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A parent of an adolescent female is asking the nurse for guidelines of when the daughter should have her first Papanicolaou test (Pap test) and then the subsequent frequency. The nurse is most correct to state which?
- A. The first Pap test should be at age 16 years and then annually thereafter.
- B. The first Pap test should be no later than 18 years of age and then every other year afterward.
- C. The first Pap test should be between 25 and 29 years and then every 3 years afterward.
- D. The first Pap test should be within the first year of menstruation and annually afterward.
Correct Answer: C
Rationale: The American Cancer Society (ACS) recommends no testing/screenings for women aged 21 to 24 years. Women between the ages of 25 and 29 years have the recommendation for HPV testing to be every 5 years (preferred), the HPV/Pap co-test every 5 years (acceptable), or the Pap test every 3 years (acceptable).
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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.
The physician and nurse are completing a physical examination of the male genitalia. Which assessment finding(s) is documented? Select all that apply.
- A. Inspection for urethral drainage
- B. Cultures
- C. Digital rectal examination
- D. Transillumination
- E. Palpation of the testes
- F. Prostate-specific antigen level
Correct Answer: A,C,D,E
Rationale: The nurse and physician document the physical assessment including inspection of external genitalia and noting any drainage. A digital rectal examination and transillumination also provide physical assessment data of the status of the prostate gland. Cultures and prostate-specific antigen levels provide diagnostic information but are not part of the physical assessment.
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.
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.
The client states to the nurse that he is very anxious about having prostate cancer ever since his prostate-specific antigen (PSA) test came back elevated. The client asks, 'Which diagnostic test produces definitive results if cancer is present?' The nurse is most correct to state which of the following?
- A. Transrectal ultrasonography
- B. Tissue biopsy
- C. Tumor marker studies
- D. Digital rectal exam
Correct Answer: B
Rationale: Obtaining an actual piece of the tissue and analyzing it for cancer is a definitive test when cancer is found. A transrectal ultrasonography is a test to view the prostate gland from different angles. This test provides additional data on the status of the prostate gland. The tumor marker studies include the prostate-specific antigen (PSA) level. This antigen indicates a potential problem but is not definitive. PSA elevations have been noted for reasons other than cancer. A digital rectal exam provides data on the shape, size, and texture of the prostate gland.