Nokea
Following a radical vulvectomy, the nurse is preparing the client for discharge to home. Which care intervention would be considered the priority for this client?
- A. Relieving edema to lower extremities
- B. Alterations for sexual function
- C. Prevention of wound complications
- D. Care of colostomy site
Correct Answer: C
Rationale: Prevention of complications and infection is paramount due to the location of the wound. The perineal area provides a warm, dark environment that supports the growth of microorganisms that can be introduced into the wound. With a radical vulvectomy, is is likely to find surgical drains and urinary catheter that can also interfere with the maintenance of the wound. Relieving edema to the lower extremities may be a necessary part of care if the lymph nodes and blood vessels are disturbed. The client may have a colostomy and care instructions should be provided. Alteration in sexual function needs to be addressed but is not a priority for the initial stage of healing.
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A female client is diagnosed with carcinoma in situ of the endometrium. The nurse interprets this as which of the following?
- A. Cancer is confined to the body of the uterus.
- B. The malignancy is localized.
- C. Cancer extends outside the uterus.
- D. The malignancy involves the uterine body and cervix.
Correct Answer: B
Rationale: A localized malignancy is referred to as carcinoma in situ. Stage I endometrial cancer is confined to the body (corpus) of the uterus, stage II involves the corpus and cervix, and stage III extends outside the uterus but not the true pelvis.
A young client has just completed the 6-month series of Gardasil vaccine. Which comment by the client would alert the nurse that is other teaching is needed?
- A. This vaccine lowers my risk for cervical cancer.
- B. Will still time need to the routine time need for cervical cancer.
- C. I am at lower risk for developing cervical warts.
- D. This vaccine will prevent human papilloma virus (HPV) from occurring.
Correct Answer: D
Rationale: Gardasil is a vaccine that protects against four types of HPV, which cause 90% of cervical cancers and 90% of cervical warts but does not protect against other strains of HPV and pre vaccination infections. Routine cervical cancer screening is recommended regardless of vaccine use.
The nurse is caring for a client who has just been diagnosed with o endometriosis. The client has been hoping to have children with her partner. Which statement by the nurse is most appropriate to provide the client with support and guidance about treatment options?
- A. Treatment is essential, so you really need to make a decision pretty quickly.
- B. If it was me, I would probably choose the medication options.
- C. If might help to include your partner in any of the discussion about options.
- D. The test results are clear and another physician would tell you the same thing.
Correct Answer: C
Rationale: The nurse assists the client through the decision-making process as it applies to family planning and medical or surgical treatment. Suggesting that the client include a partner or significant other in the discussion of options would be most helpful and therapeutic. The client does not need to make a decision immediately. The nurse should not give advice or offer personal opinions to influence the client's choice. The nurse should support the client's option of seeking a second opinion.
Which risk factor(s) supports the need for ovarian cancer screening? Select all that apply.
- A. Carrying genetic mutation for the disease
- B. Being nulliparous
- C. Family history of lung cancer
- D. Breastfeeding
- E. Use of oral contraceptives for 5 years or more
- F. Multiple full-term pregnancies
Correct Answer: A,B
Rationale: Woman who are nulliparous, have a family history of ovarian cancer, and/or carry a genetic mutation for it tend to develop ovarian cancer more often than others. Preventive measures recommended to lower the risk of ovarian cancer include having at least 2 full-term pregnancies, breastfeeding after pregnancies, and using oral contraceptives for 3 years or more. History of lung cancer is not a risk factor.
Following a colopsopsy, the confirmation of in situ carcinoma of the cervix has been determined. Which comment by the client indicates an appropriate understanding of the diagnosis?
- A. I will not need any further treatment.
- B. The cancer has not spread.
- C. I will need surgery and chemotherapy to increase my odds, for survival.
- D. I can wait until I have finished having babies to seek treatment.
Correct Answer: B
Rationale: Carcinoma in situ means the cancer has not left the original site and therefore has not invaded other tissues. Further treatment is required, which usually consists of cryossurgery or hysterectomy. Surgery with adjuvant chemotherapy is usually reserved for cancers that are more advanced. Even though cervical cancers tend to be slower growing, treatment should not be delayed.