Nokea
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.
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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.
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.
The nurse is reviewing discharge instructions with a client who has just experienced an endometrial biopsy. Which finding should be reported to the health care provider immediately?
- A. Mild cramping
- B. Slight chills and fever
- C. Bleeding of blood on a perineal pad
- D. Fatigue after anesthesia
Correct Answer: B
Rationale: Chills and fever could indicate an infection and should be reported immediately to the health care provider. Mild cramping, spotting, and fatigue are normal findings after an endometrial biopsy.
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.
The nurse is reviewing discharge plans with a client who is recovering from a cervical biopsy. Which statements indicate good understanding by the client? (Select all that apply).
- A. I can return to work this afternoon.
- B. There should be no problem lifting my 2-year-old toddler when I get home.
- C. I should not douche until the biopsy site is healed.
- D. I need to wait for about 2 weeks to have intercourse with my husband.
- E. If I have some bleeding I can use a regular tampon this evening."
Correct Answer: C,D
Rationale: The client should not douche, have intercourse, or use tampons until the biopsy site is healed, which typically takes about 2 weeks. Returning to work the same afternoon and lifting heavy objects like a toddler are not recommended, as the client should rest for 24 hours and avoid heavy lifting to promote healing. Using a tampon could introduce infection or disrupt healing.