- ANS-Chapter 44: Liver, Pancreas, and Biliary Tract Problems
- ANS-Chapter 51: Reproductive System
- ANS-Chapter 52: Breast Disorders
- ANS-Chapter 53: Sexually Transmitted Diseases
- ANS-Chapter 54: Female Reproductive Problems
- ANS-Chapter 55: Male Reproductive Problems
ANS: A
A common etiologic factor for erectile dysfunction (ED) in younger men is use of recreational
drugs or alcohol. Stress, priapism, and cardiovascular illness also contribute to ED, but they are
not common etiologic factors in younger men. - ANS-24. A 22-year-old man tells the nurse at
the health clinic that he has recently had some problems with erectile dysfunction. When
assessing for possible etiologic factors, which question should the nurse ask first?
a. "Are you using any recreational drugs or drinking a lot of alcohol?"
b. "Have you been experiencing an unusual amount of anxiety or stress?"
c. "Do you have any history of an erection that lasted for 6 hours or more?"
d. "Do you have any chronic cardiovascular or peripheral vascular disease?"
ANS: A
,A local anesthetic is given before stereotactic biopsy. NPO status is not needed because no
sedative drugs are given. The patient is placed in the prone position. A biopsy gun is used to
obtain the specimens. - ANS-14. When a patient is scheduled for stereotactic core biopsy of the
breast, which information will the nurse include in patient education?
a. A local anesthetic will be given before the biopsy specimen is obtained.
b. You will need to lie flat on your back and lie very still during the biopsy.
c. A thin needle will be inserted into the lump and aspirated to remove tissue.
d. You should not have anything to eat or drink for 6 hours before the procedure.
ANS: A
A postmenopausal woman with vaginal bleeding should be evaluated for endometrial cancer,
and endometrial biopsy is the primary test for endometrial cancer. D&C will be needed only if
the biopsy does not provide sufficient information to make a diagnosis. Endometrial ablation and
balloon therapy are used to treat menorrhagia, which is unlikely in this patient. - ANS-20. A
58-year-old woman calls the health clinic when she has a moderate amount of vaginal bleeding
after 6 years of menopause. The nurse will anticipate teaching the patient about
a. endometrial biopsy.
b. uterine balloon therapy.
c. laser endometrial ablation.
d. dilation and curettage (D&C).
ANS: A
After a laparoscopic cholecystectomy, the patient will have Band-Aids in place over the
incisions. Patients are discharged the same (or next) day and have few restrictions on activities
of daily living. Drainage from the incisions would be abnormal, and the patient should be
instructed to call the health care provider if this occurs. A low-fat diet may be recommended for
a few weeks after surgery but will not be a life-long requirement. - ANS-23. After providing
discharge instructions to a patient following a laparoscopic cholecystectomy, the nurse
recognizes that teaching has been effective when the patient states,
a. "I can remove the bandages on my incisions tomorrow and take a shower."
b. "I can expect some yellow-green drainage from the incision for a few days."
c. "I should plan to limit my activities and not return to work for 4 to 6 weeks."
d. "I will always need to maintain a low-fat diet since I no longer have a gallbladder."
ANS: A
Alcohol use is one of the most common risk factors for pancreatitis in the United States.
Cigarette smoking, diabetes, and high-protein diets are not risk factors. - ANS-21. When
obtaining a health history from a patient with acute pancreatitis, the nurse asks the patient
specifically about a history of
a. alcohol use.
b. diabetes mellitus.
c. high-protein diet.
d. cigarette smoking.
,ANS: A
All of the interventions are appropriate, but only the careful labeling of specimens and materials
will assist in maintaining the chain of evidence. - ANS-34. Which action by the nurse will be
most important in maintaining the medicolegal chain of evidence for a patient who has been
sexually assaulted?
a. Label all specimens and materials obtained from the patient.
b. Educate the patient about the reason for baseline sexually transmitted disease (STD) testing.
c. Assist the patient in filling out the application for financial compensation.
d. Discuss the availability of the "morning-after pill" for pregnancy prevention.
ANS: A
Because some medications can cause ED and patients using nitrates should not take Viagra,
the nurse should first assess for prescription drug use. The nurse may want to teach the patient
about realistic expectations and adverse effects of Viagra therapy, but this should not be the first
action. Although ED does increase with aging, it may be secondary to medication use or
cardiovascular disease in a 53-year-old. - ANS-25. A 53-year-old man tells the nurse he has
been having increasing problems with erectile dysfunction (ED) for several years but is now
interested in using Viagra (sildenafil). Which action should the nurse take first?
a. Ask the patient about any prescription drugs he is taking.
b. Tell the patient that Viagra does not always work for ED.
c. Discuss the common adverse effects of erectogenic drugs.
d. Assure the patient that ED is commonly associated with aging.
ANS: A
Complications of gonorrhea include scarring of the fallopian tubes, which can lead to tubal
pregnancies and infertility. Syphilis, genital warts, and genital herpes do not lead to problems
with conceiving, although transmission to the fetus (syphilis) or newborn (genital warts or genital
herpes) is a concern. - ANS-8. When counseling a woman who is having difficulty conceiving,
the nurse will be most concerned about a history of infection with
a. N. gonorrhoeae.
b. Treponema pallidum.
c. condyloma acuminatum.
d. herpes simplex virus type 2.
ANS: A
Depo-Provera induces a pseudopregnancy, which suppresses ovulation and causes shrinkage
of endometrial tissue. Vaginal atrophy and hot flashes are caused by synthetic androgens such
as danazol or gonadotropin-releasing hormone agonists (GNRH) such as leuprolide. Although
hormonal therapies will control endometriosis while the therapy is used, endometriosis will recur
once the menstrual cycle is reestablished. Depo-Provera use is not associated with bone loss. -
ANS-18. A patient with endometriosis is treated with medroxyprogesterone (Depo-Provera). The
nurse explains that this therapy
a. suppresses the menstrual cycle by mimicking pregnancy.
b. may cause symptoms such as vaginal atrophy and hot flashes.
, c. is associated with loss of bone density and increased fracture risk.
d. will lead to permanent suppression of abnormal endometrial tissues.
ANS: A
Doxorubicin can cause cardiac toxicity; the dysrhythmia should be reported because it may
indicate a need for a change in therapy. Anorexia, fatigue, and a low-normal WBC count are
expected effects of chemotherapy. - ANS-25. When the nurse is caring for a patient with breast
cancer who is receiving chemotherapy with doxorubicin (Adriamycin) and cyclophosphamide
(Cytoxan), which assessment finding is most important to communicate to the health care
provider?
a. The patient's apical pulse is irregular.
b. The patient has complaints of fatigue.
c. The patient eats only 15% of food on meal tray.
d. The patient's white blood cell (WBC) count is 5000/mm3.
ANS: A
Excessive exercise can cause amenorrhea. The other statements by the patient do not suggest
any urgent teaching needs. - ANS-5. A 19-year-old patient who is being assessed for
amenorrhea at the clinic makes all of the following statements to the nurse. Which one indicates
a need for patient teaching?
a. "I run at least 8 miles every day to keep in shape."
b. "I drink at least 3 glasses of non-fat milk every day."
c. "I am not sexually active but currently I have an IUD [intrauterine device]."
d. "I was recently treated for a sexually transmitted disease."
ANS: A
FNA is done in outpatient settings and results are available in 24 to 48 hours. No incision is
needed. FNA may be guided by ultrasound, but not by mammogram. Since the immobility of the
breast lump suggests cancer, further testing will be done if the FNA is negative. - ANS-3. A
patient with a small immobile breast lump is advised to have a fine needle aspiration (FNA)
biopsy. The nurse explains that an advantage to this procedure is that
a. FNA is done in the outpatient clinic, and results are available in 1 to 2 days.
b. only a small incision is needed, resulting in minimal breast pain and scarring.
c. if the biopsy results are negative, no further diagnostic testing will be needed.
d. FNA is guided by a mammogram, ensuring that cells are taken from the lesion.
ANS: A
Genital warts are caused by the human papilloma virus (HPV) and increase the risk for cervical
cancer. There is no indication that the patient needs teaching about PID, oral contraceptives, or
endometrial cancer. - ANS-32. A female patient who is seen in the health clinic is diagnosed
with genital warts. The nurse will plan to teach the patient about
a. the need for regular Pap tests.
b. increased risk for endometrial cancer.
c. appropriate use of oral contraceptives.
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