Nokea
Which laboratory test should the nurse expect for the client to rule out the diagnosis of syphilis?
- A. Vaginal cultures.
- B. Rapid plasma reagin card test (RPR-CT).
- C. Gram-stained specimen of the urethral meatus.
- D. Immunological assay.
Correct Answer: B
Rationale: RPR-CT is a standard screening test for syphilis, detecting antibodies. Vaginal cultures, Gram stains, and immunological assays are not specific for syphilis.
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The 30-year-old male client diagnosed with germinal cell carcinoma of the testes asks the nurse, 'What chance do I have? Should I end it all now?' Which response by the nurse indicates an understanding of the disease process?
- A. God does not want you to give up hope and end it all now.'
- B. There is a good chance for survival with standard treatment options.'
- C. There may be little hope, but ending it all is not the answer.'
- D. You have a 50/50 chance of living for at least 5 years.'
Correct Answer: B
Rationale: Germinal cell carcinoma has a high cure rate with treatment (e.g., orchiectomy, chemotherapy), offering good survival chances. Religious references, pessimism, or vague statistics are less appropriate.
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 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.
The client who had a right modified radical mastectomy four (4) years before is being admitted for a cardiac work-up for chest pain. Which intervention is most important for the nurse to implement?
- A. Determine when the client had chemotherapy last.
- B. Ask the client if she received Adriamycin, an antineoplastic agent.
- C. Post a message at the HOB for staff not to use the right arm for venipunctures or BPs.
- D. Examine the chest wall for cancer sites.
Correct Answer: C
Rationale: Post-mastectomy, the affected arm is at risk for lymphedema; avoiding venipuncture or BP on that arm is critical. Chemotherapy history is less urgent, Adriamycin relates to cardiotoxicity but not immediate care, and chest wall exam is secondary.
On the basis of this client's age, which statement by the nurse is the best explanation for the client's discomfort?
- A. The pelvic muscles are more sensitive to pressure after menopause.
- B. The clitoris is unable to respond to sexual foreplay as women age.
- C. The vagina hypertrophies if intercourse is infrequent.
- D. The mucus-producing glands decrease with aging.
Correct Answer: D
Rationale: Postmenopausal vaginal dryness due to decreased mucus production is a common cause of painful intercourse in older women.