Nokea
The 30-year-old male client diagnosed with germinal cell carcinoma of the testes asks the nurse, 'What chance do I have? Should I end it all now?' Which response by the nurse indicates an understanding of the disease process?
- A. God does not want you to give up hope and end it all now.'
- B. There is a good chance for survival with standard treatment options.'
- C. There may be little hope, but ending it all is not the answer.'
- D. You have a 50/50 chance of living for at least 5 years.'
Correct Answer: B
Rationale: Germinal cell carcinoma has a high cure rate with treatment (e.g., orchiectomy, chemotherapy), offering good survival chances. Religious references, pessimism, or vague statistics are less appropriate.
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The client has failed to conceive after many attempts over a three (3)-year time period and asks the nurse, 'I have tried everything. What should I do now?' Which statement is the nurse’s best response?
- A. By “everything” do you mean you have consulted an infertility specialist?'
- B. You have tried everything. This must be hard for you. Would you like to talk?'
- C. You should get on an adoption list because it can take a long time.'
- D. You need to relax and not try so hard. It is your nerves preventing conception.'
Correct Answer: A
Rationale: Referring to an infertility specialist is proactive, addressing potential medical causes. Emotional support is secondary, adoption is premature, and blaming nerves is unhelpful.
Unless the physician specifies otherwise, what is the maximum volume of urine the nurse should remove with the catheter at this time?
- A. 500 mL
- B. 1,000 mL
- C. 1,500 mL
- D. 2,000 mL
Correct Answer: B
Rationale: Removing up to 1,000 mL prevents bladder decompression injury, balancing the need to relieve retention with the risk of hypotension or hematuria.
The client who had a right modified radical mastectomy four (4) years before is being admitted for a cardiac work-up for chest pain. Which intervention is most important for the nurse to implement?
- A. Determine when the client had chemotherapy last.
- B. Ask the client if she received Adriamycin, an antineoplastic agent.
- C. Post a message at the HOB for staff not to use the right arm for venipunctures or BPs.
- D. Examine the chest wall for cancer sites.
Correct Answer: C
Rationale: Post-mastectomy, the affected arm is at risk for lymphedema; avoiding venipuncture or BP on that arm is critical. Chemotherapy history is less urgent, Adriamycin relates to cardiotoxicity but not immediate care, and chest wall exam is secondary.
Which question is most important for the nurse to ask next?
- A. Have you ever had any menstrual periods?
- B. Do you have any pubic hair growth?
- C. Have you ever been sexually attracted to males?
- D. Are there any siblings with a similar problem?
Correct Answer: A
Rationale: Determining if the client has ever menstruated is critical to differentiate between primary amenorrhea (never menstruated) and secondary amenorrhea (cessation of periods), guiding further assessment.
The client is diagnosed with benign uterine fibroid tumors. Which question should the nurse ask to determine if the client is experiencing a complication?
- A. How many periods have you missed?'
- B. Do you get short of breath easily?'
- C. How many times have you been pregnant?'
- D. Where is the location of the pain you are having?'
Correct Answer: D
Rationale: Pain location helps identify complications like fibroid degeneration or pressure on organs. Missed periods are common, shortness of breath is unrelated, and pregnancy history is less relevant.