Nokea
According to the standard staging classification for breast cancer, which criteria reflects stage 2 breast cancer?
- A. Tumor smaller than 2 cm, no regional lymph node metastasis, no distant metastasis
- B. No evidence of tumor; metastasis to lymph nodes fixed to one another or to other structure but no distant metastasis
- C. Tumor larger than 5 cm; metastasis to lymph nodes fixed to one another or to other structure; no distant metastasis
- D. Tumor larger than 2 to 5 cm; no regional lymph node metastasis; no distant metastasis
Correct Answer: D
Rationale: The correct answer is D because it aligns with the criteria for stage 2 breast cancer in the standard staging classification. In stage 2, the tumor is typically larger than 2 cm but not larger than 5 cm, there is no regional lymph node metastasis, and there are no distant metastases. Option A is incorrect because the tumor size is smaller than 2 cm, which does not meet the criteria for stage 2. Option B is incorrect as it describes no evidence of tumor with lymph node metastasis, which does not represent stage 2. Option C is incorrect as the tumor size is larger than 5 cm, exceeding the criteria for stage 2.
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A nurse is developing a plan of care for a 16-year-old female client experiencing her first outbreak of genital herpes. The client states that she contracted the disease by holding hands with someone who has syphilis. Which nursing diagnosis should the nurse identify as the priority?
- A. Acute pain related to the development of genital lesions
- B. Lack of knowledge about the disease and its transmission
- C. Ineffective coping related to the increased stress associated with the infection
- D. Noncompliance with treatment related to age of the client
Correct Answer: B
Rationale: The correct answer is B: Lack of knowledge about the disease and its transmission. This is the priority nursing diagnosis because the client's statement about contracting herpes by holding hands with someone who has syphilis indicates a lack of understanding about how genital herpes is transmitted. The nurse should prioritize educating the client about the disease, its transmission, and prevention to empower the client to make informed decisions about her health.
Choices A, C, and D are incorrect:
A: Acute pain may be a symptom of genital herpes, but addressing the lack of knowledge about the disease and its transmission is more essential for the client's well-being.
C: While coping with the stress of the infection is important, addressing the lack of knowledge should take precedence to prevent further transmission and help the client manage the condition effectively.
D: Noncompliance with treatment may be a concern, but addressing the client's lack of knowledge about the disease and its transmission is crucial in promoting understanding and adherence to treatment.
How does HPV manifest in HIV-positive clients?
- A. Cough
- B. Condylomata lata
- C. Condylomata
- D. Chancre
Correct Answer: C
Rationale: The correct answer is C: Condylomata. HPV manifests in HIV-positive clients through the development of genital warts known as condylomata acuminata. This is a common manifestation due to the weakened immune system in HIV-positive individuals. Condylomata lata (choice B) is associated with syphilis, not HPV. Cough (choice A) is not a typical manifestation of HPV in HIV-positive clients. Chancre (choice D) is a primary lesion seen in syphilis, not HPV.
The nurse is assessing a client who has a suspected cystocele. Which signs and symptoms should the nurse expect? Select all that apply.
- A. Frequent bladder infections
- B. Sense of fullness in the vaginal area
- C. Leaking of urine
- D. Irregular vaginal bleeding
Correct Answer: D
Rationale: The correct answer is D: Irregular vaginal bleeding. A cystocele is a condition where the bladder protrudes into the vagina. This can cause pressure on surrounding tissues and lead to irregular vaginal bleeding. A, B, and C are incorrect as they are more commonly associated with other conditions such as urinary tract infections (A), pelvic organ prolapse (B), and urinary incontinence (C). Irregular vaginal bleeding is a key sign specific to cystocele due to the physical displacement of organs.
What is the clinical finding most likely to be exhibited in an infant diagnosed with erythroblastosis fetalis?
- A. Edema
- B. Immature red blood cells
- C. Enlargement of the heart
- D. Ascites
Correct Answer: B
Rationale: The correct answer is B: Immature red blood cells. Erythroblastosis fetalis is a condition where maternal antibodies attack fetal red blood cells, leading to hemolysis and the release of immature red blood cells (erythroblasts) into the circulation. This can result in anemia and jaundice in the infant. Edema (choice A) is not a typical clinical finding in erythroblastosis fetalis. Enlargement of the heart (choice C) is more commonly associated with conditions like congestive heart failure. Ascites (choice D) is the accumulation of fluid in the abdominal cavity and is not a characteristic finding in erythroblastosis fetalis.
Which is a constellation of physical and psychological symptoms beginning in the luteal phase of the menstrual cycle and followed by a symptom-free period?
- A. Endometriosis
- B. Abnormal uterine bleeding
- C. Premenstrual syndrome
- D. Depression
Correct Answer: C
Rationale: Rationale:
1. Premenstrual syndrome (PMS) occurs in the luteal phase due to hormonal changes.
2. PMS includes physical and psychological symptoms.
3. It is followed by a symptom-free period (during menstruation).
4. Endometriosis is a separate condition involving tissue growth outside the uterus.
5. Abnormal uterine bleeding refers to irregular bleeding patterns.
6. Depression is a mental health condition not specific to the menstrual cycle.
Summary:
PMS is the correct answer as it aligns with the timing, symptoms, and pattern described in the question. Endometriosis, abnormal uterine bleeding, and depression do not fully match the criteria provided.