Nokea
The nurse is completing community education when asked by a client without health insurance why a mammogram is needed if the women are completing breast self-examinations at home. The nurse is most correct to respond stating which of the following?
- A. Mammograms are just better.
- B. Mammograms can detect cysts or tumors too small to palpate.
- C. Mammograms provide a baseline that shows changes in breast tissue.
- D. Mammograms provide a reassurance that the breast is free of cancer.
Correct Answer: B
Rationale: During community instruction, it is most important to relay facts in a clear, factual, and nonjudgmental way. Stating the need for mammograms to detect small cysts or tumors is clear and factual. Stating that mammograms are 'better' is vague and provides no better understanding. Although a mammogram does provide a baseline and reassurance of breast health, the most clear and factual reason why the mammogram is completed is its ability to detect cancerous tumors at an early stage.
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The nurse is conducting a health history. When a middle-aged client reports last having a menstrual period 6 months ago. Upon further questioning, the client also states symptoms of hot flashes and mood fluctuations. Which question should the nurse ask next?
- A. Do you feel like hurting yourself?
- B. Are you finished having children?
- C. When was your first menstrual period?
- D. Are you taking any hormone replacement therapy?
Correct Answer: D
Rationale: To ensure a thorough health history, a client who exhibits symptoms of perimenopause should be assessed for the use of hormone replacement therapy to alleviate the symptoms. This information adds to the data reported by the client. Asking if the client is having thoughts of self-harm may be extreme with the report of mood fluctuations. Asking if the client is finished having children produces little additional data. Asking the first menstrual period is part of the health history but not the best question to ask after the client's statement.
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 preparing a woman for an abdominal ultrasound. Which instruction would be appropriate for the nurse to include?
- A. Restrict solid food intake for 2 hours before the test.
- B. Refrain from douching for at least 1 week before the test.
- C. Drink at least 1 quart of water an hour before the test.
- D. Empty the bladder immediately before the test.
Correct Answer: C
Rationale: Drinking at least 1 quart of water 45 minutes to 1 hour before the test and not voiding until after the test ensures a full bladder and facilitates transmission of the ultrasound waves. It also elevates the bowel away from the other pelvic organs. The client should restrict solid food intake for 6 to 8 hours before the test to avoid having images of the test obscured by gas and intestinal contents. There is no restriction on douching for this test. A full bladder, not an empty one, facilitates this test.
The nurse is instructing a couple in the early stages of infertility testing who has just found that the male has a slightly low sperm count. Which easy change can a nurse suggest to a male client?
- A. Avoid riding on motorcycles
- B. Wear loose fitting underwear instead of tight ones.
- C. Take a general multivitamin.
- D. Increase sexual intercourse to every day.
Correct Answer: B
Rationale: Wearing loose fitting underwear allows the scrotum to pull the testes closer to the body to maintain proper temperature for sperm production or allow the testes to be farther from the body. Because the testes cannot produce viable sperm when temperatures are at or above body temperature, their location within the scrotal sac ensures optimal conditions. There is no evidence that the client cannot ride motorcycles. Taking a general multivitamin is encouraged for overall health. Daily sexual intercourse is not encouraged because it is most important to have sufficient sperm present during a female's ovulation period.
The nurse is caring for a client scheduled for a transrectal ultrasonography. Which instruction is essential in obtaining an accurate test?
- A. Self-administer an enema prior to arrival.
- B. Take a low-dose sedative prior to arrival.
- C. Avoid fluids after midnight.
- D. Empty the bladder prior to the exam.
Correct Answer: A
Rationale: The client will need to have an enema to remove stool from the rectum so that the ultrasound can penetrate through the tissues to visualize structures of the prostate. Typically, a sedative is not needed as the client uses normal relaxation techniques. Urine status is not the focus of the exam requiring that fluids be withheld. For the client's comfort, the nurse may encourage emptying the bladder before the exam.