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A woman has been diagnosed with single intraductal papilloma and has nipple discharge. Which diagnostic tests will most likely be required?
- A. MRI
- B. Mammogram
- C. Core needle biopsy
- D. Ductogram
Correct Answer: D
Rationale: The correct answer is D: Ductogram. In a patient with single intraductal papilloma and nipple discharge, a ductogram is the most appropriate diagnostic test to visualize the ductal system for any abnormalities. A ductogram involves injecting contrast dye into the affected duct to identify any blockages or abnormalities. This test helps in determining the extent of the papilloma and planning appropriate treatment.
Rationale for incorrect choices:
A: MRI - While MRI can provide detailed images, it is not the primary test for evaluating intraductal papilloma and nipple discharge.
B: Mammogram - Mammogram is used for breast imaging but may not provide detailed visualization of the ductal system.
C: Core needle biopsy - While a biopsy may be needed to confirm the papilloma, it does not directly assess the ductal system for other abnormalities.
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A male client reports painful urination and a creamy yellow drainage from the urethra. During the assessment, he admits to having unprotected sex. With which STI does the nurse associate these clinical manifestations?
- A. Candidiasis
- B. HPV
- C. Trichomoniasis
- D. Gonorrhea
Correct Answer: D
Rationale: The correct answer is D: Gonorrhea. Painful urination and yellow discharge from the urethra are classic symptoms of gonorrhea, a bacterial sexually transmitted infection (STI). Gonorrhea is commonly transmitted through unprotected sexual contact. The creamy yellow discharge is a key indicator of gonorrhea infection. The other choices are incorrect because:
A: Candidiasis typically presents with white, cottage cheese-like discharge and itching, not yellow discharge or painful urination.
B: HPV does not cause painful urination or discharge from the urethra; it usually presents with genital warts or abnormal pap smears.
C: Trichomoniasis may cause green, frothy discharge and discomfort, but not creamy yellow discharge or painful urination.
A nurse is performing a gynecological health history interview on a 17-year-old Caucasian adolescent. The girl appears anxious and states, 'I found a lump in my left breast, and I am worried that it may be cancer.' What factors should the nurse be aware of prior to responding to this patient? Select all that apply.
- A. Breast fibroadenomas are the most common breast tumor in women after puberty and between the ages of 15 and 30.
- B. African American women tend to develop fibroadenomas more often and at an earlier age than Caucasian women.
- C. Young women are at increased risk for breast cancer.
- D. The cause of fibroadenoma is a cancerous condition.
Correct Answer: A
Rationale: The correct answer is A because breast fibroadenomas are indeed the most common benign breast tumor in women after puberty, typically occurring between the ages of 15 and 30. The nurse should be aware of this fact when assessing the patient's concern about the lump. Fibroadenomas are non-cancerous and do not increase the risk of breast cancer.
Choice B is incorrect because fibroadenomas are more common in Caucasian women, not African American women. Choice C is incorrect because young women like the patient are generally at low risk for breast cancer. Choice D is also incorrect because fibroadenomas are not caused by cancerous conditions.
The client receives zidovudine (Retrovir) for treatment of HIV infection. Which assessment data indicates an adverse reaction to the drug?
- A. Cough
- B. Enlarged lymph nodes
- C. Decreased WBC count
- D. Fever
Correct Answer: C
Rationale: The correct answer is C: Decreased WBC count. Zidovudine is known to cause bone marrow suppression which can lead to a decrease in white blood cell count. This is an adverse reaction as it increases the risk of infections.
A: Cough is not a common adverse reaction to zidovudine.
B: Enlarged lymph nodes are not directly associated with zidovudine adverse reactions.
D: Fever is a non-specific symptom and can occur due to various reasons, not specifically related to zidovudine.
Therefore, the most concerning and relevant assessment data indicating an adverse reaction to zidovudine is a decreased white blood cell count.
Which pharmacological preparation is the least effective in relieving symptoms of dysmenorrhea?
- A. Ibuprofen
- B. Acetaminophen
- C. Oral contraceptive pills
- D. Naproxen sodium
Correct Answer: B
Rationale: The correct answer is B: Acetaminophen. Acetaminophen is not an anti-inflammatory medication, unlike Ibuprofen and Naproxen sodium, which are more effective in reducing inflammation and pain associated with dysmenorrhea. Oral contraceptive pills (Choice C) can help regulate hormones to reduce menstrual cramps. Ibuprofen and Naproxen sodium (Choices A and D) are nonsteroidal anti-inflammatory drugs (NSAIDs) that target prostaglandins, which play a role in causing menstrual cramps. Acetaminophen, being a mild pain reliever, lacks the anti-inflammatory properties needed to effectively alleviate dysmenorrhea symptoms.
The nurse is preparing a 51-year-old client for a vaginal examination. The nurse should place the client in which position?
- A. Prone
- B. Lateral Sims’
- C. Lithotomy
- D. High Fowler’s
Correct Answer: C
Rationale: The correct answer is C: Lithotomy position. This position allows for optimal visualization of the vaginal area and easier access for the examination. The client lies on their back with knees flexed and feet in stirrups, providing proper exposure. Prone (A) is face down and not suitable for a vaginal exam. Lateral Sims' (B) is on the side and not ideal for this exam. High Fowler's (D) is sitting upright, which is not appropriate for a vaginal examination.