Nokea
The 80-year-old male client has been diagnosed with cancer of the prostate. Which treatment should the nurse discuss with the client?
- A. Radiation therapy every day for four (4) weeks.
- B. Radical prostatectomy with lymph node dissection.
- C. Diethylstilbestrol (DES), an estrogen, daily.
- D. Penile implants to maintain sexual functioning.
Correct Answer: A
Rationale: Radiation therapy is often preferred for elderly patients with prostate cancer, balancing efficacy and lower surgical risk. Prostatectomy is invasive, DES is rarely used, and penile implants are unrelated.
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Which steps should the nurse provide clients who choose to perform breast self-examination (BSE) according to the American Cancer Society (ACS) guidelines? Rank in order of performance.
- A. Lie flat on the bed with a rolled towel placed under the scapula; perform palpation of each breast.
- B. Pinch each nipple to see if fluid can be expressed.
- C. With the breasts exposed, stand in front of a mirror and examine the breasts from front and each side.
- D. In the shower, soap the breasts, and perform palpation in a systematic manner on each breast.
- E. Find a private place where the self-examination can be performed.
Correct Answer: E,C,A,D,B
Rationale: ACS BSE steps: 1) Find a private place; 2) Visually inspect in mirror (front/sides); 3) Palpate lying down with towel; 4) Palpate in shower; 5) Check nipples for discharge.
The nurse is assessing the client diagnosed with a rectocele. Which signs and symptoms should the nurse expect? Select all that apply.
- A. Rectal pressure.
- B. Flatus.
- C. Fecal incontinence.
- D. Constipation.
- E. Urinary frequency.
Correct Answer: A,B,C,D
Rationale: Rectocele causes rectal pressure, flatus, fecal incontinence, and constipation due to posterior vaginal wall protrusion. Urinary frequency is more associated with cystocele.
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 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.
The female client presents to the gynecologist’s office for the fifth time with an ovarian cyst and is scheduled for an exploratory laparoscopy. The client asks the nurse, 'Why do I need to have another surgery? The other cysts have all been benign.' Which statement is the nurse’s best response?
- A. Because eventually the cysts will become cancerous.'
- B. All abnormal findings in the ovary should be checked out.'
- C. The surgery will not be painful and you will have peace of mind.'
- D. Are you afraid of having surgery? Would you like to talk about it?'
Correct Answer: B
Rationale: Persistent ovarian cysts require evaluation to rule out malignancy or complications, despite prior benign findings. Suggesting inevitable cancer is inaccurate, minimizing pain is dismissive, and addressing fear is secondary.