Nokea
The nurse gives discharge instructions to a person who has had a modified radical mastectomy of the right side to perform the 'elbow pull-in.' Which step is the first step of the exercise?
- A. Pull elbows forward until they touch.
- B. Lower and straighten the arms.
- C. Extend arms sideways to shoulder level.
- D. Bring elbows back and extend arms.
- E. Clasp hands behind neck.
Correct Answer: C
Rationale: The exercise requires that you bring the arms out at shoulder level, clasp hands behind head and bring elbows to touch, then bring elbows back and extend arms lower and straighten arms.
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The patient who had a colporrhaphy for the repair of a cystocele and rectocele asks that the catheter be removed as it is bothersome to her. In which way will the nurse explain the reason for the catheter?
- A. It replaces uncomfortable gauze packing.
- B. It will prevent adhesions and will be in place for about 2 weeks.
- C. It allows for quick urine sample collection.
- D. It keeps the bladder empty and prevents stress on the sutures.
Correct Answer: D
Rationale: A retention catheter is usually inserted into the bladder to keep it empty and prevent pressure on sutures.
A patient, age 41, has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis. She asks the nurse if she will have 'hot flashes.' Knowledge of which fact will guide the nurse's response?
- A. Only the uterus was removed, and the ovaries are still producing estrogen and she will not have hot flashes.
- B. The patient is too young to have hot flashes associated with menopause.
- C. The uterus, ovaries, and fallopian tubes were removed, and she will have surgically induced menopause and may have hot flashes.
- D. The uterus and fallopian tubes were removed, and she will not experience 'hot flashes.'
Correct Answer: C
Rationale: A total abdominal hysterectomy with bilateral salpingo-oophorectomy is the removal of the uterus, fallopian tubes, and ovaries. If the ovaries are removed in these surgeries, the surgery will induce menopause and hot flashes may occur.
Why do false-negative results in mammography occur in specific age-groups?
- A. Older women have greater density of breast tissue.
- B. Older women have less density of breast tissue.
- C. Younger women have greater density of breast tissue.
- D. Younger women have less density of breast tissue.
Correct Answer: C
Rationale: Because of the greater density of breast tissue, mammography is less sensitive in younger women, which may result in more false-negative results.
A Gram stain smear of the patient's discharge reveals the presence of Neisseria gonorrhoeae. He tells the nurse that he had sexual contact with a new girlfriend but does not think he was exposed to gonorrhea because she did not appear to have any disease. Which information will the nurse include in response to his comment?
- A. Women do not develop gonorrhea infections but can serve as carriers to spread the disease to males.'
- B. When gonorrhea infections occur in women, the disease affects only the ovaries and not the other genital organs.'
- C. Many women are not aware that they have gonorrhea because they often do not have symptoms of infection.'
- D. Women develop subclinical cases of gonorrhea that do not cause tissue damage or symptoms.'
Correct Answer: C
Rationale: Most women remain asymptomatic but may show a greenish-yellow discharge from the cervix.
Which statement indicates that the patient who has had an abdominal hysterectomy needs further home teaching?
- A. I understand I can lift as much as 20 lb.'
- B. I'm leaving today to stay with my daughter who lives 20 miles away. My husband plans to drive the family car.'
- C. The health care provider said I can't have sexual intercourse for 4 to 6 weeks.'
- D. I'm going to miss wearing my girdle or knee-high hose.'
Correct Answer: A
Rationale: If there has been an abdominal incision, there may be further restrictions on heavy lifting (nothing over 10 lb).