A nurse is providing teaching to a client who has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for uterine cancer. Which of the following instructions should the nurse include in the teaching?
Resume sexual intercourse in 2 to 3 weeks.
Increased vaginal drainage typically occurs 5 days following surgery.
Artificial lubrication can be used to treat vaginal itching and dryness.
A Papanicolaou (Pap) test should be performed every 6 months.
The Correct Answer is C
Choice A reason:
Resuming sexual intercourse in 2 to 3 weeks may not be appropriate for all patients after such a major surgery. The recovery time can vary based on individual factors, including the extent of the surgery and the patient's overall health. It's essential for patients to follow their healthcare provider's specific recommendations, which typically involve waiting until after the postoperative check-up, usually around 6 weeks, to ensure proper healing.
Choice B reason:
Increased vaginal drainage typically occurring 5 days following surgery could be a sign of infection or other complications. Normal postoperative discharge should gradually decrease over time. If a patient experiences increased drainage, especially if it's foul-smelling or accompanied by fever, they should contact their healthcare provider immediately.
Choice C reason:
After a total abdominal hysterectomy and bilateral salpingo-oophorectomy, patients may experience vaginal dryness due to decreased estrogen levels. Using artificial lubricants can help alleviate symptoms of itching and dryness, making this an appropriate instruction for postoperative care.
Choice D reason:
A Papanicolaou (Pap) test is not typically required every 6 months after a total abdominal hysterectomy and bilateral salpingo-oophorectomy for uterine cancer unless the surgery was performed as treatment for cervical cancer or serious pre-cancer. For those who had the procedure due to benign conditions, further Pap tests are generally not necessary.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
Pneumothorax, a collapsed lung, can indeed cause shortness of breath and dyspnea. However, it is typically associated with a sudden onset of these symptoms following a chest injury or spontaneously in the case of a ruptured air blister. In the context of a femoral head fracture, pneumothorax is less likely unless there was additional trauma to the chest area.
Choice B reason:
Pneumonia is an infection of the lungs that leads to inflammation of the air sacs, causing them to fill with fluid or pus. Symptoms include cough with phlegm, fever, chills, and difficulty breathing. While pneumonia could cause dyspnea, it usually develops due to an infectious process rather than directly from a femoral head fracture.
Choice C reason:
Airway obstruction involves a blockage that prevents air from passing freely to the lungs. It can be caused by foreign objects, swelling due to allergic reactions, or other medical conditions. The symptoms of airway obstruction include difficulty breathing, wheezing, and potential changes in skin color. However, airway obstruction is not commonly a direct complication of a femoral head fracture.
Choice D reason:
Fat embolism syndrome is a serious condition that occurs when fat globules enter the bloodstream and lodge within the pulmonary vasculature, leading to respiratory distress. It is a known complication following long bone fractures, such as the femur, and presents with symptoms like shortness of breath, hypoxemia, and neurological manifestations. Given the recent femoral head fracture and the symptoms reported, fat embolism syndrome is the most likely diagnosis.
Correct Answer is A
Explanation
Choice A reason:
Blood in the urine (hematuria) or semen (hematospermia) can be a sign of advanced prostate cancer. This symptom occurs when the cancer affects the urinary or reproductive tracts, causing bleeding. It is a direct result of the tumor invading nearby tissues or structures.
Choice B reason:
While anemia can be associated with chronic diseases like cancer, it is not a direct manifestation of the advancing disease process of prostate cancer. Anemia in cancer patients is often multifactorial, including chronic inflammation, nutritional deficiencies, or treatment-related side effects.
Choice C reason:
A dark-colored or elevated lesion is not typically associated with prostate cancer. Such lesions are more commonly related to skin cancers or other dermatological conditions.
Choice D reason:
An enlarged liver or gallbladder can be a sign of metastasis in advanced cancer cases, including prostate cancer. However, it is less specific than blood in the urine or semen and can be caused by a variety of other conditions.
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