MULTIDIMENSIONAL CARE 3 FINAL EXAM 2023 -2024 /MDC3 FINAL EXAM LATEST 2023 REAL EXAM QUES, Exams of Nursing

Download MULTIDIMENSIONAL CARE 3 FINAL EXAM 2023 -2024 /MDC3 FINAL EXAM LATEST 2023 REAL EXAM QUES and more Exams Nursing in PDF only on Docsity! 1 points 1 points 1 points MDC3 Exam - Lecture notes 1-4 1. Which action would the nurse teach to help the patient prevent vulvovaginitis? a Wear loose cotton underwear. . b Use feminine hygiene sprays to avoid odor. . c Cleanse the inner labial mucosa with soap . and water. d Wipe back to front after urination. . Q U ESTIO N 2 1. The nurse is educating a patient on the prevention of toxic shock syndrome (TSS). Which statement by the patient indicates a lack of understanding? a “It is best if I wash my hands before inserting the . tampon.” b “At night, I should use a feminine pad rather than a . tampon.” c “I need to change my tampon every 8 hours . during the day.” d “If I don’t use tampons, I should not get TSS.” . Q U ESTIO N 3 1. A patient is admitted to the emergency department with toxic shock syndrome. Which action by the nurse is the most important? a Remove the tampon as the source of . infection. b Transfuse the patient to manage low blood count. . c Collect a blood specimen for culture and sensitivity. . d Administer IV fluids to maintain fluid and electrolyte . balance. Q U ESTIO N 4 1. A 55-year-old postmenopausal woman reports a history of dyspareunia, backache, pelvis pressure, urinary tract infections, and a frequent urinary urgency. Which condition does the nurse suspect? a Cystocel . e b Fibroid . c Rectocele 1 points 1 points 1 points 1 points d Ovarian . cyst Q U ESTIO N 5 1. The nurse is caring for a postoperative patient following an anterior colporrhaphy. What action can be delegated to the unlicensed assistive personnel (UAP)? a Teaching the patient to avoid lifting her 4-year-old . grandson b Reviewing the hematocrit and hemoglobin results . c.Drawing a shallow hot bath for comfort . measures d Assessing the level of pain and any drainage . Q U ESTIO N 6 1. A nurse is caring for four postoperative patients who each had a total abdominal hysterectomy. Which patient would the nurse assess first upon initial rounding? a Patient who has pain of “4” on a scale of 0 to 10 . b Patient with a temperature of 99° F (37.2° C) and blood pressure of . 115/73 mm Hg c Patient who has had two saturated perineal pads in the . last 2 hours d Patient with a urinary catheter output of 150 mL in the last 3 . hours Q U ESTIO N 7 1. A patient has undergone a vaginal hysterectomy with a bilateral salpingo-oophorectomy. She is concerned about a loss of libido. What intervention by the nurse would be best? a Teach that estrogen cream inserted . vaginally may help. b Suggest increasing vitamins and supplements . daily. c Discuss the value of a balanced diet and exercise. . d Reinforce that weight gain may be inevitable. . Q U ESTIO N 8 1 points 1 points 1 points e “Now that I have time off from work, I can return to my . exercise routine next week.” Q U ESTIO N 15 1. The nurse is taking the history of a 24-year-old patient diagnosed with cervical cancer. What possible risk factors would the nurse assess? (Select all that apply.) a Poor diet . b Nulliparity . c Multiple sexual partners . d Younger than 18 at first . intercourse e Smoking . Q U ESTIO N 16 1. A patient is scheduled to start external beam radiation therapy (EBRT) for her endometrial cancer. Which teaching by the nurse is accurate? (Select all that apply.) a “It is not wise to stay out in the sun for long . periods of time.” b “Your skin needs to be inspected daily for any . breakdown.” c “The perineal area may become damaged with . the radiation.” d “The technician applies new site markings before each . treatment.” e “You will need to be hospitalized during this therapy.” . Q U ESTIO N 17 1. The nurse is teaching a patient who is undergoing brachytherapy about what to immediately report to her healthcare provider. Which signs and symptoms would be included in this teaching? (Select all that apply.) a Temperature of 99° F . (37.2° C) b Visible blood in the . urine c Heavy vaginal bleeding . d Constipation for 3 days . 1 points 1 points 1 points e Abdominal pain . Q U ESTIO N 18 1. A postmenopausal patient is experiencing low back and pelvic pain, fatigue, and bloody vaginal discharge. What laboratory tests would the nurse expect to see ordered for this patient if endometrial cancer is suspected? (Select all that apply.) a White blood cell (WBC) count . b Prothrombin time (PT) . c Hemoglobin and hematocrit . (H&H) d Cancer antigen-125 (CA- . 125) e International normalized ratio . (INR) Q U ESTIO N 19 1. A patient has recurrent vulvovaginitis. Which statements by the patient indicate a need for further teaching? (Select all that apply.) a “I should not douche or use feminine hygiene . sprays.” b “I need to take all of my antibiotics as . prescribed.” c “I can take a long, hot bath to relieve . itching.” d “I should avoid having sex until my infection . is gone.” e “I should use antibacterial soap to . clean the area.” Q U ESTIO N 20 1. The nurse is doing home care teaching for a patient who has undergone cryotherapy. Which statements by the patient indicate a correct understanding of the instructions? (Select all that apply.) a “There should be little or no discomfort.” . b “I should shower rather than take a tub bath.” . c “There may be a lot of bleeding for a few days.” . d “I should not use tampons, douche, or have . sexual activity.” 1 points e “I can resume my weight-lifting exercise class . tomorrow.” Q U ESTIO N 21 1. A patient who had a hysterectomy has a 200-mg dose of ciprofloxacin (Cipro) ordered to infuse in 30 minutes. At what rate would the nurse infuse the medication if the pharmacy provides 200 mg in a 100-mL bag of normal saline? (Record your answer using a whole number.) mL/hr 200 1 donation for someone needing a skin transplant. . 2 reconstruction. . 3 suturing to the chest wall. . 4 possible use for other skin disorders. . 1 points QUESTION 8 1. The nurse teaching a young women’s community service group about breast self-examination (BSE) will include that 1 annual mammograms should be scheduled in addition to . BSE. 2 performing BSE after the menstrual period is more . comfortable. 3 BSE should be done daily while taking a bath or shower. . 4 BSE will reduce the risk of dying from breast cancer. . 1 points QUESTION 9 1. The nurse provides discharge teaching for a 61-yr-old patient who has had a left modified radical mastectomy and lymph node dissection. Which statement by the patient indicates that teaching has been successful? 1 “I will need to use my right arm and to rest the left . one.” 2 “I will keep my left arm in a sling until the incision is . healed.” 3 “I will avoid reaching over the stove with my . left hand.” 4 “I will stop the left arm exercises if moving the arm . is painful.” 1 points QUESTION 10 1. A patient newly diagnosed with stage I breast cancer is discussing treatment options with the nurse. Which statement by the patient indicates that additional teaching may be needed? 1 “Mastectomy is the best choice to decrease the chance of . cancer recurrence.” 2 “I can probably have reconstructive surgery at the same time as a . mastectomy.” 3 “I will probably need radiation to the breast after having the . surgery.” 4 “There are several options that I can consider for treating the . cancer.” 1 points QUESTION 11 1. The nurse will anticipate teaching a patient who is diagnosed with lobular carcinoma in situ (LCIS) about 1 lumpectomy. . 2 lymphatic . mapping. 3 tamoxifen . 4 MammaPrint . testing. 1 points QUESTION 12 1. Which information should the nurse include in teaching a patient who is scheduled for external beam radiation to the breast? 1 Careful skin care in the radiated area will be . necessary. 2 Wigs may be used until the hair regrows after . radiation therapy. 3 Visitors are restricted until the radiation therapy is . completed. 4 The radiation therapy will take a week to complete. . 1 points QUESTION 13 1. Which action will the nurse include in the plan of care for a patient with right arm lymphedema? 1 Assist with application of a compression . sleeve. 2 Avoid isometric exercise on the right arm. . 3 Keep the right arm at or below the level of . the heart. 4 Check blood pressure (BP) on both right and . left arms. 1 points QUESTION 14 1. A 56-yr-old patient is concerned about having a moderate amount of vaginal bleeding after 5 years of menopause. The nurse will anticipate teaching the patient about 1 uterine balloon therapy. . 2 endometrial biopsy. . 3 endometrial ablation. . 4 dilation and curettage . (D&C). 1 points QUESTION 15 1. A nursing diagnosis that is likely to be appropriate for a 67-yr-old patient who has just been diagnosed with stage III ovarian cancer is 1 risk for infection related to impaired immune function. . 2 sexual dysfunction related to loss of vaginal sensation. . 3 anxiety related to cancer diagnosis and need for . treatment decisions. 4 situational low self-esteem related to guilt about delaying . medical care. 1 points QUESTION 16 1. Which patient in the women’s health clinic will the nurse expect to teach about an endometrial biopsy? 1 A 25-yr-old patient who has a family history of hereditary . nonpolyposis colorectal cancer 2 A 45-yr-old patient who has had six previous full-term pregnancies and . two spontaneous abortions Increased BUN, whats first action: assess patient’s dietary habits Trouble voiding, “I cant pee in public”: close curtain provide privacy Acute kidney injury lab: K 5.7, Mg 3.1 Glomerulonephritis: 24 hr collection Cause of acute pyelonephritits: urinary retention Risk of bladder cancer: 86y with 50 pack year cig Primary syphilis: are you allergic to penicillin I feel chained to hemodialysis machine: tell me more Opaque color: take a sample Renal calculi: 3L of fluid a day Acute kidney injury after mva: fluid replacement Renal CA who only has one kidney: microwave ablation Polycystic renal disease: blood transfusion Urinary incontinence: avoid caffeine in food and drinks Cause of acute kidney injury: myocardial infarction Syphilis meds: penicillin G Chlamydia medication: azithromycin Erectile dysfunction: PDE 5 inhibitor Avoid with BPH: anticholinergic Uterine fibroids: heavy bleeding Risk for breast cancer: dense breast Functional urinary incontinence: slack with elastic waistbands that are easy to pull down I am embarrassed to talk about my symptoms: take your time, use words you’re familiar with Diarrhea is not a sign of secondary syphilis Avoid nephropathy: maintain stable blood glucose level  Question 1 0 out of 1 points A nurse cares for a patient with urinary incontinence. The patient states, “I am so embarrassed. My bladder leaks like a young child’s bladder.” How would the nurse respond? Selected Answer: Answers: a. [None Given] Response Feedback: “More people experience incontinence than you might think.” b. “I understand how you feel. I would be mortified.” c. “I can teach you strategies to help control your incontinence.” d. “Incontinence pads will minimize leaks in public.” The nurse should accept and acknowledge the patient’s concerns, and assist the patient to learn techniques that will allow control of urinary incontinence. The nurse should not diminish the patient’s concerns with the use of pads or stating statistics about the occurrence of incontinence.  Question 2 0 out of 1 points A nurse provides phone triage to a pregnant patient. The patient states, “I am experiencing a burning pain when I urinate.” How would the nurse respond? Selected Answer: [None Given] Answers: a. “Make an appointment with your provider to have your infection treated.” b. “You probably have a urinary tract infection. Drink more cranberry juice.” c. “Your pelvic wall is weakening. Pelvic muscle exercises should help.” d. Response Feedback: “This means labor will start soon. Prepare to go to the hospital.” Pregnant patients with a urinary tract infection require prompt and aggressive treatment because cystitis can lead to acute pyelonephritis during pregnancy. The nurse should encourage the patient to make an appointment and have the infection treated. Burning pain when urinating does not indicate the start of labor or weakening of pelvic muscles.  Question 3 0 out of 1 points A nurse cares for a patient who has pyelonephritis. The patient states, “I am embarrassed to talk about my symptoms.” How would the nurse respond? Selected Answer: Answers: a. [None Given] Response Feedback: “You seem anxious. Would you like a nurse of the same gender to care for you?” b. “I understand. Elimination is a private topic and shouldn’t be discussed.” c. “I am a professional. Your symptoms will be kept in confidence.” d. “Take your time. It is okay to use words that are familiar to you.” Patients may be uncomfortable discussing issues related to elimination and the genitourinary area. The nurse would encourage the patient to use language that is familiar to the patient. The nurse would not make promises that cannot be kept, like keeping the patient’s symptoms confidential. The nurse must assess the patient and cannot take the time to stop the discussion or find another nurse to complete the assessment.  Question 4 0 out of 1 points A nurse assesses a patient who has had two episodes of bacterial cystitis in the last 6 months. Which questions would the nurse ask? (Select all that apply.) Selected [None Given] A nurse cares for patients with urinary incontinence. Which types of incontinence are correctly paired with their clinical manifestation? (Select all that apply.) Selected Answers: Answers: a. [None Given] Response Feedback: Functional incontinence—urine loss results from abnormal detrusor contractions b. Urge incontinence—loss of urine upon feeling the need to void c. Reflex incontinence—leakage of urine without lower urinary tract disorder d. Overflow incontinence—constant dribbling of urine e. Stress incontinence—urine loss with physical exertion Stress incontinence is a loss of urine with physical exertion, coughing, sneezing, or exercising. Urge incontinence presents with an abrupt and strong urge to void and usually has a large amount of urine released with each occurrence. Overflow incontinence occurs with bladder distention and results in a constant dribbling of urine. Functional incontinence is the leakage of urine caused by factors other than a disorder of the lower urinary tract. Reflex incontinence results from abnormal detrusor contractions from a neurologic abnormality.  Question 8 0 out of 1 points A nurse teaches a patient about self-care after experiencing a urinary calculus treated by lithotripsy. Which statements would the nurse include in this patient’s discharge teaching? (Select all that apply.) Selected Answers: Answers: a. [None Given] “It is normal to experience pain and difficulty urinating.” b. “Finish the prescribed antibiotic even if you are feeling better.” c. “Report any blood present in your urine.” Response Feedback: d. “The bruising on your back may take several weeks to resolve.” e. “Drink at least 3 L of fluid each day.” The patient should be taught to finish the prescribed antibiotic to ensure that he or she does not get a urinary tract infection. The patient should drink at least 3 L of fluid daily to dilute potential stone-forming crystals, prevent dehydration, and promote urine flow. After lithotripsy, the patient should expect bruising that may take several weeks to resolve. The patient should also experience blood in the urine for several days. The patient should report any pain, fever, chills, or difficulty with urination to the provider as these may signal the beginning of an infection or the formation of another stone.  Question 9 0 out of 1 points A nurse teaches a female patient who has stress incontinence. Which statements would the nurse include about pelvic muscle exercises? (Select all that apply.) Selected Answers: Answers: a. [None Given] Response Feedback: “Pelvic muscle exercises should only be performed sitting upright with your feet on the floor.” b. “Like any other muscle in your body, you can make your pelvic muscles stronger by contracting them.” c. “After you have been doing these exercises for a couple days, your control of urine will improve.” d. “Tighten your pelvic muscles for a slow count of 10 and then relax for a slow count of 10.” e. “When you start and stop your urine stream, you are using your pelvic muscles.” The patient should be taught that the muscles used to start and stop urination are pelvic muscles, and that pelvic muscles can be strengthened by contracting and relaxing them. The patient should tighten pelvic muscles for a slow count of 10 and then relax the muscles for a slow count of 10, and perform this exercise 15 times while in lying-down, sitting-up, and standing positions. The patient should begin to notice improvement in control of urine after several weeks of exercising the pelvic muscles.  Question 10 0 out of 1 points A nurse is teaching patients about different medications used to treat urinary incontinence. Which medications are paired with correct information? (Select all that apply.) Selected Answers: Answers: a. [None Given] Response Feedback: Anticholinergics: Assess the patient for a history of cataracts b. Estrogen cream: Apply a thin layer only c. Alpha-adrenergics: Instruct the patient to monitor the blood pressure d. Antidepressants: Warn patient to inform all providers about taking this drug e. Beta-blockers: Instruct the patient to obtain an annual flu vaccine Estrogen cream is applied in a thin layer only to avoid excessive absorption. Alpha adrenergics can increase blood pressure. Antidepressants have many drug–drug interactions, and the patient needs to inform all his or her providers about taking this drug. Anticholinergics should not be used in patients with glaucoma. Beta-blockers can affect both blood pressure and pulse. The flu vaccine is important but not related.  Question 11 0 out of 1 points After treating several young women for UTIs, the college nurse plans an educational offering on reducing the risk of getting a UTI. What information does the nurse include? (Select all that apply.) Selected Answers: Answers: a. [None Given] Response Feedback: overload e. Excessive GFR The GFR refers to the initial amount of urine that the kidneys filter from the blood. In the healthy adult, the normal GFR ranges between 100 and 120 mL/min, most of which is reabsorbed in the kidney tubules. A GFR of 40 mL/min is drastically reduced, with the patient experiencing fluid retention and risks for hypertension and pulmonary edema as a result of excess vascular fluid.  Question 15 0 out of 1 points A nurse assesses a patient who is recovering from a nephrostomy. Which assessment findings would alert the nurse to urgently contact the healthcare provider? (Select all that apply.) Selected Answers: Answers: a. [None Given] Response Feedback: Patient reports headache b. Urine draining from site c. Bloody drainage at site d. Foul-smelling drainage e. Clear drainage After a nephrostomy, the nurse would assess the patient for complications and urgently notify the provider if drainage decreases or stops, drainage is cloudy or foul smelling, the nephrostomy site leaks blood or urine, or the patient has back pain. Clear drainage is normal. A headache would be an unrelated finding.  Question 16 0 out of 1 points A nurse teaches a patient with polycystic kidney disease (PKD). Which statements would the nurse include in this patient’s discharge teaching? (Select all that apply.) Selected Answers: [None Given] Answers: a. “Take your blood pressure every morning.” b. “Adjust your diet to prevent diarrhea.” c. “Contact your provider if you have visual disturbances.” d. “Weigh yourself at the same time each day.” e. “Assess your urine for renal stones.” Response Feedback: A patient who has PKD would measure and record his or her blood pressure and weight daily, limit salt intake, and adjust dietary selections to prevent constipation. The patient should notify the provider if urine smells foul or has blood in it, as these are signs of a urinary tract infection or glomerular injury. The patient should also notify the provider if visual disturbances are experienced, as this is a sign of a possible berry aneurysm, which is a complication of PKD. Diarrhea and renal stones are not manifestations or complications of PKD; therefore, teaching related to these concepts would be inappropriate.  Question 17 0 out of 1 points The nurse is caring for five patients on the medical-surgical unit. Which patients would the nurse consider to be at risk for postrenal acute kidney injury (AKI)? (Select all that apply.) Selected Answers: [None Given] Answers: a. Man with prostate cancer b. Woman with blood clots in the urinary tract c. Firefighter with severe burns d. Young woman with lupus e. Patient with ureterolithiasis Response Feedback: Urine flow obstruction, such as prostate cancer, blood clots in the urinary tract, and kidney stones (ureterolithiasis), causes postrenal AKI. Severe burns would be a prerenal cause. Lupus would be an intrarenal cause for AKI.  Question 18 0 out of 1 points A nurse is caring for a postoperative 70-kg patient who had major blood loss during surgery. Which findings by the nurse would prompt immediate action to prevent acute kidney injury? (Select all that apply.) Selected Answers: [None Given] Answers: a. Blood pressure of 90/60 mm Hg b. Amber, odorless urine c. Urine output of 100 mL in 4 hours d. Urine output of 500 mL in 12 hours e. Large amount of sediment in the urine Response Feedback: The low urine output, sediment, and blood pressure would be reported to the provider. Postoperatively, the nurse would measure intake and output, check the characteristics of the urine, and report sediment, hematuria, and urine output of less than 0.5 mL/kg/hour for 3 to 4 hours. A urine output of 100 mL is low, but a urine output of 500 mL in 12 hours would be within normal limits. Perfusion to the kidneys is compromised with low blood pressure. The amber odorless urine is normal.  Question 19 0 out of 1 points A patient is hospitalized in the oliguric phase of acute kidney injury (AKI) and is receiving tube feedings. The nurse is teaching the patient’s spouse about the kidney-specific formulation for the enteral solution compared to standard formulas. What components would be discussed in the nurse perform to maintain blood pressure? (Select all that apply.) Selected Answers: [None Given] Answers: a. Adjust the rate of extracorporeal blood flow. b. Place the patient in the Trendelenburg position. c. Administer a 250-mL bolus of normal saline. d. Contact the healthcare provider for orders. e. Stop the hemodialysis treatment. Response Feedback: Hypotension occurs often during hemodialysis treatments as a result of vasodilation from the warmed dialysate. Modest decreases in blood pressure, as is the case with this patient, can be maintained with rate adjustment, Trendelenburg positioning, and a fluid bolus. If the blood pressure drops considerably after two boluses and cooling dialysate, the hemodialysis can be stopped and the healthcare provider contacted.  Question 23 0 out of 1 points A patient is unsure of the decision to undergo peritoneal dialysis (PD) and wishes to discuss the advantages of this treatment with the nurse. Which statements by the nurse are accurate regarding PD? (Select all that apply.) Selected Answers: Answers: a. [None Given] “It takes less time than hemodialysis treatments.” b. “There is less restriction of protein and fluids.” c. “You have flexible scheduling for the exchanges.” d. “You will have no risk for infection with Response Feedback: PD.” e. “You will not need vascular access to perform PD.” PD is based on exchanges of waste, fluid, and electrolytes in the peritoneal cavity. There is no need for vascular access. Protein is lost in the exchange, which allows for more protein and fluid in the diet. There is flexibility in the time for exchanges, but the treatment takes a longer period of time compared to hemodialysis. There still is risk for infection with PD, especially peritonitis.  Question 24 0 out of 1 points The nurse is taking a history of a 68-year-old woman. What assessment findings would indicate a high risk for the development of breast cancer? (Select all that apply.) Selected Answers: [None Given] Answers: a. Age greater than 65 years b. Osteoporosis c. Genetic factors d. Multiparity e. Increased breast density Respons e Feedbac k: The high-risk factors for breast cancer are age greater than 65 with the risk increasing until age 80; an increase in breast density because of more glandular and connective tissue; and inherited mutations of BRCA1 and/or BRCA2 genes. Osteoporosis and multiparity are not risk factors for breast cancer. A high postmenopausal bone density and nulliparity are moderate and low increased risk factors, respectively.  Question 25 0 out of 1 points The nurse is formulating a teaching plan according to evidence-based breast cancer screening guidelines for a 50- year-old woman with low-risk factors. Which diagnostic methods would be included in the plan? (Select all that apply.) Selected Answers: [None Given] Answers: a. Breast self-awareness b. Breast ultrasound c. Annual mammogram d. Magnetic resonance imaging (MRI) e. Clinical breast examination Response Feedback: Guidelines recommend a screening annual mammogram for women aged 40 years and older, breast self- awareness, and a clinical breast examination. An MRI is recommended if there are known high-risk factors. A breast ultrasound is used if there are problems discovered with the initial screening or dense breast tissue.  Question 26 0 out of 1 points After a breast examination, the nurse is documenting assessment findings that indicate possible breast cancer. Which abnormal findings need to be included as part of the patient’s electronic medical record? (Select all that apply.) Selected Answers: [None Given] Answers: a. Mobile mass at two o’clock b. Peau d’orange c. Nontender axillary nodes d. Nipple retraction e. Dense breast tissue Response Feedback: In the documentation of a breast mass, skin changes such as dimpling (peau d’orange), nipple retraction, and whether the mass is fixed or movable are charted. The Response Feedback: mother, who lives 3 hours away.” Driving and sitting for extended periods of time should be avoided until the surgeon gives permission. For 2 to 6 weeks, exercise participation should also be avoided. All of the other responses demonstrate adequate knowledge for discharge. The patient should not lift anything heavier than 10 lbs (4.5 kg), should limit stair climbing, and should refrain from sexual intercourse.  Question 30 0 out of 1 points The nurse is taking the history of a 24-year-old patient diagnosed with cervical cancer. What possible risk factors would the nurse assess? (Select all that apply.) Selected Answers: [None Given] Answers: a. Younger than 18 at first intercourse b. Multiple sexual partners c. Poor diet d. Smoking e. Nulliparity Response Feedback: Smoking, multiple sexual partners, poor diet, and age less than 18 for first intercourse are all risk factors for cervical cancer. Nulliparity is a risk factor for endometrial cancer.  Question 31 0 out of 1 points A patient is scheduled to start external beam radiation therapy (EBRT) for her endometrial cancer. Which teaching by the nurse is accurate? (Select all that apply.) Selected Answers: Answers: a. [None Given] “You will need to be hospitalized during this therapy.” b. “The perineal area may become damaged with the radiation.” c. Response Feedback: “The technician applies new site markings before each treatment.” d. “It is not wise to stay out in the sun for long periods of time.” e. “Your skin needs to be inspected daily for any breakdown.” EBRT is usually performed in ambulatory care and does not require hospitalization. The patient needs to know to evaluate the skin, especially in the perineal area, for any breakdown, and avoid sunbathing. The technician does not apply new site markings, so the patient needs to avoid washing off the markings that indicate the treatment site.  Question 32 0 out of 1 points The nurse is teaching a patient who is undergoing brachytherapy about what to immediately report to her healthcare provider. Which signs and symptoms would be included in this teaching? (Select all that apply.) Selected Answers: Answers: a. [None Given] Response Feedback: Temperature of 99° F (37.2° C) b. Heavy vaginal bleeding c. Visible blood in the urine d. Abdominal pain e. Constipation for 3 days Health teaching for a patient having brachytherapy would emphasize reporting abdominal pain, visible blood in the urine, and heavy vaginal bleeding. Severe diarrhea (not constipation), urethral burning, extreme fatigue, and a fever over 100° F (37.7° C) would also be reported.  Question 33 0 out of 1 points A postmenopausal patient is experiencing low back and pelvic pain, fatigue, and bloody vaginal discharge. What laboratory tests would the nurse expect to see ordered for this patient if endometrial cancer is suspected? (Select all that apply.) Selected Answers: Answers: a. [None Given] Response Feedback: International normalized ratio (INR) b. Hemoglobin and hematocrit (H&H) c. Prothrombin time (PT) d. Cancer antigen-125 (CA-125) e. White blood cell (WBC) count Serum tumor markers such as CA-125 assess for metastasis, especially if elevated. H&H would evaluate the possibility of anemia, a common finding with postmenopausal bleeding with endometrial cancer. WBC count is not indicated since there are no signs of infection. The INR and PT are coagulation tests to measure the time it takes for a fibrin clot to form. They are used to evaluate the extrinsic pathway of coagulation in patients receiving oral warfarin.  Question 34 0 out of 1 points A patient has recurrent vulvovaginitis. Which statements by the patient indicate a need for further teaching? (Select all that apply.) Selected Answers: Answers: a. [None Given] “I should avoid having sex until my infection is gone.” b. “I need to take all of my antibiotics as prescribed.” c. “I can take a long, hot bath to relieve itching.” d. “I should not douche or use feminine hygiene sprays.” prostate cancer. Smoking and obesity are not known risk factors.  Question 38 0 out of 1 points A patient came to the clinic with erectile dysfunction. What are some possible causes of this condition that the nurse could discuss with the patient during history taking? (Select all that apply.) Selected Answers: Answers: a. [None Given] Response Feedback: Hour-long exercise sessions b. Long-term hypertension c. Diabetes mellitus d. Recent prostatectomy e. Consumption of beer each night Organic erectile dysfunction can be caused by surgical procedures, hypertension and its treatment, diabetes mellitus, and alcohol consumption. There is no evidence that exercise is related to this problem.  Question 39 0 out of 1 points The nurse is reviewing possible complications from a phalloplasty. What factors does the nurse include? (Select all that apply.) Selected Answers: [None Given] Answers: a. Necrosis of the neopenis b. Vaginal infections c. Urinary tract stenosis d. Infection of donor Response Feedback: site e. Rectal perforation Complications from phalloplasty include infection or scarring of the donor site, necrosis, and stenosis of the urinary tract. Rectal perforation can occur with vaginoplasty, as can infections.  Question 40 0 out of 1 points A student nurse is learning about the healthcare needs of lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) patients. Which terms are correctly defined? (Select all that apply.) Selected Answers: [None Given] Answers: a. Gender dysphoria—distress caused by incongruence between natal sex and gender identity b. Transgender—a person who dresses in the clothing of the opposite sex c. Transition—the time between questioning and establishing a sexual identity d. Natal sex—the sex one is born with or is assigned to at birth e. Gender queer—a label used when gender identity does not conform to male or female Response Feedback: Gender dysphoria is emotional distress caused by the incongruence between natal sex (sex assigned at birth) and gender identity. Gender queer is a label sometimes used by people whose gender identity does not fit the established categories of male or female. Natal sex describes the gender a person is born with or is assigned to at birth. Transgender is an adjective to describe a person who crosses or transcends culturally defined categories of gender. Transition is the period of time when transgender individuals change from the gender role associated with their sex to a different gender role.  Question 41 0 out of 1 points A nurse works with many transgender patients. What routine monitoring is important for the nurse to facilitate in this population? (Select all that apply.) Selected Answers: [None Given] Answers: a. Liver function tests b. Mammograms if breast tissue is present c. Prostate-specific antigen (PSA) for natal males d. Lipid profile e. Renal profile Response Feedback : Common routine monitoring for this population includes lipid and liver panels, mammograms if any breast tissue is present, and PSA for natal males as the prostate is not removed during a vaginoplasty/penectomy. Renal profiles are not required based on treatment options for this population.  Question 42 0 out of 1 points A primary care clinic sees some clients with sexually transmitted diseases. Which clients would the nurse be required to report to the local authority in every state, according to the Centers for Disease Control and Prevention? (Select all that apply.) Selected Answers: [None Given] Answers: a. Client with Chlamydia b. Female with pelvic inflammatory disease c. Man with syphilis d. Woman with gonorrhea e. Client with human immune ay e of e or st a ic.  Question 46 0 out of 1 points The nurse is teaching a client who is taking an oral antibiotic for treatment of a sexually transmitted disease (STD). Which statements by the client indicate a correct understanding of the treatment? (Select all that apply.) Selected [None Given] Answers: Answers: a. “I need to drink at least eight glasses of fluid each d with my antibiotic.” b. “I should read the instructions to see if I can take th medication with food.” c. “I need to wait 7 days after the last dose of the antibiotic to engage in intercourse.” d. “Antacids should not interfere with the effectiveness the antibiotic.” e. “It should not matter if I skip a couple of doses of th antibiotic.” Response When a client is being treated with an oral antibiotic f Feedback: an STD, 8 to 10 glasses of fluid should be routine, medication instructions should be reviewed, and at lea week break should occur between the last dose of the antibiotic and sexual intercourse to allow for the medication’s full effects. Use of antacids and missing doses could decrease the effectiveness of the antibiot  Question 47 0 out of 1 points An emergency department nurse cares for a patient who is severely dehydrated and is prescribed 3 L of intravenous fluid over 6 hours. At what rate (mL/hr) would the nurse set the intravenous pump to infuse the fluids? (Record your answer using a whole number.) mL/hr Selected [None Answer: Given] Correct Answer: Evaluation Method Correct Answer Case Sensitivity Exact Match 500 Exact Match 500 mL/hr Because IV pumps deliver in units of milliliters per hour, Exact Match the pump would have to be set at 500 mL/hr to deliver 3 L (3000 mL) over 6 hours.  Question 48 0 out of 1 points A 23-year-old female was admitted to the hospital for intravenous antibiotic treatment of pelvic inflammatory disease. The provider has ordered cefazolin (Ancef) to be administered every 8 hours. At what rate should the nurse infuse the medication if the pharmacy provides 1 g of the medication in 50 mL of 0.9% NaCl to infuse in 30 minutes? (Record your answer using a whole number.) mL/hr Selected [None Answer: Given] Correct Answer: Evaluation Method Correct Answer Case Sensitivity Exact Match 100 Exact Match 100 mL/hr To calculate using the dimensional Exact Match analysis method: (50 mL/30 min) (60 min/1 hr) = 100 mL/hr. Screening recommendation for breast cancer: mammogram, self exam, clinical exam Risk factors for breast cancer: dense breast, genetics, increased age, no kids, having kids after 30 Lump found then what: biopsy Uterine leiomyoma blood test: CBC Endometrial cancer sign in older women: pelvic pressure, menopausal bleeding; how many pads; lightheaded, dizzy Cant button pants anymore, what is the assessment: abdomen distention Discharge teaching for total hysterectomy: gradual increase in walking Cervical ablation patient teaching: no heavy lifting, no sex for 3 weeks, no tampons, no baths, no douche Vulvovaginitis patient teaching: front to back wipe, cotton underwear, no tight clothes Prevent toxic shock syndrome: change tampon, don’t use large ones, use pad at night, no internal contraceptives Blood test for prostate: serum alk phos Common finding for BPH: difficult starting, dribble Av fistula, don’t do: take BP Med for BPH and hypertension: finasteride Modifiable risk factor: diet, smoking Open radicle prostatectamie: get him up, i/o, cath care, clots, drainage, bleeding, infection Vagina plasty post op teaching: no sex, no douche, ice packs Turp patient: infection, bleeding, ketchup pee 30 y testicular cancer: sperm bank Erectile dysfunction causes: hypertension, drinking, diabetes, surgery (prostate) Stage 5 chronic kidney disease: dialysis Acute kidney injury cause: dehydration, MI Diet teaching for nephrotic syndrome with normal gfr: protein Cystitis avoid: feminine sprays Unprotected sex leads to gential warts Signs/symptoms: flank pain, shock, nausea vomit Acute pyelonephritis: urgency, fever, foul urine, flank pain