1. A 33-year-old woman who uses oral contraceptives tells the
nurse, "I want to have children in a few years." Which response
by the nurse is appropriate?
a. "You may have more difficulty becoming pregnant after about
age 35."
b. "You have many years of fertility left, so there is no rush to
have children."
c. "You should plan to stop taking oral contraceptives several
years before you want to become pregnant."
d. "If you do not have children within the next few years, it will
be very difficult for you to become pregnant." Correct Answers
ANS: A
The probability of successfully becoming pregnant decreases
after age 35, although some patients may have no difficulty in
,becoming pregnant. Oral contraceptives do not need to be
withdrawn for several years for a woman to become pregnant.
Although the patient may be fertile for many years, it would be
inaccurate to indicate that there is no concern about infertility as
she becomes older. Although the risk for infertility increases
after age 35, not all patients have difficulty in conceiving.
1. A man who has a profuse, purulent urethral discharge with
painful urination is seen at the sexually transmitted disease
(STD) clinic. Which information will be most important for the
nurse to obtain?
a. Contraceptive use
b. Sexual orientation
c. Immunization history
d. Recent sexual contacts Correct Answers ANS: D
Information about sexual contacts is needed to help establish
whether the patient has been exposed to an STD and because
sexual contacts also will need treatment. The other information
also may be gathered, but is not as important in determining the
plan of care for the patient's current symptoms.
1. A patient contracts hepatitis from contaminated food. During
the acute (icteric) phase of the patient's illness, the nurse would
expect serologic testing to reveal
a. antibody to hepatitis D (anti-HDV).
b. hepatitis B surface antigen (HBsAg).
c. anti-hepatitis A virus immunoglobulin G (anti-HAV IgG).
d. anti-hepatitis A virus immunoglobulin M (anti-HAV IgM).
Correct Answers ANS: D
Hepatitis A is transmitted through the oral-fecal route, and
antibody to HAV IgM appears during the acute phase of
,hepatitis A. The patient would not have antigen for hepatitis B
or antibody for hepatitis D. Anti-HAV IgG would indicate past
infection and lifelong immunity.
1. The nurse is performing an assessment of an 80-year-old
patient. Which information obtained by the nurse will be of most
concern?
a. Decreased appetite
b. Difficulty chewing food
c. Unintentional weight loss
d. Complaints of indigestion Correct Answers ANS: C
Unintentional weight loss is not a normal finding in older
patients and may indicate a problem such as cancer or
depression. Poor appetite, difficulty in chewing, and complaints
of indigestion are common in older patients. These will need to
be addressed, but are not of as much concern as the weight loss
1. To determine the severity of the symptoms for a patient with
benign prostatic hyperplasia (BPH) the nurse will ask the patient
about
a. blood in the urine.
b. lower back or hip pain.
c. erectile dysfunction (ED).
d. strength of the urinary stream. Correct Answers ANS: D
The American Urological Association (AUA) Symptom Index
for a patient with BPH asks questions about the force and
frequency of urination, nocturia, etc. Blood in the urine, ED, and
back or hip pain are not typical symptoms of BPH.
1. When teaching a 28-year-old patient about breast self-
examination (BSE), the nurse will instruct the patient that
, a. BSE will reduce the risk of dying from breast cancer.
b. BSE should be done daily while taking a bath or shower.
c. annual mammograms should be scheduled in addition to BSE.
d. performing BSE right after the menstrual period will improve
comfort. Correct Answers ANS: D
Performing BSE at the end of the menstrual period will reduce
the breast tenderness associated with the procedure. The
evidence is not clear that BSE reduces breast cancer mortality.
BSE should be done monthly. Annual mammograms are not
routinely scheduled for women under age 40.
1. Which question should the nurse ask when assessing a patient
who has a history of benign prostatic hyperplasia (BPH)?
a. "Have you noticed any unusual discharge from your penis?"
b. "Has there been any change in your sex life in the last year?"
c. "Has there been a decrease in the force of your urinary
stream?"
d. "Have you been experiencing any difficulty in achieving an
erection?" Correct Answers ANS: C
Enlargement of the prostate blocks the urethra, leading to
urinary changes such as a decrease in the force of the urinary
stream. The other questions address possible problems with
infection or sexual difficulties, but would not be helpful in
determining whether there were functional changes caused by
BPH.
10. A 23-year-old patient has genital warts around her external
genitalia and perianal area. She tells the nurse that she has not
had treatment until now because "the warts are so disgusting."
Which nursing diagnosis is most appropriate?
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