Nokea
Which instruction is most appropriate if a Papanicolaou (Pap) smear will be obtained at the time of the pelvic examination?
- A. Avoid douching for several days before your appointment.
- B. Stop using any and all forms of contraception temporarily.
- C. Drink at least 1 quart of liquid an hour before your appointment.
- D. Avoid having sexual intercourse for a week before the test.
Correct Answer: A
Rationale: Douching can wash away cervical cells, leading to inaccurate Pap smear results, so it should be avoided for several days prior to the test.
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If the client chooses to perform breast self-examination (BSE), which statement demonstrates the best understanding of when BSE should be performed?
- A. I will perform a BSE on a weekly basis.
- B. I will perform a BSE every 6 months.
- C. I will perform a BSE 1 week before my period begins.
- D. I will perform a BSE 3 to 7 days after my period ends.
Correct Answer: D
Rationale: BSE is best performed 3 to 7 days after the menstrual period ends when breasts are least likely to be tender or swollen, ensuring a more accurate examination.
The client who has had a mastectomy tells the nurse, 'My husband will leave me now since I am not a whole woman anymore.' Which response by the nurse is most therapeutic?
- A. You're afraid your husband will not find you sexually appealing?'
- B. Your husband should be grateful you will be able to live and be with him.'
- C. Maybe your husband would like to attend a support group for spouses.'
- D. You don't know that is true. You need to give him a chance.'
Correct Answer: A
Rationale: Reflecting the client’s fear validates her emotions and encourages discussion, a therapeutic approach. Gratitude dismisses feelings, support groups are premature, and reassurance without exploration is less effective.
When carrying out this intervention, which action is most appropriate?
- A. Apply ice to the site in a sealed plastic bag.
- B. Place a covered ice pack to the scrotum.
- C. Position the client on a hypothermia blanket.
- D. Seat the client on an ice-filled ring.
Correct Answer: B
Rationale: A covered ice pack reduces swelling and pain in the scrotum safely and effectively post-hydrocele aspiration.
The client had a mastectomy for cancer of the breast and asks the nurse about a TRAM flap procedure. Which information should the nurse explain to the client?
- A. The surgeon will insert a saline-filled sac under the skin to simulate a breast.
- B. The surgeon will pull the client's own tissue under the skin to create a breast.
- C. The surgeon will use tissue from inside the mouth to make a nipple.
- D. The surgeon can make the breast any size the client wants the breast to be.
Correct Answer: B
Rationale: TRAM flap uses abdominal tissue for breast reconstruction. Saline sacs describe implants, mouth tissue isn’t used for nipples, and breast size is limited by available tissue.
The postmenopausal client reveals it has been several years since her last gynecological examination and states, 'Oh, I don’t need exams anymore. I am beyond having children.' Which statement should be the nurse’s response?
- A. As long as you are not sexually active, you don’t have to worry.'
- B. You should be taking hormone replacement therapy now.'
- C. You are beyond bearing children. How does that make you feel?'
- D. There are situations other than pregnancy that should be checked.'
Correct Answer: D
Rationale: Postmenopausal women need gynecological exams to screen for cancers (e.g., endometrial, ovarian). Sexual activity is irrelevant, HRT is not mandatory, and feelings are secondary to health education.