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38 Cards in this Set

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While assessing the lump in your client's breast, you practice which of the following? Check all that apply.
1. Identify the location of the mass by using the breast lump calipers (BLC.)
2. Describe the shape, size, and consistency of the mass.
3. Note any skin changes around the mass, such as dimpling, increased vascularity, nipple retraction, and ulceration.
4. Ask the client if she experiences pain or soreness in the area around the mass.
1. Identify the location of the mass by using the breast lump calipers (BLC.)
2. Describe the shape, size, and consistency of the mass.
3. Note any skin changes around the mass, such as dimpling, increased vascularity, nipple retraction, and ulceration.
4. Ask the client if she experiences pain or soreness in the area around the mass.
The pathology report on your client's breast biopsy indicates that she has Stage III breast cancer. Which of the following describes the tumor? Check all that apply.
1. Less than 2 cm, with 0 lymph nodes positive for cancer and no metastases evident.
2. Any size, with or without lymph nodes positive for cancer cells and distant metastases present.
3. Smaller than 2 cm, with axillary lymph nodes positive for cancer cells and no metastases evident.
4. Two to 5 cm, with axillary lymph nodes positive for cancer cells and no metastases evident.
1. Less than 2 cm, with 0 lymph nodes positive for cancer and no metastases evident.
2. Any size, with or without lymph nodes positive for cancer cells and distant metastases present.
3. Smaller than 2 cm, with axillary lymph nodes positive for cancer cells and no metastases evident.
4. Two to 5 cm, with axillary lymph nodes positive for cancer cells and no metastases evident.
The 21-year-old male client asks you why the skin on his penis is so loose. What is your best response?
"This means that you have not yet achieved full growth of the penis."
"This allows for penis enlargement during sexual excitement."
"Have you ever been treated for a sexually transmitted disease?"
"Have you lost a lot of weight recently?"
"This allows for penis enlargement during sexual excitement."
Which assessment question or data obtained from the client during reproductive assessment is appropriate for the Health Perception/Health Management functional pattern?
"Have you noticed any change in libido?"
"Do you have sex with men, women, or both?"
"Do you find your sexual relationship satisfying?"
"How often do you perform testicular self examination (TSE)?"
"How often do you perform testicular self examination (TSE)?"
The results of a Pap smear describe the specimen as "Class I." How should you explain information to the client? "Your Pap smear results:
are completely normal."
show cell changes related to early stage menopause."
show benign cell changes most likely due to infection."
show early-stage malignant changes and you need to schedule a follow-up visit within six months."
are completely normal."
The client scheduled for ultrasonography of the pelvis asks you if it is possible to go out to dinner after the test. What is your best response?
"By evening, the effects of the general anesthesia should have worn off, but be sure to have someone available to drive you home after the test."
"Even if you feel well, it is best to rest after the test rather than go out for the evening."
"This test requires that you remain lying flat for at least four to eight hours after the test."
"There are no restrictions for activities or food intake after this test."
"There are no restrictions for activities or food intake after this test."
The client is recovering from a laparoscopy performed two hours ago. She is sitting up in bed and tells you that she is having pain in her left shoulder. What is your best action?
Explain that the pain is caused by residual gas in the peritoneal cavity.
Raise the head of the bed and increase the IV flow rate.
Assess the sensory perception in the client's left arm.
Document the finding as the only action.
Explain that the pain is caused by residual gas in the peritoneal cavity.
Which statement made by the client who just underwent mammography indicates a need for clarification regarding the purpose of this procedure?
"If the results are abnormal, I should see my doctor."
"Now I am protected against developing breast cancer."
"Not all breast cancers can be found on mammography."
"If the results are normal, I'll schedule my next one in a yea
"Now I am protected against developing breast cancer."
The client is 42 years old. Which breast-screening regimen for breast cancer should you suggest to her based on American Cancer Society guidelines?
"Perform monthly breast self exam, have a baseline mammogram now, and have both a clinical breast exam and a mammogram each year after age fifty."
"Perform monthly breast self exam, have a clinical breast exam every six months, and a mammogram each year."
"Perform monthly breast self exam, have a clinical breast exam yearly, and a mammogram every other year until age 50."
"Perform monthly breast self exam and have both a clinical breast exam and a mammogram each year."
"Perform monthly breast self exam and have both a clinical breast exam and a mammogram each year."
You are teaching the postmenopausal client how to perform breast self-examination. Which schedule for self-examination should you teach this client to follow?
Monthly, just after menstruation has stopped
Monthly, on the same day of each month
Weekly, on the same day of each week
Yearly, in conjunction with a mammogram
Monthly, on the same day of each month
Which strategy could reduce the risk for breast cancer in a woman who is at high genetic risk for breast cancer?
Laboratory analysis to determine the presence of mutations in the BRCA1 or BRCA2 genes
Monthly BSE and yearly clinical breast exams and mammograms starting at age 30 years
Breast-feeding each baby until the child is 18 months old
Bilateral prophylactic mastectomies
Bilateral prophylactic mastectomies
Which characteristic of a breast lump/mass is more associated with benign breast disease than with breast cancer?
Fluctuates in size with the menstrual cycle
No pain or discomfort on palpation
Firmly attached to the chest wall
Presence of nipple discharge
Fluctuates in size with the menstrual cycle
The 38 year-old client who has two children under age five has just been diagnosed with cancer of the left breast and has two positive lymph nodes. She is scheduled for a mastectomy to be followed by chemotherapy. What is the priority nursing diagnosis for this client?
Risk for infection related to neutropenia.
Chronic pain related to metastatic processes
Anxiety related to diagnosis and ambiguous outcome
Body image disturbance related to alopecia and mastectomy
Anxiety related to diagnosis and ambiguous outcome
The client is returned to the nursing unit after a modified radical mastectomy on the left side. Which action should you avoid for this client?
Flexing or extending the client's left wrist and fingers
Taking the client's blood pressure on the left arm
Encouraging the client to look at the incision
Positioning the client on the right side
Taking the client's blood pressure on the left arm
The client with a mastectomy tells you she is worried about how to handle a prosthesis. What is your best response?
"Are you still grieving about the loss of your breast?"
"You are a smart woman, I know you will have no problem."
"Would you like to talk to someone who has been using a prosthesis?"
"These days, prostheses are so well made that no one could guess you are wearing one."
"Would you like to talk to someone who has been using a prosthesis?"
What infection prevention techniques should you teach the client who had a mastectomy and lymph node dissection on the right side six months ago?
"Stop exercising at the point at which pain occurs."
"Take antibiotics at the first sign of infection."
"Avoid crowds and people who are ill."
"Wear gloves when gardening."
"Wear gloves when gardening."
How is primary dysmenorrhea different from secondary dysmenorrhea?
Primary dysmenorrhea is usually not relieved by medication.
Primary dysmenorrhea occurs most frequently among younger women.
Secondary dysmenorrhea has an autosomal dominant pattern of inheritance.
Secondary dysmenorrhea responds best to medications that inhibit ovulation.
Primary dysmenorrhea occurs most frequently among younger women.
Which clinical manifestation in a menopausal client is considered abnormal?
Hot flashes
Amenorrhea
Vaginal dryness
Presence of vaginal polyps
Presence of vaginal polyps
Which statement made by a client who has had frequent vaginal yeast infections indicates correct understanding of hygiene measures thought to reduce the frequency of this problem? "I will:
wear cotton panties."
douche more frequently, especially in hot weather."
clean my bottom by wiping from the back to the front."
avoid eating dairy products, especially yogurt or cottage cheese."
"I will:
wear cotton panties."
Which dietary modification should you recommend to the client who has just had a posterior repair?
High protein; high calorie
Low fat; high carbohydrate
Low residue; increased fluids
High fiber; high carbohydrate
Low residue; increased fluids
What is the priority nursing diagnosis for the client with a leiomyoma undergoing conservative management?
Constipation related to presence of leiomyoma
Risk for fluid volume deficit related to hemorrhage
Anxiety related to increased risk for cancer development
Anticipatory grieving related to perceived loss of the uterus
Risk for fluid volume deficit related to hemorrhage
The client, who is 12 hours postoperative from a total abdominal hysterectomy for uterine leiomyomas, has partially saturated one perineal pad in six hours. What is your best action?
Document the finding as the only action.
Press on the abdomen to expel clots.
Increase the IV flow rate.
Notify the physician.
Document the finding as the only action.
Which statement about cervical cancer is true?
It is the most common neoplasm among the reproductive organs.
The death rate from cervical cancer has decreased by 50% in the past 20 years because of the availability of Pap tests.
The incidence of cervical cancer has decreased by 50% in the past 20 years because of the availability of Pap tests.
The major risk factors for cervical cancer are first pregnancy at age 29 or later and use of barrier methods of birth control.
The death rate from cervical cancer has decreased by 50% in the past 20 years because of the availability of Pap tests.
The client who has had a hysterectomy for uterine cancer is crying as you enter the room. When you ask the client why she is crying the client responds, "I know I shouldn't cry because this surgery may save my life, but I feel I am too young to have a hysterectomy." What is your best response?
"You are right. It is silly to carry on like this when your appearance hasn't changed."
"It is all right to cry. Mourning this loss can help you come to accept what has happened."
"Would you like to talk with someone who also has had a hysterectomy?"
"Have you ever known anyone else with cancer?"
"It is all right to cry. Mourning this loss can help you come to accept what has happened."
Which statement made by the client prescribed to receive intraperitoneal chemotherapy for ovarian cancer indicates correct understanding of this treatment? "I:
will not use creams or lotions on the skin of my abdomen."
have bought a wig to wear when my hair begins to fall out."
will need to avoid crowds because my susceptibility to colds and flu is increased."
should have fewer side effects from this treatment than from traditional chemotherapy."
should have fewer side effects from this treatment than from traditional chemotherapy."
Which following clinical manifestation in a client during the first week at home after pelvic exenteration surgery should you, as the home care nurse, report immediately?
Mucus draining from the perineal wound.
Passage of semi-formed stool several times a day from the colostomy.
The presence of swelling in the right calf with pain on dorsiflexion.
The presence of small, uneven lumps under the suture line of the incision.
The presence of swelling in the right calf with pain on dorsiflexion.
Which clinical manifestation in an older male client is associated with benign prostatic hyperplasia (BPH)?
Chronic low back pain extending down the legs
Difficulty maintaining an erection
Difficulty initiating urination
Thinning pubic hair
Difficulty initiating urination
Which statement made by a client with benign prostatic hypertrophy indicates a need for clarification regarding nonsurgical management of this problem? "I will:
drink at least a liter of fluid at every meal."
avoid drinking alcohol and caffeinated beverages."
try to urinate as soon as I am aware of the urge."
check with my doctor before taking any over-the-counter medications for colds."
drink at least a liter of fluid at every meal."
The client is returned to the nursing unit after a transurethral resection prostatectomy (TURP). You observe the Foley catheter to be draining blood-tinged urine containing small clots. What is your best action?
Notify the physician.
Increase the IV flow rate.
Release the traction on the catheter.
Document the observation as the only action.
Document the observation as the only action.
Which client should have follow-up testing for possible prostate cancer?
55-year-old man with a PSA of 3.5 ng/mL
75-year-old man with a PSA of 3.5 ng/mL
55-year-old man with a PSA of 4.5 ng/mL
75-year-old man with a PSA of 4.5 ng/mL
55-year-old man with a PSA of 4.5 ng/mL
The client who is taking estrogen for prostate cancer tells you he is experiencing all of the following symptoms. Which one alerts you to the possibility of complications?
Bilateral breast tenderness and swelling
Swelling of the right leg
Decreased facial hair
Mood swings
Swelling of the right leg
For which clients experiencing impotence is the drug Viagra contraindicated? Those clients:
with erectile dysfunction
with diabetes mellitus
taking nitroglycerin
over age 70 years
taking nitroglycerin
Which group of men has the highest risk for prostate cancer?
Asian-American men
African-American men
Native American men
Caucasian-American men
African-American men
Which client with testicular cancer is considered a poor candidate for sperm banking? The client who:
is gay.
is 46 years old.
has a seminoma.
has started radiation therapy.
has started radiation therapy.
What is the priority nursing diagnosis/collaborative problem during the first 24 hours for the client who has had an orchiectomy and radical retroperitoneal lymph node dissection?
Acute pain
Risk for infection
Risk for metastasis
Body image disturbance
Acute pain
Which statement from the client who is going home after a unilateral orchiectomy for testicular cancer indicates a need for further teaching during the first two postoperative weeks? "I:
am going to lift weights to regain my strength faster."
am going to perform TSE on the other side monthly."
will check the incision at least twice each day for drainage."
will limit stair-climbing to once per day until my doctor says it is okay."
am going to lift weights to regain my strength faster."
Which clinical manifestation in a client with testicular discomfort indicates a possible varicocele?
The skin of the scrotum is wrinkled.
The left testicle is about an inch lower than the right testicle.
The client has noticed an increase in the size of the scrotal contents.
Spongy, cord-like or worm-like structures are palpated through the scrotum.
Spongy, cord-like or worm-like structures are palpated through the scrotum.
The client is a 28-year-old man diagnosed with testicular cancer who is two days postoperative from a bilateral orchiectomy. Every time a young female nurse enters his room, the client makes remarks about how he would like to have sex with her. What is your best action?
Explain to the client that the nurse is already married.
Report the behavior to the head nurse and request that the nurse's assignment be changed.
Ask the client if he is worried about how the disease and surgery might affect his future sexual activity.
Tell the client that if the behavior continues the nurse will note his inappropriate behavior in his chart.
Ask the client if he is worried about how the disease and surgery might affect his future sexual activity.