing vaginal creams provides the same benefits as oral HRT. b. Increased risk of colon cancer in women taking HRT requires frequent colonoscopy. c. HRT decreases osteoporosis risk and increases the risk for cardiovascular disease and breast cancer. d. Use of HRT for up to 10 years to prevent symptoms such as hot flashes is generally considered safe.
C
A patient newly diagnosed with stage I breast cancer is discussing treatment options with the nurse. Which statement by the patient indicates that additional teaching may be needed? a. "There are several options that I can consider for treating the cancer." b. "I will probably need radiation to the breast after having the surgery." c. "Mastectomy is the best choice to decrease the chance of cancer recurrence." d. "I can probably have reconstructive surgery at the same time as a mastectomy."
C
A patient who is scheduled for a routine gynecologic examination tells the nurse that she has had intercourse during the past year with several men. The nurse will plan to teach about the reason for a. contraceptive use. c. Chlamydia testing. b. antibiotic therapy. d. pregnancy testing.
C
The following patients call the outpatient clinic. Which phone call should the nurse return first? a. A 44-yr-old patient who has bloody discharge after a hysteroscopy earlier today b. A 64-yr-old patient who is experiencing shoulder pain after a laparoscopy yesterday c. A 34-yr-old patient who is short of breath after having a pelvic CT with contrast dye d. A 54-yr-old patient who has severe breast tenderness following a needle aspiration breast biopsy
C
The nurse has just received change-of-shift report about the following four patients. Which patient should be assessed first? a. A patient with a cervical radium implant in place who is crying in her room b. A patient who is complaining of 5/10 pain after an abdominal hysterectomy c. A patient with a possible ectopic pregnancy who is complaining of shoulder pain d. A patient in the fifteenth week of gestation who has uterine cramping and spotting
C
The nurse in the infertility clinic is explaining in vitro fertilization (IVF) to a couple. The woman tells the nurse that they cannot afford IVF on her husband's salary. The man replies that if his wife worked outside the home, they would have enough money. Which nursing diagnosis is appropriate? a. Decisional conflict related to inadequate financial resources b. Ineffective sexuality patterns related to psychological stress c. Defensive coping related to anxiety about lack of conception d. Ineffective denial related to frustration about continued infertility
C
The nurse is caring for a patient with breast cancer who is receiving chemotherapy with doxorubicin and cyclophosphamide. Which assessment finding is most important to communicate to the health care provider? a. The patient complains of fatigue. b. The patient eats only 25% of meals. c. The patient's apical pulse is irregular. d. The patient's white blood cell (WBC) count is 5000/µL.
C
The nurse is caring for a patient with pelvic inflammatory disease (PID) requiring hospitalization. Which nursing intervention will be included in the plan of care? a. Monitor liver function tests. b. Use cold packs PRN for pelvic pain. c. Elevate the head of the bed at least 30 degrees. d.
C
The nurse is providing teaching by telephone to a patient who is scheduled for a pelvic examination and Pap test next week. The nurse instructs the patient that she should a. not have sexual intercourse the day before the Pap test. b. shower, but not take a tub bath, before the examination. c. avoid douching for at least 24 hours before the examination. d. schedule to have the Pap test just after her menstrual period.
C
The nurse teaching a young women's community service group about breast self-examination (BSE) will include that a. BSE will reduce the risk of dying from breast cancer. b. BSE should be done daily while taking a bath or shower. c. annual mammograms should be scheduled in addition to BSE. d. performing BSE after the menstrual period is more comfortable.
C
Which action should the nurse take when a 35-yr-old patient has a Pap test result of minor cellular changes? a. Teach the patient about colposcopy. b. Teach the patient about punch biopsy. c. Schedule another Pap test in 4 months. d. Administer human papillomavirus (HPV) vaccine.
C
Which finding from the nurse's physical assessment of a 42-yr-old male patient should be reported to the health care provider? a. One testis hangs lower than the other. b. Genital hair distribution is diamond shaped. c. Clear discharge is present at the penile meatus. d. Inguinal lymph nodes are nonpalpable bilaterally.
C
A 68-yr-old male patient tells the nurse that he is worried because he does not respond to sexual stimulation the same way he did when he was younger. Which is the nurse's best response to the patient's concern? a. "Interest in sex frequently decreases as men get older." b. "Many men need additional sexual stimulation with aging." c. "Erectile dysfunction is a common problem with older men." d. "Tell me more about how your sexual response has changed."
D
A patient has just been instructed in the treatment for a Chlamydia trachomatis vaginal infection. Which patient statement indicates that the nurse's teaching has been effective? a. "I can purchase an over-the-counter medication to treat this infection." b. "The symptoms are due to the overgrowth of normal vaginal bacteria." c. "The medication will need to be inserted once daily with an applicator." d. "Both my partner and I will need to take the medication for a full week."
D
A patient in the sexually transmitted infection clinic has a positive Venereal Disease Research Laboratory (VDRL) test, but no chancre is visible on assessment. The nurse will plan to send specimens for a. Gram stain. b. cytologic studies. c. rapid plasma reagin (RPR) agglutination. d. fluorescent treponemal antibody absorption (FTA-Abs).
D
A patient was recently diagnosed with polycystic ovary syndrome. It is most important for the nurse to teach the patient a. reasons for a total hysterectomy. b. how to decrease facial hair growth. c. ways to reduce the occurrence of acne. d. methods to maintain appropriate weight.
D
A patient who has a large cystocele was admitted 10 hours ago but has not yet voided. If the patient reports no urge to void, which action should the nurse take first? a. Insert a straight catheter per the PRN order. b. Encourage the patient to increase oral fluids. c. Notify the health care provider of the inability to void. d. Use an ultrasound scanner to check for urinary retention.
D
A woman calls the clinic because she is having an unusually heavy menstrual flow. She tells the nurse that she has saturated three tampons in the past 2 hours. The nurse estimates that the amount of blood loss over the past 2 hours is _____ mL. a. 20 to 30 c. 40 to 60 b. 30 to 40 d. 60 to 90
D
The nurse explains to a patient being prepared for colposcopy with a cervical biopsy that the procedure a. involves dilation of the cervix and biopsy of the tissue lining the uterus. b. will take place in a same-day surgery center so that local anesthesia can be used. c. requires that the patient have nothing to eat or drink for 6 hours before the procedure. d. is similar to a speculum examination of the cervix and should result in little discomfort.
D
The nurse in the women's health clinic has four patients who are waiting to be seen. Which patient should the nurse see first? a. A 22-yr-old patient with persistent red-brown vaginal drainage 3 days after having balloon thermotherapy b. A 42-yr-old patient with secondary amenorrhea who says that her last menstrual cycle was 3 months ago c. A 35-yr-old patient with heavy spotting after having a progestin-containing IUD (Mirena) inserted a month ago d. A 19-yr-old patient with menorrhagia who has been using superabsorbent tampons and has fever with weakness
D
The nurse is admitting a patient scheduled this morning for lumpectomy and axillary lymph node dissection. Which action should the nurse take first? a. Teach the patient how to deep breathe and cough. b. Discuss options for postoperative pain management. c. Explain the postdischarge care of the axillary drains. d. Ask the patient to describe what she knows about the surgery.
D