Nokea
The client is diagnosed with breast cancer and is considering whether to have a lumpectomy or a more invasive procedure, a modified radical mastectomy. Which information should the nurse discuss with the client?
- A. Ask if the client is afraid of having general anesthesia.
- B. Determine how the client feels about radiation and chemotherapy.
- C. Tell the client she will need reconstruction with either procedure.
- D. Find out if the client has any history of breast cancer in her family.
Correct Answer: B
Rationale: Discussing feelings about radiation and chemotherapy is key, as lumpectomy often requires radiation, while mastectomy may involve chemotherapy. Anesthesia fears, mandatory reconstruction, and family history are less relevant to the procedure choice.
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Which instruction is best when teaching the client about inserting vaginal medication?
- A. Place the applicator just inside the vaginal opening.
- B. Insert the applicator while sitting on the toilet.
- C. Instill the medication just before retiring for sleep.
- D. Put on disposable latex gloves before applying the drug.
Correct Answer: C
Rationale: Instilling vaginal medication before sleep allows the medication to remain in the vagina longer, increasing its effectiveness.
The nurse in the gynecology clinic is assessing the 50-year-old client who has had four (4) children and is complaining of having lower abdominal pressure and fatigue along with some urinary incontinence. Which instruction should the nurse teach the client?
- A. Wear a peri-pad to keep from having an accident.
- B. Try not to laugh or sneeze unless at home.
- C. Discuss the pros and cons of a vaginal hysterectomy.
- D. Instruct to perform Kegel exercises.
Correct Answer: D
Rationale: Kegel exercises strengthen pelvic floor muscles, reducing stress incontinence and pelvic pressure from multiparity. Peri-pads are palliative, avoiding laughter/sneezing is impractical, and hysterectomy is premature.
The nurse enters the room of a 24-year-old client diagnosed with testicular cancer. The fiancée of the client asks the nurse, 'Will we be able to have children?' Which is the nurse’s best response?
- A. Your fiancée will be able to father children like always.'
- B. You will have to adopt children because he will be sterile.'
- C. You and he should consider sperm banking prior to treatment.'
- D. Have you discussed this with your fiancée? I can’t discuss this with you.'
Correct Answer: C
Rationale: Sperm banking is recommended before testicular cancer treatment (e.g., orchiectomy, chemotherapy) to preserve fertility. Normal fertility is unlikely, sterility is not guaranteed, and discussing with the fiancée avoids privacy issues but is less proactive.
A nurse has been asked to teach ovulation and menstruation to a class of secondary school students. Place the events listed below in the order in which they occur in the menstrual cycle after menstrual flow ends. Use all the options.
- A. Ovum is released.
- B. Progesterone decreases.
- C. Endometrium begins to thicken.
- D. Ovarian follicle matures.
- E. Endometrium is shed.
- F. Corpus luteum forms.
Correct Answer: C,D,A,F,B,E
Rationale: After menstruation, the sequence is: endometrium thickens (follicular phase), ovarian follicle matures, ovum is released (ovulation), corpus luteum forms, progesterone decreases (if no pregnancy), and endometrium is shed (next menstruation).
The client diagnosed with gestational diabetes delivered a 10-pound 5-ounce infant. Which is priority for the nursery nurse to monitor?
- A. Failure to latch on to the breast during feeding.
- B. Jaundice and clay-colored stools.
- C. Parchment-like skin and lack of lanugo.
- D. Low blood glucose readings.
Correct Answer: D
Rationale: Macrosomic infants from gestational diabetes are at risk for hypoglycemia; monitoring blood glucose is priority. Latching issues, jaundice, and skin changes are secondary.