Repro 1

Created by johnbell 

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1. When caring for a male patient who has had surgical removal of both testes and is taking testosterone replacement, the nurse knows that the alterations in the patient's reproductive function includes
a. impotency.
b. both sterility and impotency.
c. loss of secondary sex characteristics.
d. sterility.

D
Rationale: Because the patient is incapable of spermatogenesis, he will be sterile; however, testosterone replacement therapy will prevent impotency or loss of secondary sex characteristics.

Cognitive Level: Application Text Reference: pp. 1324, 1328
Nursing Process: Assessment NCLEX: Physiological Integrity

2. When caring for a patient with an enlarged prostate gland, the nurse monitors the patient for
a. penile discharge.
b. urinary problems
c. constipation.
d. low back pain.

B
Rationale: Enlargement of the prostate blocks the urethra, leading to urinary retention and difficulty in initiating a urinary stream. The other clinical manifestations are not directly caused by prostate enlargement.

Cognitive Level: Application Text Reference: p. 1335
Nursing Process: Assessment NCLEX: Physiological Integrity

3. After a patient has been diagnosed with an obstructed fallopian tube resulting from infection, the nurse will anticipate teaching the patient about
a. possible difficulty in becoming pregnant.
b. use of hormone replacement therapy (HRT).
c. irregularities in the menstrual cycle.

d. changes in secondary sex characteristics.

A
Rationale: An obstructed fallopian tube may result in difficulty in fertilization or implantation of the fertilized egg. Because ovarian function is not affected, the patient will not require HRT, have irregular menstrual cycles, or experience changes in secondary sex characteristics.

Cognitive Level: Application Text Reference: p. 1325
Nursing Process: Planning NCLEX: Physiological Integrity

4. During the nursing assessment of a 62-year-old man, the patient tells the nurse that he does not respond to sexual stimulation the way he did when he was younger. The nurse's best response to the patient's comment is,
a. "Erectile dysfunction is a common problem with older men."
b. "Tell me more about how your response has changed."
c. "Interest in sex frequently decreases as men get older."
d. "Many men need more sexual stimulation with aging."

B
Rationale: The initial response by the nurse should be further assessment of the problem. The other statements by the nurse are accurate but might not respond to the patient's concerns.

Cognitive Level: Application Text Reference: pp. 1330-1331
Nursing Process: Assessment NCLEX: Psychosocial Integrity

5. When the nurse obtains a health history from a patient, the patient reports that she had cryosurgery 1 year ago. The nurse anticipates that the patient most likely has a history of
a. obstructed fallopian tubes.
b. irregular menstrual cycles.
c. abnormal Pap smear.
d. urge incontinence.

C
Rationale: Cryosurgery is done to destroy abnormal cells, such as might be found in a Pap smear. Treatment for fallopian tube obstruction, irregular menstrual cycles, and urge incontinence does not involve cryosurgery.

Cognitive Level: Comprehension Text Reference: p. 1332
Nursing Process: Assessment NCLEX: Physiological Integrity

6. A patient considering a vasectomy as a means of contraception asks the nurse what is involved in the procedure. The nurse explains that the structure partially removed is the
a. epididymis.
b. ductus deferens.
c. spermatic cord.
d. ejaculatory duct.

B
Rationale: A vasectomy involves partial removal of the vas deferens or ductus deferens. The other structures are not affected by vasectomy.

Cognitive Level: Comprehension Text Reference: p. 1332
Nursing Process: Implementation NCLEX: Physiological Integrity

7. When scheduling a pelvic examination and Pap smear for a patient, the nurse instructs the patient that she should
a. plan to have the Pap smear just after her menstrual period.
b. shower, but not take a tub bath, before the examination.
c. not douche for at least 24 hours before the examination.
d. not have sexual intercourse the day before the Pap smear.

C
Rationale: The results of a Pap smear may be affected by douching, and so the patient should not douche before the examination. The exam may be scheduled without regard to the menstrual period. The patient may shower or bathe before the examination. Sexual intercourse does not affect the results of the examination or Pap smear.

Cognitive Level: Application Text Reference: p. 1339
Nursing Process: Implementation NCLEX: Physiological Integrity

8. A 19-year-old patient who is being assessed for amenorrhea at the clinic makes all of these statements to the nurse. Which one indicates a need for patient teaching?
a. "I drink at least 3 glasses of non-fat milk every day."
b. "I am not sexually active currently but I have an IUD."
c. "I run 10 to 12 miles every day to keep in shape."
d. "I had a bladder infection once about 3 years ago."

C
Rationale: Excessive exercise can cause amenorrhea. The other statements by the patient do not suggest any urgent teaching needs.

Cognitive Level: Application Text Reference: p. 1333
Nursing Process: Assessment
NCLEX: Health Promotion and Maintenance

9. All these data are obtained by the nurse while performing a physical assessment of a male patient's reproductive system. Which one should be reported to the health care provider?
a. The foreskin is absent.
b. Clear penile discharge is present.
c. One testes hangs lower than the other.
d. Inguinal lymph nodes are nonpalpable.

B
Rationale: Clear penile discharge may be indicative of a sexually transmitted disease (STD). The other findings are normal and do not need to be reported.

Cognitive Level: Application Text Reference: pp. 1335, 1337
Nursing Process: Assessment NCLEX: Physiological Integrity

10. A 34-year-old patient is hospitalized with acute back pain. He is married and has a 3-year-old son. When the nurse is performing an assessment of the patient's sexuality-reproductive functional health pattern, an appropriate question to initiate a sexual history is,
a. "Do you consider your sex life satisfactory?"
b. "Was your back pain precipitated by sexual activity?"
c. "Have you ever had any problems with your genitourinary system?"
d. "Are you worried that your back pain will affect your sexual activity?"

D
Rationale: The initial focus when assessing this pattern should be on the impact of the back injury on sexuality. The other questions may be used as the interview progresses, based on the patient's responses.

Cognitive Level: Application Text Reference: p. 1334
Nursing Process: Assessment
NCLEX: Health Promotion and Maintenance

11. Which information found during the physical assessment of a 68-year-old woman should the nurse report to the health care provider?
a. Pendulous breasts
b. Nonpalpable ovaries
c. Serous nipple drainage
d. Atrophy of vaginal tissue

C
Rationale: Serous drainage may indicate an intraductal papilloma and should be investigated further. The other findings are not unusual in older women.

Cognitive Level: Application Text Reference: p. 1336
Nursing Process: Assessment NCLEX: Physiological Integrity

12. A woman calls the clinic because she is having an unusually heavy menstrual flow. She tells the nurse that she has saturated two pads in the past 2 hours. The nurse estimates that the amount of blood loss is ____ ml.
a. 10 to 20
b. 20 to 30
c. 30 to 40
d. 40 to 60

D
Rationale: The average pad absorbs 20 to 30 ml.

Cognitive Level: Comprehension Text Reference: p. 1329
Nursing Process: Assessment NCLEX: Physiological Integrity

13. When preparing a patient for colposcopy with a cervical biopsy, the nurse explains to the patient that the procedure
a. will take place in a same-day surgery center so that local anesthesia can be used.
b. involves dilation of the cervix and biopsy of the tissue lining the uterus.
c. is similar to a speculum examination of the cervix and should result in little or no pain.
d. requires that the patient have nothing to eat or drink for 6 hours before the procedure.

C
Rationale: Colposcopy involves visualization of the cervix with a binocular microscope and is similar to a speculum examination. A cervical biopsy may cause a minimal amount of pain.

Cognitive Level: Application Text Reference: p. 1340
Nursing Process: Implementation NCLEX: Physiological Integrity

14. A couple who has not been able to conceive is scheduled for a Huhner test for infertility. In preparation for the test, the nurse will help the couple determine
a. how long to refrain from intercourse before the test.
b. when the estimated time of ovulation will occur.
c. how to obtain a sample of the man's semen.
d. when to take the woman's basal body temperature.

B
Rationale: For the Huhner test, the couple should have intercourse at the estimated time of conception and then arrive for the test 2 to 8 hours after intercourse. There is no need to refrain from intercourse before the test. A sample of semen will be needed for a semen analysis. The woman will need to know how to take the temperature for the basal body temperature assessment.

Cognitive Level: Application Text Reference: p. 1341
Nursing Process: Implementation NCLEX: Physiological Integrity

15. A patient in the STD clinic tells the nurse about a recent exposure to syphilis through sexual intercourse. The nurse teaches the patient that the fastest information about syphilis infection will be obtained from
a. Venereal Disease Research Laboratory (VDRL) testing.
b. rapid plasma reagent (RPR) agglutination.
c. examination of a specimen obtained from an active chancre.
d. fluorescent treponemal antibody absorption (FTA-Abs) testing.

C
Rationale: If the patient has an active chancre, the Treponema pallidum bacteria can be visualized. The VDRL, RPR, and FTA Abs tests all will take longer.

Cognitive Level: Comprehension Text Reference: p. 1339
Nursing Process: Implementation NCLEX: Physiological Integrity

16. A 22-year-old woman who is scheduled for a routine physical examination tells the nurse she would like a prescription for oral contraceptives. Which information in the patient's history will be most important to report to the health care provider?
a. The patient has not been vaccinated or infected by rubella.
b. The patient has chronic iron-deficiency anemia.
c. The patient had mumps when she was in high school.
d. The patient has had episodes of acute cholecystitis.

D
Rationale: Cholecystitis is aggravated by oral contraceptives. The other information should also be reported but does not impact whether the patient should use oral contraceptives.

Cognitive Level: Application Text Reference: p. 1332
Nursing Process: Assessment
NCLEX: Health Promotion and Maintenance

17. A 42-year-old man who is taking all of the following medications tells the nurse that he has not been able to function sexually for about a year. The nurse will anticipate teaching the patient about a change in which medication?
a. Propranolol (Inderal) for high blood pressure
b. Atorvastatin (Lipitor) for hyperlipidemia
c. Metformin (Glucophage) for type 2 diabetes
d. Ranitidine (Zantac) for gastroesophageal reflux

A
Rationale: Some antihypertensives may cause erectile dysfunction, and the nurse should anticipate a change in antihypertensive therapy. The other medications will not impact sexual function directly.

Cognitive Level: Application Text Reference: p. 1332
Nursing Process: Assessment NCLEX: Physiological Integrity

18. A patient calls the clinic and tells the nurse, "My menstrual period is unusually heavy. I have to change my tampon every 4 hours." Which action should the nurse take next?
a. Schedule the patient for an appointment later that day.
b. Have the patient call again if the heavy flow continues.
c. Ask the patient how heavy her menstrual periods usually are.
d. Tell the patient that her flow is not unusually heavy.

C
Rationale: Because a heavy menstrual flow is usually indicated by saturating a pad or tampon in 1 to 2 hours, the nurse should first assess how heavy the patient's usual flow is. There is no need to schedule the patient for an appointment that day. The patient may need to call again, but this is not the first action that the nurse should take. Telling the patient that she does not have a heavy flow is implies that the patient's concern is not important.

Cognitive Level: Application Text Reference: p. 1329
Nursing Process: Implementation
NCLEX: Health Promotion and Maintenance

19. A patient with a possible ovarian cyst is scheduled for ultrasound. The nurse will teach the patient that she should
a. not eat or drink for 4 hours before the procedure.
b. experience minimal discomfort during the procedure.
c. discontinue taking aspirin before the procedure.
d. receive IV contrast solution during the procedure.

B
Rationale: Ultrasound measures high-frequency sound waves as they pass through various tissues and should cause very little discomfort. The other instructions are not accurate for this procedure.

Cognitive Level: Application Text Reference: p. 1339
Nursing Process: Implementation
NCLEX: Health Promotion and Maintenance

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