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The female client has a mother who died from ovarian cancer and a sister diagnosed with ovarian cancer. Which recommendations should the nurse make regarding early detection of ovarian cancer?
- A. The client should consider having a prophylactic bilateral oophorectomy.
- B. The client should have a transvaginal ultrasound and a CA-125 laboratory test every six (6) months.
- C. The client should have yearly magnetic resonance imaging (MRI) scans.
- D. The client should have a biannual gynecological examination with flexible sigmoidoscopy.
Correct Answer: B
Rationale: High familial risk warrants transvaginal ultrasound and CA-125 every 6 months for early detection. Prophylactic oophorectomy is a personal choice, MRI is not standard, and sigmoidoscopy is unrelated.
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The male client presents to the public health clinic complaining of joint pain and malaise. On assessment, the nurse notes a rash on the trunk, palms of the hands, and soles of the feet. Which action should the nurse implement next?
- A. Determine if the client has had a chancre sore within the last two (2) months.
- B. Ask the client how many sexual partners he has had in the past year.
- C. Refer the client to a dermatologist for a diagnostic work-up.
- D. Have the client provide a clean voided midstream urine specimen.
Correct Answer: A
Rationale: Joint pain, malaise, and a rash on palms/soles suggest secondary syphilis; confirming a prior chancre sore supports this diagnosis. Partner history, dermatology referral, and urine tests are less urgent.
Which breast palpation technique is most correct?
- A. Examine the breast while using the heel of the hand.
- B. Examine the breast while using the index finger only.
- C. Examine the breast while using the index finger and thumb.
- D. Examine the breast while using the pads of the fingertips.
Correct Answer: D
Rationale: Using the pads of the fingertips allows for better sensitivity to detect lumps or changes in breast tissue during palpation, making it the most effective technique for BSE.
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.
Which staff nurse is best suited to care for a client with a radioactive implant?
- A. A male nurse with oncology nursing experience
- B. A female nurse who has had a hysterectomy
- C. A male nurse whose mother died of cancer
Correct Answer: A
Rationale: Oncology experience equips the nurse to safely manage a client with a radioactive implant, regardless of gender or personal history.
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.