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A client, age 42, visits the gynecologist. After examining her, the physician suspects cervical cancer. The nurse reviews the client's history for risk factors for this disease. Which history finding is a risk factor for cervical cancer?
- A. Onset of sporadic sexual activity at age 17
- B. Pregnancy complicated with eclampsia at
- C. Spontaneous abortion at age 19 age 27
- D. Human papilloma virus infection at age 32
Correct Answer: D
Rationale: The human papillomavirus (HPV) infection is a major risk factor for cervical cancer. HPV is a sexually transmitted infection that is linked to almost all cases of cervical cancer. Therefore, a history of HPV infection increases the risk of developing cervical cancer. The other choices, such as onset of sexual activity at age 17, pregnancy complications, and spontaneous abortion, are not directly linked to an increased risk of cervical cancer.
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Which is characteristic of newborns whose mothers smoked during pregnancy?
- A. Large for gestational age
- B. Preterm, but size appropriate for gestational age
- C. Growth retardation in weight only
- D. Growth retardation in weight, length, and head circumference
Correct Answer: D
Rationale: Newborns whose mothers smoked during pregnancy often display growth retardation in weight, length, and head circumference. Maternal smoking is associated with intrauterine growth restriction, leading to reduced size parameters at birth. This can result in newborns being smaller in weight, length, and head circumference compared to newborns of mothers who did not smoke during pregnancy. Smoking during pregnancy can have negative effects on the developing fetus, contributing to various health risks and growth abnormalities in newborns.
A nurse prepares to administer the medication in which muscle site?
- A. Deltoid
- B. Triceps
- C. Vastus lateralis
- D. Biceps
Correct Answer: C
Rationale: The nurse prepares to administer the medication in the vastus lateralis muscle site. This site is located on the thigh and is commonly used for intramuscular injections in infants, toddlers, and smaller children. It is preferred for its large and easily accessible muscle mass, making it suitable for injections. This muscle site is also less painful and has fewer major blood vessels and nerves, reducing the risk of complications during injection.
Mr. and Mrs. Smith's child has hemophilia; which of the following actions would you instruct them to avoid?
- A. Immobilizing the joint
- B. Lowering the injured area
- C. Applying cold to the area
- D. Applying pressure
Correct Answer: C
Rationale: Hemophilia is a condition where the blood fails to clot properly. Applying cold to the area can cause vasoconstriction (narrowing of blood vessels) which may slow down the blood flow and exacerbate the bleeding in individuals with hemophilia. Therefore, instructing Mr. and Mrs. Smith to avoid applying cold to the area of injury is crucial in order to prevent further complications.
What should a male client over age 50 do to help ensure early identification of prostate cancer?
- A. Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly
- B. Have a transrectal ultrasound every 5 years
- C. Perform monthly testicular self-examinations, especially after age 50
- D. Have a complete blood count (CBC) and blood urea nitrogen (BUN) and creatinine levels
Correct Answer: A
Rationale: For male clients over age 50, early identification of prostate cancer involves a combination of regular digital rectal examination and PSA test. The digital rectal examination allows a healthcare provider to manually assess the size, shape, and consistency of the prostate gland, looking for any abnormalities such as nodules or hard areas that may indicate prostate cancer. The PSA test measures the level of prostate-specific antigen in the blood, with elevated levels potentially signaling the presence of prostate cancer. Yearly screening using both these methods increases the chances of early detection and optimal management of prostate cancer in older male clients. Regular monitoring helps in identifying the disease at an earlier, more treatable stage, improving outcomes and prognosis.
An adolescent asks the nurse what causes primary dysmenorrhea. The nurse's response should be based on which statement?
- A. It is an inherited problem.
- B. Excessive estrogen production causes uterine pain.
- C. There is no physiologic cause; it is a psychological reaction.
- D. There is a relation between prostaglandins and uterine contractility.
Correct Answer: D
Rationale: Primary dysmenorrhea is painful menstruation that occurs without any underlying gynecological conditions, such as endometriosis. The cause of primary dysmenorrhea is related to the release of prostaglandins during menstruation. Prostaglandins are lipid compounds that act as chemical messengers in the body, causing the uterus to contract and shed its lining during menstruation. High levels of prostaglandins can lead to increased uterine muscle contractions, resulting in pain. Therefore, the nurse should explain to the adolescent that there is a relation between prostaglandins and uterine contractility as the cause of primary dysmenorrhea.