Nokea
The nurse is caring for a patient who has a radium implant for treatment of cancer of the cervix. Which of the following actions should the nurse implement?
- A. Maintain the patient on complete bed rest.
- B. Use gloves when changing the patient's bed.
- C. Allow extra time for patient discussion of concerns.
- D. Flush the toilet several times after the patient voids.
Correct Answer: A
Rationale: To prevent displacement of the implant, absolute bed rest is required. Wearing of gloves when changing linens and flushing the toilet several times are not necessary because the isotope is confined to the implant. The nurse should spend minimal time in the patient's room to avoid exposure to radiation.
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The nurse is caring for a patient recently diagnosed with polycystic ovary syndrome. Which of the following information is most important for the nurse to teach the patient?
- A. Reasons for a total hysterectomy
- B. How to decrease facial hair growth
- C. Ways to reduce the occurrence of acne
- D. Methods to maintain appropriate weight
Correct Answer: D
Rationale: Obesity exacerbates the problems associated with polycystic ovary syndrome, such as insulin resistance and type 2 diabetes. The nurse will also address the problems of acne and hirsutism, but these symptoms are lower priority because they do not have long-term health consequences. Although some patients do require total hysterectomy, this is usually performed only after other therapies have been unsuccessful.
A patient who is scheduled for a Pap test tells the nurse that she has had intercourse during the last year with several men. Which of the following information should the nurse teach to the patient?
- A. Contraceptive use
- B. Antibiotic therapy
- C. Chlamydia testing
- D. Pregnancy testing
Correct Answer: C
Rationale: Chlamydia testing is recommended annually for women with multiple sex partners. There is no indication that the patient needs teaching about contraceptives, pregnancy testing, or antibiotic therapy.
The nurse is caring for a patient who has a large cystocele and has not voided since admission 8 hours previously. Which of the following actions should the nurse take first?
- A. Insert a straight catheter per the PRN order.
- B. Encourage the patient to increase oral fluids.
- C. Notify the health care provider of the inability to void.
- D. Assess for urinary retention.
Correct Answer: D
Rationale: Since urinary retention is common with a large cystocele, the nurse's first action should be to assess for the presence of urine in the bladder. The other actions may be appropriate, depending on the findings of the physical assessment.
The nurse is teaching a patient about ways to prevent primary dysmenorrhea. Which of the following information should the nurse provide to the patient?
- A. Avoid aerobic exercise during her menstrual period.
- B. Use cold packs on the abdomen and back for pain relief.
- C. Talk with health care provider about antidepressant therapy.
- D. Start taking nonsteroidal anti-inflammatory drugs (NSAIDs) regularly when menstrual period starts.
Correct Answer: D
Rationale: NSAIDs should be started as soon as the menstrual period begins and taken at regular intervals (every 4-8 hours) during the usual time frame in which pain occurs. Aerobic exercise may help reduce symptoms. Heat therapy, such as warm packs, is recommended for relief of pain. Antidepressant therapy is not a typical treatment for dysmenorrhea.
A 32-year-old patient has minor changes on her Pap test. Which of the following actions should the nurse take?
- A. Teach the patient about colposcopy.
- B. Teach the patient about punch biopsy.
- C. Schedule another Pap test in 4 months.
- D. Administer the human papilloma virus (HPV) vaccine.
Correct Answer: C
Rationale: Patients with minor changes on the Pap test can be followed with Pap tests every 4-6 months because these changes may revert to normal. Punch biopsy or colposcopy may be used if the Pap test shows more prominent changes. The HPV vaccine may reduce the risk for cervical cancer, but it is recommended only for ages 9 through 26.