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A woman is admitted for repair of cystocele and rectocele. She has nine living children. In taking her health history, what would the nurse expect to find?
- A. Sporadic vaginal bleeding accompanied by chronic pelvic pain
- B. Menstrual irregularities and hirsutism on the chin
- C. Heavy leukorrhea with vulvar pruritus
- D. Stress incontinence with feeling of low abdominal pressure
- G. D
Correct Answer: Cystocele and rectocele, caused by weakened pelvic support, commonly lead to stress incontinence (urine leakage during pressure) and a feeling of low abdominal pressure due to organ protrusion. Other options suggest unrelated conditions like endometriosis or infections.
Rationale:
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A woman who has undergone a right-sided modified-radical mastectomy returns from surgery. Which nursing intervention would be most appropriate for the nurse to include in the client's plan of care at this time?
- A. Encourage her to turn, cough, and deep breathe at frequent intervals.
- B. Ask the client how she feels about having her breast removed.
- C. Attach a sign above her bed to have BP, IV lines, and lab work on her right arm.
- D. Position her right arm below heart level.
- G. A
Correct Answer: Turning, coughing, and deep breathing prevent respiratory complications post-surgery. Asking about feelings is premature, using the right arm risks lymphedema, and elevating the arm aids drainage.
Rationale:
A nurse is assessing a male client recently diagnosed with genital herpes. Which finding would most likely correlate with this diagnosis?
- A. Reports of itching, tingling, and pain in the genital area
- B. Painful urination with a penile discharge present
- C. Wart-like flesh-colored lesions on the scrotal area
- D. A chancre on the penis
- G. A
Correct Answer: Genital herpes causes itching, tingling, and pain before painful blisters appear. Discharge suggests gonorrhea/chlamydia, warts suggest HPV, and a chancre indicates syphilis.
Rationale:
A woman with breast cancer is undergoing chemotherapy. Which side effect would the nurse interpret as being most serious?
- A. Vomiting
- B. Fatigue
- C. Hair loss
- D. Myelosuppression
- G. D
Correct Answer: Myelosuppression, reducing blood cell production, is life-threatening due to risks of anemia, infection, and bleeding. Vomiting, fatigue, and hair loss are manageable or temporary.
Rationale:
A nurse is leading a discussion about contraception with a group of 14-year-old clients. After the presentation, a client asks the nurse which method would be best for her to use. Which of the following responses should the nurse make?
- A. A provider can help you with that after a physical examination.
- B. You are so young. Are you ready for the responsibilities of a sexual relationship?
- C. Because of your age, I think that a barrier method would be the best choice.
- D. Before I can help you, I need to know more about your sexual activity.
- G. A
Correct Answer: Referring to a provider ensures personalized advice after assessing health and needs. Judgmental or assumptive responses can deter adolescents from seeking care, and probing sexual activity may violate privacy.
Rationale:
A nurse is preparing to administer enoxaparin 30 mg subcutaneously. Available is enoxaparin 40 mg/mL. How many mL should the nurse administer?(Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
- G. 0.8 mL
Correct Answer: Using the formula mL = dose / concentration, calculate: 30 mg / 40 mg/mL = 0.75 mL, rounded to 0.8 mL.
Rationale: