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The nurse is assessing a patient who had a hysterosalpingogram, endometrial biopsy, and cervical biopsy in the outpatient clinic this morning and now reports feeling light-headed and short of breath. Which of these symptoms is most important to report to the health care provider?
- A. Abdominal cramping
- B. Vaginal spotting
- C. Light-headedness
- D. Dyspnea
Correct Answer: C
Rationale: The patient's light-headedness suggests a possible vasovagal response or other complication post-procedure, requiring immediate attention. Dyspnea could also be significant, but light-headedness is prioritized due to its potential to indicate hypoperfusion or shock. Abdominal cramping and vaginal spotting are expected after these procedures.
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A male patient who is 53 years of age is scheduled for an annual physical exam. Which of the following information should the nurse include in the teaching plan?
- A. Increased risk for testicular cancer
- B. Possible changes in erectile function
- C. Normal decreases in testosterone level
- D. Annual digital rectal examination
Correct Answer: D
Rationale: A digital rectal examination is required for all men who have symptoms of prostate trouble, such as difficulty in initiating the flow and the urge to void frequently. This examination should be performed annually for all men 50 years of age or older. There is no indication that the other patient teaching topics are appropriate for this patient.
Which information about a female patient who wants to start using oral contraceptives is most important to report to the health care provider?
- A. The patient quit smoking 6 months previously.
- B. The patient's blood pressure is 164/90 mm Hg.
- C. The patient has a history of migraines.
- D. The patient is 35 years old.
Correct Answer: B
Rationale: Since hypertension increases the risk for morbidity and mortality in women taking oral contraceptives, the patient's blood pressure should be controlled before oral contraceptives are prescribed. The other information will also be reported but will not affect the choice of contraceptive.
The nurse is assessing a patient who has amenorrhea with a weight of 41 kg. The patient makes all of the following statements. Which one indicates a need for immediate teaching by the nurse?
- A. I have not been able to eat much at all for the past three months.
- B. I drink at least three glasses of nonfat milk daily.
- C. I am not sexually active but currently have a boyfriend.
- D. I was recently treated for a sexually transmitted infection.
Correct Answer: A
Rationale: Not being able to eat much at all for the past three months indicates that the patient may be experiencing anorexia. Anorexia can cause amenorrhea. The other statements by the patient do not suggest any urgent teaching needs.
Which of the following questions should the nurse ask when assessing a patient who has a history of benign prostatic hyperplasia (BPH)?
- A. Have you noticed any unusual discharge from your penis?
- B. Has there been any change in your sex life in the last year?
- C. Do you find it hard to initiate your urinary stream?
- D. Have you been experiencing any difficulty in achieving an erection?
Correct Answer: C
Rationale: Enlargement of the prostate blocks the urethra, leading to urinary changes. Benign prostatic hyperplasia is a common problem of older men. It can alter normal urination, causing retention and difficulty in initiating the urinary stream. The other questions address possible problems with infection or sexual difficulties but would not be helpful in determining whether there were functional changes caused by BPH.
The nurse is assessing the sexual-reproductive functional health pattern for a patient. Which of the following questions is most useful in determining the patient's sexual orientation and risk factors?
- A. Do you have sex with men, women, or both?
- B. Which gender do you prefer to have sex with?
- C. What types of sexual activities do you prefer?
- D. Are you heterosexual, homosexual, or bisexual?
Correct Answer: A
Rationale: This question is the most simply stated and will increase the likelihood of obtaining the relevant information about sexual orientation and possible risk factors associated with sexual activity. A patient who prefers intercourse with women may also have intercourse at times with men. The types of sexual activities engaged in may not indicate sexual orientation. Many patients who have intercourse with both men and women do not identify themselves as homosexual or bisexual.