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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.
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Which of the following questions should the nurse ask when assessing a patient who has a history of benign prostatic hyperplasia (BPH)?
- A. Have you noticed any unusual discharge from your penis?
- B. Has there been any change in your sex life in the last year?
- C. Do you find it hard to initiate your urinary stream?
- D. Have you been experiencing any difficulty in achieving an erection?
Correct Answer: C
Rationale: Enlargement of the prostate blocks the urethra, leading to urinary changes. Benign prostatic hyperplasia is a common problem of older men. It can alter normal urination, causing retention and difficulty in initiating the urinary stream. The other questions address possible problems with infection or sexual difficulties but would not be helpful in determining whether there were functional changes caused by BPH.
The nurse is providing teaching to a patient who is having an endometrial biopsy. 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: C
Rationale: An endometrial biopsy may cause mild abdominal cramping after the procedure due to uterine manipulation. IV contrast is not used, and there is no need for a driver or to drink fluids beforehand.
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 assessing a patient who has amenorrhea with a weight of 41 kg. The patient makes all of the following statements. Which one indicates a need for immediate teaching by the nurse?
- A. I have not been able to eat much at all for the past three months.
- B. I drink at least three glasses of nonfat milk daily.
- C. I am not sexually active but currently have a boyfriend.
- D. I was recently treated for a sexually transmitted infection.
Correct Answer: A
Rationale: Not being able to eat much at all for the past three months indicates that the patient may be experiencing anorexia. Anorexia can cause amenorrhea. The other statements by the patient do not suggest any urgent teaching needs.
The nurse is assessing a patient in the Sexual Health Clinic who has a positive Venereal Disease Research Laboratory (VDRL) test, but no chancre is noted. The nurse should plan to send the specimens for which of the following tests?
- A. Gram stain
- B. Cytological studies
- C. Rapid plasma reagin (RPR) agglutination
- D. Fluorescent treponemal antibody absorption (FTA-ABS)
Correct Answer: D
Rationale: Since false positives are common with VDRL and RPR testing, FTA-ABS testing is recommended to confirm a diagnosis of syphilis. Gram staining is used for other sexually transmitted infections (STIs) such as gonorrhea and chlamydia, and cytological studies are used to detect abnormal cells (such as neoplastic cells).