A breast biopsy indicates the presence of malignant cells, and the client is scheduled for a mastectomy. When preparing the client's preoperative plan of care, which area would the nurse most likely address as the priority?

Fluid balance

Body image

Urinary elimination

Activity

Answer and Explanation

The Correct Answer is B

Choice A: Fluid balance is not the most likely priority because it is not directly affected by the mastectomy. Fluid balance is the state of equilibrium between the intake and output of fluids in the body. It can be influenced by various factors such as hydration, nutrition, medication, or illness. It can be monitored by measuring vital signs, weight, urine output, or laboratory values. Fluid balance is important for maintaining homeostasis and preventing dehydration or edema, but it is not a specific concern for a client undergoing a mastectomy.

Choice B: Body image is the most likely priority because it is directly affected by the mastectomy. Body image is the perception and attitude that one has toward one's own physical appearance and function. It can be influenced by various factors such as culture, media, self-esteem, or feedback from others. It can be assessed by observing verbal and nonverbal cues, asking open-ended questions, or using standardized tools. Body image is a major psychosocial issue for a client undergoing a mastectomy, as it can affect one's sense of identity, femininity, sexuality, or attractiveness. The nurse should address body image by providing information, support, and referral to appropriate resources.

Choice C: Urinary elimination is not the most likely priority because it is not directly affected by the mastectomy. Urinary elimination is the process of expelling urine from the bladder through the urethra. It can be influenced by various factors such as fluid intake, kidney function, medication, or infection. It can be assessed by measuring urine volume, color, odor, or specific gravity. Urinary elimination is important for maintaining fluid balance and preventing urinary tract infection or retention, but it is not a specific concern for a client undergoing a mastectomy.

Choice D: Activity is not the most likely priority because it is not directly affected by the mastectomy. Activity is the level of physical movement and exercise that one engages in on a daily basis. It can be influenced by various factors such as age, health status, motivation, or environment. It can be assessed by observing mobility, endurance, strength, or coordination. Activity is important for maintaining muscle tone, joint range of motion, circulation, or metabolism, but it is not a specific concern for a client undergoing a mastectomy.

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Correct Answer is A

Explanation

Choice A: Reports of itching, tingling and pain in genital area are the correct answer because they are common symptoms of genital herpes. Genital herpes is a sexually transmitted infection (STI) caused by the herpes simplex virus (HSV). It can cause outbreaks of painful blisters or sores on or around the genitals, anus, or mouth. The blisters or sores usually heal within a few weeks, but the virus remains in the body and can reactivate at any time. Before an outbreak, some people may experience prodromal symptoms such as itching, tingling, or pain in the affected area.

Choice B: Painful urination with a penile discharge present is not the correct answer because it is more likely a symptom of another STI, such as gonorrhea or chlamydia. Gonorrhea and chlamydia are bacterial infections that can affect the urethra, cervix, rectum, or throat. They can cause symptoms such as burning or pain during urination, abnormal discharge from the penis or vagina, or bleeding between periods.

Choice C: Wart-like flesh-colored lesions on the scrotal area are not the correct answer because they are more likely a symptom of another STI, such as human papillomavirus (HPV). HPV is a viral infection that can cause genital warts or cervical cancer. Genital warts are small, soft, flesh-colored growths that can appear on or around the genitals, anus, or mouth. They may be flat, raised, or cauliflower-shaped.

Choice D: A chancre on the penis is not the correct answer because it is more likely a symptom of another STI, such as syphilis. Syphilis is a bacterial infection that can affect various organs and systems of the body. It has four stages: primary, secondary, latent, and tertiary. In the primary stage, syphilis causes a painless sore called a chancre that can appear on or around the genitals, anus, or mouth. The chancre usually heals within a few weeks, but the infection can progress to the next stages if left untreated.

A. A 26-year-old client who has migraine headaches at the start of each menstrual cycle B. A 28-year-old client who has a history of pelvic inflammatory disease C. A 32-year-old client who has benign breast disease D. A 38-year-old client who reports smoking one pack of cigarettes every day

Correct Answer is D

Explanation

Choice A: A 26-year-old client who has migraine headaches at the start of each menstrual cycle does not have a contraindication for receiving oral contraceptives. Oral contraceptives are pills that contain synthetic hormones (estrogen and progestin) that prevent ovulation and pregnancy. They can also help regulate menstrual cycles and reduce menstrual pain and bleeding. Some women with migraine headaches may benefit from oral contraceptives, especially if their migraines are related to hormonal fluctuations or menstruation. However, oral contraceptives may worsen migraines in some women, especially if they have aura (visual or sensory disturbances) or other risk factors for stroke. Therefore, oral contraceptives should be used with caution and under medical supervision in women with migraine headaches.

Choice B: A 28-year-old client who has a history of pelvic inflammatory disease does not have a contraindication for receiving oral contraceptives. Pelvic inflammatory disease (PID) is an infection of the female reproductive organs (uterus, fallopian tubes, ovaries) that can cause pain, fever, discharge, or infertility. It can be caused by various bacteria, often sexually transmitted ones such as gonorrhea or chlamydia. Oral contraceptives do not protect against STIs or PID, but they may reduce the risk of PID by thickening the cervical mucus and preventing bacteria from entering the uterus. Therefore, oral contraceptives can be used safely in women with a history of PID, but they should also use condoms or other barrier methods to prevent STIs.

Choice C: A 32-year-old client who has benign breast disease does not have a contraindication for receiving oral contraceptives. Benign breast disease (BBD) is a term that refers to various noncancerous conditions that affect the breast tissue, such as cysts, fibroadenomas, or mastitis. They can cause symptoms such as lumps, pain, or tenderness in the breasts. Oral contraceptives do not cause or increase the risk of BBD, but they may improve some symptoms of BBD by stabilizing the hormonal levels and reducing breast tissue sensitivity. Therefore, oral contraceptives can be used safely in women with BBD, but they should also have regular breast exams and mammograms to monitor their breast health.

Choice D: A 38-year-old client who reports smoking one pack of cigarettes every day has a contraindication for receiving oral contraceptives. Smoking is a habit that involves inhaling the smoke of tobacco or other substances that can cause various health problems, such as lung cancer, heart disease, or stroke. Oral contraceptives can increase the risk of these problems, especially in women who are older than 35 years or smoke more than 15 cigarettes per day. Smoking and oral contraceptives can interact and cause blood clots, high blood pressure, or reduced blood flow to the organs. Therefore, oral contraceptives should be avoided or discontinued in women who smoke, and alternative methods of contraception should be used.

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A breast biopsy indicates the presence of malignant cells, and the client is scheduled for a mastectomy. When preparing the client's preoperative plan of care, which area would the nurse most likely address as the priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a male client recently diagnosed with genital herpes. Which finding would most likely correlate with this diagnosis?

Correct Answer is A

Explanation

A nurse is reviewing contraception options for four clients. The nurse should identify which of the following clients has a contraindication for receiving oral contraceptives.

Correct Answer is D

Explanation

A nurse reading a journal article about the care of a woman with pelvic organ prolapse would expect to find information on which disorder. Select all that apply.

A nurse is preparing to administer hydrocortisone 100 mg IM daily to a client. Available as hydrocortisone 250 mg/2 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth number. Use a leading zero if it applies. Do not use a trailing zero.)

A woman who has undergone a right-sided modified-radical mastectomy returns from surgery. Which nursing intervention would be most appropriate for the nurse to include in the client's plan of care at this time?

Assessment of a female client reveals a thick, white vaginal discharge. She also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has:

A postmenopausal woman with uterine prolapse is being fitted with a pessary. The nurse would be most alert for which side effect?

A nurse is preparing a class discussion on the clinical manifestations of a heart attack observed in women. Which symptoms would the nurse include as key assessment data? Select all that apply.

A nurse is reinforcing teaching about self-care with a client who has pelvic inflammatory disease. The client does not speak English. Which of the following actions by the nurse is appropriate?

Which finding would the nurse expect in a client with bacterial vaginosis?