Question 5321)
A woman is to have a routine gynecological examination tomorrow. What
instructions should the nurse give this client?
A. “Bring a urine sample with you.”
B. “Be sure to drink plenty of fluids in the morning before you come so that your bladder will be full.”
C. “Be sure not to douche today or tomorrow.”
D. “Don’t eat breakfast. You will be able to eat right after the exam.”
Answer: C
Explanation: There is no special preparation for a gynecological exam. The client should not douche, however.
There is no need to bring a urine specimen. The client may be asked to give a specimen prior to the examination.
Drinking plenty of fluids would be appropriate prior to a pelvic ultrasound examination. There is no need to fast
before a gynecological exam.
Question 5322)
A 46-year-old woman visits her gynecologist because she has been spotting. She is
to be evaluated for carcinoma of the cervix. If she has cancer of the cervix, she is most likely to
report that vaginal spotting occurred at what time?
A. On arising
B. While sitting
C. After intercourse
D. On stair climbing
Answer: C
Explanation: Postcoital (after intercourse) spotting is often seen with cancer of the cervix. The other responses are
not correct.
Question 5323)
The nurse is discussing breast self-examination with a group of women in a clinic.
One woman asks, “When should I do this examination?” What is the best response for the nurse?
A. “You should perform breast self-examination early in the morning for most accurate results.”
B. “Breast self-examination should be done a few days after your period begins every month.”
C. “Breast self-examination should be done by women after the age of 40 on the first of every month.”
D. “Breast self-examination is best done just before you expect your menstrual period.”
Answer: B
Explanation: The best time to perform breast self-examination is a few days after the menstrual period begins
because the breasts are least tender at this time. It should be done every month. Answer 1 is incorrect. It does not
matter what time of day the exam is performed. Breast self-examination should be done monthly, starting right
after puberty. The incidence of breast cancer does increase with age, but it can occur in teenagers. The breasts
are most tender just before the period starts; this is the least desirable time to do a breast self-examination.
Question 5324)
The physician prescribes clomiphene (Clomid) for a woman who has been having
difficulty getting pregnant. When discussing this drug with the woman, the nurse should know that
which of the following is known to be a side effect of clomiphene?
A. Infertility
B. Multiple births
C. Vaginal bleeding
D. Painful intercourse
Answer: B
Explanation: One of the major side effects of fertility drugs, such as clomiphene, which increases ovulation, is
multiple births. Clomiphene is used to treat infertility; it does not cause infertility. Clomiphene does not cause
vaginal bleeding or painful intercourse.
Question 5325)
A young couple asks the nurse which method of contraception is the best and the
one that they should use. Which response is most helpful to the couple?
A. “The pill is the best because it is 100% effective with few side effects.”
B. “The best method is the one that you both agree upon and will use consistently.”
C. “The condom is the best method because it prevents diseases as well as pregnancy.”
D. “No method is completely effective; you should practice abstinence until you are ready to have children.”
Answer: B
Explanation: The best method for any couple is one they will use consistently. The only 100% effective method is
abstinence, which is not a realistic choice for most couples. To be effective, contraception must be used
consistently and correctly. Answer 1 is not correct. If the pill is not taken exactly as directed, pregnancies can and
do occur. The pill has several side effects, including nausea, weight gain, and enlarged breasts. Answer 3 contains
correct information in that the condom does help to prevent disease transmission. However, with a married
couple, this is not likely to be an issue. Answer 4 is an unrealistic answer for a married couple and therefore is not
very helpful.
Question 5326)
A woman is being treated for Trichomonas vaginalis with metronidazole (Flagyl).
Which statement the woman makes indicates a need for further teaching?
A. My husband is also taking medicines
B. “I will take Flagyl with meals.”
C. The doctor said I might get a metallic taste in my mouth while I am taking Flagyl.”
D. “I will drink only one glass of wine per meal while I am taking Flagyl.”
Answer: D
Explanation: Alcohol taken with Flagyl causes an Antabuselike reaction, nausea, and vomiting. The client should
drink no alcoholic beverages. The husband (partner) should also be treated, even if he has no symptoms, to
prevent reinfection. Flagyl, unless it is extended release, should be taken with food to decrease gastrointestinal
side effects. People commonly get a metallic taste when taking Flagyl.
Question 5327)
A client who is being treated for syphilis says to the nurse, “Why does the doctor
want to know who I have had sex with?” What should the nurse include when responding to this
question?
A. It really is not any of the physician’s concern.
B. The physician wants to help you make better decisions about your lifestyle.
C. Reporting of sexual contacts is mandatory so that the contacts can receive testing and treatment.
D. Studies need to be done on sexual activities to learn how to reduce the spread of the disease.
Answer: C
Explanation: Sexual contacts must be reported so that they can be contacted, tested, and treated to avoid the
serious complications of untreated syphilis. Answer 1 is not correct. It is possible that there might be some truth to
answer 2. However, the information regarding contacts is usually obtained in a nonjudgmental manner for the
reasons described above. Answer 4 is not correct.
Question 5328)
During the early period following a right modified radical mastectomy, which
nursing action would be appropriate to include in the client’s plan of care?
A. Position the client in the right lateral position
B. Encourage a high fluid intake
C. Ambulate as soon as sensation and motion have returned
D. Elevate the right arm on pillows
Answer: D
Explanation: The arm on the affected side should be elevated on pillows to help prevent the development of
lymphedema. The client should not be positioned on the affected side. Once the client is awake following
anesthesia, the head of the bed will be elevated. The client may have liquids following surgery, but there is no
particular need to encourage a high fluid intake. The client will begin to ambulate fairly quickly. However, the
client will not have had an epidural anesthetic for a mastectomy, so the return of sensation and motion is not an
issue. A mastectomy is too high for an epidural. Epidurals are not given for surgery above the waist.
Question 5329)
The nurse is caring for a client who has had a right modified radical mastectomy
this morning. Which exercise should the nurse encourage the client to perform this evening?
A. Hair combing exercises with the right arm
B. Wall climbing exercises with the right arm
C. Movement of the fingers and wrists of the right arm
D. Exercises of the left arm only
Answer: C
Explanation: On the day of surgery, the client should be encouraged to move the fingers and wrists of the affected
arm. Hair combing and wall climbing exercises will be performed later, not on the day of surgery. The client should
be encouraged to exercise the fingers and wrists of the affected extremity on the day of surgery as well as
exercising the unaffected arm.
Question 5330)
The client is being discharged following a left simple mastectomy. Which
statement the client makes indicates an understanding of discharge teaching?
A. “I won’t let anyone take blood pressures on my left arm.”
B. “I understand that I should not have sexual relations for at least three months.”
C. “I won’t move my arm any more than necessary.”
D. “I will not lift my arm above my head for the next two weeks.”
Answer: A
Explanation: The client who has had a mastectomy should not have blood drawn or blood pressures taken on that
arm. There is no reason why she should not have sexual relations for three months. As soon as she feels well
enough, sexual relations can resume. She should use a position that does not put pressure on her left side. Answers
3 and 4 are incorrect. A woman who has had a mastectomy will need to perform arm exercises regularly. These will
include lifting the arm above the head in exercises like hair combing and wall climbing.
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