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Questions 164

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Question 1 of 5

Which of the following instructions should be given to a client regarding testicular self-exam?

Correct Answer: B

Rationale: Testicular self-examination (TSE) is recommended monthly, not bimonthly or yearly, and is best performed during or after a warm shower or bath when the scrotum is relaxed, making it easier to detect abnormalities. Transillumination is a medical procedure, not part of TSE.

Question 2 of 5

A mother asks the nurse if she should be concerned about her child's tendency to stutter. What assessment data will be most useful in counseling the parent?

Correct Answer: A

Rationale: Age of the child. Stuttering is often a normal part of language development in preschoolers, making age a critical factor.

Question 3 of 5

A client was re-admitted to the hospital following a recent skull fracture. Which finding requires the nurse's immediate attention?

Correct Answer: A

Rationale: Lethargy. The level of consciousness or responsiveness is the most important measure of the client's rising intracranial pressure, requiring immediate attention.

Question 4 of 5

The nurse is caring for a client who underwent a transsphenoidal hypophysectomy to remove a pituitary adenoma. Which of the following interventions should the nurse implement? Select all that apply.

Correct Answer: B,D,E

Rationale: Mouth care prevents infection, neurologic checks monitor for complications (e.g., CSF leak), and avoiding toothbrushing prevents suture disruption. Coughing risks increasing intracranial pressure, and the head of the bed should be elevated to reduce pressure.

Question 5 of 5

The nurse is assessing a 12 year-old who has hemophilia A. Which finding would the nurse anticipate?

Correct Answer: C

Rationale: Hemophilia A is characterized by an absence or deficiency of Factor VIII.

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