Nokea
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.
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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 female client has a mother who died from ovarian cancer and a sister diagnosed with ovarian cancer. Which recommendations should the nurse make regarding early detection of ovarian cancer?
- A. The client should consider having a prophylactic bilateral oophorectomy.
- B. The client should have a transvaginal ultrasound and a CA-125 laboratory test every six (6) months.
- C. The client should have yearly magnetic resonance imaging (MRI) scans.
- D. The client should have a biannual gynecological examination with flexible sigmoidoscopy.
Correct Answer: B
Rationale: High familial risk warrants transvaginal ultrasound and CA-125 every 6 months for early detection. Prophylactic oophorectomy is a personal choice, MRI is not standard, and sigmoidoscopy is unrelated.
The male client presents to the public health clinic complaining of joint pain and malaise. On assessment, the nurse notes a rash on the trunk, palms of the hands, and soles of the feet. Which action should the nurse implement next?
- A. Determine if the client has had a chancre sore within the last two (2) months.
- B. Ask the client how many sexual partners he has had in the past year.
- C. Refer the client to a dermatologist for a diagnostic work-up.
- D. Have the client provide a clean voided midstream urine specimen.
Correct Answer: A
Rationale: Joint pain, malaise, and a rash on palms/soles suggest secondary syphilis; confirming a prior chancre sore supports this diagnosis. Partner history, dermatology referral, and urine tests are less urgent.
Which breast palpation technique is most correct?
- A. Examine the breast while using the heel of the hand.
- B. Examine the breast while using the index finger only.
- C. Examine the breast while using the index finger and thumb.
- D. Examine the breast while using the pads of the fingertips.
Correct Answer: D
Rationale: Using the pads of the fingertips allows for better sensitivity to detect lumps or changes in breast tissue during palpation, making it the most effective technique for BSE.
When obtaining a sexual history from this client, which question is most important for the nurse to ask?
- A. Have you ever had a painless sore on your penis?
- B. Does any sex partner have similar symptoms?
- C. At what age did you first have sexual intercourse?
- D. When did you last have sexual intercourse?
Correct Answer: B
Rationale: Asking about partner symptoms helps identify potential sources of infection and guides contact tracing, critical for STI management.