Nokea
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.
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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.
What information would the nurse give the client when the client inquires what makes breast milk production?
- A. Estrogen
- B. Progesterone
- C. Prolactin
- D. Testosterone
Correct Answer: C
Rationale: Prolactin promotes the production of breast milk. Estrogen secreted by the ovaries at the onset of puberty causes the development of the mammary system. Progesterone, secreted by the placenta, stimulates the development of alveoli, which secrete the milk. Testosterone does not impact milk production.
A nurse is caring for a client who is being evaluated for a lump found on the lateral aspect of the right breast. The client is anxious and asks the nurse if the next step is to have a mastectomy. Which is the nurse's best response?
- A. Yes, breast lumps are abnormal and will need to be removed.
- B. The doctor will need a biopsy first to see if the lump is cancerous.
- C. The doctor will answer your questions when he or she arrives.
- D. Many times, an ultrasound is done to distinguish between a tumor and cyst.
Correct Answer: D
Rationale: Ultrasonography is often used with a mammogram after a breast lump is found to provide additional data on the breast lump. An ultrasound can differentiate if the lump is a fluid-filled cyst or other types of breast lesions. This step may be used before a mastectomy is performed or even a biopsy is completed. The nurse is able to provide factual information on common treatment paths, understanding that it is the physician who prescribes the medical care.
The expert nurse is assisting a novice nurse insert a Foley catheter. The novice nurse has tried unsuccessfully to insert the catheter, and the expert nurse is providing verbal guidance while spreading which area to reveal the urethral opening?
- A. Labia majora and minora
- B. Meatus
- C. Clitoris
- D. Fourchette
Correct Answer: A
Rationale: The labia majora and minora are a portion of the external genitalia and when parted reveals the urethral opening. The meatus refers to an opening or passage. The clitoris is sensitive erectile tissue considered the site of sexual pleasure. The fourchette is the area beneath the vaginal opening at the base of the labia majora.
The nurse is assisting a 30-year-old client in scheduling an appointment for a cervical biopsy. The nurse would recommend that the client schedule the testing at which time?
- A. 1 week after completion of the client's menstrual cycle
- B. 2 weeks before the onset of the client's menstrual cycle
- C. 3 weeks after the onset of the client's menstrual cycle
- D. 2 weeks after the cessation of the client's menstrual cycle
Correct Answer: A
Rationale: Because the client is premenopausal, the nurse would recommend scheduling the cervical biopsy for 1 week after the end of a menstrual period, when the cervix is least vascular. Scheduling the test for any other time would be inappropriate.