Sexuality

Front 1

Female external genitalia

Back 1

Vulva, labia majora, mons pubis, labia minora, clitoris, vestibule, perineum

Front 2

Female internal genitalia

Back 2

Vagina, uterus, corpus, cervix, fallopian tubes, ovaries

Front 3

Male external genitalia

Back 3

Penis, scrotum

Front 4

Male internal genitalia

Back 4

Testes, prostate gland

Front 5

Drug and alcohol abuse can affect

Back 5

Sperm production, libido, erections

Front 6

Can cause orchitis or sterility in men

Back 6

Mumps

Front 7

Reasons people usually seek treatment

Back 7

Pain, bleeding, discharge, masses

Front 8

Patient education prior to pap smear exam

Back 8

Do not douche, use vaginal medications or deodorants or have Intercourse 24 hrs prior, schedule appointment in between menstrual periods

Front 9

Cytologic vaginal cultures

Back 9

Pap screenings after age 21

Front 10

HPV test

Back 10

HPV with pap over age 30 if abnormal pap

Front 11

Prostate-specific antigen (PSA) test

Back 11

Elevated result will require further testing

Front 12

Hysterosalpingogram

Back 12

X-ray that uses contrast medium to visualize the cervix, uterus and fallopian tubes (elevates tubal patency, lithotomy position)

Front 13

Mammography

Back 13

Over age 40

Front 14

Cervical biopsy post-procedure instructions

Back 14

No douching, Intercourse or tampon use until biopsy site is healed, rest 24 hrs post procedure, no heavy lifting for 24-48hrs

Front 15

Endometrial biopsy post procedure teaching

Back 15

Report fever or chills immediately

Front 16

Fibroademona

Back 16

Mass of connective tissue unattached to surrounding breast tissue (most common benign tumor in women during reproductive yrs)

Tumors are oval, freely movable, rubbery

Vary in size: 0.5in to 6 in

Front 17

Fibrocystic breast condition

Back 17

Common in premenopausal women between age 20 and 50

Thought to be caused by imbalance of normal estrogen to progesterone ratio

Front 18

Symptoms of fibrocystic breast condition

Back 18

Breast pain, tender lumps, swelling (often before menstruation)

Front 19

Management of fibrocystic breast condition

Back 19

Analgesics, limit salt intake before menses, wear supportive bra at all times, ice or heat may help, reduce or eliminate caffeine or dairy, needle aspiration may be necessary, oral contraceptives or selective estrogen receptor modulators may be prescribed; most women with this have minimal issues. Treat with tylenol, aspirin, motrin

Front 20

Ductal ectasia

Back 20

Benign breast problem of women approaching menopause. Caused by dilation and thickening of collecting ducts in subareolar area. Hard mass, irregular borders, tender. Greenish-brown nipped discharge, enlarged axillary nodes, redness and edema over mass

Front 21

Management of ductal ecstasia

Back 21

May improve without treatment. Reduce anxiety regarding threat of breast cancer. Warm compresses. Antibiotics. May require surgical removal

Front 22

Intraductal papilloma

Back 22

Occurs most often in women 40-55. Benign process in epithelial lining of duct, forming a pedunculated outgrowth of tissue. Trauma and erosion within the duct, bloody or serous nipple discharge. Mass is rarely palpable. Must rule out breast cancer.

Front 23

Gynecomastia

Back 23

Benign condition of breast enlargement in men. Can be result of a primary cancer or drugs, aging, obesity, underlying disease causing estrogen excess, androgen deficiency.

Front 24

Modifiable risk factors for breast cancer

Back 24

Alcohol use, oral contraceptive use, have first child after age 30, obesity, hormone replacement therapy

Front 25

Breast cancer

Back 25

Most common cancer in women. Non tender, immobile mass in upper quadrant of breast. Early detection is key to effective treatment and survival. Most common sites of mets are bone, lungs, brain and liver. BRCA1, BRCA2 genetic predisposition

Front 26

Elevated alkaline phosphate and calcium equals

Back 26

Bone mets

Front 27

Breast cancer in men

Back 27

Usually presents as hard, painless, subareolar mass. Should be carefully evaluated. Treatment is the same as for women at similar stage.

Front 28

Breast cancer screenings

Back 28

Screening mammogram for women age 40 and older. Clinical breast exam at least every 3 years for women age 20-40

Front 29

Options for high risk women

Back 29

Close surveillance. Annual mammography and clinical breast exam. Annual breast MRI screening. Prophylactic mastectomy. Prophylactic oophorectomy. Anti estrogen chemopreventive drugs.

Front 30

Care of the patient with a breast mass

Back 30

Develop coping strategies (support persons, support groups). Decreasing risk for mets. Surgical management. Radiation/chemotherapy. Drug/hormone therapy. Stem cell transplant.

Front 31

Mastectomy

Back 31

Lumpectomy - tumor removal. Sentinel lymph node biopsy - injection of a dye and cancerous nodes are removed. Mastectomy - removal of breast. Radical mastectomy - removal of breast and nodes.

Front 32

Mastectomy post op care

Back 32

Focus on relieving anxiety. Drainage tube. Mobility restrictions. Address body image issues. Avoid using affected arm for BP, injections, blood draws. Hand wall climbing. Elevate head of bed. Arm elevated to enhance lymphatic flow. Support arm initially when ambulating

Front 33

Endometriosis

Back 33

Endometrial tissue implantation outside the uterine cavity

Front 34

Most common symptom of endometriosis

Back 34

Pain, peaking just before menstrual flow

Front 35

Treatment of endometriosis

Back 35

Reduction of pain, restoration of sexual function, decrease in anxiety, education, prevention of self-concept disturbance r/t infertility

Front 36

Dysfunctional uterine bleeding

Back 36

Excessive and frequent bleeding - most common at beginning or end of a woman's reproductive years

Front 37

Treatment of dysfunctional uterine bleeding

Back 37

Prevention or treatment of anemia, control of bleeding via surgical or nonsurgical methods (hormone replacement, ablation, hysterectomy if all else fails)

Front 38

Vulvovaginitis

Back 38

Inflammation of lower genital tract resulting from imbalance of hormones and flora in vagina and vulva

Front 39

Characteristics of vulvovaginitis

Back 39

Itching, change in vaginal discharge, odor or lesions

Front 40

Toxic shock syndrome (TSS)

Back 40

Usually results from menstruation and tampon use - can be fatal. *Staphylococcus aureus.

Front 41

Symptoms of toxic shock syndrome

Back 41

Develops within 5 days after menstruation. Fever, rash, my alias, sore throat, edema, hypotension

Front 42

Treatment of TSS

Back 42

Focuses on removal of infection source. Change tampon every 8 hrs

Front 43

Pelvic organ prolapse

Back 43

Pelvic organ muscles can become weak and no longer able to hold organ in place. Can be uterine, cystic electronic or rectocele. Pts often report the feeling of "something falling out"

Front 44

Symptoms of pelvic organ prolapse

Back 44

Dyspareunia (painful intercourse), backache, heaviness or pressure in pelvis, bowel or bladder problems

Front 45

Treatment of pelvic organ prolapse

Back 45

Focuses on degree of POF. Conservative treatment is preferred over surgical treatment when possible. Kegal exercises, pessaires, intravaginal estrogen therapy

Front 46

Uterine leiomyoma

Back 46

Benign solid growing tumors. Unknown cause. May not need treatment if asymptomatic. Nonsurgical/surgical management

Front 47

Colporrhaphy

Back 47

Vaginal wall repair (minor surgery) For discomfort - heating pad, warm compresses, hot bath

Front 48

Men should have what vaccine to prevent sterility issues

Back 48

MMR (mumps can cause orchitis - infection of testes, and sterility)

Front 49

Priority assessments for reproductive system

Back 49

Pain, bleeding, discharge, masses

Front 50

During physical assessment of women, what requires further evaluation

Back 50

Increased size of uterus

Front 51

Bimanual pelvic examination

Back 51

Feels for enlarged uterus and masses

Front 52

Prior to Pap smear

Back 52

Avoid anything that could interfere with outcome of pathology study (no douching, vaginal meds or deodorants, no sex for 24 hrs prior)

Front 53

What age is recommended for all screenings in women

Back 53

21

Front 54

Hormone levels studies done when

Back 54

If women have missed menstrual cycles

Front 55

Elevated result of what test will require further testing in men

Back 55

Prostate specific antigen (PSA) - men start getting this screening at age 40 but it is a routine test if they have an enlarged prostate

Front 56

After a laparascopy

Back 56

No strenuous activity for 7 days post op

Front 57

After endometrial biopsy

Back 57

Report fever and chills immediately

Front 58

After cervical biopsy

Back 58

No douching, Intercourse or tampon use until biopsy site is healed; rest for 24 hrs post procedure; no heaving lifting for 24-48 hrs

Front 59

Which ethnic group has a higher frequency of developing testicular cancer

Back 59

Caucasian

Front 60

Teaching for someone scheduled for a routine mammogram

Back 60

If you might be pregnant, the test should be rescheduled; you should not eat or drink after midnight before your mammogram

Front 61

Does NOT increase a woman's chance of developing breast cancer

Back 61

Fibrocystic breast condition

Front 62

Uterine leiomyoma

Back 62

Benign solid growing tumors. Unknown cause. May not need treatment if asymptomatic but there is surgical and nonsurgical management

Front 63

Treatment of POP

Back 63

Conservative treatment preferred if possible. Kegal exercises, pessaires (attachment to hold up the organs), intravaginal estrogen therapy

Front 64

To avoid TSS

Back 64

Change tampon at least every 8 hours

Front 65

Hysterectomy

Back 65

Many methods of removal including laparoscopically. Psychosocial assessment is essential!

Front 66

Postoperative hysterectomy care

Back 66

Management of vaginal bleeding (normal = pt saturates 1-2 pads per shift. Anything more than that = contact provider), monitor incisional intactness, urinary output and pain

Front 67

Salpingo-oophorectomy

Back 67

Removal of uterus and ovaries. Psychosocial assessment!!! Pts have concerns with sexuality and libido. Teach about vaginal estrogen cream

Front 68

Bartholin cyst

Back 68

Obstruction of the duct of the bartholin gland. Caused by infection, thickened mucus near ductal opening or trauma (lacerations)

Front 69

Treatment of bartholin cysts

Back 69

Pts may be asymptomatic or in extreme pain. May need simple incision and drainage (I&D). Obtain fluid sample for lab analysis

Front 70

Cervical polyp

Back 70

Pedunculated tumors that arise from mucosa that extends through opening of cervical os

Front 71

Treatment of cervical polyps

Back 71

Pts may be asymptomatic but common symptoms are bleeding, leukorrhea. Usually removed during an office visit via clamp and cautery. Little or no discomfort during procedure

Front 72

Endometrial (uterine) cancer

Back 72

Cancer of the inner uterine lining. Slow growing

Front 73

Adenocarcinoma

Back 73

Most common type of tumor r/t endometrial cancer. Arises from the glandular part of endometrium

Front 74

Main symptom of endometrial cancer

Back 74

Postmenopausal bleeding

Front 75

Psychosocial care of pt with endometrial cancer

Back 75

Relationship with pt is key! Provide emotional support. Very traumatic to pt

Front 76

Diagnostic assessment for endometrial cancer

Back 76

CA-125 tumor marker, transvaginal ultrasound, endometrial biopsy

Front 77

Cervical cancer

Back 77

This form of cancer is a progression. Pts go from normal cervical cells to premalignnant changes in appearance of cervical cells (dysplasia), to changes in function and ultimately transform to cancer

Front 78

Most cases of cervical cancer are caused by

Back 78

Certain types of HPV

Front 79

Gardisil or Cervarix

Back 79

HPV vaccine for girls and women ages 9-26. Educate families with young girls about vaccination

Front 80

Risk factors for cervical cancer

Back 80

Smoking, multiple partners, first Intercourse before age 18

Front 81

Brachytherapy

Back 81

Internal radiation delivery. Ensure applicator is in correct position. Radio Radioisotope remains in place for several minutes. Generally 2-5 times once or twice a week. Pt is NOT radioactive between treatments and there are no restrictions on interactions with others

Front 82

Normal after brachytherapy

Back 82

Vaginal bleeding

Front 83

Not normal after brachytherapy

Back 83

Constipation, elevated temp

Front 84

Ovarian cancer

Back 84

Leading cause of death from female reproductive cancer (but not most common). Vague abdominal and GI symptoms. Survival rates are low due to late detection. Treatment involves surgery and chemo. BRCA1 and BRCA2 can test for predisposition

Front 85

Tests most likely to be ordered for patient with suspected endometrial cancer

Back 85

Transvaginal ultrasound and endometrial biopsy

Front 86

Pt teaching before brachytherapy

Back 86

It will require a hospital stay. The purpose is to prevent recurrence of the disease. They will be isolated in private room while the isotope is in place

Front 87

"Menopausal" definition

Back 87

A woman who has not had a period for 1 full year

Front 88

"Perimenopausal" definition

Back 88

The months leading up to menopause

Front 89

Normal psychological response after hysterectomy

Back 89

Grief reaction to removal of uterus, tubes and ovaries may be experienced

Front 90

The nurse understands that which physical change may be expected by the patient who has undergone a total abdominal hysterectomy

Back 90

The patient will not longer have a period

Front 91

A 51 yr old female who is Perimenopausal broke her arm after a fall in her home. She also reports progressive fatigue, insomnia and hot flashes. What is the priority assessment question to collect more data regarding pt's health history

Back 91

Do you engage in exercise?

Front 92

Cialis

Back 92

Helps with benign prostatic hyperplasia as well as erectile dysfunction (increases blood flow to area). Caution with pts presenting with MI and on cialis. If given nitroglycerin as both are vasodilators

Front 93

Benign prostatic hyperplasia

Back 93

Glandular units in the prostate multiple, resulting in enlargement of the prostate. Puts extra pressure on urethra

Front 94

Symptoms of benign prostatic hyperplasia

Back 94

Hyperirritable bladder, urinary urgency and frequency, hypertrophied bladder wall muscles, hydroureter, hydronephrosis, overflow urinary incontinence, nocturia

Front 95

Bactrim

Back 95

Sulfa drug. Given for UTI before giving pt heavy duty antibiotics

Front 96

When taking five-alpha reductase inhibitor meds

Back 96

Monitor for orthostatic hypotension, liver problems, amylase lab levels

Front 97

Chance of erectile dysfunction with TURP

Back 97

80-85%

Front 98

If irrigating bladder and we see frank red blood

Back 98

Get a set of VS and notify provider

Front 99

Transurethral resection of the prostate (TURP)

Back 99

Laparoscopic procedure

Front 100

Postoperative TURP

Back 100

Catheter with retention balloon placed into bladder. Traction via taping to pts abdomen or thigh. Uncomfortable urge to void continuously

Front 101

Postoperative monitoring for TURP

Back 101

Watch for bleeding. We do not want clots (once a clot forms, the prostate will bleed excessively). All fluids should be clear. If sodium levels start dropping, decrease amount of fluids being put in with bladder irrigation

Front 102

Distended bladder

Back 102

Irrigation needed

Front 103

Green light laser

Back 103

Laser cauterizes during procedure. Less risk than TURP. No overnight admission needed. No post op bleeding. Minimal risk of erectile dysfunction

Front 104

Prostate cancer

Back 104

Slow-growing predictable malignancy. First symptoms r/t bladder neck obstruction

Front 105

Assessment for prostate cancer

Back 105

Digital rectal exam, prostate specific antigen, biopsy to confirm

Front 106

Luteinizing releasing hormone

Back 106

To reduce testosterone and decrease related bone issues

Front 107

Erectile dysfunction

Back 107

Inability to achieve or maintain erections for sexual intercourse

Front 108

Assessment for ED

Back 108

Medical, social, sexual history; complete physical exam; duplex doppler ultrasonography test

Front 109

Risk factors for ED

Back 109

Diabetes, alcoholism, hypertension, atherosclerosis

Front 110

Testicular cancer

Back 110

Most common malignancy in men 15-34; curable with early detection by testicular self exam and treatment with combination chemotherapy. Be sensitive to pts of reproductive age - may want to salvage sperm.

Front 111

Hydrocele

Back 111

Cystic mass usually filled with straw-colored fluid forms around testis. Results from impaired lymphatic drainage of scrotum resulting in swelling of tissue surrounding testes

Front 112

Treatment of hydrocele

Back 112

Drainage via needle and syringe or surgical removal

Front 113

Spermatocele

Back 113

Sperm containing cyst develops on epididymis alongside the testicle. Normally small and asymptomatic requiring no intervention. If large enough to cause discomfort, spermatocelectomy performed

Front 114

Varicocele

Back 114

Cluster of dilated veins occurring behind and above testis. Can cause infertility. Varicocelectomy performed through inguinal incision. Spermatic veins ligated in the cord

Front 115

Circumcision in infants almost always eliminates possibility of

Back 115

Cancer of the penis

Front 116

Cancer of the penis

Back 116

Painless, wartlike growth or ulcer. Excisional biopsy, radiation therapy, penectomy

Front 117

Phimosis and paraphimosis

Back 117

Constricted prepuce that cannot be retracted over the gland. Medical emergency: requires immediate treatment (circumcision, warm bath to allow dressing to loosen, barbiturate sleeping meds)

Front 118

Foley catheter care for uncircumcised pts

Back 118

Ensure foreskin is back down after Foley placement. If skin left up, it can obstruct blood flow

Front 119

Priapism

Back 119

Uncontrolled and long maintained erection without sexual desire. Can occur as result of: thrombosis, leukemia, sickle cell disease, spinal cord injury and as a side effect of cialis or viagra

Front 120

Treatment of priapism

Back 120

Multiple injections of epinephrine

Front 121

Prostatitis

Back 121

Inflammation of prostate gland. Acute or chronic

Front 122

Epididymitis

Back 122

Inflammation of epididymis resulting from infection (STDs) or trauma. Treatment: bedrest, elevation of scrotum, scrotal support when ambulating

Front 123

Orchitis

Back 123

Acute testicular inflammation resulting from trauma or infection. Mumps orchitis - can cause sterility. Treatment: bedrest with scrotal elevation, application of ice, analgesics and antibiotics

Front 124

Priority for care of pts with reproductive problems

Back 124

Be sensitive to situation. Pts often embarrassed to talk about it

Front 125

Expected finding in pt with BPH

Back 125

Distended bladder

Front 126

Medications used to treat BPH

Back 126

Can take several weeks to reach full effect

Front 127

Priority interventions after TURP

Back 127

Assess for signs of infection, check urine output every 2 hrs, remind pt that urine will be blood tinged, admin pain and antispasmodic drugs as needed

Front 128

An older male pt is being evaluated for hydronephrosis. What priority health history question will the nurse ask?

Back 128

Have you had a recent UTI?

Front 129

Priority concern after TURP

Back 129

Hemorrhage

Front 130

Transgender

Back 130

An inner sense of being born in the wrong body

Front 131

Transsexual

Back 131

A person who has modified his or her natal body to match the appropriate gender identity either through cosmetic, hormonal or surgical means

Front 132

Natal sex

Back 132

A person's genital Anatomy at birth

Front 133

Gender dysphoria

Back 133

Discomfort with one's natal sex

Front 134

Problems associated with transgender pts

Back 134

Drug and alcohol abuse, violence, relationship abuse

Front 135

Important with transgender pts

Back 135

Ask how they would like to be addressed. Use correct pronouns. Remain non-judgmental

Front 136

Gender reassignment

Back 136

Can take several years to complete

Front 137

Health history assessment for transgender pts

Back 137

Ask about interventions pt has used if any; inquire about use of drug therapy; record surgical history; pts in transition will need to be assessed for any interventions, like catheter placement

Front 138

Patients in transition

Back 138

Will need screenings pertaining to whatever body parts that still apply (prostate, breast exams?)

Front 139

Psychosocial assessment of transgender pts

Back 139

Ask specific questions to determine what factors may affect care; reassure patient regarding confidentiality; evidence of abuse must be reported by law

Front 140

Nonsurgical management of transgender pts

Back 140

Drug therapy, reproductive health options, voice and communication therapy for MtF

Front 141

Surgical management of transgender pts

Back 141

Gender reassignment surgery, much can be done under epidural anesthesia - post op ensure pt is assisted when getting out of bed for the first time

Front 142

Community based care for transgender pts

Back 142

Teach pts that ongoing follow up is needed to maintain health and detect any complications; assess support systems and coping mechanisms; collaborate with care manager; urogenital care needed for pts who have gender reassignment surgery; preventive health screenings are important!!!!!

Front 143

MtF drug therapy

Back 143

Estrogen therapy (estradiol, transdermal estrogen) - DVT risk; androgen reducing agents, block testosterone (Aldactone, Proscar, zoladex) - Aldactone also used as diuretic to help with BP

Front 144

FtM drug therapy

Back 144

Testosterone therapy (andriol, androgel) - if pts have heart palpitations, get EKG!

Front 145

How is Zoladex given

Back 145

Subcu injection (androgen reducing agent for MtF transition)

Front 146

Which patient teaching about testosterone therapy will the nurse provide to a female transitioning to male (FtM) patient

Back 146

Avoid sharing needles as this can transmit HIV or hepatitis. A lot of these meds are given as injections

Front 147

More susceptible to STDs

Back 147

Women

Front 148

Syphilis

Back 148

Caused by T. Pallidum; transmitted by sexual contact or kissing; 4 stages; wear gloves for any visible signs of the disease like chancres or scaly rash

Front 149

Primary phase of syphilis

Back 149

Chancre, develops at site of innoculation, highly infectious, spreads throughout the body, lasts up to 6 weeks

Front 150

Second stage of syphilis

Back 150

Develops 6 wks to 6 months, vague symptoms, spirochetes circulate throughout the blood, malaise, low grade fever, HA, sore throat, pustules, highly contagious

Front 151

Latent stage of syphilis

Back 151

Early latent = first year, late latent = 4-20 years, infectious only to fetus, can affect mental capabilities

Front 152

Testing for syphilis

Back 152

VDRL, if positive, FTA-ABS (fluorescent treponemal antibody absorption). Immediate treatment with penicillin

Front 153

Complications of syphilis

Back 153

Can become systemic and cause serious complications including death

Front 154

Palmar and plantar secondary syphilis

Back 154

Contact precautions!!!!!

Front 155

Genital herpes

Back 155

Viral infection - acute, recurring, incurable. When immune system is compromised, outbreak more likely

Front 156

Assessment of genital herpes

Back 156

History, physical exam, viral culture

Front 157

Treatment of genital herpes

Back 157

Address symptoms, decrease discomfort, promote healing, decrease viral shedding, prevent transmission, refer to a support group. If mother has suspected genital herpes, vaginal delivery is not allowed

Front 158

Condylomata acuminata (genital warts)

Back 158

Caused by certain types of HPV. Single, small papillary growth that may grow into large, cauliflower like masses (will keep growing, removal may be needed).

Front 159

Treatment of genital warts

Back 159

Remove warts, treat symptoms, prevent development of atypical or dysplastic cells, annual PAP recommended due to strong link of warts and dysplasia of cervix

Front 160

Chlamydia infection

Back 160

Chlamydia trachomatis - intracellular bacterium. Reportable to health dept. Females often asymptomatic (70%) but symptoms include discharge, painful urination

Front 161

Treatment of chlamydia

Back 161

Zithromax 1G orally, single dose treatment

Front 162

Complications of chlamydia

Back 162

Any infection or inflammation of reproductive tract can cause infertility issues later in life

Front 163

Gonorrhea

Back 163

Seuxally transmitted bacterial infection; possible anal and oral manifestations. Many pts often embarrassed to go to primary care Dr with these symptoms and will end up in ED

Front 164

Symptoms of gonorrhea is women

Back 164

Change in vaginal discharge, urinary frequency or dysuria, ascending spread that can cause endometritis, salpingitis, and pelvic inflammatory disease

Front 165

Symptoms of gonorrhea in men

Back 165

Dysuria and penile discharge

Front 166

Pelvic inflammatory disease

Back 166

Complex infectious process, organisms from lower genital tract migrate from endocervix upward through uterine cavity into fallopian tubes

Front 167

Infections related to PID

Back 167

Endometritis, salpingitis, oophoritis, parametritis, peritonitis

Front 168

Complications of PID

Back 168

Must rule out ectopic pregnancy and appendicitis. STDs are most often (but not always) responsible for PID. Sepsis and death can occur if treatment is delayed or inadequate. Internal scarring remains even after treatment and can cause problems in fallopian tubes affecting fertility

Front 169

What position is most comfortable for pts with PID

Back 169

Semi fowlers

Front 170

Risk factors for PID

Back 170

Multiple sexual partners, under age 26, IUD within 3 weeks, smoking, history of STDs (alcohol is NOT a risk factor)

Front 171

HPV

Back 171

Many different strains of virus (over 100); affects 80% of all women by age 30. 90% of healthy people clear virus on their own but this can take up to 3 years. Routine pap is important for monitoring

Front 172

PID medication treatment

Back 172

Doxycycline (vibramycin) 100 mg twice a day for 14 days OR ceftriaxone (rocephin) IM one time dose if pt is homeless or has no access to medicine

Front 173

Discharge teaching for pt with PID

Back 173

Abstain from sexual intercourse, check temp twice a day, make follow up appt with provider within 72 hrs, take all medications as directed

Front 174

Estrogen medication

Back 174

Estradiol (estrace): used for relief of postmenopausal symptoms. Prolonged use can contribute to endometrial and ovarian cancers. Risk for MI, PE, DVT, stroke. Client teaching - take med at same time each day. Report menstrual changes (dysmenorrhea, amenorrhea, breakthrough bleeding) and breast changes. Annual breast and gynecologic exam

Front 175

Medroxyprogesterone (Provera)

Back 175

For dysfunctional uterine bleeding, amenorrhea rt hormonal imbalance and endometriosis and advanced endometrial cancer

Front 176

Side effects of medroxyprogesterone

Back 176

Breast cancer, thromboembolic events, breakthrough bleeding, edema, jaundice, migraines

Front 177

Client teaching for medroxyprogesterone

Back 177

Anticipate withdrawal bleeding 3-7 days after stopping med. Stop taking immediately if pregnancy is suspected (conception should be delayed 3 months following use).

Front 178

Testosterone (androderm 50, testopel)

Back 178

To treat: Postmenopausal breast cancer, delayed puberty in boys, muscle wasting in aids pts, androgen replacement in testicular failure and transgender transitions. Monitor women for signs of masculinization

Front 179

Testosterone side effects

Back 179

Edema from Salt and water retention, epiphyseal closure, weight gain, deepening of voice, increased facial hair, cessation of menses

Front 180

Client teaching for testosterone

Back 180

When using gel formations, wash hands after every application because of possibility of skin to skin transfer; inject IM formulations into large muscles and rotate sites. Reduce cholesterol in diet, advise clients about abuse potential

Front 181

5-alpha reductase inhibitors

Back 181

Finasteride (proscar): treats benign prostatic hyperplasia

Front 182

Side effects of 5-alpha reductase inhibitors

Back 182

Decreased libido, gynecomastia, orthostatic hypotension

Front 183

Teaching for 5-alpha reductase inhibitors

Back 183

Therapeutic effects may take 6 months or longer

Front 184

Alpha1-adrenergic antagonist

Back 184

Tamsulosin (flomax): treats benign prostatic hyperplasia, thus increasing urinary flow

Front 185

Side effects of tamsulosin

Back 185

Hypotension, sleepiness, problems with ejaculation

Front 186

Client teaching for tamsulosin

Back 186

Advise clients to take medication 30 min after a meal at same time each day

Front 187

Sildenafil (viagra)

Back 187

Treats erectile dysfunction (it is a PDE5 inhibitor). Side effects are MI, sudden death, priapism. Combined use with organic nitrates can lead to fatal hypotension

Front 188

The nurse is interviewing a 52 yr old woman who reports irregular and decreased flow of menses for several months. Which question does the nurse ask?

Back 188

Are you having any discomfort during intercourse?

Front 189

The nurse is assisting a patient to assume the correct position for a hysteroscopy procedure. Which position is correct?

Back 189

Lithotomy position

Front 190

An insufficient estrogen level is related to what condition?

Back 190

Osteoporosis

Front 191

A male patient had mumps as a child which caused orchitis. Which potential complication could result?

Back 191

Testicular atrophy

Front 192

A male patient reports that he has decreased libido. The nurse assesses for which factors related to this condition?

Back 192

- tobacco use

- alcohol consumption

- illicit drug use

Front 193

Most diseases that alter a woman's metabolism or nutrition can result in which condition?

Back 193

Amenorrhea

Front 194

A 60 yr old female patient informs the nurse that she has experienced some vaginal changes since menopause. What gynecologic change is the patient most likely to report?

Back 194

Vaginal dryness

Front 195

The mother of a 17 year old adolescent girl tells the nurse that her daughter has been purging, showing anorexic behavior and continuously exercising. Based on the mother's report, which question related to reproduction would the nurse ask the girl?

Back 195

When was your last normal menstrual period?

Front 196

A 29 year old patient has strictures and adhesions in her fallopian tubes. This may be a result of which condition?

Back 196

Pelvic inflammatory disease

Front 197

In a patient with a reproductive health problem, what health and lifestyle habits would the nurse assess?

Back 197

- diet

- exercise pattern

- sleep pattern

Front 198

A patient is diagnosed with a chlamydial infection but is reluctant to spend the money for treatment because she is asymptomatic and does not have a job or health insurance. The nurse advises her that chlamydial infections can result in which condition?

Back 198

Female infertility

Front 199

A 40 yr old woman has heavy vaginal bleeding. Which question is the priority in evaluating the patient's chief complaint?

Back 199

Are you feeling weak, dizzy or lightheaded?

Front 200

A 37 year old patient reports abdominal bleeding not related to her menstrual cycle. The nurse would ask the patient about which associated symptoms?

Back 200

- pain

- change in bowel habits

- abdominal fullness

- urinary difficulties

Front 201

For a patient with low testosterone level, which symptom is the patient most likely to report?

Back 201

Change in sexual performance

Front 202

The Healthcare provider has just informed the patient about the diagnosis and complications of salpingitis. Which intervention is the nurse most likely to use with the patient?

Back 202

Use empathetic listening for feelings related to possible infertility

Front 203

What features would be considered normal findings for the scrotum of a young white male?

Back 203

- suspended below the pubic bone

- contracts with exposure to cold

- sparse hair follicles

Front 204

What is the function of the prostate gland?

Back 204

Secretes fluid to enhance sperm movement

Front 205

A 72 year old patient admitted to the med surg unit tells the nurse that he has benign prostatic hyperplasia. Which question will the nurse ask?

Back 205

Are you having urinary incontinence or frequency at night?

Front 206

A young woman reports that she has a genital discharge causing irritation and odor. She feels embarrassed but insists she has not had recent sexual relations. Which question is the nurse most likely to ask?

Back 206

Have you recently taken any antibiotic medications?

Front 207

The nurse is interviewing a patient to who reports a discharge from his penis thay started 3 days ago. What does the nurse ask regarding this problem?

Back 207

- has your sexual partner noticed a discharge?

- does the discharge have an odor?

- what is the consistency of the discharge?

Front 208

A nurse is working in an ambulatory clinic. Which patient is most likely to need to be prepared for a pelvic examination?

Back 208

62 year old who reports resumption of menses

Front 209

A 31 year old is diagnosed with salpingitis. Which area of the reproductive system is most affected by this condition?

Back 209

Fallopian tubes

Front 210

Which diagnostic test is used to differentiate solid tissue masses from cystic or hemorrhagic structures in the abdomen and pelvis?

Back 210

Computed tomography

Front 211

Which test detects cancerous and precancerous cells of the cervix?

Back 211

Pap smear

Front 212

A 79 year old man is being seen for difficulty voiding and some blood in the urine. Which is the first screening test likely to be done?

Back 212

Prostate specific antigen testing

Front 213

An African American male patient has a PSA level less than 2.5 ng/ml. Which information should the nurse give to the patient?

Back 213

PSA level less than 2.5 is generally considered normal

Front 214

A patient received treatment for prostate cancer. Which test is most likely to be ordered to monitor the disease after treatment?

Back 214

PSA test

Front 215

The patient reports fatigue and low libido. Based on the patient's report of symptoms, which lab result would the nurse seek out first?

Back 215

Red blood cell count

Front 216

Which patient is most likely to require an iron supplement?

Back 216

32 year old female with heavy menstrual bleeding and an IUD

Front 217

Which statement about PSA testing is true?

Back 217

It is used to screen for prostate cancer

Front 218

The nurse is teaching a patient about the contraindications for hysteroscopy. What does the nurse tell the patient?

Back 218

During the procedure, normal or abnormal cells can be pushed through the fallopian tubes and into your pelvic cavity. Therefore, pregnancy is contraindicated

Front 219

What test is used to assess tubal Anatomy and patency and uterine problems?

Back 219

Hysterosalpingography

Front 220

The nurse is caring for a patient who had a laparascopy. What is included in the postoperative care for this patient?

Back 220

- admin oral analgesics for incisional pain

- instruct pt to change the small adhesive bandage as needed

- teach pts to observe the incision for signs of infection or hematoma

Front 221

The nurse is helping a patient schedule an appointment for a hysteroscopy. When does the nurse advise the patient that the procedure should be done?

Back 221

5 days after menses have ceased

Front 222

Which man has the greatest risk for developing prostate cancer?

Back 222

Pts father was diagnosed and treated for prostate cancer at age 50

Front 223

The nurse is assisting a patient who needs a pelvic examination. Which action will the nurse perform?

Back 223

Instruct to empty the urinary bladder

Front 224

A patient has just been informed that she has an abnormal pap smear and a positive HPV test. The nurse should be prepared to provide information about which topic?

Back 224

Increased risk for cervical cancer

Front 225

Which patient disclosure could result in rescheduling a hysterosalpingogram?

Back 225

Pt reports fever with malodorous vaginal discharge

Front 226

What preprocedural instructions would the nurse give the patient about a mammogram?

Back 226

Do not use lotions, creams or powder on breasts before the study

Front 227

What post-procedure instructions would the nurse give to a patient who just had a colposcopy?

Back 227

Do not use tampons and abstain from sexual intercourse for at least 1 week

Front 228

A patient needs to be scheduled for an endometrial biopsy to assess unusually heavy menstrual bleeding. Which question is most important to ask, in relation to scheduling the exam?

Back 228

What was the date of your last menstrual period and are you regular?

Front 229

What post-procedure instructions would the nurse give to a patient who had a prostate biopsy?

Back 229

Light rectal bleeding and blood in the urine or stools is expected for a few days

Front 230

For a patient with mild discomfort from fibrocystic breast condition, what will the nurse teach the patient about self care measures?

Back 230

Take analgesics and limit salt before menses to help decrease swelling

Front 231

A 22 year old woman is being seen for a self detected mass in her right breast. Clinical examination reveals an oval-shaped, freely mobile and rubbery lesion measuring 1cm x 2.5cm. What type of tumor is this most likely to be?

Back 231

Fibroadenoma

Front 232

A 33 year old woman reports that the skin over her left breast is reddened, warm and has swelling. These characteristics are typically found in which type of breast disorder?

Back 232

Inflammatory breast cancer

Front 233

What information does the nurse include about health risks for large breasted women?

Back 233

Increased risk for fungal infections and backaches

Front 234

A patient with FBC has just undergone fine needle aspiration to drain the cyst fluid and reduce pressure and pain. At what points does the nurse prepare patient education material about breast biopsy?

Back 234

- if fluid is not aspirated

- if the mammogram shows suspicious findings

- if the mass remains palpable after aspiration

- if aspirated fluid reveals cancer cells

Front 235

A patient with FBC is prescribed drug therapy to manage symptoms. The nurse prepares teaching materials for which group of medications?

Back 235

Oral contraceptives, vitamin therapy, diuretics

Front 236

A 54 year old woman has identified a hard breast mass with irregular borders, redness and edema. She reports greenish brown nipple discharge and enlarge axillary nodes. Based on the patient's age and description of symptoms, what does the nurse suspect?

Back 236

Ductal ectasia

Front 237

The nurse notes in the electronic medical record that the patient has a round, firm, nontender, mobile breast mass not attached to breast tissue or the chest wall. What does this describe?

Back 237

Fibroadenoma

Front 238

The nurse is reviewing discharge instructions for a patient who had breast augmentation surgery. What does the nurse include in these instructions?

Back 238

- breasts will feel tight and sensitive, the breast skin may feel warm or itchy

- anticipate having difficulty raising arm over head

- walk every few hours to prevent DVT

- expect some swelling for 3 to 4 weeks after surgery

Front 239

What is the most common breast dysfunction found in the male breast?

Back 239

Gynecomastia

Front 240

What does the nurse instruct the patient to do before a scheduled breast augmentation surgery?

Back 240

- stop smoking

- avoid taking NSAIDS

- avoid taking gingko biloba

Front 241

After surgery, a female patient has been told her breast tumor contains estrogen receptors. How will this type of cancer be treated?

Back 241

Hormonal therapy

Front 242

Which factor has the most influence on the choice for treatment of breast cancer?

Back 242

Extent and location of metastasis of the breast mass

Front 243

Which factor is the incidence of breast disease most closely related to?

Back 243

Aging

Front 244

Which combination of screening techniques is best for early detection of breast cancer?

Back 244

Mammogram

Clinical breast exam

Breast self awareness

Front 245

During which time should a patient perform a breast self exam?

Back 245

One week after menstrual period

(For postmenopausal women, any time is best but follow a consistent schedule)

Front 246

Which factor makes the mammogram a more sensitive screening tool than other tests?

Back 246

Able to reveal masses too small to be palpated manually

Front 247

Correct actions for breast self exam?

Back 247

- lie down on your back and place your right arm behind your head

- use three different levels of pressure

- move around breasts in an up and down pattern

- stand in front of a mirror, press hands firmly down on your hips and observe breasts

Front 248

Women who have a personal history of breast cancer are at high risk for developing recurrence if which factors are present?

Back 248

BRCA1, BRCA2, strong family history

Front 249

The nurse is instructing a patient with ductal ectasia about her risk for breast cancer. What does the nurse tell the patient?

Back 249

There is no increased risk for developing breast cancer

Front 250

A patient had a partial mastectomy. When teaching about care of the arm on the affected side, what does the nurse tell the patient?

Back 250

Keep the arm elevated so the elbow is above the shoulder and the wrist is above the elbow

Front 251

Which interventions would be used for a patient after a modified radical mastectomy?

Back 251

Teach signs and symptoms of infection and how to monitor for altered wound healing

Front 252

Prophylactic mastectomy would have what effect on a patient's risk for developing breast cancer?

Back 252

Reduces the risk for breast cancer

Front 253

Which woman had the highest risk for developing breast cancer?

Back 253

68 year old who takes hormone replacement therapy

Front 254

A patient found a mass in her breast 6 months ago. What question does the nurse ask related to possible metastases of potential cancer?

Back 254

Have you noticed any joint or bone pain or other changes in your body?

Front 255

What type of metastasis does an increased serum calcium and alkaline phosphatase levels suggest?

Back 255

Bone

Front 256

The nurse is caring for a patient who had a right sided modified radical mastectomy. Which task does the nurse delegate to the UAP?

Back 256

Assist the patient to ambulating the day after surgery

Front 257

A patient is lying in bed after a mastectomy. How does the nurse position the patient?

Back 257

Head of the bed up at least 30 degrees with the affected arm elevated on a pillow

Front 258

A patient is one day postsurgery after a mastectomy and is anxious to begin the prescribed exercises. Which exercise is appropriate for the patient's first efforts?

Back 258

Squeeze the affected hand around a soft, round object

Front 259

Because of the common side effect of tamoxifen, what does the nurse suggest to the patient in taking this drug?

Back 259

Purchase a scale to monitor body weight

Front 260

What is the priority nursing intervention for a patient taking trastuzumab (Herceptin) for breast cancer?

Back 260

Obtain an order for baseline ECG

Front 261

The nurse is caring for a patient who is diagnosed with ductal ectasia. What is the primary goal of the nursing care?

Back 261

Reduce anxiety associated with the threat of breast cancer

Front 262

When assessing a patient with very large breasts, in addition to routine breast assessment, what specific assessment will the nurse also perform?

Back 262

Observe underneath the breast for fungal infection

Front 263

What is important information regarding breast cancer surveillance for a patient who had breast augmentation surgery?

Back 263

Implant displacement x-rays allow more complete examination

Front 264

Which intervention would address one of the modifiable risk factors for breast cancer?

Back 264

Discuss strategies to avoid weight gain and obesity

Front 265

What subjective symptoms would a nurse anticipate in a patient who had a prophylactic oophorectomy?

Back 265

Menopausal symptoms

Front 266

Which diagnostic test is considered the most definitive for diagnosing breast cancer?

Back 266

Breast biopsy

Front 267

A patient with what laboratory levels should avoid acupuncture therapy?

Back 267

Low white blood cell count

Front 268

What is the most important question the nurse will ask a UAP who is assisting a patient during brachytherapy?

Back 268

Is there any chance you could be pregnant?

Front 269

The nurse is designing a teaching plan for a patient who had surgery for breast cancer. What information does the nurse include in the plan?

Back 269

- do not use lotions or ointments on the area

- delay using Deodorant under effected arm until healing is complete

- report any increased heat and tenderness of the area to the surgeon

- begin range of motion exercises 1 week after surgery

Front 270

For a patient with endometriosis, which supplement might offer relief of the muscle cramping?

Back 270

Magnesium

Front 271

A 20 year old woman is being evaluated for possible toxic shock syndrome. What question would the nurse ask?

Back 271

Do you use internal contraceptives?

Front 272

A patient tells the nurse thay she was told that she had a "chocolate" cyst. Which assessment is the nurse most likely to perform?

Back 272

Assess onset and description of pain

Front 273

A 22 year old reports abdominal pain that seems to start several days before her menstrual period. What questions does the nurse ask in order to obtain a thorough menstrual history?

Back 273

- how old were you when you started menstruation?

- typically how long does your period last?

- how would you describe your menstrual flow?

Front 274

What self management strategy would the nurse recommend to a patient to prevent vulvovaginitis?

Back 274

Avoid wearing tight fitting clothing

Front 275

A current treatment of non-emergent dysfunctional uterine bleeding includes which medication?

Back 275

Oral or patch contraceptives

Front 276

The nurse is teaching self care management to a 39 year old woman who had an abdominal all hysterectomy. Which point would be emphasized to avoid complications of this surgery?

Back 276

Take temperature twice a day for the first 3 days after surgery

Front 277

What types of exams are done to reveal the presence of uterine enlargement related to fibroids?

Back 277

- abdominal exam

- vaginal exam

- rectal exam

- transvaginal ultrasound with saline infusion

Front 278

Example of a woman at greatest risk for developing pelvic organ prolapse?

Back 278

48 year old obese mother of four children

Front 279

Example of a woman at greatest risk for dysfunctional uterine bleeding?

Back 279

45 year old attorney with a stressful life

Front 280

Following a uterine embolization using a vascular closure device, what patient care would the nurse provide?

Back 280

- assist the ambulating 2 hrs after the procedure

- assess patient's pain level and admin analgesics as needed

- raise the head of the bed

Front 281

The nurse educates the patient for which diagnostic test that is used to evaluate for endometrial cancer?

Back 281

Endometrial biopsy

Front 282

A patient has dysfunctional uterine bleeding. During a pelvic examination, the provider determines the bleeding is acute and heavy. What is the nurse's priority action?

Back 282

Prepare to administer combination hormonal therapy

Front 283

What signs/symptoms does the nurse assess in a patient with dysfunctional uterine bleeding?

Back 283

Male hair pattern

Thyroid enlargement

Abdominal pain

Abdominal masses

Front 284

What is the primary treatment for dysfunctional uterine bleeding in Perimenopausal women?

Back 284

Progestin or combination hormone therapy

Front 285

A patient has excessive bleeding from uterine fibroids. Which therapy stops the blood flow to the fibroids?

Back 285

Endometrial ablation

Front 286

A patient has undergone a total hysterectomy with vaginal repair. The nurse advises her about careful intercourse and which OTC product to decrease sexual discomfort related to intercourse?

Back 286

Water based lubricants

Front 287

The nurse suspects the patient has vulvovaginitis. Based on knowledge about the common causes of vulvovaginitis, which question would the nurse ask?

Back 287

Have you recently been taking antibiotics?

Front 288

The nurse sees that a patient has been advised by the health care provider to apply lindane (Kwell) to the affected area. What is a self care measures for this patient to ensure that the symptoms do not return after using the medication?

Back 288

Wash clothes, linens and disinfect the home environment

Front 289

A patient with a fever, myalgia, sore throat and sunburn like rash is admitted with a diagnosis of TSS. What additional clinical manifestation should the nurse assess for?

Back 289

Hypotension

Front 290

What preventive measures regarding TSS should the nurse include?

Back 290

Avoid use of superabsorbent tampons

Use sanitary napkins at night

Avoid using internal contraceptives

Front 291

What organism is frequently associated with TSS when it occurs as a menstrually related infection?

Back 291

Staph. Aureus

Front 292

A patient reports the sensation of feeling as if something is "falling out" along with painful intercourse, backache and a feeling of heaviness or pressure in the pelvis. Which question does the nurse ask to assess for cystocele?

Back 292

Are you having urinary frequency or urgency?

Front 293

After an anterior colporrhaphy, what patient statement indicates that the procedure has achieved the desired therapeutic outcome?

Back 293

I have good control over my urination

Front 294

A patient had a posterior colporrhaphy. What is included in the nursing care of this patient?

Back 294

Admin pain meds before a BM

Instruct to avoid straining during a BM

Provide sitz baths

Promote a low-residue (low fiber) diet

Front 295

The nurse is giving discharge teaching to a patient who had a transvaginal repair for pelvic organ prolapse using a surgical mesh. What does the nurse include?

Back 295

Abstain from sexual intercourse for 6 weeks

Front 296

A patient is diagnosed with uterine leiomyomas. What does the nurse expect to see in the documentation for this patient as the chief presenting symptom?

Back 296

Heavy vaginal bleeding

Front 297

A patient with uterine leiomyomas reports a feeling of pelvic pressure, constipation and urinary retention. What does the nurse assess for to further evaluate the patient's symptoms?

Back 297

Assess the abdomen for distention or enlargement

Front 298

A patient has had a pelvic examination and needs additional diagnostic test for possible uterine leiomyomas. The nurse prepares the patient design which first choice diagnostic test?

Back 298

Transvaginal ultrasound

Front 299

What is the priority nursing care most commonly seen preoperatively and postoperative in a patient with leiomyomas?

Back 299

Monitoring for bleeding

Front 300

What disease is strongly associated with prolonged exposure to estrogen without the protective effects of progesterone?

Back 300

Endometrial cancer

Front 301

A patient with cancer has also been diagnosed with uterine leiomyomas. Which procedure does the nurse prepare the patient for?

Back 301

Hysterectomy

Front 302

What post-procedure information does the nurse provide to the patient after a total abdominal hysterectomy?

Back 302

Avoid sitting for prolonged periods

Do not lift anything heavier than 5-10 lbs

When sitting, do not cross legs

Front 303

After receiving a total abdominal hysterectomy, which patient demeanor is the strongest indicator that there is a need for psychological referral?

Back 303

Disheveled and lackluster and displays lack of interest in questions

Front 304

The nurse is giving discharge teaching to a woman who had a local cervical ablation. What information would be included?

Back 304

Report heavy vaginal bleeding or foul smelling drainage

Showering is permitted but no tub baths

Avoid lifting heavy objects for 3 wks

Front 305

A patient with swelling in the perineum area is diagnosed with a bartholin cyst. Nonsurgical management is recommended. What does the nurse instruct the patient to do?

Back 305

Apply moist heat (sitz baths, hot wet packs) to the vulva

Front 306

What diagnostic tests are considered the gold standard tests for determining the presence of endometrial thickening and cancer?

Back 306

Transvaginal ultrasound and endometrial biopsy

Front 307

The surgical procedure for stage 1 disease of endometrial cancer involves the removal of which components?

Back 307

Uterus

Fallopian tubes

Ovaries

Front 308

The nurse is caring for a patient with a radioactive implant in the uterus. Which instruction will the nurse give to the UAP?

Back 308

Patient is on bedrest and excessive movement is restricted

Front 309

A patient is receiving external radiation therapy for treatment of endometrial cancer. What task does the nurse delegate to the UAP?

Back 309

Assist the patient to ambulate if she feels tired or fatigued

Front 310

Which classic symptom is indicative of invasive gynecologic cancer in an older patient?

Back 310

Painless vaginal bleeding

Front 311

The nurse is taking a history on a patient with probable gynecologic cancer. Which clinical manifestation is a sign of metastasis?

Back 311

Dysuria

Front 312

Which conditions does the nurse tell the patient to immediately report to the surgeon following a total abdominal hysterectomy?

Back 312

Vaginal drainage that becomes thicker or foul smelling

Temp over 100

Burning during urination

Front 313

A patient had a total abdominal hysterectomy. Which patient behavior is the best indicator that she is coping and adapting successfully?

Back 313

Asks questions about the wound care but seems reluctant to do self care

Front 314

The home health nurse is reviewing a patient's medication list and sees that the patient was given doxorubicin (Adriamycin) at the hospital. What gynecologic diagnosis would the nurse expect to see?

Back 314

Endometrial cancer

Front 315

Which surgical procedure is most likely to induce menopausal symptoms?

Back 315

Bilateral Salpingo-oophorectomy

Front 316

What information does the nurse include to a patient receiving brachytherapy for cervical cancer?

Back 316

You are not radioactive between treatments

Report any blood in the urine or several diarrhea immediately

You will be on bedrest during the treatment session

Front 317

What is the primary factor for the low survival rates for patients diagnosed with ovarian cancer?

Back 317

Symptoms are mild and vague therefore the cancer is often not detected until on the late stage

Front 318

Young women who have Intercourse as teenagers and/or have multiple sex partners are at high risk for what disease?

Back 318

Cervical cancer

Front 319

A fast food and high fat diet places the patient at risk for which disorder?

Back 319

Cancer of the ovaries

Front 320

A patient tells the nurse that he was diagnosed with benign prostatic hyperplasia. Which symptoms is the patient most likely to report?

Back 320

Trouble passing urine

Front 321

The nurse teaches a patient with BPH to follow which instructions?

Back 321

Avoid diuretics

Avoid antihistamines

Avoid caffeine

Avoid drinking large amounts of fluid in a short time

Front 322

What type of surgery is most commonly used to treat BPH

Back 322

Transurethral resection of the prostate

Front 323

The nurse is preparing to assess and obese patient who reports subjective symptoms and urinary patterns associates with BPH. Which technique does the nurse use to perform the physical assessment?

Back 323

Instruct the patient to void and then use the bedside ultrasound bladder scan

Front 324

The nurse is interviewing a patient to determine presence of lower urinary tract symptoms associated with BPH. Which questions would the nurse ask?

Back 324

Do you have difficulty starting and continuing urination?

Reduced force and size of urinary the?

Post void dribbling or leaking?

How many times to you get up at night to urinate?

Blood at the start or end of voiding?

Front 325

The advanced practice nurse is preparing to examine a patient's prostate gland. Before the exam, what does the nurse tell the patient?

Back 325

The gland will be massaged to obtain a fluid sample for possible prostatitis

Front 326

What does an elevated prostate specific antigen level and serum acid phosphatase level indicate?

Back 326

Prostate cancer

Front 327

A patient is taking tamsulosin (Flomax). What question does the nurse ask to determine if medication is achieving the desired therapeutic effect?

Back 327

Are you having any trouble passing urine?

Front 328

Which assessment tool is commonly used to ask patients about the effect of urinary symptoms in their quality of life?

Back 328

International prostate symptom score

Front 329

A patient has an enlarged prostate. Which procedure does the nurse anticipate the health care provider will order to test for bladder obstruction?

Back 329

Urodynamic pressure flow study

Front 330

The nurse is designing a teaching plan for a patient with an enlarged prostate and obstructive symptoms. What does the nurse teach the patient to avoid?

Back 330

Diuretics

Front 331

Patients with which condition meet the criteria for having a TURP?

Back 331

Acute urinary retention

Hydronephrosis

Hematuria

Front 332

A patient had a TURP and has a three way urinary catheter taped to the left thigh. What does the nurse instruct about the position of the left leg?

Back 332

Keep the leg straight

Front 333

An older patient is scheduled for annual physical including a PSA and a digital rectal examination. How are these two tests scheduled for the patient?

Back 333

PSA is drawn before the DRE is performed

Front 334

The nurse notes bright red blood with numerous clots in the urinary drainage bag for a patient who had a TURP. After notifying the surgeon, what does the nurse do next?

Back 334

Irrigate the catheter with normal saline per protocol

Front 335

The nurse is giving discharge instructions to a patient who had a TURP. What does the nurse include in the instructions?

Back 335

Reassurance that loss of control of urination or dribbling of urine is temporary

Front 336

A nurse is giving instructions to UAP about hygienic care for an older patient who is uncircumcised. What does the nurse instruct the UAP to do?

Back 336

Replace the foreskin over the penis after bathing

Front 337

An older patient reports that he has an enlarged prostate and chronic urinary retention but declines to seek treatment because "it's been that way for a long time." The nurse would encourage a follow up appointment to prevent which complication of this chronic condition?

Back 337

Hydronephrosis

Front 338

The nurse is teaching a patient who is taking finasteride (Proscar), a 5-alpha reductase inhibitor. What medication side effects does the nurse include in the teaching?

Back 338

ED

Dizziness

Decreased libido

Front 339

The nurse notes that the patient has just started taking an alpha blocker medication to treat BPH. What instruction, related to the medication side effects, will the nurse give to the UAP who will assist the patient with ADLs?

Back 339

Have him sit up slowly and pause before standing

Front 340

The nurse hears in shift report that the patient had a transurethral needle ablation. Which question would the nurse ask the patient to determine if the procedure achieved the intended therapeutic goal?

Back 340

Have your problems with urination been resolved?

Front 341

A patient is undergoing large volume bladder irrigation. During and after the procedure, the nurse observes the patient for confusion, muscle weakness and increased GI motility related to which potentially adverse effect of large volume irrigation?

Back 341

Hyponatremia

Front 342

What instructions does the nurse give the UAP regarding a TURP catheter?

Back 342

Maintain traction on the catheter

Front 343

The patient had a TURP several days ago and the urinary catheter was removed 6 hours ago. What sign/symptom must be resolved before the patient is discharged?

Back 343

Patient has not voided since the catheter was removed

Front 344

Example of a patient at high risk for prostate cancer?

Back 344

75 year old African American man whose brother had prostate cancer

Front 345

The nurse is reviewing PSA results for a patient who had a prostatectomy for prostate cancer several weeks ago. The PSA level is 40 ng/ml. How does the nurse interpret this data?

Back 345

The cancer is most likely reccurring

Front 346

What are common serum tumor markers that confirm a diagnosis of testicular cancer?

Back 346

Lactate dehydrogenase (LDH)

Alpha fetoprotein (AFP)

Beta human chorionic gonadotropin (hCG)

Front 347

The nurse is reviewing the lab results for a patient with prostate cancer. Which lab result suggests metastasis to the bone?

Back 347

Elevated serum alkaline phosphatase

Front 348

A patient had a transrectal ultrasound with biopsy earlier in the day. What urine characteristic does the nurse expect to see?

Back 348

Light pink urine

Front 349

The nurse is teaching a patient diagnosed with ED about the common treatments and therapies. Which topics does the nurse include?

Back 349

PDE-5 inhibitors

Intrauretheral applications

Vacuum devices

Penile implants

Front 350

During the first 24 hours after prostatectomy, what is the priority assessment in the nursing care plan?

Back 350

Hemorrhage

Front 351

An african american patient tells the nurse that his father and older brother were diagnosed with prostate cancer in their 50s. What should the nurse tell the patient?

Back 351

Your genetic and racial risk factors suggest testing should begin at age 40

Front 352

The nurse is teaching a patient at risk for prostate cancer about food sources of omega 3 fatty acids. Which food does the nurse suggest?

Back 352

Fish

Front 353

Which sign or symptom is associated with advanced prostate cancer?

Back 353

Swollen groin lymph nodes

Front 354

What are common sites of metastasis for prostate cancer?

Back 354

Bones of the pelvis

Liver

Lungs

Front 355

A patient had a transrectal ultrasound with biopsy. After this procedure, what does the nurse instruct the patient to do?

Back 355

Report fever, chills, bloody urine and any difficulty voiding

Avoid strenuous physical activity

Front 356

A patient was just told he has prostate cancer and the physician told him to watch and wait. What does this mean?

Back 356

Prostate cancer is slow growing. The patient need regular DRE and PSA testing and should watch for symptoms

Front 357

After an open radical prostatectomy, the nurse notes that the penis and scrotum are swollen. What does the nurse do next?

Back 357

Elevate the scrotum and penis and intermittently apply ice to the area for 24-48 hrs

Front 358

What nursing implication is related to brachytherapy?

Back 358

Teach the patient that fatigue is common but should pass after several months.

Front 359

What possible side effects of luteinizing releasing hormone agonist leuprolide (Lupron) does the nurse advise the patient about?

Back 359

ED

Front 360

A patient reports having uncomfortable and unsettling episodes of hot flashes after receiving hormonal therapy for prostate cancer. To alleviate this symptom, which prescription does the nurse assist the patient in obtaining?

Back 360

Hormonal inhibitor drug like megestrol acetate (Megace)

Front 361

What does the nurse include in the teaching regarding self care after a radical prostatectomy?

Back 361

How to care for indwelling catheter and manifestations of infection

Walk short distances

Maintain an upright position and do not walk bent or flexed

Shower rather than soak in a bathtub for the first 2-3 weeks

Front 362

A patient is diagnosed with prostatitis. Which intervention does the nurse use to alleviate the discomfort associated with this condition?

Back 362

Assist with comfort measures such as sitz baths for pain

Front 363

A patient is diagnosed with acute bacterial prostatitis. What assessment findings does the nurse expect to find?

Back 363

Fever

Chills

Dysuria

Urethral discharge

Front 364

The patient is prescribed trimethoprim/sulfamethoxazole (Bactrim, Septra) for prostatitis. What lab result indicates the medication is achieving the desired therapeutic effect?

Back 364

Normalization of white blood cell count

Front 365

What are possible causes of organic ED?

Back 365

Medications for hypertension

Thyroid disorders

Diabetes mellitus

Front 366

A patient reports having ED and is seeking a prescription for sildenafil (Viagra). Because of the potential for dangerous drug to drug interactions, the nurse asks the patient specifically if he takes which type of drug?

Back 366

Nitrates

Front 367

A patient who has testicular cancer is likely to have which common problem?

Back 367

Azoospermia

Front 368

The practitioner finds a lump, which the patient reports is painless, in a young Caucasian male patient. This finding is the most common manifestation of which disease?

Back 368

Testicular cancer

Front 369

A young patient has been diagnosed with testicular cancer. What information does the nurse give the patient and his wife regarding sperm storage?

Back 369

Arrangements for sperm storage should be made as soon as possible after diagnosis

Front 370

A patient had an open retro peritoneal lymph node dissection. What instructions does the nurse give to the patient?

Back 370

Do not drive a car for several weeks

Perform monthly testicular self exams on the remaining testes

Have follow up diagnostic testing for at least 3 years after the surgery

Front 371

Which patient statement most accurately describes identifying oneself as transgender?

Back 371

"Since childhood, I have always felt like I was born into the wrong body"

Front 372

According to the American psychiatric association, which circumstance best describes gender identity?

Back 372

The person takes on the social roles of mother, wife and sister

Front 373

The nurse reads in the patient's medical record that the patient has gender dysphoria. Which question is the nurse most likely to first ask the patient?

Back 373

"How do you prefer to be addressed?"

Front 374

A male patient with gender dysphoria confides in the nurse that he notices that his 4 year old son shows a preference for playing with dolls and other traditional girls toys. What is the nurse's best response?

Back 374

When you see him playing with dolls, how does that make you feel?

Front 375

The nursing student is writing a report about caring for a 56 year old patient with diabetes who identifies himself as transgender. Which sentence reflects proper use of terminology?

Back 375

A 56 year old transgender patient was admitted for complications due to diabetes.

Front 376

Which comment from a family member would be most strongly associated with the term natal sex?

Back 376

My brother just called me. His wife delivered a healthy baby girl this morning.

Front 377

Which terms refer specifically to sexual orientation?

Back 377

Lesbian

Gay

Bisexual

Front 378

How does the nurse interpret the term genderqueer?

Back 378

Patient's gender identity does not conform to male or female

Front 379

In caring for transgender patients, under which circumstance would the nurse make a clinical judgment and decide to forego extensive questioning about gender identity?

Back 379

Needs treatment for a sprained ankle sustained during a soccer game

Front 380

A patient needs an indwelling catheter. The patient's natal sex is male but the patient appears female. What should the nurse do first?

Back 380

Introduce self, verify patient's identity by checking name band and explain the procedure for catheterization

Front 381

The staff is continuously debating about how to direct LGBTQ patients to public restrooms. What should the nursing staff do?

Back 381

Advocate for creation of designated unisex or single stall restrooms

Front 382

A nurse inadvertently makes an error in the name of a transgender patient. What should the nurse do?

Back 382

Self correct and continue with care rather than a prolonged apology

Front 383

The nurse is taking a health history and inquiring about any interventions that the patient has had for gender reassignment. Which questions would the nurse include?

Back 383

Have you made any changes in gender expression, such as clothes or hairstyle?

Have you ever had psychotherapy for body image or to strengthen coping mechanisms?

Are you currently taking any hormonal therapy to feminize or masculinize your body?

Have you had or considered having surgery to change sexual characteristics?

Front 384

For a patient who is taking estrogen therapy, which vital signs is the most important to assess for the detection of a health risk that can be caused by this therapy?

Back 384

Blood pressure

Front 385

The nurse is caring for an older transgender adult who transitioned years ago from MtF. Which question is the nurse most likely to ask?

Back 385

Do you experience urinary retention or dribbling?

Front 386

The nurse must insert a urinary catheter in a transgender pt who is in early transition from female to male. The patient appears to be male and identifies self as male. Why would the nurse assess the genitalia prior to opening the sterile catheter kit?

Back 386

Genitals may not match physical appearance, so technique and equipment must be modified accordingly

Front 387

Examples of patients who would not meet the criteria for hormone therapy

Back 387

16 yr old with gender dysphoria since early childhood

35 yr old lesbian with history of suicide attempts

62 yr old with known gender dysphoria who has symptoms of dementia

22 yr old who has bisexual relationships but calls self queer/questioning

Front 388

A patient is considering estrogen therapy for MtF transition. What is an expected change that will occur with this therapy?

Back 388

Decreased testicular size

Front 389

A patient is taking estrogen therapy. Which patient report is cause for greatest concern?

Back 389

Tenderness and swelling in the calf

Front 390

The nurse sees that in addition to estrogen therapy, the patient is also taking spironolactone (Aldactone). Which laboratory result will the nurse assess to ensure the patient does not suffer adverse effects due to the medication?

Back 390

Serum potassium level

Front 391

What is an indication that testosterone therapy is having the desired effect?

Back 391

Nurse observes increased body hair

Front 392

What should be included in preoperative care for a MtF patient undergoing a vaginoplasty?

Back 392

Administer a fleet enema and laxatives as ordered

Monitor and report hemoglobin and hematocrit results

Administer preoperative antimicrobial to minimize infection

Front 393

The nurse is providing the first 12 hours of postoperative care for a MtF patient who underwent vaginoplasty with epidural anesthesia. What is an expected assessment finding?

Back 393

Patient is unable to move legs

Front 394

Which patient report indicates that the patient is experiencing the most serious complication of vaginoplasty?

Back 394

Reports leakage of stool from the vagina

Front 395

A FtM patient is seeking information about sex reassignment surgery. Which reconstructive surgery is the most difficult and least likely to yield patient satisfaction?

Back 395

Phalloplasty

Front 396

What is the first symptoms of primary syphilis?

Back 396

Small painless, indurated, smooth, weeping lesion

Front 397

A patient phones the clinic because of a onetime exposure to syphilis thay occurred about 6 weeks ago. He reports being asymptomatic and abstinent since the incident. What is the nurse's best response?

Back 397

The chancre can appear and then disappear so you must come in for testing

Front 398

A patient has a pustular rash related to secondary syphilis. What instructions does the nurse give to the UAP?

Back 398

Gloves should be worn at all times when touching the patient

Front 399

A patient is diagnosed with primary syphilis. The nurse prepares to administer and educate the patient about which treatment regimen?

Back 399

Benzathine penicillin G given intramuscularly as a single 2.4 million unit dose and follow up eval at 6, 12 and 24 months

Front 400

A patient has no reaction to a penicillin skin test so the health care provider orders benzathine penicillin G intramuscularly. What does the nurse do immediately after the injection?

Back 400

Observe the patient for at least 30 minutes to detect any allergic reaction

Front 401

The health care provider tells the nurse that a patient has Jarisch Herxheimer reaction. Which interventions does the nurse anticipate?

Back 401

Analgesics and antipyretics

Front 402

A patient is diagnosed with late tertiary syphilis. In addition to benign lesions of the skin and mucous membranes, what other findings does the nurse expect to see documented in the patient's record?

Back 402

Cardiovascular syphilis

Front 403

A patient is diagnosed with early latent syphilis. Which assessment will the nurse make related to the medication that is likely to be prescribed for the patient?

Back 403

Assess for allergies to penicillin

Front 404

A patient reports possible exposure to syphilis. What screening tests are typically done first?

Back 404

Venereal disease research laboratory (VDRL) serum test and the more sensitive rapid plasma reagin (RPR)

Front 405

Which STDs are reportable to the local health authorities in every state?

Back 405

Chlamydia

Gonorrhea

Syphilis

Chancroid

HIV

Front 406

What is the causative organism of syphilis?

Back 406

Treponema pallidum

Front 407

What sexually transmitted organisms are most often responsible for pelvic inflammatory disease?

Back 407

Chlamydia trachomatis and Neisseria gonorrhoeae

Front 408

What are the goals of medication therapy used for treating genital herpes?

Back 408

Reduce symptoms

Reduce the risk of transmission

Reduce discomfort

Front 409

Based on evidence from the US Preventive Task Force, which teaching strategy is most likely to yield a change in individual sexual behavior?

Back 409

Frequent high-intensity education and counseling

Front 410

The nurse is teaching a patient being discharges after treatment for genital herpes. Which patient statement indicates a need for further teaching?

Back 410

After taking acyclovir (Zovirax), I will never have to worry about exposing my partner

Front 411

A female patient is prescribed azithromycin (Zithromax) 1G orally in a single dose for treatment of Chlamydia. What additional information does the nurse give to the patient about treatment issues?

Back 411

Abstinence from sex is required until 7 days from the date of treatment

Front 412

Why do women develop complications more often than men when being treated for gonorrhea?

Back 412

Men are more likely to have symptoms and will seek curative treatment

Front 413

The patient tells the nurse that he had unprotected sex 1 week ago and just found out that the person might have gonorrhea. The patient reports that he has been watching for symptoms but has not noticed anything so he is hoping that he is okay. What is the nurse's best response?

Back 413

Symptoms usually develop in 3 to 10 days but you should be tested even if there are no symptoms

Front 414

The nurse is performing a history and physical on the male patient who suspects exposure to an STD. Which symptom is the most common in the male with chlamydia?

Back 414

Urethritis

Front 415

When taking a sexual history from a patient, which approach is the most therapeutic to elicit information from the patient?

Back 415

Ask open ended questions

Front 416

For the nurse to be an effective clinician when working with patients who have issues with sexuality, STDs or other sexual concerns, what must the nurse do first?

Back 416

Be aware of his or her own sexual values, attitudes and sexuality

Front 417

A female patient is reporting troublesome vaginal discharge is diagnosed with trichomoniasis and is given medication to treat the infection. What does the nurse teach the patient about the diagnosis?

Back 417

The patient's sexual partner must be treated if the problem is to be resolved

Front 418

Women with PID are at an increased risk for which condition?

Back 418

Infertility

Front 419

What is the most common chief complaint that leads a patient with PID to seek medical attention?

Back 419

Lower abdominal pain

Front 420

A patient with PID is on bedrest with bathroom privileges. What position is best for the patient while on bedrest?

Back 420

Semi fowlers

Front 421

A patient with PID is discharged home on oral antibiotics. What are important measures for the nurse to include in patient teaching?

Back 421

Report an increase in temperature right away

Continue taking the antibiotics until the medication is gone

Front 422

When performing discharge teaching about resuming sexual relations to a female patient diagnosed with an STD, what does the nurse teach the patient?

Back 422

Intercourse should be postponed until the treatment regimen is completed

Front 423

What does the nurse tell a patient with PID about the practice of vaginal douching?

Back 423

It increases a woman's risk for developing PID

Front 424

Which infection describes an STD that is limited to the vagina, is very irritating but has no long term sequelae?

Back 424

Candida

Front 425

A patient with HPV will commonly develop which disease?

Back 425

Genital warts

Front 426

The nurse is preparing an information packet about women's health considerations for STDs. What information does the nurse include?

Back 426

Young women mistakenly believe that contraceptives protect them from STDs

Mucosal tears in postmenopausal women may also place them at greater risk for STDs

Women have more asymptomatic infections that may delay diagnosis and treatment

Front 427

A young female patient requires hospitalization for a severe case of genital herpes. What information is given to the patient regarding the long term consequences?

Back 427

There is a risk of neonatal transmission and an increased risk for acquiring HIV infection

Front 428

The nurse is counseling a patient who is experiencing recurrent outbreaks of genital herpes. What suggestions for symptomatic treatment does the nurse include?

Back 428

Oral analgesics, sitz baths and increased oral fluid intake

Front 429

A patient is diagnosed with condylomata acuminata. What are the desired outcomes of management for this patient?

Back 429

Remove the warts and treat the symptoms

Front 430

A patient requires treatment for genital warts. Which treatment is done by the patient at home if given proper instructions?

Back 430

Imiquimod (Aldara) 5% cream

Front 431

What is the incubation period for genital warts?

Back 431

2 to 3 months

Front 432

A patient has had podophyllin treatment for condylomata acuminata. For which sign/symptom does the nurse tell the patient to return for further treatment?

Back 432

Infection at the site

Front 433

A male patient reports that a female sexual partner just told him that she was treated for gonorrhea. What symptoms does the nurse ask him about, because they are most likely to occur with gonorrhea in a male?

Back 433

Dysuria and a profuse yellowish green or scant clear penile discharge

Front 434

A patient is being treated for gonorrhea. The nurse would question the use of which medication for this patient?

Back 434

Ciprofloxacin (Cipro)

Front 435

A female patient is tested for and diagnosed with gonorrhea. The nurse advocates that the choice of drug therapy include medications that concurrently treat which condition?

Back 435

Chlamydia

Front 436

A young woman discovers she has chlamydia after going to her health care provider for a routine pap smear. She is reluctant to accept the diagnosis because she is asymptomatic and does not have any money for unnecessary treatment right now. What is the nurse's best response?

Back 436

Talk to the woman about her financial situation and help her find resources

Front 437

A patient with an STD freely admits to being a commercial sex worker. In talking to this patient, the nurse recognizes that she has not disclosed a true name, address or partner contact information. What is the best strategy to use with this patient?

Back 437

Administer a one dose course of treatment and dispense a box of condoms

Front 438

What factors increase the risk for PID?

Back 438

Age younger than 26

Multiple sexual partners

Smoking

History of chlamydia or gonococcal infection

Front 439

A young female patient with a history of previous STDs has a hunched over gait and has difficulty getting on the examination table. On observing this behavior, what does the nurse first assess for?

Back 439

Lower abdominal pain

Front 440

The nurse is reviewing lab results for a patient with PID. Which lab results does the nurse expect to see?

Back 440

Elevated WBC

Elevated erythrocyte sedimentation rate (ESR)

Presence of more than 10 wbcs per high power field for vaginal discharge

Front 441

In the emergency dept, a patient is diagnosed with PID and there is an order to discharge the patient home with a prescription for antibiotics. What circumstance causes the nurse to question the order for discharge to home?

Back 441

The patient is pregnant but willing to attempt self care if properly instructed

Front 442

The nurse is caring for a patient admitted for PID. Which task does the nurse delegate to the UAP?

Back 442

Place the patient in semi fowlers position

Front 443

A patient reports an itching or tingling sensation felt in the skin 1 to 2 days followed by a blister on the perfect is which ruptured spontaneously with painful erosion. These symptoms are consistent with which condition?

Back 443

Genital herpes

Front 444

The nurse is teaching a group of high school students about the use of condoms. What information does the nurse include?

Back 444

Keep condoms (especially latex) in a cool, dry place and out of direct sunlight

Do not use condoms that are in damaged packages or that are brittle or discolored

If you use lubricant, make sure it is water based

Front 445

Which STD is associated with an increased risk for cervical cancer?

Back 445

Condylomata acuminata: HPV type 16

Front 446

Which group has the greatest risk for contracting primary and secondary syphilis?

Back 446

Men who have sex with men

Front 447

Which patient statement most indicates that the patient will succeed in making a behavior change related to STD prevention?

Back 447

I am going directly to the pharmacy and buy a supply of condoms

Front 448

Which patient circumstance is most appropriate for expedited partner treatment?

Back 448

Partner is afraid to come to health care facility

Front 449

The nurse sees that the patient was prescribed valacyclovir (Valtrex). Which patient statement indicates the goal of therapy is being met?

Back 449

The sores are not as painful as they were before

Front 450

How should the nurse respond to a patient with altered sexuality as a result of STD?

Back 450

Report and document all findings

Provide pain control measures

Teach about prescribed antibiotic or antiviral therapy

Emphasize importance of treating all sexual partners

Front 451

During a genital exam on a teenage patient, the examiner sees multiple large cauliflower like growths in the perineum area. The patient reports these appeared about 3 months after her first sexual experience. What does the examiner suspect?

Back 451

Condylomata acuminata (genital warts)