Nokea
If the lump has the following characteristics when the nurse palpates the breast tissue, which one is most suggestive that the lump may be a common?
- A. The lump can be easily moved about.
- B. The lump is about 1/2" (1 cm).
- C. The lump is irregularly shaped.
- D. The lump is near the areola.
Correct Answer: C
Rationale: Irregularly shaped lumps are more suggestive of malignancy, as benign lumps are typically smooth and mobile. Size, mobility, and location near the areola are less specific indicators.
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The client who has had a mastectomy tells the nurse, 'My husband will leave me now since I am not a whole woman anymore.' Which response by the nurse is most therapeutic?
- A. You're afraid your husband will not find you sexually appealing?'
- B. Your husband should be grateful you will be able to live and be with him.'
- C. Maybe your husband would like to attend a support group for spouses.'
- D. You don't know that is true. You need to give him a chance.'
Correct Answer: A
Rationale: Reflecting the client’s fear validates her emotions and encourages discussion, a therapeutic approach. Gratitude dismisses feelings, support groups are premature, and reassurance without exploration is less effective.
The postmenopausal client reveals it has been several years since her last gynecological examination and states, 'Oh, I don’t need exams anymore. I am beyond having children.' Which statement should be the nurse’s response?
- A. As long as you are not sexually active, you don’t have to worry.'
- B. You should be taking hormone replacement therapy now.'
- C. You are beyond bearing children. How does that make you feel?'
- D. There are situations other than pregnancy that should be checked.'
Correct Answer: D
Rationale: Postmenopausal women need gynecological exams to screen for cancers (e.g., endometrial, ovarian). Sexual activity is irrelevant, HRT is not mandatory, and feelings are secondary to health education.
Which instruction is most appropriate if a Papanicolaou (Pap) smear will be obtained at the time of the pelvic examination?
- A. Avoid douching for several days before your appointment.
- B. Stop using any and all forms of contraception temporarily.
- C. Drink at least 1 quart of liquid an hour before your appointment.
- D. Avoid having sexual intercourse for a week before the test.
Correct Answer: A
Rationale: Douching can wash away cervical cells, leading to inaccurate Pap smear results, so it should be avoided for several days prior to the test.
The nurse is caring for a client who is eight (8) hours postoperative unilateral orchiectomy for cancer of the testes. Which intervention should the nurse implement?
- A. Provide an athletic supporter before ambulating.
- B. Encourage the client to delay use of pain medications.
- C. Place the client on a clear liquid diet for the first 48 hours.
- D. Monitor the PT/INR levels and have vitamin K ready.
Correct Answer: A
Rationale: An athletic supporter reduces scrotal swelling and discomfort during ambulation post-orchiectomy. Delaying pain medication, clear liquids, and PT/INR monitoring are inappropriate.
To determine the significance of the client's symptomatic bleeding, which questions are most important for the nurse to ask? Select all that apply.
- A. Has your energy level changed remarkably?
- B. Do you have intercourse more than once a week?
- C. How many sanitary pads do you use?
- D. Is the bleeding light or dark red?
- E. Do you have itching and swelling of the labia?
- F. Have you lost weight in the past few months?
Correct Answer: A,C,D,F
Rationale: Energy level, pad usage, bleeding color, and weight loss assess the severity and impact of heavy bleeding, indicating potential anemia or underlying pathology.