NSG 6440 EXAM WEEK 9 PREDICTOR TEST EXAM 2024-2025 questions and answers.pdf, Exams of Nursing

Download NSG 6440 EXAM WEEK 9 PREDICTOR TEST EXAM 2024-2025 questions and answers.pdf and more Exams Nursing in PDF only on Docsity! NSG 6440 EXAM WEEK 9 PREDICTOR TEST | SOUTH UNIVERSITY EXAM 2024- 2025 QUESTIONS AND CORRECT VERIFIED ANSWERS /100% PASS SOLUTION / ALREADY GRADED A+ 1. It is documented in the medical record that a patient has gummas. For which sexually transmitted infection should the nurse plan care? a. Syphilis b. Gonorrhea c. Chlamydia d. Genital herpes - ANSWER--a. Syphilis In the tertiary stage ofsyphilis, the spirochete may form gummas, which are tumors of a rubbery consistency that can break down and ulcerate, leaving holes in body tissues. D. Herpes is associated with vesicular skin lesions. B. C. Gonorrhea and Chlamydia are not associated with skin lesions 2. The nurse is providing care for a patient with genital herpes who has vesicular lesions. What term should the nurse use to describe these lesions to the patient? a. Warts b. Rashes c. Blisters d. Papules - ANSWER--c. Blisters 3. During data collection the nurse notes the presence of a chancre on a male patients penis. For which sexually transmitted infection should the nurse focus additional data collection? a. Herpes b. Syphilis c. Gonorrhea d. Chlamydia - ANSWER--b. Syphilis The primary stage of syphilis begins with the entry of the Treponema pallidum spirochete through the skin or mucous membranes. Between 3 and 90 days later, a papule develops at the site of entry, then sloughs off, leaving a painless, red, ulcerated area called a chancre. A. Herpes is associated with vesicular skin lesions. C. D. Gonorrhea and Chlamydia are not associated with skin lesions 4. The nurse is assisting with teaching a 22-year-old female patient who is diagnosed with a sexually transmitted infection (STI). She says, I dont understand. My boyfriend always wears a condom. Which understanding by the nurse should guide teaching in this situation? a. Condoms are a reliable source of protection against STIs. b. It is a myth that condoms provide any protection against STIs. c. Condoms can decrease the risk of STIs, but they are not foolproof. d. Condoms must be used with a spermicide to guarantee protection against STIs. - ANSWER--4. ANS: Condoms Condoms can greatly decrease the risk of STIs, but condoms can have tiny channels in the rubber (or other elastic material) that can allow microorganisms to pass through. Condoms can break, slip off, or be applied improperly. Petroleum-based lubricants may weaken latex condoms. A.Condoms do not provide a barrier for any area other than the penis and most of the vagina (or anus). B. Some STIs may still be transmitted by contact of surrounding uncovered tissues. D. Spermicide helps protect against pregnancy. 5. A patient is diagnosed with a parasitic infection caused by close contact with another persons genitals. For which infection should the nurse plan care? a. Phthirus pubis b. Treponema pallidum c. Neisseria gonorrhoeae 12. The nurse must bathe a patient with herpes. What is the nurses best protection against contracting sexually transmitted infections (STIs) from patients while providing perineal hygiene? a. Wearing gloves at all times b. Washing hands following care c. Practicing standard precautions d. Avoiding touching patients who have STIs - ANSWER--c. Practicing standard precautions 13. The nurse is caring for a pregnant woman who is fearful that her unborn child will be born blind because of having a sexually transmitted infection (STI). For which STI should the nurse plan care to prevent ophthalmia neonatorum in the newborn? a. Syphilis b. Gonorrhea c. Genital warts d. Genital herpes - ANSWER--b. Gonorrhea 14. The nurse is caring for a young woman who is newly diagnosed with genital warts. She states, I heard you can get cancer from STIs. Is that true? Which response by the nurse is correct? a. No, you cannot get cancer from STIs. b. Yes, most STIs can lead to cancerous changes if not treated promptly. c. Yes, some STIs have been linked to cancer, so adequate treatment is very important. d. No, that is not true, but a diagnosis of cancer does increase the risk of contracting an STI. - ANSWER-- c. Yes, some STIs have been linked to cancer, so adequate treatment is very important. Herpes, human papillomavirus (HPV), and hepatitis (not most sexually transmitted infections [STIs]) have been associated with cancers. 15. The nurse is identifying ways for a young adult to reduce the risk of contracting a sexually transmitted infection (STI). What should the nurse teach about the relationship between consumption of alcohol and immediate risk of contracting an STI? a. Alcohol may reduce inhibitions. b. Alcohol increases risk for liver disease. c. Alcohol lowers the bodys resistance to infection. d. Alcohol impairs the integrity of the mucous membranes, providing a portal of entry for infection. 1\ - ANSWER--a. Alcohol may reduce inhibitions. Consumption of alcohol or other psychoactive drugs can reduce inhibitions and may result in unintended sexual encounters, which can transmit STIs. 16. The nurse reviews the ways to prevent condom breakage with a patient. Which patient statement indicates that more teaching is necessary? a. Condoms should never be reused. b. I should use a water-soluble lubricant. c. Before I use a condom, I should inflate it and check it for holes and leaks. d. I should make sure to leave a half inch extra space at the end of the condom - ANSWER-- c. Before I use a condom, I should inflate it and check it for holes and leaks. 17. The nurse is assisting with the admission of a known intravenous drug abuser to a medical unit. In addition to drug abuse, which disorder in the patients history is most consistent with a diagnosis of hepatitis? a. Jaundice b. Diabetes mellitus c. Bowel obstruction d. Chronic headaches - ANSWER--a. Jaundice 18. The nurse is teaching a patient the importance of completing treatment for gonorrhea. On which information is the nurse basing this teaching? a. Gonorrhea is not treatable. b. Only men experience symptoms; women are usually asymptomatic. c. Men and women may be asymptomatic and still transmit the infection. d. Treatment is associated with many serious side effects, so compliance is low. - ANSWER- -c. Men and women may be asymptomatic and still transmit the infection. 19. The nurse is assisting in the preparation of a teaching seminar for adolescents to prevent the development of a sexually transmitted infection (STI). Which nonsexual activity should the nurse teach that may transmit a sexually transmitted infection (STI)? a. Sharing a cigarette b. Borrowing a hairbrush c. Coughing and sneezing d. Sharing intravenous drug equipment - ANSWER--d. Sharing intravenous drug equipment 20. A patient asks for the best way to prevent contracting a sexually transmitted infection (STI). What response should the nurse make to this patients question? a. Abstinence b. Oral contraceptives c. Condom with spermicide d. Prophylactic oral antibiotics - ANSWER--a. Abstinence 21. A patient diagnosed with genital warts asks how they developed. Which pathogen should the nurse explain as causing genital warts? a. Sarcoptes scabiei b. Hepatitis A and B d. The public health authority can notify a list of sexual contacts without including my identity. - ANSWER--b. Reporting regulations are the same throughout the country. 29. The nurse is assisting with teaching a patient who has been exposed to hepatitis B. Which symptoms should the nurse explain may occur before jaundice appears? (Select all that apply.) a. Rash b. Nausea c. Confusion d. Dark-colored urine e. Muscle or joint pain f. Elevated blood glucose - ANSWER--a. Rash b. Nausea e. Muscle or joint pain 30. The nurse is reviewing prescribed laboratory tests for a patient demonstrating manifestations ofsyphilis. What diagnostic tests should the nurse expect to be prescribed for this patient? (Select all that apply.) a. RPR b. NAT c. VDRL d. ELISA e. Culture f. CD4 counts - ANSWER--a. RPR c. VDRL d. ELISA e. Culture 31. A 24-year-old woman diagnosed with Chlamydia has been prescribed doxycycline. What should be included in the nurses teaching about the drug treatment? (Select all that apply.) a. Take this drug with a meal. b. Do not take with dairy products. c. Avoid unnecessary exposure to sunlight. d. Abstain from alcohol for at least 48 hours after treatment. e. Use birth control methods to ensure you do not become pregnant - ANSWER--b. Do not take with dairy products. c. Avoid unnecessary exposure to sunlight. e. Use birth control methods to ensure you do not become pregnant 32. The nurse is teaching a patient about the use of condoms to prevent sexually transmitted infections (STIs). Which information should the nurse include in this teaching? Select all that apply. a. Condoms can decrease the risk of transmitting STDs. b. Latex condoms are less likely to break than other types. c. Inflating the condom prior to use allows for effective inspection d. Condoms should be used no more than twice and then discarded properly. e. Use of a water-soluble lubricant with a condom increases its effectiveness in preventing the spread of an STD. f. Use of a petroleum-based lubricant with a condom increases its effectiveness in preventing the spread of an STD. - ANSWER--b. Latex condoms are less likely to break than other types. c. Inflating the condom prior to use allows for effective inspection e. Use of a water-soluble lubricant with a condom increases its effectiveness in preventing the spread of an STD. 33. The nurse is providing care for a patient recently diagnosed with Chlamydia. Which information should the nurse recommend be included in patient teaching? (Select all that apply.) a. Women with Chlamydia may complain of a sore throat. b. Chlamydia is characterized by the development of chancres. c. Ophthalmia neonatorum is seen in infants born to women with Chlamydia. d. Chlamydia can be transmitted sexually and by blood and body fluid contact. e. The risk of ectopic pregnancy is increased in women with a history of Chlamydia. f. The Chlamydia virus can lie dormant in the nervous system tissues and reactivate when an individual is under stress or has a compromised immune system - ANSWER--d. Chlamydia can be transmitted sexually and by blood and body fluid contact. e. The risk of ectopic pregnancy is increased in women with a history of Chlamydia. 34. The nurse notesthat a patient is diagnosed with vulvovaginitis. What should the nurse expect when assessing this patient? (Select all that apply.) a. Vaginal edema b. Vaginal discharge c. Areas of ecchymosis d. Dark brown vaginal bleeding e. Complaints of vaginal itching and burning - ANSWER--a. Vaginal edema b. Vaginal discharge e. Complaints of vaginal itching and burning 35. A patient in labor is diagnosed with mucopurulent cervicitis. For which health problems should the nurse anticipate providing care to the newborn? (Select all that apply.) a. Pneumonia b. Conjunctivitis c. Irregular heart rate 4. Immunizations are an example of which type of prevention? a. Primary b. Secondary c. Tertiary - ANSWER--a. Primary 1. Prevalence is the number of new cases of a particular disease. - ANSWER--False 2. The number of cases of a particular disease for the past 5 years is an example of the incidence rate - ANSWER--False 3. ―There are 1,185,000 cases of HIV/AIDS in the United States‖ is an example of the morbidity rate. - ANSWER--True 4. Endemic is the term used when the presence of an event is constant. - ANSWER--True 5. The ―bird‖ flu of 2005 to 2006 is considered a sporadic outbreak. - ANSWER--False 6. A pandemic affects many communities in a short period of time. - ANSWER--True Identify the choice that best completes the statement or answers the question. 1. The World Health Organization defines self-care as: a. An important global activity for all health-care providers b. A set of deliberate actions that all individuals, families, and communities should engage in to maintain good health c. Essential to efficacious advanced practice nursing (APRN) practice d. An awareness by the APRN of their self-care behaviors as related to diet, activity, and mental attitude - ANSWER--b. A set of deliberate actions that all individuals, families, and communities should engage in to maintain good health 2. Nurse theorist Dorothea Orem defines self-care activities as: a. Attainment of professional self-development goals b. Ability to persevere through hardship c. Striving to attain balance and harmony in one's life d. Comprising activities that are performed independently by an individual to promote and maintain well-being throughout life - ANSWER--d. Comprising activities that are performed independently by an individual to promote and mai 3. Self-care and personal development are built into the standards of practice of: a. The American Holistic Nurses Association b. The American Nurses Association c. The American Association of Nurse Practitioners d. The American Academy of Nursing - ANSWER--a. The American Holistic Nurses Association 4. There are many pressures inherent in primary care practice today for APRNs. These pressures include all of the following: a. Electronic medical record, the Affordable Care Act, and the implementation of socialized medicine b. Patient care outcomes being tied to reimbursement, role diffusion with physicians and physician assistants c. Uncertainty, the team approach to care, and the need for patient-centered care d. Availability of medical information on the internet, educational programs for patients, and Medicare drug benefits - ANSWER--b. Patient care outcomes being tied to reimbursement, role diffusion with physicians and physician assistants 5. A new era of health care leads to: a. Greater opportunity for independent practice, yet increased legal risk in accountability for patients b. Lowered reimbursement for all health-care services and providers c. Decrease in status for health-care providers d. No ability to individualize care - ANSWER--a. Greater opportunity for independent practice, yet increased legal risk in accountability for patients 6. Compassion fatigue is another side-effect of today's health-care delivery system. This term means: a. The APRN feels sudden guilt and distress when he or she cannot rescue or save an individual, such as when bad health habits persist despite the best efforts of the APRN. b. This happens over time related to the need to see increasing numbers of patients in busy primary care practices. c. This may persist over time, even when the APRN transfers to a new and different setting. d. Patients' problems and circumstances can be so overwhelming that the APRN needs to set severe boundaries to maintain safe function. - ANSWER--a. The APRN feels sudden guilt and distress when he or she cannot rescue or save an individual, such as when bad health habits persist despite the best efforts of the APRN. 14. The qualities of resilience that Patsy demonstrated when responding to Sue include: a. Protecting her own positive attitude by lessening her contact with Sue, a negative person b. The ego strength to admit failure in her ability to orient Sue, a destructive person c. Protecting her organization by sharing Sue's deficiencies with their supervisor d. Asserting her positive approach and basic optimism by initiating an honest discussion with Sue and having the emotional insight to recognize Sue's negative effect on her - ANSWER-- d. Asserting her positive approach and basic optimism by initiating an honest discussion with Sue and having the emotional insight to recognize Sue's negative effect on her 15. According to nurse theorist Jean Watson, a focus on positive intentionality—holding caring thoughts, loving kindness, and open receptivity—enhances caring energy, which leads to healing. How can the APRN bring this to their practice? a. Spiritual readings, centering oneself before patient encounters, engaging in behaviors that help build positive energy b. Review of materials on primary care before going into the work environment to increase one's confidence, leading to caring energy c. Travel to sacred places d. Helping the poor and homeless—volunteering at a domestic violence shelter, for example— in addition to one's regular practice - ANSWER--a. Spiritual readings, centering oneself before patient encounters, engaging in behaviors that help build positive energy 1. Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause? a. ―You must be under a lot ofstress lately. b. ―It is hereditary. Did your father experience this also? c. ―The cause is unknown, but we suspect it is due to an immunologic mechanism. d. ―We'll have to do some tests. - ANSWER--c. ―The cause is unknown, but we suspect it is due to an immunologic mechanism. 2. Which of the following is ―a linear crack extending from the epidermis to the dermis? a. An ulcer b. A fissure c. Lichenification d. An excoriation - ANSWER--b. A fissure 3. A bulla is: a. A vesicle larger than 1 cm in diameter b. An elevated solid mass with a hard texture; the shape and borders can be regular or irregular c. A superficial elevated lesion filled with purulent fluid d. Thinning of the skin (epidermis and dermis) that appears white or translucent - ANSWER--a. A vesicle larger than 1 cm in diameter 4. An example of ecchymosis is: a. A hematoma b. A keloid c. A bruise d. A patch - ANSWER--c. A bruise 5. When looking under the microscope to diagnose an intravaginal infection, you see a cluster ofsmall and oval to round shapes. What do you suspect they are? a. Spores b. Leukocytes c. Pseudohyphae d. Epithelial cells - ANSWER--a. Spores 6. Your patient is in her second trimester of pregnancy and has a yeast infection. Which of the following is a treatment that you usually recommend/order in nonpregnant patients, but is listed as a Pregnancy category D? a. Vagistat vaginal cream b. Monistat combination pack c. Terazol vaginal cream d. Diflucan, 150 mg - ANSWER--d. Diflucan, 150 mg 7. Tinea unguium is also known as: a. Onychomycosis b. Tinea versicolor c. Tinea manuum d. Tinea corporis - ANSWER--a. Onychomycosis 8. Sally, age 25, presents with impetigo that has been diagnosed as infected with Staphylococcus. The clinical presentation is pruritic tender, red vesicles surrounded by erythema with a rash that is ulcerating. Her recent treatment has not been adequate. Which type of impetigo is this? a. Bullous impetigo b. Staphylococcalscalded skin syndrome (SSSS) c. Nonbullous impetigo d. Ecthyma - ANSWER--d. Ecthyma 9. Mark has necrotizing fasciitis of his left lower extremity. Pressure on the skin reveals crepitus due to gas production by which anaerobic bacteria? a. Staphylococcal aureus b. Best practice c. Boundary d. Border irregularity - ANSWER--d. Border irregularity 19. The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection? a. IgA b. IgE c. IgG d. IgM - ANSWER--c. IgG 20. Eighty percent of men have noticeable hair loss by what age? a. 35 b. 50 c. 70 d. 85 - ANSWER--d. 85 21. Prevalence of psoriasis is highest in which group? a. Scandinavians b. African Americans c. Asians d. Native Americans - ANSWER--a. Scandinavians 22. The most common precancerous skin lesion found in Caucasians is: a. A skin tag b. Actinic keratosis c. A melanoma d. A basal cell lesion - ANSWER--b. Actinic keratosis 23. Ian, age 62, presents with a wide, diffuse area of erythematous skin on his lower left leg that is warm and tender to palpation. There is some edema involved. You suspect: a. Necrotizing fasciitis b. Kaposi's sarcoma c. Cellulitis d. A diabetic ulcer - ANSWER--c. Cellulitis 24. Josh, aged 22, has tinea versicolor. Which description is the most likely for this condition? a. There are round, hypopigmented macules on his back. b. Josh has red papules on his face. c. There are crusted plaques in Josh's groin area. d. There are white streaks on his neck. - ANSWER--a. There are round, hypopigmented macules on his back. 25. Tori is on systemic antifungals for a bad tinea infection. You are aware that the antifungals may cause: a. Renal failure b. Skin discoloration c. Breathing difficulties d. Hepatotoxicity - ANSWER--d. Hepatotoxicity 26. Which scalp problem can be caused by a fever and certain drugs? a. Telogen effluvium (TE) b. Trichotillomania c. Psoriasis d. Alopecia areata - ANSWER--a. Telogen effluvium (TE) 27. Why do people of African descent have a lower incidence of non-melanoma skin cancer? a. They have an increased number of melanocytes. b. Their darker skin protects from ultraviolet radiation. c. Their skin is thicker. d. Their immune system is stronger. - ANSWER--b. Their darker skin protects from ultraviolet radiation. 28. Which statement is true regarding chloasma, the ‗mask of pregnancy'? a. It is caused by a decrease in the melanocyte-stimulating hormone during pregnancy. b. This condition only occurs on the face. c. Exposure to sunlight will even out the discoloration. d. It is caused by increased levels of estrogen and progesterone. - ANSWER--d. It is caused by increased levels of estrogen and progesterone. 29. When instructing your elderly client about treating her xerosis, what do you tell her? a. A daily hot bath may help the associated pruritus. b. Rub the skin briskly to make sure it is completely dry after bathing. c. Only take short tepid showers. 2. Which ofthe following are nursing interventions and patient teaching for the treatment of head lice and scabies? (Select all that apply.) a. Clothing, linens, and bath articles thoroughly cleaned in hot water b. Stress nature and transmission of the disease c. Special carbohydrate diet to promote healing d. Complete isolation from the public - ANSWER--a. Clothing, linens, and bath articles thoroughly cleaned in hot water & b. Stress nature and transmission of the disease 3. The nurse is caring for a patient with lesions on the skin. Which assessment finding should cause the nurse to suspect scabies? a. Large, fluid-filled blisters b. Short, wavy, brownish black lines c. Reddish brown dots at the base of hairs d. Gray blue macules on the thighs and axillae - ANSWER--b. Short, wavy, brownish black lines 1. A client is experiencing a circular lesion with an advancing, red, scaly border on the abdomen. The nurse recognizes this lesion as being: 1 tinea capitis. 2 tinea corporis. 3 tinea cruris. 4 tinea pedis. - ANSWER--2 tinea corporis. Tinea corporis is a fungal infection that involves the face, trunk, and limbs. Tinea pedis is a common infection of the feet. Tinea cruris occurs in the groin and inner thigh, and tinea capitis involves the scalp. 2.A client is diagnosed with tinea versicolor. Which of the following should the nurse instruct this client regarding the care for this skin condition? 1 Do nothing since there is no treatment. 2 Utilize shampoo with selenium. 3 Utilize an oral antifungal preparation as prescribed 4 Apply warm compresses to the affected areas - ANSWER--ANS: 2 utilize shampoo with selenium Treatment for tinea versicolor includes the use of selenium shampoo. The nurse should not instruct the client to do nothing since treatment does exist for this condition. Oral antifungal preparations are not necessary for this condition. Warm compresses will not help this condition. 3.A school nurse assesses a child who has an erythematous circular patch of vesicles on her scalp with alopecia and complains of pain and pruritus. Why would the nurse use a Woods lamp? a. To dry out the lesions b. To reduce the pruritus c. To kill the fungus d. To cause fluorescence of the infected hairs - ANSWER--d. To cause fluorescence of the infected hairs Tinea capitis is commonly known as ringworm of the scalp. Microsporum audouinii is the major fungal pathogen. The use of the diagnostic Woods lamp causes the infected hairs to turn a brilliant blue green. 1.A client has what appears to be a bacterial infection or warts on her fingertips. This can be a sign of: 1 herpes gladiatorum. 2 herpes simplex. 3 herpes zoster. 4 herpetic whitlow - ANSWER--ANS: 4 Herpetic whitlow Herpetic whitlow usually occurs on the fingertips and can resemble a bacterial infection or warts. Herpes gladiatorum is most frequently found in athletes who participate in contact sports. The appearance of herpes zoster is usually down a single dermatome. Herpes simplex is usually seen orally or on the genitals. 2.A school-age child is experiencing pruritic vesicles around the mouth. The lesions have a honey- colored crust. The nurse realizes that the child is most likely experiencing: 1 candidiasis. 2 herpes simplex. 3 impetigo. 4 tinea corporis. - ANSWER--3 impetigo. Impetigo is a common, superficial skin infection beginning as a focal erythema and progressing to pruritic vesicles, erosions, and honey-colored crusts. Oral herpes simplex would look like a cold sore. Tinea corporis has a circular, red, scaly border, and candidiasis is a proliferation of the normal yeast flora. 3.A client is diagnosed with severe nodulocystic acne. The nurse should instruct the client on which of the following types of treatments? (Select all that apply.) 1 Oral antibiotics 2 Benzoyl peroxide Nystatin (Mycostatin) is an antifungal medication. Boric acid is an antipruritic solution. Hydrogen peroxide is an antiseptic solution 2.A client is diagnosed with genital herpes simplex virus. The nurse know that symptoms of the primary infection occur: 1. 1 to 4 days after exposure. 2. 3 to 7 days after exposure. 3. 5 to 9 days after exposure. 4. 7 to 11 days after exposure. - ANSWER--2. 3 to 7 days after exposure. 3. What should a patient be assessed for upon the diagnosis of genital herpes? a. Hepatitis B b. Syphilis c. Human immunodeficiency virus (HIV). d. Cirrhosis - ANSWER--ANS: C HIV Persons with genital herpes should be assessed for HIV because the therapy for herpes is suppressive; persons with HIV are not candidates for suppressant therapy. 4. The nurse is care for a patient with shingles. Which statement should the nurse include in patient teaching? a. Herpes simplex 2 causes shingles. b. Shingles is caused by herpes simplex 1 virus. c. Varicella zoster is the virus responsible for shingles. d. Herpes zoster is a virus that is common in older patients. - ANSWER--c. Varicella zoster is the virus responsible for shingles. Herpes zoster, or shingles, is caused by the varicella zoster virus. B. Herpes simplex 1 causes cold sores. A. Herpes simplex 2 causes genital herpes. C. This disease occurs most commonly in older patients or in those who have a diminished resistance, such as the patient with AIDS, the patient on immunosuppressant agents, or the patient with a malignancy or injury to the spine or a cranial nerve 1. Which of the following should the nurse instruct a client who is prescribed a topical medication for a skin condition? 1 Apply directly to broken or irritated skin. 2 Apply before bathing. 3 Apply after bathing. 4 Cover the area with an occlusive dressing. - ANSWER--3 Apply after bathing. 2.A client is diagnosed with a dermatologic condition causing pruritis and inflammation. Which of the following should the nurse instruct this client? 1 Use regular perfumed lotion to moisturize the skin. 2 Use scented soap to bathe the skin daily 3 Apply skin oil daily. 4 Apply a body moisturizer to the skin within 3 to 5 minutes after bathing. - ANSWER--4 Apply a body moisturizer to the skin within 3 to 5 minutes after bathing. 3. What is the initial intervention for relief of the pruritus of dermatitis venenata? a. Apply baking soda to lesions b. Wash area with copious amounts of water c. Apply cool compresses continuously d. Expose area to air - ANSWER--b. Wash area with copious amounts of water In dermatitis venenata (poison oak or ivy), the patient should wash the affected part immediately after contact with the offending allergen. 4.A patient developed a severe contact dermatitis of the hands, arms, and lower legs after spending an afternoon picking strawberries. The patient states that the itching is severe and cannot keep from scratching. Which instruction would be most helpful in managing the pruritus? a. Use cool, wet dressings and baths to promote vasoconstriction. b. Trim the fingernails short to prevent skin damage from scratching. c. Expose the areas to the sun to promote drying and healing of the lesions. d. Wear cotton gloves and cover all other affected areas with clothing to prevent environmental irritation - ANSWER--a. Use cool, wet dressings and baths to promote vasoconstriction. Wet dressings and using Burows solution help promote the healing process. 1.A client is experiencing a circular lesion with an advancing, red, scaly border on the abdomen. The nurse recognizes this lesion as being: 1 tinea capitis. 2 tinea corporis. 3 tinea cruris. 4 tinea pedis - ANSWER--ANS: 2 Tinea corporis is a fungal infection that involves the face, trunk, and limbs. Tinea pedis is a common infection of the feet. Tinea cruris occurs in the groin and inner thigh, and tinea capitis involves the scalp. 2.A middle-aged construction worker has a raised lesion with a pearly border on his arm that bleeds easily. The nurse realizes that this client most likely is experiencing a(n): 7. The nurse assesses a linear lesion along the length of a clients leg. Which diagnosis does the nurse realize is associated with linear lesions? (Select all that apply.) 1. Drug reaction 2. Herpes zoster 3. Herpes simplex 4. Hookworm 5. Dermatitis 6. Poison ivy - ANSWER--ANS: 4, 5, 6 Linear lesions are associated with poison ivy, dermatitis, or hookworm. Polycyclic lesions are associated with drug reactions. Linear lesions along a nerve root are associated with herpes zoster. Grouped or clustered lesions are associated with herpes simplex 8. The home health nurse assessing skin lesions uses the PQRST mnemonic as a guide. What does the S in this guide indicate? a. Severity of the symptoms b. Site ofthe lesions c. Symptomatology of the lesions d. Surface area ofthe lesions - ANSWER--ANS: A The mnemonic PQRST stands for Provocative factors (causes), Quantity, Region of the body, Severity of the symptoms, Time (length of time the disorder has been present) 1. A nurse from the ICU is participating in the hospitals disaster response preparedness team. One issue that proves difficult for the team to agree on is a statement regarding the standard of medical care observed during a disaster. Which of the following do you think the nurse should recommend to the team? A) The goal should be to provide the highest care possible, with limited resources and equipment. B) The lack of resources should not diminish the standard of care that the hospital provides. C) The medicalstaff should tend to the needs of the most critically ill first. D) If electrical power should be lost to the facility, patients on life support should be given lowest priority. - ANSWER--A) The goal should be to provide the highest care possible, with limited resources and equipment. 2. A nurse learns that local law enforcement officials have informed the hospital that an imminent terrorist attack has been threatened in a building just down the street from the hospital. Which of the following are appropriate responses? Select all that apply. A) Explain to the patients in the ICU that a terrorist attack is expected and that their care may be interrupted. B) Begin making preparations to move all ICU patients to other hospital facilities in the area in the event of an attack. C) Review the hospitals disaster plan and make sure that it is distributed to the rest of the medical staff. D) Determine what her specific role in the disaster plan is. E) Not be concerned because federal deployable medical teams will likely be sent to the hospital in the event of an attack. F) Check the number of ventilators available in the ICU to determine whether more would be needed in the event of an attack. - ANSWER--C) Review the hospitals disaster plan and make sure that it is distributed to the rest of the medical staff. D) Determine what her specific role in the disaster plan is. F) Check the number of ventilators available in the ICU to determine whether more would be needed in the event of an attack. 3. The nurse is at the bedside of her 90-year-old patient, Ruth, who is comatose and on life support in the ICU, when she begins to feel the room shaking violently. The power suddenly fails and emergency generators have not started yet. The nurse provides bag-mask resuscitation for Ruth while she waits for the power to be restored. Moments later, the ICU is inundated with patients injured by the collapse of a nearby apartment building as a result of the earthquake. The nurse is called to help. Kevin has been impaled by a metal rod through the chest, is in a state of shock, and will die without immediate intervention. Gwyneth has compound fractures ofthe femur and a dislocated shoulder, is in pain, but is responsive. Mason is unconscious and unresponsive. Based on the START triage categories, whom should the nurse assist first in this situation? A) Ruth B) Kevin C) Gwyneth D) Mason - ANSWER--B) Kevin 4. A patient arrives at the ICU after being injured by car bomb that exploded 20 feet away. The patient sustained only primary blast injuries. Which of the following are injuries he might have sustained? Select all that apply. A) Perforated eardrum caused by a sudden change in atmospheric pressure B) Laceration from a shard of glass that struck the patient C) Concussion as a result of his body being thrown against a brick wall D) Hemorrhagic contusion of the lungs E) Gastrointestinal hemorrhage F) Blunt force trauma from a piece of metalshrapnel that struck the patients head - ANSWER--A) Perforated eardrum caused by a sudden change in atmospheric pressure D) Hemorrhagic contusion of the lungs E) Gastrointestinal hemorrhage 5. A group of patients, colleagues from the same office, arrive at the ICU with symptoms of nausea, vomiting, and diarrhea. It is determined that they are suffering from radiation exposure as a result of an inconspicuous device placed in the office that leaked radiation over a period of days. The nurse suspects that which of the following was used in this terrorist attack? 11. The nurse is caring for a group of patients from the same workplace who have similar symptoms of cough, respiratory distress, and nausea and vomiting. What should the nurse suspect? A) Food poisoning at local restaurant B) Mass exposure to an inhaled agent C) Allergic response to a new cleaning agent D) Acute asthma exacerbation syndrome - ANSWER--B) Mass exposure to an inhaled agent 12. The nurse is part of a planning committee developing a disaster response plan for a hospital that serves as the major trauma center for the local area. The committee has identified that the most likely cause of a disaster in the community is a devastating tornado that significantly damages most major structures, including hospitals of all sizes, in the community. What component of the plan is least likely to be realistic? A) Transfer all noncritical patients to smaller hospitals in the community. B) Provide for secure storage of emergency supplies and equipment. C) Agree with other hospitals in town to share supplies and equipment. D) Interface with the city disaster management plan and command center. - ANSWER--A) Transfer all noncritical patients to smaller hospitals in the community. 13. The nurse is preparing to assist with triage of victims from a large mass casualty incident. The patients are sorted into categories at the door of the facility. What category will receive care last? A) Minimal B) Delayed C) Immediate D) Expectant - ANSWER--D) Expectant 14. The nurse is assisting with triage in the emergency department. A large group of patients from a mass casualty incident arrive. These patients have been classified at the scene as minimal, delayed, immediate, and expectant. What is the best nursing approach? A) Use the classifications from the scene to determine the order of treatment. B) Reassess and reclassify patients quickly to determine the order of treatment. C) Treat the patients in the order they arrive at the emergency department. D) After the first 20 patients, refer all others to another emergency care facility. - ANSWER- -B) Reassess and reclassify patients quickly to determine the order of treatment. 15. The nurse is caring for a patient who was exposed to a high dose of external radiation. What is the least likely nursing action? A) Assess for and facilitate treatment of life-threatening injuries. B) Assess radiological measurements with a Geiger counter. C) Remove clothing and shower patient as soon as possible. D) Assist in removing penetrating radioactive materials. - ANSWER--D) Assist in removing penetrating radioactive materials. 16. The nurse is caring for a patient who has been exposed to radiation. The patient has been increasingly unstable, with decreasing lymphocytes, leukocytes, thrombocytes, and erythrocytes, along with shock, diarrhea, and altered level of consciousness for some weeks. Today, there is clear evidence of worsening shock, subnormal body temperature, and increased intracranial pressure. The family asks what the patients prognosis is. The best nursing response is based on what rationale? A) Increased intracranial pressure following other symptoms is a sign of impending death. B) The symptoms listed are typical of the latent phase of recovery, which lasts several weeks. C) Full recovery from radiation exposure can take many weeks to months. D) The absence of fever indicates the patient has entered the latent phase of recovery. - ANSWER--A) Increased intracranial pressure following other symptoms is a sign of impending death. 17. The nurse is caring for a patient with a suspected cyanide exposure. The patient is anxious and hyperventilating. What is the nursing priority of care? A) Give antiseizure medications. B) Send toxicology screen. C) Give cyanide antidote. D) Obtain history of exposure. - ANSWER--C) Give cyanide antidote. 18. The nurse is assisting with the initial care and assessment of a group of patients with a massive topical toxic chemical exposure. What is the best way to decontaminate these patients? A) Use an antidote to the chemical of exposure. B) Use an alkaline substance for an acid contaminant. C) Soap-and-water shower first for most chemicals D) Administer 100% oxygen under positive pressure. - ANSWER--C) Soap-and-water shower first for most chemicals 19. A worker in a tanning factory comes to the emergency department with itchy, papular lesions on his hands and arms. Some of the lesions have black eschar in the center and some are vesicular. What biological exposure is most likely? A) Cutaneous anthrax B) Pulmonary anthrax C) Cutaneous smallpox D) Pneumonic plague - ANSWER--A) Cutaneous anthrax Fibrous bands running directly from one bone to another that strengthen the joint and help prevent movement in undesirable directions are called ligaments. The other options are not correct. 6. The nurse notices that a woman in an exercise class is unable to jump rope. The nurse is aware that to jump rope, ones shoulder has to be capable of: a. Inversion. b. Supination. c. Protraction. d. Circumduction. - ANSWER--ANS: D Circumduction Circumduction is defined as moving the arm in a circle around the shoulder. The other options are 7. The articulation ofthe mandible and the temporal bone is known as the: a. Intervertebral foramen. b. Condyle of the mandible. c. Temporomandibular joint. d. Zygomatic arch of the temporal bone. - ANSWER--c. Temporomandibular joint. 8. To palpate the temporomandibular joint, the nurses fingers should be placed in the depression of the ear. a. Distal to the helix b. Proximal to the helix c. Anterior to the tragus d. Posterior to the tragus - ANSWER--c. Anterior to the tragus 9. Of the 33 vertebrae in the spinal column, there are: a. 5 lumbar. b. 5 thoracic. c. 7 sacral. d. 12 cervical. - ANSWER--ANS: A 5 lumbar There are 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 3 to 4 coccygeal vertebrae in the spinal column. 10. An imaginary line connecting the highest point on each iliac crest would cross the vertebra. a. First sacral b. Fourth lumbar c. Seventh cervical d. Twelfth thoracic - ANSWER--b. Fourth lumbar 11. The nurse is explaining to a patient that there are shock absorbers in his back to cushion the spine and to help it move. The nurse is referring to his: a. Vertebral column. b. Nucleus pulposus. c. Vertebral foramen. d. Intervertebral disks. - ANSWER--ANS: D Intervertebral disks. Intervertebral disks are elastic fibrocartilaginous plates that cushion the spine similar to shock absorbers and help it move. The vertebral column is the spinal column itself. The nucleus pulposus is located in the center of each disk. The vertebral foramen is the channel, or opening, for the spinal cord in the vertebrae. 12. The nurse is providing patient education for a man who has been diagnosed with a rotator cuff injury. The nurse knows that a rotator cuff injury involves the: a. Nucleus pulposus. b. Articular processes. c. Medial epicondyle. d. Glenohumeral joint. - ANSWER--d. Glenohumeral joint. A rotator cuff injury involves the glenohumeral joint, which is enclosed by a group of four powerful muscles and tendons that support and stabilize it. The nucleus pulposus is located in the center of each intervertebral disk. The articular processes are projections in each vertebral disk that lock onto the next vertebra, thereby stabilizing the spinal column. The medial epicondyle is located at the elbow. 13. During an interview the patient states, I can feel this bump on the top of both of my shouldersit doesnt hurt but I am curious about what it might be. The nurse should tell the patient that it is his: a. Subacromial bursa. b. Acromion process. c. Glenohumeral joint. d. Greater tubercle of the humerus. - ANSWER--b. Acromion process. 14. The nurse is checking the range of motion in a patients knee and knows that the knee is capable of which movement(s)? a. flexion and extension 20. A woman who is 8 months pregnant comments that she has noticed a change in her posture and is having lower back pain. The nurse tells her that during pregnancy, women have a posture shift to compensate for the enlarging fetus. This shift in posture is known as: a. Lordosis. b. Scoliosis. c. Ankylosis. d. Kyphosis. - ANSWER--a. Lordosis. Lordosis compensates for the enlarging fetus, which would shift the center of balance forward. This shift in balance, in turn, creates a strain on the low back muscles, felt as low back pain during late pregnancy by some women. Scoliosis is lateral curvature of portions of the spine; ankylosis is extreme flexion of the wrist, as observed with severe rheumatoid arthritis; and kyphosis is an enhanced thoracic curvature of the spine. 21. An 85-year-old patient comments during his annual physical examination that he seems to be getting shorter as he ages. The nurse should explain that decreased height occurs with aging because: a. Long bones tend to shorten with age. b. The vertebral column shortens. c. A significant loss ofsubcutaneous fat occurs. d. A thickening ofthe intervertebral disks develops. - ANSWER--b. The vertebral column shortens. 22. A patient has been diagnosed with osteoporosis and asks the nurse, What is osteoporosis? The nurse explains that osteoporosis is defined as: a. Increased bone matrix. b. Loss of bone density. c. New, weaker bone growth. d. Increased phagocytic activity. - ANSWER--b. Loss of bone density. 23. The nurse is teaching a class on preventing osteoporosis to a group of perimenopausal women. Which of these actions is the best way to prevent or delay bone loss in this group? a. Taking calcium and vitamin D supplements b. Taking medications to prevent osteoporosis c. Performing physical activity, such as fast walking d. Assessing bone density annually - ANSWER--c. Performing physical activity, such as fast walking 24. A teenage girl has arrived complaining of pain in her left wrist. She was playing basketball when she fell and landed on her left hand. The nurse examines her hand and would expect a fracture if the girl complains of a: a. Dull ache. b. Deep pain in her wrist. c. Sharp pain that increases with movement. d. Dull throbbing pain that increases with rest. - ANSWER--c. Sharp pain that increases with movement. 25. A patient is complaining of pain in his joints that is worse in the morning, better after he moves around for a while, and then gets worse again if he sits for long periods. The nurse should assess for other signs of what problem? a. Tendinitis b. Osteoarthritis c. Rheumatoid arthritis d. Intermittent claudication - ANSWER--c. Rheumatoid arthritis Rheumatoid arthritis is worse in the morning when a person arises. Movement increases most joint pain, except the pain with rheumatoid arthritis, which decreases with movement. The other options are not correct. 26. A patient states, I can hear a crunching or grating sound when I kneel. She also states that it is very difficult to get out of bed in the morning because of stiffness and pain in my joints. The nurse should assess for signs of what problem? a. Crepitation b. Bone spur c. Loose tendon d. Fluid in the knee joint - ANSWER--a. Crepitation 27. A patient is able to flex his right arm forward without difficulty or pain but is unable to abduct his arm because of pain and muscle spasms. The nurse should suspect: a. Crepitation. b. Rotator cuff lesions. c. Dislocated shoulder. d. Rheumatoid arthritis. - ANSWER--b. Rotator cuff lesions. Rotator cuff lesions may limit range of motion and cause pain and muscle spasms during abduction, whereas forward flexion remains fairly normal. 28. A professional tennis player comes into the clinic complaining of a sore elbow. The nurse will assess for tenderness at the: a. Olecranon bursa. b. Annular ligament. the nurse will feel and hear a clunk, as the head of the femur pops back into place. A positive Ortolanisign also reflects hip instability. The Allis test also tests for hip dislocation but is performed by comparing leg lengths. 1.A male client asks the nurse about the purpose ofthe prostate gland. The nurse should respond that it is a structure that: 1. secretes an alkaline substance that neutralizes residual acidic urine in the urethra. 2. provides a milky alkaline substance that neutralizes the acidity of the male urethra and the female vagina. 3. secretes a fluid for the health and nutrition of sperm. 4. propels sperm into the ejaculatory duct. - ANSWER--ANS: 2. provides a milky alkaline substance that neutralizes the acidity of the male urethra and the female vagina. The prostate gland produces a milky alkaline fluid that helps neutralize the acidity of the male urethra and female vagina. The bulbourethral (Cowpers) gland secretes an alkaline substance that neutralizes any residual acidic urine in the urethra. The seminal vesicles secrete a fluid for the health and nutrition of sperm. The vas deferens is a duct that propels sperm into the ejaculatory duct. 2.A 50-year-old male client has had a prostate-specific antigen test. The nurse realizes that the normal range for this test would be: 1.0 to 2 ng/mL. 2.0 to 3 ng/mL. 3.0 to 4 ng/mL. 4.0 to 5 ng/mL. - ANSWER--3.0 to 4 ng/mL. The prostate-specific antigen is used to test for both benign and malignant diseases of the prostate. A PSA reading of 4 nanograms and below is considered normal. 3.A male client, having difficulty voiding, tells the nurse that he thinks something is wrong with his penis. The nurse reviews the structures of the penis with the client and explains that the structure that surrounds the urethra is the: 1. corpus cavernosa. 2. corpusspongiosum. 3. glans penis. 4. prepuce. - ANSWER--2. corpus spongiosum. The corpus spongiosum surrounds the urethra. The corpus cavernosa lies near the top of the penis. The glans penis is the erectile tip of the penis, and the prepuce is the foreskin. 4.The nurse is preparing to discuss the male reproductive system with a group of adolescent school students. Which of the following would the nurse not include as a primary function of the male reproductive system? 1.Frequent erectile functioning and increased libido 2.Production ofsperm 3. Secretion of testosterone 4. Transportation and depositing ofsperm - ANSWER--1.Frequent erectile functioning and increased libido The primary functions of the male reproductive system are the production of sperm, the transportation and depositing of sperm in the female reproductive tract, and the secretion of testosterone. Frequent erectile functioning and increased libido are not primary functions. 5.A male client is diagnosed as being infertile. The nurse realizes which of the following structures of the clients reproductive system is affected? 1.Epididymis 2.Rete testes 3.Seminal vesicles 4.Seminiferous tubules - ANSWER--ANS: 4 Seminiferous tubules The seminiferoustubules produce spermatozoa. The rete testes and epididymis store sperm. The seminal vesicles secrete a fluid for the health and nutrition ofsperm. 6.The nurse, preparing to discuss the female reproductive system with a group of adolescent females, would include that which of the following is not a primary function of the female reproductive system? 1.Breastfeeding 2.Hormone secretion 3.Pregnancy 4.Sensory innervation - ANSWER--4.Sensory innervation The primary functions of the female reproductive system are the production of ova, the secretion of hormones, pregnancy and birth of a fetus, and breastfeeding. Sensory innervation is not a primary function of the female reproductive system. 7.A young adult female client is concerned that she does not have enough eggs since she has not yet become pregnant. The nurse should assure her that the number of ova available to produce a pregnancy would be around: 1.500. 2.10,000. 3.300,000. 4.2,000,000. - ANSWER--ANS: 3 At birth the ovaries contain between 2 and 4 million ova. Most of the ova degenerate across time until there are only 300,000 to 400,000 ova present at puberty. A woman may release fewer that 500 mature ova during monthly ovulation. 8.During a gynecological exam, it is noted that a clients os is in the shape of a slit. The nurse realizes that this shape means that the client has: 1. borne children. 2. not started menses. 3. not borne any children. 4. gone through menopause. - ANSWER--ANS: 1 borne children. The shape of the os in women who have not borne children is circular. In women who have borne children, the os is slit-like. The shape ofthe cervical os does not change if a client has not started menses or has gone through menopause. 9.The nurse, reviewing the reproductive hormones needed to produce sperm and ova, realizes that which of the following hormones is not involved in the formation of sperm and ova? promotes atherosclerosis. After menopause the low-density lipoprotein levels will not decrease. After menopause, the high-density lipoprotein levels will not increase. 3.The nurse is reviewing the physiologicalsexual response pattern within males and females and realizes that which of the following occur in both genders? (Select all that apply.) 1.Resolution 2.Orgasm 3.Erection 4.Lubrication 5.Plateau 6.Excitement - ANSWER--ANS: 1, 2, 5, 6 The physiological sexual response pattern that occurs in both males and females are: excitement, plateau, orgasm, and resolution. Erection is a response in males. Lubrication is a response in females. 4.A female client is concerned that she has not had sexual intercourse with her husband for over 2 months. Which of the following can the nurse respond as causes for an alteration in sexual functioning? (Select all that apply.) 1.Chronic illnesses 2.Physical disabilities 3.Negative body image 4.Medications 5.Surgical procedures 6.Employment status - ANSWER--ANS: 1, 2, 3, 4, 5 There are a variety of causes for sexual dysfunction. Some reasons include chronic illnesses, physical disabilities, negative body image, medications, and surgical procedures. Employment status is not an identified cause for sexual dysfunction. 5.The nurse is concerned that a female client might be experiencing intimate partner violence. Which of the following assessment questions can be used to gain more information from the client? (Select all that apply.) 1.In the last year have you been hit, slapped, or physically hurt by someone? 2.Are you currently sexually active? 3.Within the last year has someone made you do something sexual that you did not want to do? 4.Is sex satisfying to you? 5.Are you afraid of your partner or anyone else? 6.Do you have discomfort with intercourse? - ANSWER- -ANS: 1, 3, 5 To assess if a client might be experiencing intimate partner violence, the nurse can ask the questions: In the last year have you been hit, slapped, or physically hurt by someone?; Within the last year has someone made you do something sexual that you did not want to do?; and Are you afraid of your partner or anyone else? The other choices are questions that are used for a sexual history. 1.A client who has just given birth is planning on breastfeeding the baby. The nurse realizes that which of the following hormones influences breast milk secretion? 1.Follicle-stimulating hormone 2.Luteinizing hormone 3.Oxytocin 4.Prolactin - ANSWER--4.Prolactin Prolactin is necessary for breast formation and the production of breast milk. Oxytocin is responsible for uterine contractions and the breast milk let down. Follicle-stimulating hormone stimulates the production of sperm and ova. In men, luteinizing hormone stimulates testosterone needed for sperm production, and in women, it stimulates ovulation. 2. The nurse is instructing a female client about breast self-examination. Which of the following instructions would not be correct for the nurse to provide? 1.A menstruating woman should check her breast monthly 8 days following her menses. 2.An inverted nipple is not a cause for alarm. 3. During menopause, you should check your breasts once a month during the same time frame. 4. Visually check the breasts in front of a mirror. - ANSWER--ANS: 2 An inverted nipple is not a cause for alarm. An inverted nipple is not necessarily a cause for alarm if it has been present since puberty, but any change in the nipple or breast tissue should be evaluated. The other instructions would be appropriate for the nurse to provide. 3.A client who has been breastfeeding a newborn for the last 3 months is experiencing an inflammation of the breast. The nurse realizes this client is experiencing: 1. intraductal papilloma. 2. mastalgia. 3. mastitis. 4. mastodynia - ANSWER--ANS: 3 Mastitis Mastitis, inflammation of the breast, may be caused from irritation, injury, or infection, and it most commonly occurs within the first 3 months after childbirth. Mastalgia and mastodynia are terms that refer to breast pain. Intraductal papilloma is a small benign tumor that grows within the terminal portion of a solitary milk duct of the breast. 4.During the examination of a female clients breasts, the nurse determines that which of the following assessment findings would be normal? 1.Nipple discharge 2.Masses 3.Scaling 4. Symmetrical nipples - ANSWER--4. Symmetrical nipples 5. The nurse is instructing a female client on the importance of having routine mammograms because mammograms: 1.can detect masses before they become palpable. 2. involves no radiation. 3. has a 25% rate of false positives. 4.combines a blood test with radiology. - ANSWER-- 1.can detect masses before they become palpable. Mammography is a radiological procedure that is useful because it allows visualization of benign and malignant disorders before they become palpable. The rate of false positives is 5% to 10%. Mammography does use radiation. Mammography does not include a blood test. 6.The nurse is instructing a female client on what should be done if a lump is discovered while performing breast self-examination (BSE). What should the nurse instruct the client to do? 1.Call her physician and immediately schedule an appointment. 2.Call to schedule an appointment next month. 3. Take the antibiotics she has in her medicine cabinet. 1.When instructing a client on breast self-examination, the nurse reviews the importance of visual inspection of the breasts. Which of the following should the nurse instruct the client to focus on when doing this part of the examination? (Select all that apply.) 1.Contour and symmetry of the breasts 2.Skin changes 3.Position of the nipples 4.Presence or absence of masses 5.Pain 6.Size - ANSWER--ANS: 1, 2, 3, 4 1.Contour and symmetry of the breasts 2.Skin changes 3.Position of the nipples 4.Presence or absence of masses Visual inspection of the breast self-examination focuses on the contour and symmetry of the breasts; skin changes such as scaling, puckering, dimpling, or scars; the position of the nipples; nipple discharge or retraction; and presence or absence of masses. This part of the examination does not include pain or size of the breasts. 2.The nurse is preparing to assess a clients nipples during a breast examination. Which of the following are considered pathological conditions that affect the nipple? (Select all that apply.) 1.Bleeding 2.Lumps 3.Discharge 4.Scars 5.Fissures 6.Large size - ANSWER--1.Bleeding 3.Discharge 5.Fissures 3.Which of the following should the nurse do if a female client is experiencing nipple discharge? (Select all that apply.) 1. Note the color of the discharge. 2. Determine if the discharge is from one or both breasts. 3. Obtain a sample of the discharge with a sterile cotton-tipped swab. 4.Assess the nipple drainage for occult blood 5.Apply sterile bandages over the nipple. 6.Pad the clients bra with gauze. - ANSWER--1. Note the color of the discharge. 2. Determine if the discharge is from one or both breasts. 3. Obtain a sample of the discharge with a sterile cotton-tipped swab. 4.Assess the nipple drainage for occult blood 4.A client is experiencing galactorrhea. Which ofthe following should the nurse assess in this client? (Select all that apply.) 1. Recent vigorous nipple stimulation 2. Prescribed hormones, blood pressure medications, or antidepressants 3.Intake of herbal remedies such as fennel or anise 4.Use ofstreet drugs such as opiates and marijuana 5.Recent chest trauma 6.Age of menarche - ANSWER--1. Recent vigorous nipple stimulation 2. Prescribed hormones, blood pressure medications, or antidepressants 3.Intake of herbal remedies such as fennel or anise 4.Use ofstreet drugs such as opiates and marijuana 5.Recent chest trauma 5.A client is considering breast augmentation surgery. Which of the following postoperative complications should the nurse discuss with the client regarding this surgery? (Select all that apply.) 1.Change in sensation 2.Development of a hematoma 3.Fibrous tissue around the implant 4.Heart palpitations 5.High blood pressure 6.Arm pain - ANSWER--1.Change in sensation 2.Development of a hematoma 3.Fibrous tissue around the implant 1. A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her examination? a. Human papillomavirus (HPV) b. Endometrial hyperplasia c. Vagismus d. Polycystic ovarian syndrome - ANSWER--a. Human papillomavirus (HPV) 2. A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which ofthe following is the treatment of choice for gonorrhea? a. Ceftriaxone b. Doxycycline c. Acyclovir d. Metronidazole - ANSWER--a. Ceftriaxone 3. A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease has she most probably been exposed to? a. Gonorrhea b. HPV c. Chlamydia d. Trichomonas - ANSWER--c. Chlamydia 4. A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear. Which of the following diagnoses is associated with this finding? a. Trichomonas b. Bacterial vaginosis c. HPV d. Herpes simplex virus - ANSWER--b. Bacterial vaginosis 5. Which ofthe following medications is the treatment of choice for trichomonas? a. Metronidazole 12. A 44-year-old patient with breast cancer is prescribed tamoxifen by her surgeon. She is complaining about hot flashes. Which of the following responses by the clinician would be most appropriate? a. ―You must be having menopause.‖ b. ―The hot flashes are a result ofthe antiestrogenic effects of tamoxifen.‖ c. ―Tamoxifen will impact your temperature regulation center.‖ d. ―The drug destroys your ovaries.‖ - ANSWER--b. ―The hot flashes are a result ofthe antiestrogenic effects of tamoxifen 13. A 32-year-old woman is seen in the clinic because she has been unable to get pregnant after 12 months of unprotected sex. In order to determine the cause of the infertility, the clinician should question her about which of these possible causes? a. Pelvic inflammatory disease b. Oral contraceptive use for 15 years c. Early menarche d. Diet high in soy protein - ANSWER--a. Pelvic inflammatory disease 14. When assessing a woman for infertility, which of the following tests should be done first? a. Analysis of partner's sperm b. Magnetic resonance imaging (MRI) c. Hysterosalpingogram d. Estrogen leve - ANSWER--a. Analysis of partner's sperm 15. A 15-year-old girl is seen in the clinic because she has not yet had her first period. Which ofthe following questions would help the clinician determine the cause? a. ―Are you sexually active?‖ b. ―How long have you been underweight?‖ c. ―Did your mother take diethylstilbestrol during her pregnancy?‖ d. ―Have you noticed any changes in your moods lately?‖ - ANSWER--b. ―How long have you been underweight? 16. What is the most common cause ofsecondary amenorrhea? a. Pregnancy b. Pituitary dysfunction c. Inadequate estrogen levels d. Genetic disorders - ANSWER--a. Pregnancy 17. A 22-year-old woman is diagnosed with premenstrual syndrome. Which of the following lifestyle changes should the clinician suggest to help minimize the patient's symptoms? a. At least 4 cups of green tea daily b. Regular exercise c. Take vitamin A supplements d. Eat a diet high in iron - ANSWER--b. Regular exercise 18. A 25-year-old woman is seen in the clinic complaining of painful menstruation. Which ofthe following pelvic pathologies is the most common cause of dysmenorrhea? a. Pelvic inflammatory disease b. Endometriosis c. Sexually transmitted infections d. Ovarian cyst - ANSWER--b. Endometriosis 19. A 26-year-old woman tells the clinician that she has endometriosis, because she has frequent pelvic pain. The clinician also should consider which of these differential diagnoses? a. Diverticulitis b. Cholelithiasis c. Kidney stones d. Ovarian cysts - ANSWER--d. Ovarian cysts 20. Which ofthe following would be appropriate treatment for a woman with mild endometriosis? a. Oral contraceptives b. Leuprolide acetate injections c. Nafarelin nasal spray d. Hysterectomy - ANSWER--a. Oral contraceptives 21. A 45-year-old woman is seen in the clinic with abnormal uterine bleeding and pain during intercourse. The clinician should consider which ofthe following diagnoses? a. Leiomyoma b. Pregnancy c. Ovarian cancer d. All of the above - ANSWER--d. All of the above 22. A 48-year-old woman is seen in the clinic with complaints of prolonged heavy menstrual periods. She is pale and states she can no longer exercise. Pelvic exam reveals a single, very large mass. Which of the following diagnostic tests should the clinician order first? a. Transvaginal ultrasound b. Endometrial biopsy c. MRI