A woman has sought care because of urinary incontinence. She states that running or jumping
often precipitates leakage of urine, an event that has been occurring with increasing regularity in
recent months. Which assessment question is most relevant to try to determine the cause of the
patient's problem?
"Do you know if your mother or sisters have had similar problems?"
"Do you find that you are prone to frequent urinary tract infections?"
"Did you have any muscle damage when giving birth to your children?"
"Do you take part in a regular program of physical exercise and stretching?" correct answers
"Did you have any muscle damage when giving birth to your children?"
Rationale: Trauma to the pelvic musculature during birth is often the cause of urge and stress
incontinence in female patients. UTIs, family history, and exercise are less likely to contribute to
an ongoing pattern of incontinence.
The nurse is performing an assessment on a female patient. What assessment finding should be
documented and reported to the primary health care provider?
Dimpling of breast
Dark pink genitalia
Watery cervical mucus
Triangular hair distribution correct answers Dimpling of breast
Rationale: Dimpling of the breast is highly suspicious for carcinoma of the breast.
Dark pink genitalia, watery cervical mucus, and triangular pubic hair distribution are all normal
female reproductive system assessment findings.
correct answers "Do not douche for at least 24 hours before the procedure."
Rationale: The patient should be told to not douche for at least 24 hours before a Pap test. The
patient should empty the bladder before a Pap test. There are no activity restrictions after a Pap
test. The patient should rest for 2 to 3 days after a conization. A culture or a smear tests for
sexually transmitted infections. A Pap test is a cytologic study used to detect abnormal cells.
The nurse is performing an admission assessment of an older adult male patient prior to bladder
resection surgery. What assessment finding of the patient's genitourinary system would be
unexpected?
The patient's left testicle hangs lower than his right.
Pubic hair is absent from the patient's genital region.
The patient's intestines are not palpable through the inguinal rings.
The patient's foreskin can be manually retracted to expose the meatus. correct answers Pubic hair
is absent from the patient's genital region.
,Rationale: An absence of pubic hair is an unexpected finding in an older male patient. It is
common for the left testicle to hang lower than the right, and the intestines are often not palpable
through the inguinal rings. The foreskin should be easily retractable.
The nurse performs a breast examination on a female patient who has never been pregnant, 1
week after her menstrual period. Which finding, if made by the nurse, would indicate a normal
breast examination?
Nipples are soft without retractions.
Unilateral breast dimpling is present.
Milky fluid is expressed from the nipples.
Axillary lymph nodes are fixed and palpable. correct answers Nipples are soft without
retractions.
Rationale: Normal breasts are *symmetric without dimpling*. Nipples are soft with *NO
drainage, retraction, or lesions noted*. No masses, tenderness, or lymphadenopathy is present.
Which male patient does the nurse identify is most susceptible to experiencing erectile
dysfunction as a consequence of his drug regimen?
A patient who takes a biguanide for type 2 diabetes.
A patient who takes a β-adrenergic blocker for hypertension.
A patient who uses a proton pump inhibitor to control acid reflux.
A patient who is taking a cephalosporin antibiotic in order to treat cellulitis. correct answers A
patient who takes a β-adrenergic blocker for hypertension.
Rationale: Antihypertensives are commonly implicated in cases of erectile dysfunction.
Antibiotics, PPIs, and biguanides are less likely to negatively impact men's sexual function.
When teaching nursing students about the male sexual response, what should the nurse call the
phase that includes ejaculation?
Plateau phase
Orgasmic phase
Resolution phase
Excitement phase correct answers Orgasmic phase
Rationale: The orgasmic phase is when ejaculation occurs from contraction of the penile &
urethral musculature propelling the sperm outward through the meatus. The excitement phase is
manifested by penile erection in response to sexual stimulation. The plateau phase is when the
erection is maintained. There is a slight increase in vasocongestion and testicle size, and the
glans penis may be more reddish-purple. The resolution phase is after ejaculation when the penis
gradually returns to its unstimulated, flaccid state.
The nurse is asked to teach an adolescent female patient about menstruation. What is important
for the nurse to include when teaching the adolescent?
, The length of the menstrual cycle should be 28 days.
Menstrual cycles are often irregular for the first 1 to 2 years.
The female loses around 1 cup of blood with each menstrual period.
Follicle-stimulating hormone (FSH) causes maturity of the follicle for ovulation. correct answers
Menstrual cycles are often irregular for the first 1 to 2 years.
Rationale: Teaching the patient that menstrual cycles are often irregular for the first 1 to 2 years
is important. The length of a menstrual cycle may be from 21 to 35 days, with the average length
being 28 days. About 20 to 80 mL (which at most is only 1/3 cup) of blood is lost with each
menstrual period. FSH begins the follicle maturation, but LH must be present for complete
maturation and ovulation to occur.
The nurse is obtaining a sexual history from a woman who is a new patient in the primary care
clinic. It would be most appropriate for the nurse to ask which question first?
"Have you ever had a sexually transmitted infection?"
"Have you ever been in a relationship with anyone who hurt you?"
"Have you ever been forced into sexual acts as a child or an adult?"
"Are you satisfied with your sexual relationship with your partner?" correct answers "Are you
satisfied with your sexual relationship with your partner?"
Rationale: When taking a sexual health history, the nurse should begin with the least sensitive
area of questioning and then move to more sensitive areas.
The patient who has been told she will have blood drawn for a prolactin assay asks the nurse,
"What is this test for?" What is the best response by the nurse?
"It will tell you if you are pregnant."
"It is used to detect a cause of amenorrhea."
"It will tell us if you have a reproductive cancer."
"It can indicate if you have a sexually transmitted infection." correct answers "It is used to detect
a cause of amenorrhea."
Rationale: A prolactin assay will detect pituitary dysfunction that can cause amenorrhea.
- Human chorionic gonadotropin (hCG) is used to detect pregnancy. - The biologic tumor
markers α-fetoprotein, hCG, and CA 125 may be used to assess for reproductive cancers and to
monitor therapy.
- The assay does not screen for a sexually transmitted infection.
An older adult male patient with hypertension is prescribed amlodipine. The nurse should assess
for which possible adverse effect?
Gynecomastia
Increased sex drive