Nokea
The client has undergone a bilateral orchiectomy for cancer of the prostate. Which intervention should the nurse implement?
- A. Support the scrotal sac with a towel and apply ice.
- B. Administer testosterone replacement hormone orally.
- C. Encourage the client to place sperm in a sperm bank.
- D. Have the client talk to another man with ejaculation dysfunction.
Correct Answer: A
Rationale: Supporting the scrotum and applying ice reduce swelling and pain post-orchiectomy. Testosterone is contraindicated, sperm banking is preoperative, and ejaculation discussions are secondary.
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The client is diagnosed with vulvar cancer. Which are the most common symptoms of cancer of the vulva?
- A. Red, painful lesions.
- B. Vulvar itching.
- C. Thin, white vulvar skin.
- D. Vaginal dryness.
Correct Answer: B
Rationale: Vulvar itching is the most common symptom of vulvar cancer, often persistent. Red lesions, thin skin, and dryness are less specific or associated with other conditions.
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.
The client diagnosed with cancer of the prostate tells the nurse, 'I caused this by being promiscuous when I was young and now I have to pay for my sins.' Which statement is the nurse’s most therapeutic response?
- A. Why would you think prostate cancer is caused by sex?'
- B. You feel guilty about some of your actions when you were young?'
- C. Well, there is nothing you can do about that behavior now.'
- D. Have you told the HCP and been checked for an AIDS infection?'
Correct Answer: B
Rationale: Reflecting the client’s guilt validates emotions and encourages discussion, a therapeutic approach. Questioning causation, dismissing behavior, or suggesting AIDS testing is less supportive.
The nurse and an unlicensed assistive personnel (UAP) are caring for clients on a gynecology surgery floor. Which intervention cannot be delegated to the UAP?
- A. Empty the indwelling catheter on the three (3)-hour postoperative client.
- B. Assist the client who is two (2) days post-hysterectomy to the bathroom.
- C. Monitor the peri-pad count on a client diagnosed with fibroid tumors.
- D. Encourage the client who is refusing to get out of bed to walk in the hall.
Correct Answer: C
Rationale: Monitoring peri-pad count involves assessing bleeding, requiring nursing judgment. Emptying catheters, assisting to the bathroom, and encouraging ambulation are within UAP scope.
The nurse is performing the admission assessment on a 78-year-old female client and observes bilateral pendulous breasts with a stringy appearance. Which intervention should the nurse implement?
- A. Request a mammogram.
- B. Notify the HCP of the finding.
- C. Continue with the examination.
- D. Assess for peau d’orange skin.
Correct Answer: C
Rationale: Pendulous, stringy breasts are normal age-related changes; the nurse should continue the exam. Mammogram, HCP notification, or peau d’orange assessment are unnecessary without abnormal findings.