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When obtaining a sexual history from this client, which question is most important for the nurse to ask?
- A. Have you ever had a painless sore on your penis?
- B. Does any sex partner have similar symptoms?
- C. At what age did you first have sexual intercourse?
- D. When did you last have sexual intercourse?
Correct Answer: B
Rationale: Asking about partner symptoms helps identify potential sources of infection and guides contact tracing, critical for STI management.
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The client diagnosed with testicular cancer is scheduled for a unilateral orchiectomy. Which information is important to teach regarding sexual functioning?
- A. The client will have ejaculation difficulties after the surgery.
- B. The client will be prescribed male hormones following the surgery.
- C. The client may need to have a penile implant to be able to have intercourse.
- D. Libido and orgasm usually are unimpaired after this surgery.
Correct Answer: D
Rationale: Unilateral orchiectomy typically preserves libido and orgasm, as one testis maintains hormonal function. Ejaculation issues, hormone therapy, or penile implants are not standard post-surgery.
Which breast palpation technique is most correct?
- A. Examine the breast while using the heel of the hand.
- B. Examine the breast while using the index finger only.
- C. Examine the breast while using the index finger and thumb.
- D. Examine the breast while using the pads of the fingertips.
Correct Answer: D
Rationale: Using the pads of the fingertips allows for better sensitivity to detect lumps or changes in breast tissue during palpation, making it the most effective technique for BSE.
Which steps should the nurse provide clients who choose to perform breast self-examination (BSE) according to the American Cancer Society (ACS) guidelines? Rank in order of performance.
- A. Lie flat on the bed with a rolled towel placed under the scapula; perform palpation of each breast.
- B. Pinch each nipple to see if fluid can be expressed.
- C. With the breasts exposed, stand in front of a mirror and examine the breasts from front and each side.
- D. In the shower, soap the breasts, and perform palpation in a systematic manner on each breast.
- E. Find a private place where the self-examination can be performed.
Correct Answer: E,C,A,D,B
Rationale: ACS BSE steps: 1) Find a private place; 2) Visually inspect in mirror (front/sides); 3) Palpate lying down with towel; 4) Palpate in shower; 5) Check nipples for discharge.
The client has undergone a wedge resection for cancer of the left breast. Which discharge instruction should the nurse teach?
- A. Don't lift more than five (5) pounds with the left hand until released by the HCP.
- B. The cancer has been totally removed and no follow-up therapy will be required.
- C. The client should empty the Hemovac drain about every 12 hours.
- D. The client should arrange an appointment with a plastic surgeon for reconstruction.
Correct Answer: A
Rationale: Limiting lifting with the affected arm prevents strain and lymphedema risk post-wedge resection. Claiming cancer is fully removed is misleading, Hemovac drains are uncommon in lumpectomy, and reconstruction is not universally needed.
The nurse in the gynecology clinic is assessing a 14-year-old client who reports being sexually active. Which information should the nurse teach the client? Select all that apply.
- A. Inform the client that the nurse must tell the parents of her being sexually active.
- B. Teach the client about possible birth control options.
- C. Instruct the client regarding sexually transmitted disease.
- D. Demonstrate how a condom is applied correctly.
- E. Tell the client the importance of finishing all antibiotics.
- F. Discuss the importance of attending parenting classes.
Correct Answer: B,C,D
Rationale: Teaching birth control, STD prevention, and condom use empowers the sexually active teen. Parental notification depends on jurisdiction, antibiotics are irrelevant without infection, and parenting classes are premature.