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While assessing a male client with tertiary syphilis, which finding is most characteristic of this stage of the disease?
- A. Stabbing leg pain
- B. Red, raised rash
- C. Fever
- D. Patchy hair loss
Correct Answer: A
Rationale: Tertiary syphilis can cause neurological symptoms like tabes dorsalis, characterized by stabbing leg pain due to nerve damage.
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The female client presents to the gynecologist’s office for the fifth time with an ovarian cyst and is scheduled for an exploratory laparoscopy. The client asks the nurse, 'Why do I need to have another surgery? The other cysts have all been benign.' Which statement is the nurse’s best response?
- A. Because eventually the cysts will become cancerous.'
- B. All abnormal findings in the ovary should be checked out.'
- C. The surgery will not be painful and you will have peace of mind.'
- D. Are you afraid of having surgery? Would you like to talk about it?'
Correct Answer: B
Rationale: Persistent ovarian cysts require evaluation to rule out malignancy or complications, despite prior benign findings. Suggesting inevitable cancer is inaccurate, minimizing pain is dismissive, and addressing fear is secondary.
Which staff nurse is best suited to care for a client with a radioactive implant?
- A. A male nurse with oncology nursing experience
- B. A female nurse who has had a hysterectomy
- C. A male nurse whose mother died of cancer
Correct Answer: A
Rationale: Oncology experience equips the nurse to safely manage a client with a radioactive implant, regardless of gender or personal history.
The nurse is assessing the client diagnosed with a rectocele. Which signs and symptoms should the nurse expect? Select all that apply.
- A. Rectal pressure.
- B. Flatus.
- C. Fecal incontinence.
- D. Constipation.
- E. Urinary frequency.
Correct Answer: A,B,C,D
Rationale: Rectocele causes rectal pressure, flatus, fecal incontinence, and constipation due to posterior vaginal wall protrusion. Urinary frequency is more associated with cystocele.
The client is diagnosed with a rectovaginal fistula which is to be managed medically. Which information should the nurse teach the client prior to discharge?
- A. Douche with normal saline.
- B. Eat a low-residue diet.
- C. Keep ice packs to the area.
- D. Use an abdominal binder.
Correct Answer: B
Rationale: A low-residue diet reduces fecal output, aiding healing of a rectovaginal fistula. Douching risks infection, ice packs are ineffective, and binders are 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.