Reproductive First 15

A nurse is providing breast self-examination teaching to a client who is menopausal. Which of the following statements should the nurse identify as an indication that the teaching was effective? Select all that apply a. "I don't have to lie down to check my breasts. I can stand in the shower." b. "If I feel a firm ridge in the lower curve of my breasts I should report this immediately." c. "It is important to use pressure when feeling my breasts to detect changes." d. "Since I no longer have periods, I can perform an examination at any time of the month." e. "I will make sure to feel for changes in my underarm area."

A, C, D, E -The client can start a breast self-examination either standing or lying down. When standing, she should look in a mirror first with her arms at her side, then behind her head, and then with hands pressed to her hips. She can palpate the breasts standing as well but then she should lie down, with one arm behind the head to spread the breast tissues evenly over the chest wall, which makes it easier to palpate the tissue. -A firm ridge in the lower curve of the breasts is an expected finding. -The client should use three different levels of pressure to feel the tissue closest to the skin, tissue a little deeper, and then the tissues that is closest to the ribs and chest. -The client who no longer has the monthly hormonal influences of menstruation can perform an examination at any time of the month. She should pick a date and perform the examination monthly on this date. -It is important for the client to check the area between the breast tissue and the underarm as well as the underarm itself for any changes. The client should palpate the lymph for inflammation, tenderness, and firmness.

PSA education is to be part of an annual physical at what age? a. 30-35 b. 50-69 c. 70+ d. 20-29

B. PSA are usually recommended starting at age 50 years for men who have an average risk for prostate cancer. While the general guidelines recommend starting at age 55, you may need PSA screening between the ages of 40 and 54 if you:Have at least one first-degree relative (such as your father or brother) who has had prostate cancerHave at least two extended family members who have had prostate cancerAre African-American, an ethnicity that has a higher risk of developing more aggressive cancers

A nurse is caring for a client who is 5 hr postoperative following a transurethral resection of the prostate (TURP). The nurse notes that the client's indwelling urinary catheter has not drained in the past hour. Which of the following actions should the nurse take first? A. Notify the provider. B. Check the tubing for kinks. C. Adjust the rate of the bladder irrigate. D. Irrigate the catheter

B. When providing client care, the nurse should first use the least restrictive intervention; therefore, the nurse should check the catheter tubing for kinks. The nurse must ensure constant flow of the bladder irrigant into the catheter and outward drainage from the catheter to prevent clotting, which could occlude the catheter lumen.

When examining a female client, the nurse observes tissue protruding from the vaginal opening. The nurse checks the medical record for a documented history of which of the following disorders? •a. Rectocele •b. Uterine prolapse •c. Cystocele •d. Vaginal infection

B. uterine prolapse is visible outside the body as the uterus protrudes through the opening of the vaginal canal. Rectocele is prolapse of the rectum through the wall of the vagina. Cystocele is prolapse of the bladder through the wall of the vagina. A vaginal infection would not cause tissue protrusion from the vagina, although the vaginal tissues would be reddened and/or edematous.

A community health nurse is developing a pamphlet about breast self-examination (BSE) for a local health fair. Which of the following instructions should the nurse include? •a. Expect some breast dimpling or discharge with age. •b. For those who have a menstrual cycle, perform a BSE every month, 2 or 3 days before menstruation. •c. Using the palm of the hand, feel for lumps using a circular motion. •d. Breasts can be examined in the shower with soapy hands.

D. BSE: 1. completed in front of the mirror, 2. laying down, and parts of the exam can be in the shower •completed monthly 5 to 7 days after menses start and monthly for menopausal women •Clinician breast exam: Ask the client to lift arms above head when screening for nipple and skin retraction •Signs of cancerous lump: non mobile with irregular edges.

Which of the following diagnostic tests are used to differentiate benign prostatic hypertrophy (BPH) from prostate cancer? (Select all that apply.) a. Digital rectal examination b. Prostate-specific antigen (PSA) level c. Skin integrity d. Pelvic ultrasound e. Urinary elimination

A & B In a digital rectal exam for BPH, the prostate is asymmetrical and enlarged, while in prostate cancer the exam shows nodules and a fixed position. PSA is specific to the prostate gland and is released by both benign and malignant cells The other tests are not helpful in differentiating prostate cancer from BPH.

The nurse is caring for a client who has been diagnosed with testicular torsion. Which of the following does the nurse understand is characteristic for the pathophysiology of testicular torsion? Select all that apply a. Sudden Severe scrotal pain b. Dysuria c. Nausea d. Absence of cremasteric reflex e. Gradual scrotal pain

A, C, D Patients will generally present with sudden onset severe unilateral testicular pain. This is often associated with nausea and vomiting, secondary to the pain. Referred abdominal pain can also occur. Classically, the cremasteric reflex is absent and pain continues despite elevation of the testicle, termed a negative Prehn's sign. Dysuria is painful urination

The nurse is volunteering at a community center to teach women about breast cancer. What should the nurse include when discussing risk factors (select all that apply) A. Nulliparity (never given birth to a child, or has never carried a pregnancy) B. Age 30 or over C. Early menarche D. Late menopause E. Personal history of colon cancer

A, C, D, E -Women are at an increased risk for development of breast cancer if they are over the age of 50 -have a family history of breast cancer -have a personal history of breast, colon, endometrial, or ovarian cancer -have a long menstrual history as seen with early menarche or late menopause; -have had a first full-term pregnancy after the age of 30 or are nulliparous.

Which of the following assessment findings is an anticipated finding for the client with a rectocele? •a. Difficulty in voiding •b. Tarry stools •c. Stress incontinence •d. Hemorrhoids

D. A rectocele is herniation of the rectum into the vagina. As a rectocele enlarges, the client has difficulty having a bowel movement, becomes constipated, and begins to strain to have a bowel movement, resulting in hemorrhoids. A rectocele does not affect the urinary tract. Tarry stools would occur with gastrointestinal bleeding at a site remote from the rectum

A nurse is teaching a client who has benign prostatic hypertrophy and has a new prescription for finasteride. Which of the following instructions should the nurse include in the teaching? •a. "Avoid drinking grapefruit juice when taking this medication." •b. "Expect to see a response from the medication within one week." •c. "Decreased libido is an adverse effect of the medication." •d. "PSA levels will increase while taking this medication."

C. The nurse should include in the teaching that the client may experience decreased libido as an adverse effect of the medication because of the androgenic effect on the prostate.

A client is admitted with the diagnosis of testicular cancer. Which of the following factors in the client's history would be associated with the disease? A. Epididymitis B. Sexual relations at an early age C. Seminal vesiculitis D. Undescended testis

D. A history of undescended testis or cryptorchidism is a known risk factor.