Nokea
A 67-year-old male client had some serum tests performed during his annual examination. The nurse reviews his results, as follows: testosterone: 600 g/L, prostate-specific antigen: 10 mg/L, prolactin: 5 mg/L. What is the nurse's best action?
- A. Assess for possible galactorrhea with breast discharge.
- B. Note the possibility of a testicular tumor.
- C. Remember that prior results were normal.
- D. Refer the client for further diagnostic testing.
Correct Answer: D
Rationale: The prostate-specific antigen is increased from the normal range of 0 to 2.5 mg/L, which could indicate benign prostatic hyperplasia or prostate cancer. Further testing is required. The values of testosterone and prolactin are within normal range. If prolactin were increased, there would be a possibility of galactorrhea. An increase in testosterone could indicate a possible testicular tumor.
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The nurse is developing a teaching plan for a client who is scheduled for her first Papaniccolous test. What instructions by the nurse is the most important?
- A. The timing of the Pap smear does not matter.
- B. Sexual intercourse will not interfere with the results.
- C. Results can be interpreted immediately at the office.
- D. Results are best if you do not douche 24 hours before the test.
Correct Answer: D
Rationale: In order to prevent false interpretation, the client must not douche or have sexual intercourse for at least 24 hours before the Pap smear. Timing is important, with the test scheduled between the client's menstrual periods so that the menstrual flow does not interfere with laboratory analysis. The specimens are placed on a glass slide and sent to the laboratory for examination and cannot be interpreted immediately.
A 72-year-old woman is being assessed by the nurse for an annual physical. Which finding is of concern to the nurse?
- A. Mild vaginal dryness
- B. Occasional urinary incontinence
- C. Vaginal bleeding
- D. History of regular Pap smears
Correct Answer: C
Rationale: Vaginal bleeding in a 72-year-old postmenopausal woman is concerning and requires further investigation, as it may indicate serious conditions such as endometrial cancer. Mild vaginal dryness and occasional urinary incontinence are common in this age group, and a history of regular Pap smears is a positive finding.
The nurse is assessing the reproductive history of a 68-year-old postmenopausal woman. Which finding is cause for immediate action by the nurse?
- A. Vaginal dryness
- B. Need for a Papaniccolous test if none for 3 years
- C. Vaginal bleeding
- D. Leakage of urine
Correct Answer: C
Rationale: Vaginal bleeding is not normal for the postmenopausal woman and requires immediate action to investigate potential serious conditions such as endometrial cancer. Vaginal dryness and leakage of urine are common findings in adults of this age range. Pap tests may not be needed for women over 65 who have had regular cervical cancer screening with normal results.
A client is scheduled for a laparoscopy to remove endometriosis tissue. Which response by the client alerts the nurse of the need for further teaching?
- A. The surgeon told me that carbon dioxide would infused into my pelvic cavity.
- B. There will be one or more small incisions in order to visualize all of my pelvic organs.
- C. There will be some shoulder pain after the procedure that may last a few days.
- D. I can return to my normal routine in a few days.
Correct Answer: D
Rationale: The client's statement about returning to a normal routine in a few days indicates a need for further teaching, as recovery from laparoscopy typically requires avoiding strenuous activity for about a week to ensure proper healing.
A nurse and unlicensed assistive personnel (UAP) are helping with a procedure. Which task is appropriate for the UAP to perform?
- A. Assessing the client's pain level
- B. Positioning the client for the procedure
- C. Witnessing the consent form
- D. Asking about allergies to iodine or shellfish
Correct Answer: B
Rationale: The UAP can assist with positioning the client for the procedure, as this is within their scope of practice. Tasks such as witnessing the consent form, assessing allergies, and assessing pain are within the nurse's scope of practice and require professional judgment.