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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.
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The client is diagnosed with a rectovaginal fistula which is to be managed medically. Which information should the nurse teach the client prior to discharge?
- A. Douche with normal saline.
- B. Eat a low-residue diet.
- C. Keep ice packs to the area.
- D. Use an abdominal binder.
Correct Answer: B
Rationale: A low-residue diet reduces fecal output, aiding healing of a rectovaginal fistula. Douching risks infection, ice packs are ineffective, and binders are unrelated.
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.
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.
Before the physician performs the vaginal examination, which nursing intervention is most important?
- A. Arrange to have a female nurse present during the examination.
- B. Instruct the client on the dangers of cervical cancer.
- C. Palpate the internal organs to obtain a baseline assessment.
- D. Encourage the client to instill a vaginal lubricant.
Correct Answer: A
Rationale: Having a female nurse present ensures the client's comfort and adheres to ethical standards, providing a chaperone during the examination.
On the basis of this client's age, which statement by the nurse is the best explanation for the client's discomfort?
- A. The pelvic muscles are more sensitive to pressure after menopause.
- B. The clitoris is unable to respond to sexual foreplay as women age.
- C. The vagina hypertrophies if intercourse is infrequent.
- D. The mucus-producing glands decrease with aging.
Correct Answer: D
Rationale: Postmenopausal vaginal dryness due to decreased mucus production is a common cause of painful intercourse in older women.