Which client should the nurse refer for further testing?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Small dimple located in the upper outer quadrant of the right breast. This finding is concerning as it could indicate an underlying issue such as a breast mass or tumor pulling on the skin, causing the dimpling. Any new, unexplained breast changes should be evaluated promptly to rule out malignancy. Option A, a slight difference in breast size, is a common and usually benign finding. Option B, nipple elevation, is also a common variant and not typically a cause for concern. Option C, faintly visible bilateral venous symmetry, is a normal finding as breast vasculature can vary among individuals. From an educational standpoint, it is crucial for nurses to recognize abnormal breast changes and understand the significance of each finding. Prompt referral for further testing in cases of suspicious changes is vital for early detection and intervention in breast health. Nurses play a key role in educating patients about breast self-examinations and the importance of regular screenings for early detection of breast abnormalities.

Correct Answer: B

Rationale: Stating that she will miss having sexual intercourse with her husband indicates that further teaching is needed for this client regarding sexual activities after a hysterectomy. Although intercourse may be initially uncomfortable, the use of water-soluble lubricants, relaxation exercises, and changes in position may be helpful.

Correct Answer: A

Rationale: In the context of ethical issues in maternal newborn nursing, understanding the most common reproductive tract cancer associated with pregnancy is crucial for providing comprehensive care to pregnant individuals. The correct answer is A) Cervical cancer. During pregnancy, there are physiological changes in the cervix that may contribute to an increased risk of developing cervical cancer. Regular prenatal screenings, such as Pap smears, are essential to detect any abnormalities early on. Option B) Uterine cancer is less commonly associated with pregnancy compared to cervical cancer. Pregnancy itself does not significantly increase the risk of uterine cancer development. Option C) Ovarian cancer is not directly associated with pregnancy. The risk factors and mechanisms of ovarian cancer are different from cervical cancer, making it less likely to be the correct answer in this context. Option D) Fallopian tube cancer is rare and not typically associated with pregnancy. While fallopian tube issues can impact fertility and pregnancy, cancer of the fallopian tubes is not a common concern during pregnancy. By understanding the specific risks and associations between reproductive tract cancers and pregnancy, maternal newborn nurses can provide informed care, education, and support to pregnant individuals, promoting early detection and optimal health outcomes.

Correct Answer: B

Rationale: In the context of Ethical Issues in Maternal Newborn Nursing, it is crucial for nurses to provide accurate and comprehensive information to patients regarding their care, especially after surgical procedures like a vaginal hysterectomy. The correct answer, option B, "Expect no changes in her hormone levels," is important to include in planning the care for a woman who has had a vaginal hysterectomy because in this procedure, the ovaries are left intact, so hormone levels remain unaffected. Option A, "Expect to be fully recovered in 4 to 6 weeks," is incorrect as the recovery period after a vaginal hysterectomy may vary from person to person and can extend beyond 4 to 6 weeks. Providing a specific timeframe may lead to unrealistic expectations and dissatisfaction. Option C, "Expect surgical menopause," is incorrect for a vaginal hysterectomy as this procedure only involves the removal of the uterus, not the ovaries. Surgical menopause occurs when both ovaries are removed during a hysterectomy. Option D, "Take tub baths to aid in healing," is not the most important information to include in planning for the care of a woman who has had a vaginal hysterectomy. While tub baths can sometimes aid in healing, it is not a critical piece of information compared to understanding the impact on hormone levels post-surgery. Educationally, nurses should emphasize individualized care and provide accurate, evidence-based information to empower patients in making informed decisions about their health. Understanding the implications of a vaginal hysterectomy on hormone levels helps patients better prepare for potential changes in their body post-surgery.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) Postmenopausal woman with hypertension. Endometrial cancer is influenced by hormonal factors, particularly estrogen exposure. Postmenopausal women with hypertension are at higher risk due to their prolonged exposure to estrogen unopposed by progesterone, which can lead to endometrial hyperplasia and potentially cancer. Option B) Woman who has an intrauterine device (IUD) is less likely to develop endometrial cancer as the IUD use has been associated with a decreased risk of this type of cancer due to its effect on reducing estrogen exposure. Option C) Client who has been on birth control for 15 years has a reduced risk of endometrial cancer due to the progestin component in most birth control pills, which helps counter the estrogen's effects on the endometrium. Option D) Perimenopausal woman who has a cystocele is not at the highest risk for endometrial cancer. While perimenopausal women may still have some estrogen exposure, other options present higher risk factors for endometrial cancer. Educationally, understanding the risk factors for endometrial cancer is crucial for nurses caring for women's health. Recognizing the impact of hormonal influences and comorbidities like hypertension can inform nursing assessments, patient education, and preventive care strategies to promote early detection and optimal outcomes.