Question 1

On the fourth postoperative day after a modified radical mastectomy,the nurse finds the patient with her back to the nurse.She is crying and tells the nurse she feels ugly and is worried that her husband will not be in love with her anymore.The nurse bases subsequent nursing interventions on what diagnosis?

Accepted Answer

After losing a breast,many patients experience grief over the loss of a body part.The process of grieving is essential for personal adaptation to the loss.The nurse can assist the patient to find helpful coping mechanisms.

Question 2

Why is a mammogram the most useful method of diagnosing breast cancer?

Accepted Answer

Mammography is radiography of the soft tissue of the breast to allow identification of various benign and neoplastic processes,especially those not palpable on physical examination.

Question 3

Which patient is most at risk for the infection of epididymitis?

Accepted Answer

Symptoms can occur after trauma to the genital area,after instrumentation of the urethra and cystoscopy,and after physical exertion or prolonged sexual activity.

Question 4

Which condition would prevent the use of a vaginal hysterectomy?

Accepted Answer

In the case of large uterine fibroids,a vaginal hysterectomy is not an option.

Question 5

A 20-year-old patient presents in the emergency room with a temperature of 103° F,blood pressure of 92/58,headache,and desquamation of both palms.What should the nurse make sure to ask about during the interview?

Accepted Answer

These are signs of toxic shock frequently brought on by leaving a tampon in place too long.The nurse should inquire about tampon use,headache,muscle pain,and fatigue.

Question 6

What is the recommended age range for a baseline mammogram?

Accepted Answer

The American Cancer Society recommends that mammograms be performed on women between 35 and 39,and annually for women 40 years of age and older.

Question 7

What instruction should a nurse give a patient with congenital herpes who does not have lesions at the present?

Accepted Answer

Sexual transmission of HSV (genital herpes,a virus)has been documented even in the absence of clinical lesions,and the use of condoms should be encouraged.Acyclovir does not cure the disease but makes the attacks less virulent.

Question 8

At what age should a male be taught testicular self-examination (TSE)?

Accepted Answer

Young men should be taught to perform TSE monthly beginning at 15 years of age.

Question 9

Why would the nurse encourage the patient who is recovering from a modified radical mastectomy to exercise the affected arm?

Accepted Answer

An exercise regimen,built up gradually,can help reduce lymphedema following a modified radical mastectomy.

Question 10

A patient,age 26,has had a tubal insufflation (Rubin test)to ascertain whether her fallopian tubes are patent.She complains of pain in her right shoulder.Which response is most appropriate?

Accepted Answer

The Rubin insufflation test determines tubal patency.Carbon dioxide escapes into the abdominal cavity through the patent left fallopian tube.

Question 11

The nurse provides discharge teaching for a patient regarding her activity level as she recovers from her modified radical mastectomy.Which statement by her indicates to the nurse that the teaching has been successful?

Accepted Answer

The patient should be instructed to avoid sleeping on the involved arm.

Question 12

Which statement made by a patient who has been taught the technique of testicular self-examination indicates the need for further teaching?

Accepted Answer

It is not recommended for a patient to perform a testicular self-examination after every ejaculation.Perform testicular self-examination after a bath or shower when the scrotum is warm and most relaxed.The testes should feel smooth and be firm to the touch.The epididymis feels like a soft tube.

Question 13

A Gram stain smear of the patient's discharge reveals the presence of N.gonorrhoeae.He tells the nurse that he had sexual contact with a new girlfriend but does not think he was exposed to gonorrhea because she did not appear to have any disease.Which information should the nurse include in response to his comment?

Accepted Answer

Most women remain asymptomatic but may show a greenish-yellow discharge from the cervix.

Question 14

A patient,age 41,has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis.She asks the nurse if she will have "hot flashes." What knowledge will guide the nurse's response?

Accepted Answer

A total abdominal hysterectomy with bilateral salpingo-oophorectomy is the removal of the uterus,fallopian tubes,and ovaries.If the ovaries are removed in these surgeries,the surgery will induce menopause and hot flashes may occur.

Question 15

What does the diagnosis of secondary infertility refer to?

Accepted Answer

Secondary infertility refers to a woman who has conceived in the past and now is unable to do so.

Question 16

On the second postoperative day,a patient who has had an abdominal hysterectomy complains of gas and abdominal distention.Which intervention would be most appropriate to stimulate a bowel movement?

Accepted Answer

Early ambulation is very helpful to return the bowel to normal function.

Question 17

The patient who had a colporrhaphy for the repair of a cystocele and rectocele asks that the catheter be removed as it is bothersome to her.How should the nurse explain the reason for the catheter?

Accepted Answer

A retention catheter is usually inserted into the bladder to keep it empty and prevent pressure on sutures.

Question 18

The 10-year-old clinic patient reports that she is free of gonorrhea and can now engage in sexual activity.Which response is most appropriate?

Accepted Answer

No case of gonorrhea is considered cured until you have had three consecutive negative cervical smears.The RPR and the VDRL are tests for syphilis.

Question 19

A female patient,age 48,is undergoing a routine physical examination for the first time in 5 years.Which procedure would be included in this examination?

Accepted Answer

The American Cancer Society recommends that all women who are or have been sexually active or who are at least 18 years of age have an annual Pap smear for 3 consecutive years and then every 3 years until middle age.

Question 20

The young husband of a patient who has been scheduled for a hysterectomy because of the discovery of ovarian cancer in both ovaries says to the nurse,"Please go talk to my wife.She is real upset and says she won't be a 'woman' anymore." What is the nurse's most therapeutic response?

Accepted Answer

Assisting patients with recognizing and clarifying fears and with developing coping strategies for those fears by listening is helpful.

Quiz 12: Care of the Patient with a Reproductive Disorder