Nokea
A 17-year-old client presents to the clinic with concerns that she has not begun menstruating. She states that she is a gymnast and has been competing since she was 9 years old. Based on this history, what does the nurse know the client is most likely experiencing?
- A. Secondary amenorrhea
- B. Polycystic ovary syndrome
- C. Primary amenorrhea
- D. Dysmenorrhea
Correct Answer: C
Rationale: The correct answer is C: Primary amenorrhea. A 17-year-old who has not started menstruating is experiencing primary amenorrhea. This is likely due to her intense physical activity as a gymnast, which can delay the onset of menstruation. Secondary amenorrhea (A) occurs when menstruation stops after it has already begun. Polycystic ovary syndrome (B) is characterized by hormonal imbalances and ovarian cysts, not delayed onset of menstruation. Dysmenorrhea (D) refers to painful menstruation, which is not the issue in this case.
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The nurse is grading a woman's reflexes. Which of the following grades would indicate reflexes that are slightly brisker than normal?
- A. +1.'
- B. +2.'
- C. +3.'
- D. +4.'
Correct Answer: C
Rationale: The correct answer is C: +3'. This indicates brisk reflexes. A: +1' indicates a low-normal response, B: +2' indicates a normal response, and D: +4' indicates hyperactive reflexes. +3' is slightly brisker than normal, reflecting an increased response without being hyperactive.
A woman has been diagnosed with single intraductal papilloma and has nipple discharge. Which diagnostic tests will most likely be required?
- A. MRI
- B. Mammogram
- C. Core needle biopsy
- D. Ductogram
Correct Answer: D
Rationale: The correct answer is D: Ductogram. In a patient with single intraductal papilloma and nipple discharge, a ductogram is the most appropriate diagnostic test to visualize the ductal system for any abnormalities. A ductogram involves injecting contrast dye into the affected duct to identify any blockages or abnormalities. This test helps in determining the extent of the papilloma and planning appropriate treatment.
Rationale for incorrect choices:
A: MRI - While MRI can provide detailed images, it is not the primary test for evaluating intraductal papilloma and nipple discharge.
B: Mammogram - Mammogram is used for breast imaging but may not provide detailed visualization of the ductal system.
C: Core needle biopsy - While a biopsy may be needed to confirm the papilloma, it does not directly assess the ductal system for other abnormalities.
Which statement by the client indicates further teaching is needed about uterine cancer?
- A. A Pap test is used to diagnose uterine cancer.
- B. Uterine cancer is the most common cancer of the reproductive tract.
- C. I used estrogen for 2 years without progesterone. This puts me at risk for developing uterine cancer.
- D. Postmenopausal bleeding could indicate uterine cancer.
Correct Answer: A
Rationale: The correct answer is A because a Pap test is used to detect cervical cancer, not uterine cancer.
1. A Pap test screens for cervical cancer by detecting abnormal cells in the cervix.
2. Uterine cancer is the most common cancer of the reproductive tract, making choice B accurate.
3. Choice C is correct as using estrogen without progesterone can increase uterine cancer risk.
4. Choice D is also accurate as postmenopausal bleeding can be a symptom of uterine cancer.
In summary, the need for further teaching arises from the misconception that a Pap test can diagnose uterine cancer.
The nurse has completed instructions on ways to improve the client’s symptoms related to her rectocele. Which statement by the client indicates a need for further education?
- A. Weight loss will decrease pressure on the pelvic floor.
- B. Increasing fiber and water in my diet will help prevent constipation.
- C. Heavy lifting will not affect my rectocele.
- D. Kegel exercises will help with pelvic floor strength.
Correct Answer: C
Rationale: The correct answer is C because heavy lifting can worsen rectocele symptoms by putting strain on the pelvic floor muscles. A is correct because weight loss reduces pressure. B is correct because fiber and water prevent constipation. D is correct because Kegel exercises strengthen the pelvic floor.
The nurse is providing education to parents of a child with cleft palate. What will the nurse instruct the parents to report immediately?
- A. Facial paralysis
- B. Ear infections
- C. Increasing intracranial pressure (ICP)
- D. Drooling
Correct Answer: B
Rationale: The correct answer is B: Ear infections. Parents of a child with a cleft palate should report ear infections immediately because children with cleft palate are at higher risk for developing ear infections due to issues with Eustachian tube function. Ear infections can lead to hearing loss if left untreated. Facial paralysis (A) is not directly related to cleft palate. Increasing ICP (C) is not typically associated with cleft palate. Drooling (D) is common in children with cleft palate and does not require immediate reporting unless there are other concerning symptoms present.