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A nurse is caring for a client who is being evaluated for a lump found on the lateral aspect of the right breast. The client is anxious and asks the nurse if the next step is to have a mastectomy. Which is the nurse's best response?
- A. Yes, breast lumps are abnormal and will need to be removed.
- B. The doctor will need a biopsy first to see if the lump is cancerous.
- C. The doctor will answer your questions when he or she arrives.
- D. Many times, an ultrasound is done to distinguish between a tumor and cyst.
Correct Answer: D
Rationale: Ultrasonography is often used with a mammogram after a breast lump is found to provide additional data on the breast lump. An ultrasound can differentiate if the lump is a fluid-filled cyst or other types of breast lesions. This step may be used before a mastectomy is performed or even a biopsy is completed. The nurse is able to provide factual information on common treatment paths, understanding that it is the physician who prescribes the medical care.
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A nurse is caring for a client following a culdoscopy. Which assessment data would the licensed practical nurse report to the registered nurse?
- A. Pain level of 7 on the 0-to-10 pain scale
- B. Skin, cold, pulse, 110 beat/minute, blood pressure, 104/64 mm Hg
- C. Dark drainage noted on surgical pad
- D. Fleshy smell noted to perineal region
Correct Answer: B
Rationale: Culdoscopy is performed to visualize the uterus, broad ligaments, and fallopian tubes. An endoscope is inserted through a small incision made in the posterior vaginal wall. Afterward, the nurse must observe for signs of internal bleeding and shock. A client with cold and clammy skin, a rapid pulse, and low blood pressure indicates shock and the need to consult the registered nurse and even the physician. All of the other symptoms are able to be addressed by the licensed practical nurse. The client is to be medicated. Dark drainage and a fleshy smell to the perineal area are normal for old surgical drainage.
Which of the following would be most important for the nurse to include to ensure a thorough baseline history related to the reproductive system?
- A. Age of menarche
- B. Nutritional history
- C. Exercise and fitness routine
- D. Cultural history
Correct Answer: A
Rationale: To ensure a thorough baseline history, the nurse obtains information on the client's general health and family history, age of menarche, and menstrual history. Although the client's nutritional history, exercise and fitness routines, and cultural history are important, they are part of the overall client health history and not specific to the reproductive system.
The nurse is caring for a client who states having an irregular menstrual period. Which diagnostic test provides information of the body's ability to ovulate?
- A. Thyroid level
- B. Serum luteinizing hormone
- C. Serum follicle-stimulating hormone
- D. Estrogen level
Correct Answer: C
Rationale: The anterior pituitary hormone known as follicle-stimulating hormone (FSH) initiates ovulation monthly. Monitoring the FSH level provides information about the timing of ovulation. Thyroid level, estrogen level, and serum luteinizing hormone do not give information about the ability to ovulate.
What information would the nurse give the client when the client inquires what makes breast milk production?
- A. Estrogen
- B. Progesterone
- C. Prolactin
- D. Testosterone
Correct Answer: C
Rationale: Prolactin promotes the production of breast milk. Estrogen secreted by the ovaries at the onset of puberty causes the development of the mammary system. Progesterone, secreted by the placenta, stimulates the development of alveoli, which secrete the milk. Testosterone does not impact milk production.
A client presents with symptoms of menstrual difficulties and infertility. Which hormone is essential in the maintenance of the endometrium?
- A. Estrogen
- B. Progesterone
- C. Testosterone
- D. Prolactin
Correct Answer: B
Rationale: Without a high level of progesterone, the endometrium (uterine lining) degenerates and sheds. Estrogen is a hormone that is essential for menstruation and prepares the uterus for pregnancy. Women produce testosterone, which maintains muscle mass, bone strength, and sex drive. Prolactin is produced by the pituitary gland and stimulates lactation.