Nokea
During a breast examination, which finding most strongly suggests that the client has breast cancer?
- A. Slight asymmetry of the breasts
- B. A fixed nodular mass with dimpling of the overlying skin
- C. Bloody discharge from the nipple
- D. Multiple firm, round, freely movable masses that change with the menstrual cycle
Correct Answer: B
Rationale: A fixed nodular mass with dimpling of the overlying skin is the finding that most strongly suggests breast cancer. This presentation is concerning for an invasive carcinoma that has invaded into the surrounding tissues, leading to the dimpling of the skin. Breast cancer typically presents as a painless, hard, irregularly shaped, non-mobile mass. Dimpling of the skin overlying the mass is a sign of advanced disease and is often associated with a poor prognosis. Therefore, this finding should raise suspicion for breast cancer and prompt further evaluation and workup.
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A male client who is HIV positive is admitted to the hospital with a diagnosis of Pneumocystis carinii pneumonia. His live-in partner has accompanied him. During the history interview, the nurse is aware of feeling a negative attitude about the client's lifestyle, what action is most appropriate?
- A. Share these feelings with the client
- B. Discuss the negative feelings with the
- C. Develop a written interview form charge nurse
- D. Avoid eye contact with the client
Correct Answer: B
Rationale: It is important for the nurse to acknowledge and address any negative feelings or biases that may arise during patient care, especially when caring for a patient with a stigmatized condition like HIV/AIDS. Discussing these negative feelings with a trusted colleague, such as the charge nurse, can help the nurse process and overcome their biases in a safe and non-judgmental environment. By addressing these feelings, the nurse can ensure that they provide compassionate and professional care to the patient and their partner without any personal biases interfering with the care delivery. Sharing these feelings with the client or avoiding eye contact would be inappropriate and counterproductive to establishing trust and providing care. Developing a written interview form would not address the underlying issue of negative attitudes or biases and may not be effective in promoting unbiased care.
Which is true of a Wilms tumor? (Select all that apply.)
- A. It is also referred to as neuroblastoma.
- B. It is most commonly seen between the ages of 2 and 5 years.
- C. It can occur on its own or be associated with congenital anomalies.
- D. It is a slow-growing tumor.
Correct Answer: C
Rationale: Wilms tumor typically occurs in children aged 2-5 years and may be associated with congenital anomalies. It is not the same as neuroblastoma, and its prognosis is generally good with treatment.
Children with ALL who carry poor outcome include all the following EXCEPT
- A. age younger than 1 year and older than 10 year
- B. T-cell immunophenotype
- C. hyperdiploidy chromosomal abnormality
- D. initial leukocyte count of > 50,000
Correct Answer: C
Rationale: Hyperdiploidy is generally associated with a favorable prognosis in ALL, unlike other listed factors.
The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is often prone (face down) while awake. What knowledge should the nurse's response should be based?
- A. Unacceptable because of the risk of sudden infant death syndrome (SIDS)
- B. Unacceptable because it does not encourage achievement of developmental milestones
- C. Acceptable to encourage fine motor development
- D. Acceptable to encourage head control and turning over
Correct Answer: D
Rationale: The correct knowledge that the nurse's response should be based on is that it is acceptable to encourage head control and turning over. At 3 months of age, encouraging the infant to be prone while awake can help promote the development of head control, neck strength, and eventually facilitate the ability to turn over. This practice is considered safe and beneficial for infants within the appropriate age range, as long as the infant is supervised during the awake period. It is important to promote safe sleep practices for infants to reduce the risk of Sudden Infant Death Syndrome (SIDS), but allowing supervised tummy time for an awake infant is beneficial for their motor development.
A client with rheumatoid arthritis is about to begin aspirin therapy to reduce inflammation. When teaching the client about aspirin, the nurse discusses adverse reactions to prolonged aspirin therapy. These include:
- A. Weight gain
- B. Respiratory acidosis
- C. Fine motor tremors
- D. Bilateral hearing loss
Correct Answer: D
Rationale: Prolonged aspirin therapy can lead to a rare side effect known as aspirin-induced hearing loss, which manifests as bilateral hearing loss. This adverse reaction is typically associated with higher doses of aspirin and longer durations of use. It is important for healthcare providers to monitor for signs of hearing loss in patients receiving long-term aspirin therapy, especially those with rheumatoid arthritis or other inflammatory conditions, to prevent irreversible damage to the hearing. Weight gain, respiratory acidosis, and fine motor tremors are not commonly associated with prolonged aspirin therapy.