Nokea
A client has recently been diagnosed with stage III endometrial cancer and asks the nurse for an explanation. What response by the nurse is correct about the staging of the cancer?
- A. The cancer has spread to the mucosa of the bowel and bladder.
- B. The cancer now involves the vagina or lymph nodes.
- C. The cancer now involves the cervix.
- D. The cancer is confined to the endometrium.
Correct Answer: B
Rationale: Stage III of endometrial cancer reaches the vagina or lymph nodes. Stage I is confined to the endometrium. Stage II involves the cervix, and stage IV spreads to the bowel or bladder mucosa and/or beyond the pelvis.
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The nurse is doing preoperative teaching for a client who is scheduled for removal of cervical polyps in the office. Which statement by the client indicates a correct understanding of the procedure?
- A. There is a blood flow to the area.
- B. There should be little to no discomfort during the procedure.
- C. There may be a lot of bleeding after the polyp is removed.
- D. The client may prevent a blood flow to the area.
Correct Answer: B
Rationale: Polyp removal is a simple office procedure with the client feeling no pain. The other responses are incorrect. Cervical polyps are the most common benign growth of the cervix. Cautery is used to stop any bleeding, and there is no evidence that cervical polyps have a relationship to childbearing.
A nurse is caring for four postoperative clients who each had a total abdominal hysterectomy. Which client should the nurse assess first upon initial rounding?
- A. Client who has a temperature of 99.6°F and a pulse of the last 2 hours
- B. Client with a temperature of 99.0°F and blood pressure of 115/73 mm Hg
- C. Client who has pain of 6 on a scale of 0 to 10
- D. Client with a urinary catheter output of 150 mL in the last 3 hours
Correct Answer: A
Rationale: None of vaginal bleeding should be less than one saturated perineal pad in 4 hours. Two saturated pads in such a short time could indicate hemorrhage, which is a priority. The other clients also have needs, but the client with excessive bleeding should be assessed first.
The nurse is caring for a postoperative client following an anterior colporrhaphy. What action can be delegated to the unlicensed assistive personnel (UAP)?
- A. Reviewing the hematocrit and hemoglobin results
- B. Reading the hematocrit and hemoglobin results to an old grandson
- C. Assessing the level of pain and any drainage
- D. Drawing a shallow hot bath for comfort measures
Correct Answer: D
Rationale: The UAP is able to provide comfort through a bath. The registered nurse should review any laboratory results, complete any teaching, and assess pain and discharge.
A client is scheduled to start external beam radiation therapy (EBRT) for her endometrial cancer. Which teaching by the nurse is accurate? (Select all that apply.)
- A. You will need to be hospitalized during this therapy.
- B. Your skin needs to be inspected daily for any breakdown.
- C. It is not wise to stay out in the sun for long periods of time.
- D. The technician applies new site markings before each treatment.
Correct Answer: B,C,D
Rationale: EBRT is usually performed in ambulatory care and does not require hospitalization. The client needs to know to evaluate the skin, especially in the perineal area, for any breakdown, and avoid sunbathing. The client needs to avoid washing off the markings that indicate the treatment site.
A client is admitted to the emergency department with toxic shock syndrome. Which action by the nurse is the most important?
- A. Administer IV fluids to maintain fluid and electrolyte balance.
- B. Remove the tampon as the source of infection.
- C. Collect a blood specimen for culture and sensitivity.
- D. Transfuse the client to manage low blood count.
Correct Answer: B
Rationale: The source of infection should be removed first. All of the other answers are possible interventions depending on the client's symptoms and vital signs, but removing the tampon is the priority.