NR 509 WEEK 7 QUIZ / NR509 WEEK 7 QUIZ: LATEST,CHAMBERLAIN COLLEGE OF NURSING

NR 509 WEEK 7 QUIZ / NR509 WEEK 7 QUIZ: LATEST,CHAMBERLAIN COLLEGE OF NURSING Question 1. Question : A 43-year-old woman is at the clinic for a routine examination. She reports that she has had a breast lump in her right breast for years. Recently, it has begun to change in consistency and is becoming harder. She reports that 5 years ago, her physician evaluated the lump and determined that it “was nothing to worry about.” The examination validates the presence of a mass in the right upper outer quadrant at 1 o’clock, approximately 5 cm from the nipple. It is firm, mobile, nontender, with borders that are not well defined. The nurse’s recommendation to her is Student Answer: “Because of the change in consistency of the lump, it should be further evaluated by a physician.” “The changes could be related to your menstrual cycles. Keep track of changes in the mass each month.” “This is probably nothing to worry about because it has been present for years and was determined to be noncancerous at that time.” “Because you are experiencing no pain and the size has not changed, continue to monitor the lump and return to the clinic in 3 months.” Question 2. Question : During an examination of a woman, the nurse notices that her left breast is slightly larger than her right breast. Which of these statements is true about this finding? Student Answer: Breasts should always be symmetric. This finding is probably due to breastfeeding and is nothing to worry about. This finding is not unusual, but the nurse should verify that this change is not new. This finding is very unusual and means she may have an inflammation or growth. Question 3. Question : A 9-year-old girl is in the clinic for a sports physical. After some initial shyness, she finally asks, “Am I normal? I don’t seem to need a bra yet, but I have some friends who do. What if I never get breasts?” The nurse’s best response would be Student Answer: “Don’t worry, you still have plenty of time to develop.” “I know just how you feel, I was a late bloomer myself. Just be patient and they will grow.” “You will probably get your period before you notice any significant growth in your breasts.” “I understand that it is hard to feel different from your friends. Breasts usually develop between 8 and 10 years of age.” Question 4. Question : A 65-year-old patient remarks that she just can’t believe that her breasts sag so much. She states it must be from lack of exercise. What explanation should the nurse offer her? Student Answer: After menopause, only women with large breasts experience sagging. After menopause, sagging is usually due to decreased muscle mass within the breast. After menopause, a diet that is high in protein will help maintain muscle mass, which keeps the breasts from sagging. After menopause, the glandular and fat tissue atrophies, causing breast size and elasticity to diminish, resulting in breasts that sag. Question 5. Question : If a patient reports a recent breast infection, then the nurse should expect to find _____ node enlargement. Student Answer: nonspecific ipsilateral axillary contralateral axillary inguinal and cervical Question 6. Question : A patient states during the interview that she noticed a new lump in the shower a few days ago. It was on her left breast near her axilla. The nurse should plan to Student Answer: palpate the lump first. palpate the unaffected breast first. avoid palpating the lump because it could be a cyst, which might rupture. palpate the breast with the lump first but plan to palpate the axilla last. Question 7. Question : Which of these clinical situations would the nurse consider to be outside normal limits? Student Answer: A patient has had one pregnancy. She states that she believes she may be entering menopause. Her breast examination reveals breasts that are soft and sag slightly. A patient has never been pregnant. Her breast examination reveals large pendulous breasts that have a firm, transverse ridge along the lower quadrant in both breasts. A patient has never been pregnant. She reports that she should begin her period tomorrow. Her breast examination reveals breast tissue that is nodular and somewhat engorged. She states that the examination was slightly painful. A patient has had two pregnancies and she breastfed both of her children. Her youngest child is now 10 years old. Her breast examination reveals breast tissue that is somewhat soft and she has a small amount of thick yellow discharge from both nipples. Question 8. Question : The nurse is performing a breast examination. Which of these statements best describes the correct procedure to use when screening for nipple and skin retraction during a breast examination? Have the woman Student Answer: bend over and touch her toes. lie down on her left side and notice any retraction. shift from a supine position to a standing position; notice any lag or retraction. slowly lift her arms above her head and note any retraction or lag in movement. Question 9. Question : When performing the bimanual examination, the nurse notices that the cervix feels smooth and firm, is round, and is fixed in place (does not move). When cervical palpation is performed, the patient complains of some pain. The nurse’s interpretation of these results should be which of these? Student Answer: These findings are all within normal limits. The cervical consistency should be soft and velvety—not firm. The cervix should move when palpated; an immobile cervix may indicate malignancy. Pain may occur during palpation of the cervix. Question 10. Question : A married couple has come to the clinic seeking advice on pregnancy. They have been trying to conceive for 4 months and have not been successful. What should the nurse do first? Student Answer: Ascertain whether either of them has been using broad-spectrum antibiotics. Explain that couples are considered infertile after 1 year of unprotected intercourse. Immediately refer the woman to an expert in pelvic inflammatory disease—the most common cause of infertility. Explain that couples are considered infertile after 3 months of engaging in unprotected intercourse and that they will need a referral to a fertility expert. Question 11. Question : A 54-year-old woman who has just completed menopause is in the clinic today for a yearly physical examination. Which of these statements should the nurse include in patient education? “A postmenopausal woman Student Answer: is not at any greater risk for heart disease than a younger woman is.” should be aware that she is at increased risk for dyspareunia because of decreased vaginal secretions.” has only stopped menstruating; there really are no other significant changes with which she should be concerned.” is likely to have difficulty with sexual pleasure as a result of drastic changes in the female sexual response cycle.” Question 12. Question : A 52-year-old patient states that when she sneezes or coughs, she “wets herself a little.” She is very concerned that something may be wrong with her. The nurse suspects that the problem is Student Answer: dysuria. stress incontinence. hematuria. urge incontinence. Question 13. Question : A patient calls the clinic for instructions before having a Papanicolaou (Pap) smear. The most appropriate instructions from the nurse are Student Answer: “If you are menstruating, please use pads to avoid placing anything into the vagina.” “Avoid intercourse, inserting anything into the vagina, or douching within 24 hours of your appointment.” “If you suspect that you have a vaginal infection, please gather a sample of the discharge to bring with you.” “We would like you to use a mild saline douche before your examination. You may pick this up in our office.” Question 14. Question : During an examination, which tests will the nurse collect to screen for cervical cancer? Student Answer: Endocervical specimen, cervical scrape, and vaginal pool Endocervical specimen, vaginal pool, and acetic acid wash Endocervical specimen, KOH preparation, and acetic acid wash Cervical scrape, acetic acid wash, saline mount (“wet prep”) Question 15. Question : A 35-year-old woman is at the clinic for a gynecologic examination. During the examination, she asks the nurse, “How often do I need to have this Pap test done?” Which reply by the nurse is correct? Student Answer: “It depends. Do you smoke?” “This will need to be done annually until you are 65.” “If you have 2 consecutive normal Pap tests, then you can wait 5 years between tests.” “After age 30, if you have 3 consecutive normal Pap tests, then you may be screened every 2 to 3 years.” Question 16. Question : A woman has just been diagnosed with HPV, or genital warts. The nurse should counsel her to receive regular examinations because this virus makes her at a higher risk for _____ cancer. Student Answer: uterine cervical ovarian endometrial Question 17. Question : The nurse is examining a 35-year-old female patient. During the history, the nurse notices that she has had two term pregnancies, and both babies were delivered vaginally. During the internal examination, the nurse observes that the cervical os is a horizontal slit with some healed lacerations and that the cervix has some nabothian cysts that are small, smooth, and yellow. In addition, the nurse notices that the cervical surface is granular and red, especially around the os. Finally, the nurse notices the presence of stringy, opaque, odorless secretions. Which of these findings are abnormal? Student Answer: Nabothian cysts are present. The cervical os is a horizontal slit. The cervical surface is granular and red. Stringy and opaque secretions are present. Question 18. Question : When the nurse is assessing the deep tendon reflexes (DTRs) on a woman who is 32 weeks pregnant, which of these would be considered a normal finding on a 0 to 4+ scale? Student Answer: Absent DTRs 2+ 4+ Brisk reflexes and the presence of clonus Question 19. Question : During an internal examination of a woman during her first prenatal visit, the nurse finds that the cervix is soft. This is known as _____ sign. Student Answer: Hegar’s Chadwick’s Homans’ Goodell’s Question 20. Question : A 25-year-old woman is in the clinic for her first prenatal visit. The nurse will prepare to obtain which laboratory screening test at this time? Student Answer: Urine toxicology Complete blood cell count Alpha-fetoprotein Carrier screening for cystic fibrosis Question 21. Question : During a woman’s 34th week of pregnancy, she is told that she has preeclampsia. The nurse knows that which of these statements about preeclampsia is true? Student Answer: Preeclampsia has little effect on the fetus. Edema is one of the main indications of preeclampsia. Eclampsia only occurs before delivery of the baby. Untreated preeclampsia may contribute to restriction of fetal growth. Question 22. Question : Which of these is considered a normal and expected finding when the nurse is performing a physical examination on a pregnant woman? Student Answer: A palpable, full thyroid Edema in one lower leg Significant diffuse enlargement of the thyroid Pale mucous membranes of the mouth Question 23. Question : A woman who is 28 weeks pregnant has edema in her lower legs bilaterally after working 8 hours a day as a cashier at a local grocery store. She is worried about her legs. What is the nurse’s best response? Student Answer: “You will be at risk for development of varicose veins when your legs are edematous.” “I would like to listen to your heart sounds. Edema can indicate a problem with your heart.” “Edema is usually the result of too much salt and fluids in your diet. You may need to try to cut down on salty foods.” “As your baby grows, it slows blood return from your legs, causing the swelling. This often occurs with prolonged standing.” Question 24. Question : A patient who is 20 weeks pregnant tells the nurse that she feels more shortness of breath as her pregnancy progresses. The nurse recognizes that which of these statements is true? Student Answer: High levels of estrogen cause shortness of breath. Feelings of shortness of breath are abnormal during pregnancy. The hormones of pregnancy cause an increased respiratory effort. She should get more exercise in an attempt to increase her respiratory reserve. Question 25. Question : The nurse knows that the best time to assess a woman’s blood pressure during an initial prenatal visit is Student Answer: at the end of the examination when she will be the most relaxed. at the beginning of the interview as a nonthreatening method of gaining rapport. during the middle of the physical examination when she is the most comfortable. before beginning the pelvic examination because her blood pressure will be higher after the pelvic examination.