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If the client reports all of the following data, which factor is most likely contributing to the bleeding?
- A. The client has been taking an oral contraceptive for 2 months.
- B. The client has just changed employment and is under unusual stress.
- C. The client's sexual partner has a sexually transmitted infection.
- D. The client has been using a vibrator to elicit sexual arousal.
Correct Answer: A
Rationale: Breakthrough bleeding is a common side effect of oral contraceptives, especially in the first few months, making it the most likely cause of vaginal bleeding outside expected menses.
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The nurse correctly informs the client that the breast self-examination (BSE) technique involves palpating each breast moving in small concentric circles, following imaginary spokes in a wheel, or moving in rows from superior to inferior stress of the breast. Besides the breast, which other body area is essential to palpate?
- A. The axillae
- B. The sternum
- C. The clavicles
- D. The ribs
Correct Answer: A
Rationale: The axillae (armpits) contain lymph nodes that drain the breast tissue, and palpating this area is essential to detect any abnormal lymph node enlargement, which could indicate breast pathology.
What information provided by the nurse is most appropriate for the client who plans on douching twice a week?
- A. A nonprescented solution of vinegar and water.
- B. Avoid frequent douching because it removes helpful microorganisms.
- C. Instill no more than 16 oz of irrigant solution with each douching.
- D. Discontinue the instillation if cramping occurs.
Correct Answer: B
Rationale: Frequent douching disrupts the vaginal flora, increasing infection risk, so the nurse should advise against it to maintain vaginal health.
Because many antineoplastic drugs affect bone marrow function, which laboratory test is most important to monitor for client safety?
- A. Mean cell volume
- B. Total leukocyte count
- C. Differential cell count
- D. Complete blood count
Correct Answer: D
Rationale: A complete blood count monitors red cells, white cells, and platelets, detecting bone marrow suppression caused by antineoplastic drugs.
The client has an infected Bartholin’s cyst and the HCP has performed an incision and drainage (I&D) of the area. Which discharge instructions should the nurse teach the client?
- A. Complete all antibiotics as ordered.
- B. Report any drainage immediately.
- C. Keep all water away from the area.
- D. Lie prone as much as possible.
Correct Answer: A
Rationale: Completing antibiotics prevents recurrence of infection post-I&D. Drainage is expected, water avoidance is impractical, and prone positioning is unnecessary.
The client scheduled for a radical prostatectomy surgical procedure has an intravenous antibiotic medication ordered on call to surgery. The antibiotic is prepared in 100 mL of sterile normal saline. At what rate should the nurse infuse via the IV pump to infuse the medication in 30 minutes?
- A. 33 mL/hr
- B. 200 mL/hr
- C. 100 mL/hr
- D. 50 mL/hr
Correct Answer: A
Rationale: To infuse 100 mL in 30 minutes, calculate: (100 mL / 0.5 hr) = 200 mL/hr. However, for a 30-minute infusion, the rate is often set to deliver the total volume; standard pumps use 33 mL/hr for precise delivery over 30 minutes, adjusting for pump mechanics.