Nokea
The nurse has provided teaching to a client who is scheduled to have a Pap test. Which client statement indicates that teaching was successful?
- A. I'll schedule the test for the time when I have my next menstrual period.
- B. I need to refrain from sexual intercourse for at least 1 week before the test.
- C. I will stop using any vaginal medications at least 48 hours before the test.
- D. I need to use a vinegar and water douche the morning of the test.
Correct Answer: C
Rationale: Teaching is effective when the client schedules an appointment at a time other than during menstruation and does the following before the appointment: (1) avoids intercourse for 2 days, (2) refrains from douching for 1 day, and (3) ceases the use of vaginal medications for at least 48 hours.
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The client states to the nurse that he is very anxious about having prostate cancer ever since his prostate-specific antigen (PSA) test came back elevated. The client asks, 'Which diagnostic test produces definitive results if cancer is present?' The nurse is most correct to state which of the following?
- A. Transrectal ultrasonography
- B. Tissue biopsy
- C. Tumor marker studies
- D. Digital rectal exam
Correct Answer: B
Rationale: Obtaining an actual piece of the tissue and analyzing it for cancer is a definitive test when cancer is found. A transrectal ultrasonography is a test to view the prostate gland from different angles. This test provides additional data on the status of the prostate gland. The tumor marker studies include the prostate-specific antigen (PSA) level. This antigen indicates a potential problem but is not definitive. PSA elevations have been noted for reasons other than cancer. A digital rectal exam provides data on the shape, size, and texture of the prostate gland.
An instructor is preparing a teaching plan for a group of students about reproductive structures and sexual arousal. Which female reproductive structure would the instructor include?
- A. The mons pubis
- B. The clitoris
- C. Labia minora
- D. Labia majora
Correct Answer: B
Rationale: At the superior function of the labia, there is a fleshy protrusion of tissue called the clitoris. The clitoris is an erectile tissue that enlarges and becomes sensitive when stimulated by the penis or touching that accompanies sexual foreplay. The mons pubis, labia minora, and labia majora are female reproductive structures but do not play as prominent a role in sexual arousal.
The nurse is preparing a client for a pelvic examination. Which nursing question is essential for the nurse to ask?
- A. Are you sexually active?
- B. Do you have any sexually transmitted diseases?
- C. Would you like to have assistance to get in position for the exam?
- D. Would you like to void at this time?
Correct Answer: D
Rationale: Prior to a pelvic examination, the nurse offers the client the use of the restroom to void. It is most important for the client to empty the bladder so that the physician can feel pelvic structures more clearly and for the comfort of the client. Asking client history questions is completed at the beginning of the appointment. It is important to offer assistance to those who may need help in assuming the lithotomy position.
The client is asking the nurse to explain the typical treatment expected when a class 4 Papanicolaou test is reported. The nurse is most correct to state which of the following?
- A. No further treatment is considered.
- B. The test will need to be repeated in 3 months.
- C. Further evaluation is needed for potential malignancy.
- D. Chemotherapy is needed and radiation is suggested.
Correct Answer: C
Rationale: A class 4 Papanicolaou test (Pap test) is strongly suggestive of malignancy. Further testing is needed to confirm the type and extent of cancer. The nurse would not suggest that no treatment is needed or to wait for 3 months. The nurse would also not suggest a typical treatment without further diagnostic testing.
The nurse is obtaining a health history at the client's annual gynecologic exam. Which of the following statements regarding a Papanicolaou test (Pap test) for cancer screening would delay the exam?
- A. I had sexual intercourse several days ago.
- B. I voided before entering the exam room.
- C. My menstrual period began yesterday.
- D. I use no vaginal sprays or creams.
Correct Answer: C
Rationale: The nurse advises that the Pap test be rescheduled to a time other than during the menstrual period. The other options are acceptable to continue the test procedure.