The Client with Reproductivehealth Problems TEST
The Client with ReproductiveHealth Problems TEST
■The Client with Uterine Fibroids
■The Client with Breast Disease
■The Client with Benign Prostatic Hypertrophy
■The Client with a Sexually Transmitted Disease
■The Client with Cancer of the Cervix
■The Client with Cancer of the Ovaries
■The Client Having Gynecological Surgery
■The Client with Testicular Disease
■The Client with Cancer of the Prostate
■The Client with Erectile Dysfunction
■Managing Care Quality and Safety
■Answers, Rationales, and Test Taking Strategies
The Client with Breast Disease
23. A postmenopausal woman is worried about
pain in the upper outer quadrant of her left breast.
The nurse’s fi rstcourse of action is to:
■1. Do a breast examination and report the results
to the physician.
■2. Explain that pain is caused by hormonal fluctuations.
■3. Reassure the client that pain is not a symptom
of breast cancer.
■4. Teach the client the correct procedure for
breast self-examination (BSE).
24. The nurse teaches a female client that the
best time in the menstrual cycle to examine the
breasts is during the:
■1. Week that ovulation occurs.
■2. Week that menstruation occurs.
■3. First week after menstruation.
■4. Week before menstruation occurs.
The Client with Breast Disease
23. A postmenopausal woman is worried about
pain in the upper outer quadrant of her left breast.
The nurse’s fi rstcourse of action is to:
■1. Do a breast examination and report the results
to the physician.
■2. Explain that pain is caused by hormonal fluctuations.
■3. Reassure the client that pain is not a symptom
of breast cancer.
■4. Teach the client the correct procedure for
breast self-examination (BSE).
24. The nurse teaches a female client that the
best time in the menstrual cycle to examine the
breasts is during the:
■1. Week that ovulation occurs.
■2. Week that menstruation occurs.
■3. First week after menstruation.
■4. Week before menstruation occurs.
29. During the admission workup for a modified
radical mastectomy, the client is extremely anxious
and asks many questions. Which of the following
approaches would offer the best guide for the nurse
to answer questions raised by this apprehensive
preoperative client?
■1. Tell the client as much as she wants to know
and is able to understand.
■2. Delay discussing the client’s questions with
her until she is convalescing.
■3. Delay discussing the client’s questions with
her until her apprehension subsides.
■4. Explain to the client that she should discuss
her questions fi rst with the physician.
30. A client asks the nurse, “Where is cancer
usually found in the breast?” When responding to
the client, the nurse uses a diagram of a left breast
and indicates that most malignant tumors occur in
which quadrant of the breast?
■1. Upper outer quadrant.
■2. Upper inner quadrant.
■3. Lower outer quadrant.
■4. Lower inner quadrant.
31. Atropine sulfate is included in the preoperative
orders for a client undergoing a modified radical
mastectomy. The expected outcome is to:
■1. promote general muscular relaxation.
■2. decrease pulse and respiratory rates.
■3. decrease nausea.
■4. inhibit oral and respiratory secretions.
32. During the postoperative period after a modifi
ed radical mastectomy, the client confi des in the
nurse that she thinks she got breast cancer because
she had an abortion and she did not tell her husband.
The best response by the nurse is which of the
following?
■1. “Cancer is not a punishment; it is a disease.”
■2. “You might feel better if you confided in your
husband.”
■3. “Tell me more about your feelings on this.”
■4. “I can have the social worker talk to you if
you would like.”
33. Postoperatively after a modified radical
mastectomy, a client has an incisional drainage tube
attached to Hemovac suction. The nurse determines
the suction is effective when:
■1. The intrathoracic pressure is decreased and
the client breathes easier.
■2. There is an increased collateral lymphatic
flow toward the operative area.
■3. Accumulated serum and blood in the operative
area are removed.
■4. No adhesions are formed between the skin
and chest wall in the operative area.
34. Which of the following positions would be
best for a client’s right arm when she returns to her
room after a right modified radical mastectomy with
multiple lymph node excisions?
■1. Across her chest wall.
■2. At her side at the same level as her body.
■3. In the position that affords her the greatest comfort
without placing pressure on the incision.
■4. On pillows, with her hand higher than her
elbow and her elbow higher than her shoulder.
35. The client with breast cancer is prescribed
tamoxifen (Nolvadex) 20 mg daily. The client states
she does not like taking medicine and asks the nurse
if the tamoxifen is really worth taking. The nurse’s
best response is which of the following?
■1. “This drug is part of your chemotherapy program.”
■2. “This drug has been found to decrease metastatic
breast cancer.”
■3. “This drug will act as an estrogen in your
breast tissue.”
■4. “This drug will prevent hot fl ashes since you
cannot take hormone replacement.”
36. A client undergoing chemotherapy after a
modified radical mastectomy asks the nurse questions
about a breast prosthesis and wigs. After answering
the questions directly, the nurse should also:
■1. Provide a list of resources, including the local
breast cancer support group.
■2. Offer a referral to the social worker.
■3. Call the home health care agency.
■4. Contact the plastic surgeon.
37. A client is to have radiation therapy after
a modified radical mastectomy. The nurse should
teach the client to care for the skin at the site of
therapy by:
■1. Washing the area with water.
■2. Exposing the area to dry heat.
■3. Applying an ointment to the area.
■4. Using talcum powder on the area.
38. The nurse should teach a client that a normal
local tissue response to radiation is:
■1. Atrophy of the skin.
■2. Scattered pustule formation.
■3. Redness of the surface tissue.
■4. Sloughing of two layers of skin.
39. The nurse refers a client who had a mastectomy
to “Reach to Recovery.” The primary purpose
of the American Cancer Society’s Reach to Recovery
program is to:
■1. Foster rehabilitation in women who have had
mastectomies.
■2. Raise funds to support early breast cancer
detection programs.
■3. Provide free dressings for women who have
had radical mastectomies.
■4. Collect statistics for research from women
who have had mastectomies.
The Client with Benign Prostatic
Hypertrophy
40. A 72-year-old male is in the emergency
department because he has been unable to void for
the past 12 hours. The best method for the nurse to
use when assessing for bladder distention in a male
client is to check for:
■1. A rounded swelling above the pubis.
■2. Dullness in the lower left quadrant.
■3. Rebound tenderness below the symphysis.
■4. Urine discharge from the urethral meatus.
41. During a client’s urinary bladder catheterization,
the nurse ensures that the bladder is emptied
gradually. The best rationale for the nurse’s action is
that completely emptying an overdistended bladder
at one time tends to cause:
■1. Renal failure.
■2. Abdominal cramping.
■3. Possible shock.
■4. Atrophy of bladder musculature.
42. The primary reason for lubricating the urinary
catheter generously before inserting it into a
male client is that this technique helps reduce:
■1. Spasms at the orifice of the bladder.
■2. Friction along the urethra when the catheter
is being inserted.
■3. The number of organisms gaining entrance to
the bladder.
■4. The formation of encrustations that may
occur at the end of the catheter.
43. The primary reason for taping an indwelling
catheter laterally to the thigh of a male client
is to:
■1. Eliminate pressure at the penoscrotal angle.
■2. Prevent the catheter from kinking in the urethra.
■3. Prevent accidental catheter removal.
■4. Allow the client to turn without kinking the
catheter.
44. Many older men with prostatic hypertrophy
do not seek medical attention until urinary obstruction
is almost complete. One reason for this delay in
seeking attention is that these men may:
■1. Feel too self-conscious to seek help when
reproductive organs are involved.
■2. Expect that it is normal to have to live
with some urinary problems as they grow
older.
■3. Fear that sexual indiscretions in earlier life
may be the cause of their problem.
■4. Have little discomfort in relation to the
amount of pathology because responses to
pain stimuli fade with age.
45. When caring for a client with a history of
benign prostatic hypertrophy (BPH), the nurse
should do which of the following? Select all that
apply.
■1. Provide privacy and time for the client to void.
■2. Monitor intake and output.
■3. Catheterize the client for post void residual
urine.
■4. Ask the client if he has urinary retention.
■5. Test the urine for hematuria.
46. The nurse should specifically assess a client
with prostatic hypertrophy for which of the following ?
■1. Voiding at less frequent intervals.
■2. Difficulty starting the flow of urine.
■3. Painful urination.
■4. Increased force of the urine stream.
47. The nurse is reviewing the medication history
of a client with benign prostatic hypertrophy
(BPH). Which medication will likely aggravate BPH?
■1. Metformin (Glucophage).
■2. Buspirone (BuSpar).
■3. Inhaled ipratropium (Atrovent).
■4. Ophthalmic timolol (Timoptic).
48. A client is scheduled to undergo transurethral
resection of the prostate. The procedure is to
be done under spinal anesthesia. Postoperatively,
the nurse should assess the client for:
■1. Seizures.
■2. Cardiac arrest.
■3. Renal shutdown.
■4. Respiratory paralysis.
49. A client with benign prostatic hypertrophy
(BPH) is being treated with terazosin (Hytrin) 2 mg
at bedtime. The nurse should monitor the client’s:
■1. Urine nitrites.
■2. White blood cell count.
■3. Blood pressure.
■4. Pulse.
50. A client underwent transurethral resection of
the prostate (TURP), and a large three-way indwelling
urinary catheter was inserted in the bladder
with continuous bladder irrigation. In which of the
following circumstances should the nurse increase
the flow rate of the continuous bladder irrigation?
■1. When drainage is continuous but slow.
■2. When drainage appears cloudy and dark yellow.
■3. When drainage becomes bright red.
■4. When there is no drainage of urine and irrigating
solution.
51. A client is to receive belladonna and opium
suppositories, as needed, postoperatively after
transurethral resection of the prostate (TURP). The
nurse should give the client these drugs when he
demonstrates signs of:
■1. A urinary tract infection.
■2. Urine retention.
■3. Frequent urination.
■4. Pain from bladder spasms.
52. A nursing assistant tells the nurse, “I think
the client is confused. He keeps telling me he has to
void, but that isn’t possible because he has a catheter
in place that is draining well.” Which of the
following responses would be most appropriate for
the nurse to make?
■1. “His catheter is probably plugged. I’ll irrigate
it in a few minutes.”
■2. “That’s a common complaint after prostate
surgery. The client only imagines the urge to
void.”
■3. “The urge to void is usually created by the
large catheter, and he may be having some
bladder spasms.”
■4. “I think he may be somewhat confused.”
53. A physician has ordered amoxicillin 100
P.O. BID (Ampicillin). The nurse should teach the
client to: Select all that apply.
■1. Drink 2,500 mL of fluids daily.
■2. Void frequently, at least every 2 to 3 hours.
■3. Take time to empty the bladder completely.
■4. Take the last dose of the antibiotic for the day
at bedtime.
■5. Take the antibiotic with food.
54. In discussing home care with a client after
transurethral resection of the prostate (TURP), the
nurse should teach the male client that dribbling of
urine:
■1. Can be a chronic problem.
■2. Can persist for several months.
■3. Is an abnormal sign that requires intervention.
■4. Is a sign of healing within the prostate.
55. A priority nursing diagnosis for the client
who is being discharged to home 3 days after transurethral
resection of the prostate (TURP) is:
■1. Deficientfluid volume.
■2. Imbalanced nutrition: Less than body requirements.
■3. Impaired tissue integrity.
■4. Ineffective airway clearance.
56. A client with benign prostatic hypertrophy
(BPH) has an elevated prostate-specifi c antigen
(PSA) level. The nurse should?
■1. Instruct the client to have a colonoscopy
before coming to conclusions about the PSA
results.
■2. Instruct the client that a urologist will monitor
the PSA level biannually when elevated.
■3. Determine if the prostatic palpation was done
before or after the blood sample was drawn.
■4. Ask the client if he emptied his bladder
before the blood sample was obtained.
The Client with Testicular Disease
98. A 28-year-old male is diagnosed with acute
epididymitis. The nurse should assess the client for:
■1. Burning and pain on urination.
■2. Severe tenderness and swelling in the scrotum.
■3. Foul-smelling ejaculate.
■4. Foul-smelling urine.
99. A 20-year-old client is being treated for
epididymitis. Teaching for this client should include
the fact that epididymitis is commonly a result of a:
■1. Virus.
■2. Parasite.
■3. Sexually transmitted infection.
■4. Protozoon.
100. When teaching a client to perform testicular
self-examination, the nurse explains that the examination
should be performed:
■1. After intercourse.
■2. At the end of the day.
■3. After a warm bath or shower.
■4. After exercise.
101. The nurse is assessing a client’s testes. Which
of the following fi ndings indicate the testes are
normal?
■1. Soft.
■2. Egg-shaped.
■3. Spongy.
■4. Lumpy.
102. A client has a testicular nodule that is highly
suspicious for testicular cancer. A laboratory test
that supports this diagnosis is:
■1. Decreased alpha fetoprotein (AFP).
■2. Decreased beta–human chorionic gonadotropin
(hCG).
■3. Increased testosterone.
■4. Increased AFP.
103. Although the cause of testicular cancer is
unknown, it is associated with a history of:
■1. Undescended testes.
■2. Sexual relations at an early age.
■3. Seminal vesiculitis.
■4. Epididymitis.
104. Risk factors associated with testicular malignancies
include:
■1. African-American race.
■2. Residing in a rural area.
■3. Lower socioeconomic status.
■4. Age older than 40 years.
105. A client with a testicular malignancy undergoes
a radical orchiectomy. In the immediate postoperative
period the nurse should particularly
assess the client for:
■1. Bladder spasms.
■2. Urine output.
■3. Pain.
■4. Nausea.
106. A right orchiectomy is performed on a client
with a testicular malignancy. The client expresses
concerns regarding his sexuality. The nurse should
base the response on the knowledge that the client:
■1. Is not a candidate for sperm banking.
■2. Should retain normal sexual drive and function.
■3. Will be impotent.
■4. Will have a change in secondary sexual characteristics.
107. A client diagnosed with seminomatous testicular
cancer expresses fear and questions the nurse
about his prognosis. The nurse should base the
response on the knowledge that:
■1. Testicular cancer is almost always fatal.
■2. Testicular cancer has a cure rate of 90% when
diagnosed early.
■3. Surgery is the treatment of choice for testicular
cancer.
■4. Testicular cancer has a 50% cure rate when
diagnosed early.
The Client with Cancer
of the Prostate
108. The nurse is developing a program about
prostate cancer for a health fair. The nurse should
provide information about which of the following
topics?
■1. The Prostate-Specifi c Antigen (PSA) test is reliable
for detecting the presence of prostate cancer.
■2. For all men, age 50 and older, the American
Cancer Society recommends an annual rectal
examination.
■3. Avoid lifting more than 20 lb aids in prevention
of prostate cancer.
■4. Regular sexual activity promotes health of the
prostate gland to prevent cancer.
109. The nurse is caring for a client who will
have a bilateral orchiectomy. The client asks what
is involved with this procedure. The nurse’s most
appropriate response would be? “The surgery:
■1. Removes the entire prostate gland, prostatic
capsule, and seminal vesicles.”
■2. Tends to cause urinary incontinence and
impotence.”
■3. Freezes prostate tissue, killing cells.”
■4. Results in reduction of the major circulating
androgen, testosterone.”
110. The nurse is teaching a client newly diagnosed
with prostate cancer. Which of the following points
should be included in the instruction? Select all that
apply.
■1. Prostate cancer is usually multifocal and
slow-growing.
■2. Most prostate cancers are adenocarcinoma.
■3. The incidence of prostate cancer is higher
in African American men, and the onset is
earlier.
■4. A prostate specifi c antigen (PSA) lab
test greater than 4 ng/mg will need to be
monitored.
■5. Cancer cells are detectable in the urine.
111. When a client is receiving hormone replacement
for prostate cancer, the nurse should do which
of the following? Select all that apply.
■1. Inform the client that increased libido is
expected with hormone therapy.
■2. Reassure the client and his significant other
that erectile dysfunction will not occur as a
consequence of hormone therapy.
■3. Provide the client the opportunity to communicate
concerns and needs.
■4. Utilize communication strategies that
enable the client to gain some feeling of
control.
■5. Suggest that an appointment be made to see a
psychiatrist.
112. A client asks the nurse why the prostate
specifi c antigen (PSA) level is determined before the
digital rectal examination. The nurse’s best response
is which of the following?
■1. “It is easier for the client.”
■2. “A prostate examination can possibly
decrease the PSA.”
■3. “A prostate examination can possibly
increase the PSA.”
■4. “If the PSA is normal, the client will not have
to undergo the rectal examination.”
113. The nurse is performing a digital rectal
examination. Which of the following fi nding is a
key sign for prostate cancer?
■1. A hard prostate, localized or diffuse.
■2. Abdominal pain.