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A male patient who is 53 years of age is scheduled for an annual physical exam. Which of the following information should the nurse include in the teaching plan?
- A. Increased risk for testicular cancer
- B. Possible changes in erectile function
- C. Normal decreases in testosterone level
- D. Annual digital rectal examination
Correct Answer: D
Rationale: A digital rectal examination is required for all men who have symptoms of prostate trouble, such as difficulty in initiating the flow and the urge to void frequently. This examination should be performed annually for all men 50 years of age or older. There is no indication that the other patient teaching topics are appropriate for this patient.
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Which information about a female patient who wants to start using oral contraceptives is most important to report to the health care provider?
- A. The patient quit smoking 6 months previously.
- B. The patient's blood pressure is 164/90 mm Hg.
- C. The patient has a history of migraines.
- D. The patient is 35 years old.
Correct Answer: B
Rationale: Since hypertension increases the risk for morbidity and mortality in women taking oral contraceptives, the patient's blood pressure should be controlled before oral contraceptives are prescribed. The other information will also be reported but will not affect the choice of contraceptive.
When scheduling a pelvic examination and Pap test, which of the following instructions should the nurse include?
- A. Shower, but not a tub bath, before the examination.
- B. Do not have sexual intercourse the day before the Pap.
- C. Plan to have the Pap test just after her menstrual period.
- D. Avoid douching for at least 24 hours before the examination.
Correct Answer: D
Rationale: The results of a Pap test may be affected by douching, which can remove cells from the cervix. The patient may shower or take a bath before the examination, and sexual intercourse or timing relative to the menstrual period do not significantly impact the results.
A patient calls the clinic because of an unusually heavy menstrual flow. She tells the nurse that she has saturated two tampons in the past 2 hours. Which of the following amounts of blood loss should the nurse estimate from the patient's information?
- A. 10-20 mL
- B. 20-30 mL
- C. 30-40 mL
- D. 40-60 mL
Correct Answer: D
Rationale: The average tampon absorbs 20-30 mL. Since the patient saturated two tampons in 2 hours, the estimated blood loss is 40-60 mL.
A couple who has not been able to conceive is scheduled for a postcoital test for infertility. Which of the following information should the nurse provide to the couple in preparation for the test?
- A. Possible shoulder pain after the procedure
- B. Sedative medications used during the procedure
- C. Ways to determine the estimated time of ovulation
- D. How long to refrain from intercourse before the test
Correct Answer: C
Rationale: For the postcoital test, the couple should have intercourse at the estimated time of ovulation and then arrive for the test 2-8 hours after intercourse. The other instructions would be used for other types of fertility testing.
The nurse is assessing a patient who has amenorrhea with a weight of 41 kg. The patient makes all of the following statements. Which one indicates a need for immediate teaching by the nurse?
- A. I have not been able to eat much at all for the past three months.
- B. I drink at least three glasses of nonfat milk daily.
- C. I am not sexually active but currently have a boyfriend.
- D. I was recently treated for a sexually transmitted infection.
Correct Answer: A
Rationale: Not being able to eat much at all for the past three months indicates that the patient may be experiencing anorexia. Anorexia can cause amenorrhea. The other statements by the patient do not suggest any urgent teaching needs.