NUR 314 FINAL EXAM QUESTIONS WITH COMPLETE
SOLUTIONS
Administer oxybutynin (Ditropan) for bladder spasms.
- Manually irrigate the urinary catheter to restore catheter flow.
- Monitor catheter drainage for clots and increase flow of
irrigation as needed.
Rationale: The nurse may delegate the following to an LPN/VN:
monitor catheter drainage for increased blood or clots, increase
flow of irrigating solution to maintain light pink color in
outflow, and administer antispasmodics and analgesics as
needed. A registered nurse may not delegate teaching,
assessments, or clinical judgments to the LPN/VN.
A personal companion is staying in the room for company
Rationale: Brachytherapy is internal radiation applied directly to
the tumor. Health care providers should limit close contact with
the patient to less than 30 minutes/day. Internal radiation causes
the destruction of cells and results in a foul-smelling vaginal
discharge. Internal radiation may cause systemic reactions such
as nausea, vomiting, diarrhea, & malaise. The patient receiving
brachytherapy is placed in a lead-lined private room and on
absolute bed rest.
Absence of genital lesions
Rationale: Primary genital herpes is a *viral* disorder caused by
the herpes simplex virus. Genital herpes results in painful,
,vesicular lesions. The lesions rupture, form crusts, and heal in
17 to 21 days.
Genital warts are caused by the human papillomavirus. Genital
herpes is caused by a viral infection (not bacterial). Syphilis is
caused by a bacterial organism and results in a chancre, which is
a painless, indurated lesion.
Application of ice
Oral contraceptives
Reduce caffeine intake
Wear a supportive bra during the day
Rationale: To reduce breast pain, the patient may apply ice,
reduce caffeine intake, and use oral contraceptive therapy.
Wearing a supportive bra continuously may reduce discomfort.
Increasing fluids and use of antibiotics are not indicated for
treatment of mastalgia.
Avoid strenuous exercise during her recovery period.
Rationale: As with all types of breast surgery, strenuous exercise
is contraindicated during the recovery period after breast
augmentation. A bra should be worn to prevent dehiscence and
provide comfort. Sleeping in a semi-Fowler's position is not
necessary, and passive range-of-motion exercises should be
avoided at first.
Ensure patient adheres to her prescribed antibiotic regimen.
,Rationale: Mastitis normally requires antibiotic therapy that is
closely adhered to. Breastfeeding should be continued if
possible, but effective treatment of infection would be the
immediate priority. If a palpable mass develops, medical follow-
up may be needed to determine if an abscess is present. Mastitis
is not necessarily self-limiting, and mammography is not
normally indicated.
Erectile dysfunction
Rationale: Stroke is a common cause of erectile dysfunction. A
stroke and underlying cardiovascular disease is unlikely to be
related to an inguinal hernia, testosterone deficiency, or BPH.
Irregular, nontender lump with induration
Rationale: Manifestations of breast cancer may include a
palpable lump that is *hard, irregular, poorly delineated,
nonmobile, and nontender.* Nipple retraction, peau d'orange,
induration, and dimpling of the overlying skin may also be
noted.
Mastitis presents with breasts that are warm to touch, indurated,
and painful. Atrophy of the mammary glands associated with
aging may result in pendulous breasts. Manifestations of
fibrocystic breast changes include palpable lumps that are round,
well delineated, and freely movable. The lump is usually tender
and increases in size and tenderness before menstruation.
The estrogen in your body is decreased since menopause.
Rationale:
, Many of the reproductive changes associated with aging for
women occur related to the decrease in estrogen associated with
menopause. After menopause there may be increased androgens.
Estrogen stimulation is related to negative feedback, and GnRH
would stimulate greater follicle-stimulating hormone (FSH) and
luteinizing hormone (LH), which results in a higher level of
estrogen production by the ovaries. The negative feedback
mechanism is not active because this system occurs when there
is decreased level of circulating estrogen, which increases the
level of GnRH production by the hypothalamus, leading to
increased FSH and LH from the pituitary, which results in
higher estrogen production.
25 y.o. woman tells RN she has had sex with multiple male
partners in the past year. The nurse will plan to teach about:
Correct Answers 1. STI testing
2. Based on results treat, test partners, treat partners, abstain, use
barrier protections
5 P's of repro assessment Correct Answers 1. *Partners*
a. Number of partners...men, women, or both
2. *Practices* (sexual)
3. *Pregnancy* (protection, and/or plans, history)
4. Protection from STIs
5. Past (history) of STIs
5 P's of sexual health history Correct Answers - Partners
- Practices (Sexual)
- Past STDs
- Pregnancy (history, prevention/protection, and plans)
- Protection from STDs (contraception)
SOLUTIONS
Administer oxybutynin (Ditropan) for bladder spasms.
- Manually irrigate the urinary catheter to restore catheter flow.
- Monitor catheter drainage for clots and increase flow of
irrigation as needed.
Rationale: The nurse may delegate the following to an LPN/VN:
monitor catheter drainage for increased blood or clots, increase
flow of irrigating solution to maintain light pink color in
outflow, and administer antispasmodics and analgesics as
needed. A registered nurse may not delegate teaching,
assessments, or clinical judgments to the LPN/VN.
A personal companion is staying in the room for company
Rationale: Brachytherapy is internal radiation applied directly to
the tumor. Health care providers should limit close contact with
the patient to less than 30 minutes/day. Internal radiation causes
the destruction of cells and results in a foul-smelling vaginal
discharge. Internal radiation may cause systemic reactions such
as nausea, vomiting, diarrhea, & malaise. The patient receiving
brachytherapy is placed in a lead-lined private room and on
absolute bed rest.
Absence of genital lesions
Rationale: Primary genital herpes is a *viral* disorder caused by
the herpes simplex virus. Genital herpes results in painful,
,vesicular lesions. The lesions rupture, form crusts, and heal in
17 to 21 days.
Genital warts are caused by the human papillomavirus. Genital
herpes is caused by a viral infection (not bacterial). Syphilis is
caused by a bacterial organism and results in a chancre, which is
a painless, indurated lesion.
Application of ice
Oral contraceptives
Reduce caffeine intake
Wear a supportive bra during the day
Rationale: To reduce breast pain, the patient may apply ice,
reduce caffeine intake, and use oral contraceptive therapy.
Wearing a supportive bra continuously may reduce discomfort.
Increasing fluids and use of antibiotics are not indicated for
treatment of mastalgia.
Avoid strenuous exercise during her recovery period.
Rationale: As with all types of breast surgery, strenuous exercise
is contraindicated during the recovery period after breast
augmentation. A bra should be worn to prevent dehiscence and
provide comfort. Sleeping in a semi-Fowler's position is not
necessary, and passive range-of-motion exercises should be
avoided at first.
Ensure patient adheres to her prescribed antibiotic regimen.
,Rationale: Mastitis normally requires antibiotic therapy that is
closely adhered to. Breastfeeding should be continued if
possible, but effective treatment of infection would be the
immediate priority. If a palpable mass develops, medical follow-
up may be needed to determine if an abscess is present. Mastitis
is not necessarily self-limiting, and mammography is not
normally indicated.
Erectile dysfunction
Rationale: Stroke is a common cause of erectile dysfunction. A
stroke and underlying cardiovascular disease is unlikely to be
related to an inguinal hernia, testosterone deficiency, or BPH.
Irregular, nontender lump with induration
Rationale: Manifestations of breast cancer may include a
palpable lump that is *hard, irregular, poorly delineated,
nonmobile, and nontender.* Nipple retraction, peau d'orange,
induration, and dimpling of the overlying skin may also be
noted.
Mastitis presents with breasts that are warm to touch, indurated,
and painful. Atrophy of the mammary glands associated with
aging may result in pendulous breasts. Manifestations of
fibrocystic breast changes include palpable lumps that are round,
well delineated, and freely movable. The lump is usually tender
and increases in size and tenderness before menstruation.
The estrogen in your body is decreased since menopause.
Rationale:
, Many of the reproductive changes associated with aging for
women occur related to the decrease in estrogen associated with
menopause. After menopause there may be increased androgens.
Estrogen stimulation is related to negative feedback, and GnRH
would stimulate greater follicle-stimulating hormone (FSH) and
luteinizing hormone (LH), which results in a higher level of
estrogen production by the ovaries. The negative feedback
mechanism is not active because this system occurs when there
is decreased level of circulating estrogen, which increases the
level of GnRH production by the hypothalamus, leading to
increased FSH and LH from the pituitary, which results in
higher estrogen production.
25 y.o. woman tells RN she has had sex with multiple male
partners in the past year. The nurse will plan to teach about:
Correct Answers 1. STI testing
2. Based on results treat, test partners, treat partners, abstain, use
barrier protections
5 P's of repro assessment Correct Answers 1. *Partners*
a. Number of partners...men, women, or both
2. *Practices* (sexual)
3. *Pregnancy* (protection, and/or plans, history)
4. Protection from STIs
5. Past (history) of STIs
5 P's of sexual health history Correct Answers - Partners
- Practices (Sexual)
- Past STDs
- Pregnancy (history, prevention/protection, and plans)
- Protection from STDs (contraception)
