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Which is the American Cancer Society’s recommendation for the early detection of cancer of the prostate?
- A. A yearly PSA level and DRE beginning at age 50.
- B. A biannual rectal examination beginning at age 40.
- C. A semiannual alkaline phosphatase level beginning at age 45.
- D. A yearly urinalysis to determine the presence of prostatic fluid.
Correct Answer: A
Rationale: ACS recommends yearly PSA and DRE starting at age 50 for average-risk men. Biannual DRE, alkaline phosphatase, and urinalysis are not standard for prostate cancer screening.
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The client who is scheduled to have a breast biopsy with sentinel node dissection states, 'I don't understand. What does a sentinel node biopsy do?' Which scientific rationale should the nurse use to base the response?
- A. A dye is injected into the tumor and traced to determine spread of cells.
- B. The surgeon removes the nodes that drain the diseased portion of the breast.
- C. The nodes felt manually will be removed and sent to pathology.
- D. A visual inspection of the lymph nodes will be made while the client is sleeping.
Correct Answer: A
Rationale: Sentinel node biopsy involves injecting dye to identify the first lymph node(s) draining the tumor, assessing cancer spread. Removing all draining nodes is outdated, manual palpation is not specific, and visual inspection alone is insufficient.
Which assessment findings recorded by the nurse indicate high risk factors for developing breast cancer? Select all that apply.
- A. The client began menstruating before age 12.
- B. The client had three full-term pregnancies.
- C. The client has a very large breast.
- D. The client has had radiation treatment to the chest.
- E. The client has had breast implants.
Correct Answer: A,D
Rationale: Early menarche (before age 12) and chest radiation exposure are established risk factors for breast cancer due to prolonged estrogen exposure and DNA damage, respectively. Multiple pregnancies reduce risk, and breast size or implants are not significant risk factors.
Which question is most important for the nurse to ask the client with a cystocele who is scheduled to have a pessary inserted?
- A. Do you know if you are allergic to latex?'
- B. When did you start having incontinence?'
- C. When was your last bowel movement?'
- D. Are you experiencing any pelvic pressure?'
Correct Answer: A
Rationale: Latex allergies are critical to assess before pessary insertion, as many pessaries are latex-based, risking anaphylaxis. Incontinence history, bowel movements, and pelvic pressure are relevant but secondary to safety.
The outpatient clinic nurse is working with clients diagnosed with sexually transmitted diseases (STD). Which long-term complication should the nurse discuss with the clients about STDs?
- A. Stress the need for clients to completely finish all antibiotics prescriptions.
- B. Inform the clients that, legally, many STIs must be reported to the health department.
- C. Sexually transmitted diseases can result in reproductive problems.
- D. Discuss the myth that acquired immunodeficiency syndrome is an STI.
Correct Answer: C
Rationale: STDs like chlamydia and gonorrhea can cause infertility or ectopic pregnancy, a critical long-term complication. Antibiotic completion, reporting, and AIDS myths are important but not complications.
The client diagnosed with uterine cancer is complaining of lower back pain and unilateral leg edema. Which statement best explains the scientific rationale for these signs/symptoms?
- A. This is expected pain for this type of cancer.
- B. This means the cancer has spread to other areas of the pelvis.
- C. The pain is a result of the treatment of uterine cancer.
- D. Radiation treatment always causes some type of pain in the region.
Correct Answer: B
Rationale: Lower back pain and leg edema suggest pelvic lymph node involvement or metastasis, indicating cancer spread. Expected pain is vague, and treatment or radiation is less likely the cause.