Exam 4 Ch. 33 – Flashcards
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A 23 year old woman has just been told that she has a 2cm fibroadenoma in her right breast. What information would the nurse give the client that would be most helpful to her? A. A fibroadenoma will most likely lead to breast cancer and should be removed right away. B. A fibroadenoma can be treated with chemotheraputic agents. C. A fibroadenoma is a benign breast tumor and is common in women her age. D. A fibroadenoma is caused by trauma to the breast.
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Answer C: Pellico page 912
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Fibroadenomas are proliferative lesions that usually present as: (select all that apply) A. Round B. Benign C. Malignant D. Moveable
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Answer (s) A, B, and D: Pellico page 912.
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A 25 year old woman has just been told she has a 2X3 cm fibroadenoma in her left breast. What information should the nurse provide to this client? A. A fibroadenoma is usually a precursor to breast cancer and must be surgically removed B. A fibroadenoma can be treated by chemotherapy C. A fibroadenoma is a benign breast tumor and is common in women her age D. A fibroadenoma is caused by trauma to the breast
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C. A fibroadenoma is a benign breast tumor and is common in women her age
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A 20 year old student comes to the health center after discovering a small painless lump in her right breast. She is worried that she might have cancer because her mother had cervical cancer. The nurse's response to the patient is based on the knowledge that the most likely cause of the breast lump is: A. Fibrocystic complex B. Fibroadenoma C. Breast abscess D. Adenocarcinoma
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B. Fibroadenoma
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Which of the following would increase risk of getting a breast cancer? A. Family history of breast cancer B. High fiber diet C. Excessive daily exercise D. Wearing a tight bra
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A. Family history of breast cancer
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Which of the following would be an appropriate nursing intervention for a patient undergoing a chemotherapy with diagnosis of breast cancer? A. Inform the patient that she or him will be hyperactive after chemotherapy B. Encourage exercise to control side effect such as fatigue C. Exclude the side effect such as depression D. Perform daily weights twice a day
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B. Encourage exercise to control side effect such as fatigue
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Which of the following terms is used to describe removal of the breast tissue and axillary lymph node dissection leaving muscular structure intact as surgical treatment of breast cancer? A. Segmental mastectomy B. Modified radical mastectomy C. Total mastectomy D. Radical mastectomy
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B. Modified radical mastectomy
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A nurse is providing breast cancer education at a community facility. The Americal cancer society recommends that women get mammograms: A. Yearly starting at age 40 B. After the birth of the first child and every 2 years thereafter C. After the first menstrual period and annually thereafter D. Every 3 years between ages 20 and 40 and annually thereafter
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A. Yearly starting at age 40
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A nurse caring for a postmastectomy patient should not perform which of the following on the operative side? Select all that apply: A. Blood draws B. Pulse check C. Intravenous sticks D. Injections E. Blood pressure
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A, C, D, E
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Which of the following symptoms would support a diagnosis of breast cancer in a patient suspected of having this diagnosis? A. Area of skin discoloration B. Complaints of achy, dull pain C. Palpable mobile mass D. Presence of an inverted nipple
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D. Presence of an inverted nipple
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What is the recommendation for routine breast cancer screening (mammography) in women 40 years and older? A. Every 6 months B. Every year C. Every 2 years D. Every 5 years
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B. Every year
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Select all that apply. A patient comes into the office for a breast reconstruction pre-op visist. The doctor explains how the autologous tissue transfer occurs. The patient asks what elements are used during the transfer. What elements are used from the patient's body for this procedure? A. Muscle B. Bone fragments C. Fat D. Skin E. Blood supply
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A, C, D, E
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What is the priority nursing diagnosis for a post-op patient who received breast reconstructive surgery? A. Disturbed body image B. Anxiety C. Risk for infection D. Acute pain
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D. Acute pain
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A TRAM (transverse rectus abdominis myocutaneos) flap procedure was performed on a female patient in order to create a breast mound. In the postop period, the nurse notes mottling and a decrease in skin temperature on the newly constructed breast site. What is the appropriate nursing intervention? A. Elevate the arm of the affected side on a pillow above heart level B. Place a warm compress on the affected arm C. Notify the physician D. Have the patient perform breathing and leg exercises
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C. Notify the physician
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The nurse is teaching a client about reconstructive breast surgery options. The nurse tell the client that mastopexy is: A . A reduction surgery performed on women with large breasts B. Performed when a client is not content with the size of her breasts but wishes to have the shape improved and a lift performed C. An augmentation surgery performed on women who desire larger or fuller breasts D. Performed when a client is content with the size of her breasts but wishes to have the shape improved and a lift performed.
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D. Performed when a client is content with the size of her breasts but wishes to have the shape improved and a lift performed.
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Select all that apply. Causes of amenorrhea include: A. Hypothyroidism B. Poor nutrition C. Excessive exercise D. Eating too much fiber E. Hyperparathyroidism
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A, B, C
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Absence of menses for a period of atleast 6 months following a history of normal menses is considered: A. Primary amenorrhea B. Tertiary amenorrhea C. Causal amenorrhea D. Secondary amenorrhea
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D. Secondary amenorrhea
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Erin a 18 year old female who is in good shape and very healthy has been training for tryouts for the school swim team for the last 8 months. Erin has noticed that in the last 6-7 months she has not gotten her period, which is irregular for her. Erin is experiencing a disorder of menstrual cycle know as: A. Osteoporosis B. Menorrhagia C. Amenorrhea D. Dysmenorrheal
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C. Amenorrhea
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Anatomical deviations of internal or external genitalia relating to the absence of menses for 6 or more months after a regular cycle of menstruation has been established is: A. Menopause B. Secondary amenorrhea C. Primary amenorrhea D. Dysmenorrhea
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B. Secondary amenorrhea
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1. When teaching a patient about ways to prevent primary dysmenorrhea, the nurse will suggest that the patient: a. avoid aerobic exercise during her menstrual period b. use cold packs on the abdomen and back for pain relief c .start taking nonsteroidal anti-inflammatory drugs (NSAIDs) regularly when her menstrual period starts d. talk with her health care provider about antidepressant therapy
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: C Rationale: NSAIDs should be started as soon as the menstrual period begins and taken at regular intervals during the usual time frame in which pain occurs. Aerobic exercise may help reduce symptoms. Heat therapy, such as warm packs, is recommended for relief of pain. Antidepressant therapy is not a typical treatment for dysmenorrhea.
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A client at the family planning clinic is diagnosed with primary dysmenorrhea. Which of the following should be included in the nurse's teaching plan for nonpharmacological comfort measures? a. initiation of oral contraception b. application of cold to the abdomen c. balanced meals and adequate rest d. regular emotional counseling
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: C Rationale: Self-care measures to treat dysmenorrhea would include regular exercise, rest, application of heat, and good nutrition
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A nurse is teaching a class on female reproductive health ,an attendee is accurate in defining painful menstruation as: A. Dysmetrorraghia B. Dyspareunia C. Dyschezia D. Dysmenorrhea
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D. Dysmenorrhea
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An Asian teenager comes to the Sick Bay at the school where u work doubled over and requesting pain medication. She stated that it happens every month when she gets her period but she's not menstruating now.You attempt a focused assessment to determine premenstrual cramps or a more serious condition before you administer NSAIDS. She keeps looking away ,head down and does not speak very clearly.You Should assume that: A The pain is debilitating and hurry up with the medication foregoing the assessment B She is correct in her diagnosis and just need the paracetamol so she can get back to class C She has been brought up to believe direct eye contact is impolite D She finds questions about getting her period embarrassing
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C She has been brought up to believe direct eye contact is impolite
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The best diagnostic method for PMS includes: A. Testing hormone levels B. Keeping a symptoms diary for 2-3 months C. A pap smear D. Urinalysis
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B. Keeping a symptoms diary for 2-3 months
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A patient suspects that she may have PMS. The nurse should ask the patient about which of the following symptoms? A. Symptoms occur during the follicular phase of the menstrual cycle B. Symptoms occur during the luteal phase of the menstrual cycle C. Symptoms that worsen during menopause D. Symptoms persist throughout the entire menstrual cycle
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B. Symptoms occur during the luteal phase of the menstrual cycle
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A patient suspects that she may have PMS. The nurse should ask the patient about which of the following symptoms? A. Symptoms occur during the luteal phase of the menstrual cycle. B. Symptoms occur during the follicular phase of the menstrual cycle. C. Symptoms worsen during menopause. D. Symptoms persist throughout the entire menstrual cycle.
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A. Symptoms occur during the luteal phase of the menstrual cycle.
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Which fluctuating level of hormones cause the symptoms of PMS and more severely PMDD during the menstrual cycle? Please select all that apply. A. Luteinizing Hormone B. Serotonin C. Estrogen D. Progesterone
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B, C, D
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What are the common signs and symptoms of prolapse? (Select all that apply) A. Sensation of sitting on a ball B. Sensation that something is falling out of vagina C. Diarrhea D. Back pain E. Urinary incontinence
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A, B, D, E
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A patient asks about a removable device that is inserted into the vagina to help provide support for uterine prolapse. The nurse knows that this device is called: A. kegel B. pessary C. vaginal mesh implant D. tampon
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B. pessary
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A 26 year old female patient is diagnosed with endometriosis. She begins to cry and states "I can't believe that I may not be able to have any children". What is the priority nursing diagnosis for this patient? A. Acute pain r/t onset of menses with distention of endometrial tissue. B. Grieving r/t possible infertility C. Deficient knowledge r/t information misinterpretation D. Sexual dysfunction r/t painful intercourse
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B. Grieving r/t possible infertility
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A young female client presents with dysmenorrhea, menorrhagia, dyspareunia and chronic pelvic pain. Tenderness is noted when the ovaries are palpated. What condition does the nurse likely suspect? A. Pregnancy B. PMS C. Endometriosis D. Brain cancer
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C. Endometriosis
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A 26 year old patient visits her OB with complaints of severe pain related to endometriosis. She questions the nurse as to why endometriosis cause pain in some women. The nurse knows that the pain is due to the fact that: A. Endometriosis tissue cannot leave the body B. Endometriosis areas make chemicals that irritate pelvic tissues C. Endometriosis produces chemicals that are known to cause pain D. All of the above
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D. All of the above
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A 33 year old woman goes to see her OB after 3 years of unsuccessful attempts to conceive. She is surprised to find out that she has endometriosis. The nurse knows that one of the most common symptoms of endometriosis is: A. Bloating B. Infertility C. Pelvic muscle spasms D. Diarrhea
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B. Infertility
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A client, age 41, visits the gynecologist. After examining her, the physician suspects cervical cancer. The nurse reviews the client's history for risk factors for this disease. Which history finding is a risk factor for cervical cancer? A. Onset of sporadic sexual activity at age 17 B. Spontaneous abortion at age 19 C. Pregnancy complicated with eclampsia at age 27 D. Human papillomavirus infection at age 32
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D. Human papillomavirus infection at age 32
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Which one of the following is not a risk factor for cervical cancer? A. Smoking B. History of genital warts C. High socioeconomic status D. Micronutrient deficiency E. HIV infection
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C. High socioeconomic status
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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 scheduling the patient for a. endometrial biopsy. b. dilation and curettage (D&C). c. laser endometrial ablation. d. uterine balloon therapy.
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: A Rationale: 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
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During assessment of a patient with suspected endometrial cancer, the nurse identifies an important risk factor for cancer of the endometrium when the patient's history includes a. alcohol addiction. b. multiple pregnancies. c. long-standing obesity. d. early sexual activity.
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: C Rationale: Because adipose cells store estrogen, obesity is a risk factor for endometrial cancer. Alcohol addiction does not increase this risk. Multiple pregnancies offer protection from endometrial cancer. Early sexual activity is associated with increased cervical cancer risk, but it does not increase risk for endometrial cancer.
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A patient is newly diagnosed with ovarian cancer. To meet this patients needs in the best way possible, the nurse should a. wait until the patient brings up any questions or concerns, so as not to overwhelm the patient with too much information. b. assess the patient's psychosocial, economic and spiritual needs c. discuss palliative care programs for the patient to consider right away d. address the patients physical needs right away and wait to address the psychosocial needs until later
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b. assess the patient's psychosocial, economic and spiritual needs
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Which tumor stage offers the patient the best possible chance of survival? a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4
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a. Stage 1
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The following risk factors have been linked to ovarian cancer: (Select all that apply) A. Age over 40 or postmenopausal. B. Long term use of hormone replacement therapy. C. Obesity with a BMI >30. D. African American or Hispanic descent. E. Personal history of breast, colon or endometrial cancer.
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(Correct answer: A, B, C, E) (Pellico, Med Surge. P. 945)
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The following are considered accurate modes of transport when describing how metastasis occurs: (Select all that apply) A. Lymphatic system. B. Hematogenous spread. C. Inhalation of asbestos or other environmental carcinogens. D. Angiogenesis.
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(Correct answer: A, B, D) (Pellico Med Surge. P. 152)
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Ovarian cancer can be accurately described as: A. A cancer that is easily detected through Pap Smear testing. B. A cancer that has a low fatality rate if diagnosed early. C. A rare disease that affects only low socio-economical classes that have little access to healthcare. D. A cancer that "whispers" because it is usually not detected until it has invaded surrounding tissues.
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(Correct answer: D) (Pellico, Med Surge. P. 944)
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The client who has the human papilloma virus is most at risk for which of the following diseases or problems? A) Pneumocystis carinii B) Autoimmune disorders such as Addison's disease, Hashimoto's thyroiditis, and others C) Shingles D) Vaginal, cervical, vulvar, and anal cancers in females
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D) Vaginal, cervical, vulvar, and anal cancers in females
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A patient who has undergone a radical vulvectomy for vulvar carcinoma returns to the medical-surgical unit after the surgery. In planning care for the patient, the nurse identifies a priority nursing diagnosis of: a. risk for infection related to contamination of the wound with urine and stool. b. self-care deficit: bathing/hygiene related to pain and difficulty in changing position. c. imbalanced nutrition: less than body requirements related to low-residue diet. d. risk for ineffective sexual pattern related to disfiguration caused by the surgery.
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a. risk for infection related to contamination of the wound with urine and stool.
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A female patient has been admitted to a med/surg unit after undergoing a vulvectomy. The nurse caring for this patient knows that the highest priority nursing diagnosis for this patient is ... A. Disturbed body image B. Risk for infection C. Impaired skin integrity D. Altered sexuality patterns
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B. Risk for infection
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The nurse knows that the most common symptom found in patients who are in the early stages of vulvar cancer is ... A. Bleeding of the external genitalia B. Lesions appearing on the vulva, perianal and rectal area C. Pain associated with urinating D. Itching of the external genitalia
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D. Itching of the external genitalia
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A 45 year old woman has been diagnosed with uterine cancer and is preparing to have a hysterectomy, she ask the nurse how common is the procedure. The best response would be: A. A hysterectomy is the most common non-obstetric major surgery B. Not a very common surgery performed C. The doctors do this all the time D. Women have this surgery all the time
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C. The doctors do this all the time
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Sandra a 25 years old woman was brought to your unit after hysterectomy surgery. She is sad and withdrawn, what could possibly be her concern. A. She is homeless and despair about her future B. Concerns about body image, sexual function after hysterectomy C. She hates the hospital staff D. She is loner
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B. Concerns about body image, sexual function after hysterectomy
