MS 3 CH 69-74
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
Chlamydia testing.
A 19-yr-old patient has genital warts around her external genitalia and perianal area. She tells the nurse that she has not sought treatment until now because "the warts are so disgusting." Which nursing diagnosis is consistent with these data?
Disturbed body image related to feelings about the genital warts
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
FNA is done in the outpatient clinic, and results are available in 1 to 2 days.
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?
Risk factors for cervical cancer
Which action should the nurse take when a 35-yr-old patient has a Pap test result of minor cellular changes?
Schedule another Pap test in 4 months.
Which topics will the nurse include when preparing to teach a patient with recurrent genital herpes simplex (select all that apply)?
Sitz baths may be used to relieve discomfort caused by the lesions. Recurrent genital herpes episodes usually are shorter than the first episode. The virus can infect sexual partners even when you do not have symptoms.
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?
Take the patient's personal and family health history.
Which information will the nurse plan to include when teaching a young adult who has a family history of testicular cancer about testicular self-examination?
Testicular self-examination should be done in a warm room.
The nurse will plan to teach a 67-yr-old patient who has been diagnosed with orchitis about
pain management.
A 53-yr-old patient is scheduled for an annual physical examination. The nurse will plan to teach the patient about the purpose of
prostate specific antigen (PSA) testing.
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?
"At what age did you start having menstrual periods?"
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?
"Both my partner and I will need to take the medication for a full week."
The nurse is obtaining the pertinent health history for a man who is being evaluated for infertility. Which question focuses on a possible cause of infertility?
"Do you use medications to improve muscle mass?"
A 22-yr-old patient tells the nurse at the health clinic that he has recently had some problems with erectile dysfunction. Which question should the nurse ask to assess for possible etiologic factors in this age group?
"Do you use recreational drugs or drink alcohol?"
Which patient statement indicates that the nurse's teaching about tamoxifen has been effective?
"I will call if I have any eye problems."
After the nurse has taught a patient with a newly diagnosed sexually transmitted infection (STI) about expedited partner therapy, which patient statement indicates that the teaching has been effective?
"I will make sure that my partner takes all of the prescribed medication."
Which statement by a 24-yr-old patient indicates that the nurse's teaching about management of primary genital herpes has been effective?
"I will take the acyclovir (Zovirax) every 8 hours for the next week."
A 32-yr-old patient who is diagnosed with Chlamydia tells the nurse that she is very angry because her husband is her only sexual partner. Which response should the nurse make first?
"It is understandable that you feel angry about contracting an infection."
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?
"Tell me what you think is important to know about the surgery."
When a 31-yr-old male patient returns to the clinic for follow-up after treatment for gonococcal urethritis, a purulent urethral discharge is still present. Which question will the nurse ask to identify a possible cause of recurrent infection?
"Were your sexual partners treated with antibiotics?"
When using the accompanying illustration to teach a patient about breast self-examination, the nurse will include the information that most breast cancers are located in which part of the breast?
1
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)?
Administering an analgesic 30 minutes before scheduled arm exercises
Which information will the nurse include when teaching a patient who has developed a small vesicovaginal fistula 2 weeks into the postpartum period?
Change the perineal pad frequently to prevent perineal skin breakdown.
Which nursing actions can the nurse working in a women's health clinic delegate to experienced unlicensed assistive personnel (UAP) (select all that apply)?
Draw blood for CA-125 levels for a patient with ovarian cancer. Assist the health care provider with performing a Pap test.
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?
Explain the reason for taking vital signs every 15 to 30 minutes.
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?
History of migraine headaches
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?
Left calf swelling
A 39-yr-old patient with a history of IV drug use is seen at a community clinic. The patient reports difficulty walking, stating, "I don't know where my feet are." Diagnostic screening reveals positive Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody absorption (FTA-Abs) test results. Based on the patient history, what will the nurse assess (select all that apply)?a 3
Mental state for judgment and orientation Skin and mucous membranes for gummas Heart sounds
Which infection, reported in the health history of a female patient who is having difficulty conceiving, will the nurse identify as a risk factor for infertility?
N. gonorrhoeae
Which topic will the nurse include in the preoperative teaching for a patient admitted for an abdominal hysterectomy?
Purpose of ambulation and leg exercises
The nurse notes bilateral enlargement of the breasts during examination of a 62-yr-old male patient. Which action should the nurse take first?
Question the patient about current medications.
A male patient who has a profuse, purulent urethral discharge with painful urination is seen at the clinic. Which information will be most important for the nurse to obtain?
Recent sexual contacts
When caring for a patient with continuous bladder irrigation after having transurethral resection of the prostate, which action could the nurse delegate to unlicensed assistive personnel (UAP)?
Report any complaints of pain or spasms to the nurse.
Which action by the unlicensed assistive personnel (UAP) who are assisting with the care of male patients with reproductive problems indicates that the nurse should provide more teaching?
The UAP leave the foreskin pulled back after cleaning the glans of a patient who has a retention catheter.
Which assessment information collected by the nurse may present a contraindication to a testosterone replacement therapy (TRT)?
The patient has been using sildenafil (Viagra) several times every week.
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?
The patient's apical pulse is irregular.
A patient is on the surgical unit after a radical abdominal hysterectomy. Which finding requires a report to the health care provider?
Urine output of 125 mL in the first 8 hours after surgery
A patient admitted with chest pain is also found to have positive Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody absorption (FAT-Abs) tests, rashes on the palms and the soles of the feet, and moist papules in the anal and vulvar area. Which action will the nurse include in the plan of care?
Wear gloves for patient contact.
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
anxiety related to cancer diagnosis and need for treatment decisions.
The nurse will plan to teach the patient who is incontinent of urine following a radical retropubic prostatectomy to
do pelvic muscle exercises.
When caring for a patient who has a radium implant for treatment of cervical cancer, the nurse will
encourage the patient to discuss any concerns by telephone.
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
endometrial biopsy
The nurse will inform a patient with cancer of the prostate that side effects of leuprolide (Lupron) may include
flushing.
The nurse will plan to teach the patient scheduled for photovaporization of the prostate (PVP)
how to care for an indwelling urinary catheter.
A patient is diagnosed with primary syphilis during her eighth week of pregnancy. The nurse will plan to teach the patient about the
intramuscular injection of penicillin.
A patient tells the nurse that he decided to seek treatment for erectile dysfunction (ED) because his wife "is losing patience with the situation." The nurse's follow-up questions should focus on the man's identified concern with
role performance.
A patient with gonorrhea is treated with a single IM dose of ceftriaxone (Rocephin) and is given a prescription for doxycycline (Vibramycin) 100 mg bid for 7 days. The nurse explains to the patient that this combination is prescribed to
treat any coexisting chlamydial infection.
The nurse taking a focused health history for a patient with possible testicular cancer will ask the patient about a history of
undescended testicles.
The nurse performing a focused examination to determine possible causes of infertility will assess for
varicocele
A 48-yr-old male patient who has been diagnosed with gonococcal urethritis tells the nurse he had recent sexual contact with a woman but says she did not appear to have any disease. In responding to the patient, the nurse explains that
women may not be aware they have gonorrhea because they often do not have symptoms of infection.