Nokea
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.
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Which action would the nurse teach to help the client prevent vulvovaginitis?
- A. Wipe back front after urination.
- B. Cleanse the inner labial mucosa with soap and water.
- C. Use feminine hygiene sprays to avoid odor.
- D. Wear loose cotton underwear.
Correct Answer: D
Rationale: To prevent vulvovaginitis, the client should wear cotton underwear. The client should wipe front to back after urination, not back to front. The client should cleanse the inner labial mucosa with water only, and avoid using feminine hygiene sprays.
A client has a recurrent Bartholin cyst. What is the nurse's priority action?
- A. Apply an ice pack to the area.
- B. Administer a prophylactic antibiotic.
- C. Support a fluid transfer to the liver analysis.
- D. Suggest moist heat such as a sitz bath.
Correct Answer: C
Rationale: A major cause of an obstructed duct forming a cyst is infection. The laboratory specimen is a priority since a culture is needed in order to prescribe sensitive antibiotics. Comfort measures can then be used, such as ice packs and moist heat.
The client is emotionally upset about the recent diagnosis of stage IV endometrial cancer. Which action by the nurse is incorrect?
- A. Listen attentively to the client's concerns.
- B. Let the client alone for a long period of reflection time.
- C. Ask friends and relatives to limit their visits.
- D. Tell the client that an emotional response is unacceptable.
- E. Create an atmosphere of acceptance and discussion.
Correct Answer: D
Rationale: Discussion of a client's concerns about the presence of cancer and the potential for recurrence will provide emotional support and allay fears. Coping behaviors are encouraged with the support of friends and relatives. An emotional response should be accepted.
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.
A 55-year-old post-menopausal woman is assessed by the nurse with a history of dyspareunia, backache, pelvic pressure, urinary tract infections, and frequent urinary urgency. Which condition does the nurse suggest?
- A. Ovarian cyst
- B. Rectocele
- C. Cystocele
- D. Fibroid
Correct Answer: C
Rationale: Dyspareunia, backache, pelvic pressure, urinary tract infections, and urinary urgency are all symptoms of a cystocele, a protrusion of the bladder through the vaginal wall. Ovarian cysts are rare after menopause, a rectocele is associated with constipation, hemorrhoids, and local impaction. Fibroids are associated with heavy bleeding.