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When scheduling a pelvic examination and Pap test, which of the following instructions should the nurse include?
- A. Shower, but not a tub bath, before the examination.
- B. Do not have sexual intercourse the day before the Pap.
- C. Plan to have the Pap test just after her menstrual period.
- D. Avoid douching for at least 24 hours before the examination.
Correct Answer: D
Rationale: The results of a Pap test may be affected by douching, which can remove cells from the cervix. The patient may shower or take a bath before the examination, and sexual intercourse or timing relative to the menstrual period do not significantly impact the results.
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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.
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.
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.
The nurse is performing a physical assessment on a male patient and obtains this information. Which of the following findings is most important to report to the health care provider?
- A. One testis hangs lower than the other
- B. Inguinal lymph nodes are nonpalpable
- C. Genital hair distribution is diamond shaped
- D. Clear penile discharge is present at the meatus
Correct Answer: D
Rationale: Clear penile discharge may be indicative of a sexually transmitted infection (STI). The other findings are normal and do not need to be reported.
The nurse is providing teaching to a patient who is having an abdominal ultrasound to evaluate pelvic pain. Which of the following instructions should the nurse include?
- A. Plan to have someone drive you home after the procedure.
- B. Receive IV contrast solution during the procedure.
- C. Expect mild abdominal cramps after the procedure.
- D. Drink several glasses of fluids before the procedure.
Correct Answer: D
Rationale: A full bladder is needed for many ultrasound procedures, so the nurse will have the patient drink fluids before arriving for the ultrasound. The other instructions are not accurate for this procedure.