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What assessment finding suggests that a patient may have fibrocystic breast changes?
- A. green-tinged nipple discharge
- B. ongoing breast pain
- C. firm, ropy feel of the breast tissue under the skin
- D. peau d’orange appearance of the skin
Correct Answer: C
Rationale: Fibrocystic breast changes typically present with breast pain and a cyclic pattern of nodularity and/or lumps in the breast tissue. The characteristic assessment finding that suggests fibrocystic breast changes is the firm, ropy feel of the breast tissue under the skin. This texture is due to the presence of fibrous tissue and cysts within the breast, which can be felt during the physical examination. While nipple discharge and skin changes like peau d’orange can be associated with different breast conditions, the firm and ropy feel of the breast tissue is more specific to fibrocystic changes.
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The nurse is planning a teaching session for staff on ethical theories. Which situation best reflects the Deontologic theory?
- A. Approving a physician-assisted suicide
- B. Supporting the transplantation of fetal tissue and organs
- C. Using experimental medications for the treatment of AIDS
- D. Initiating resuscitative measures on a 90-year-old patient with terminal cancer
Correct Answer: D
Rationale: Deontologic theory, also known as deontological ethics, focuses on the duty to follow moral rules and obligations regardless of the consequences. In this scenario, initiating resuscitative measures on a 90-year-old patient with terminal cancer reflects a commitment to upholding the duty to provide care and uphold the sanctity of life. Despite the patient's poor prognosis, the nurse is ethically bound to provide care according to established principles and guidelines, emphasizing duty over outcome. This aligns with the Deontologic theory's emphasis on following moral rules and obligations without consideration of the consequences.
The nurse is providing care to a 35-year-old female patient who complains of low back pain, pain with defecation, pelvic pressure, and premenstrual spotting. The health care provider has prescribed the hormonal therapy Lupron for this condition. What is the goal of this prescription?
- A. To prevent pregnancy at this time to promote healing
- B. To suppress menstruation and further growth of the tissue
- C. To prevent retrograde menstruation outside the uterine cavity
- D. To increase blood flow to decrease the endometrial lining
Correct Answer: B
Rationale: The goal of prescribing Lupron for this patient is to suppress menstruation and further growth of the tissue. Lupron is a hormonal therapy that works by suppressing the production of certain hormones that stimulate the growth of endometrial tissue. In conditions like endometriosis, where the endometrial tissue grows outside the uterus, suppressing menstruation can help alleviate symptoms such as pelvic pain, back pain, and pelvic pressure. By halting the growth of the tissue, Lupron can help manage the symptoms associated with endometriosis and improve the patient's quality of life.
The nurse is preparing to teach the community about risk factors for the second most common cancer of the female reproductive system. Which of the following groups of women are at higher risk for this cancer? Select all that apply.
- A. Menopausal women with an intact uterus who receive hormonal therapy
- B. Women who have undergone treatment for breast cancer
- C. Women who have many pregnancies and nursed their infants
- D. Women who smoke and have many sexual partners
Correct Answer: A
Rationale: A. Menopausal women with an intact uterus who receive hormonal therapy are at higher risk for endometrial cancer, which is the second most common cancer of the female reproductive system. Estrogen therapy without progesterone can increase the risk of endometrial cancer due to unopposed estrogen stimulation.
A nurse is admitting a patient to the labor and birth unit in early labor that was sent to the facility following a checkup with her health care provider in the office. The patient is a gravida 1, para 0, and is at term. No health issues are discerned from the initial assessment, and the nurse prepares to initiate physician orders based on standard procedures. Which action by the nurse manager is warranted in this situation?
- A. No action is indicated because the nurse is acting within the scope of practice.
- B. The nurse manager should intervene and ask the nurse to clarify admission orders directly with the physician.
- C. The nurse manager should review standard procedures with the nurse to validate that orders are being carried out accurately.
- D. The nurse manger should review the admission procedure with the nurse.
Correct Answer: B
Rationale: In this scenario, the nurse is admitting a patient based on orders initiated by the physician during an office visit. Given that the patient is in early labor and has no discernible health issues, the nurse manager should intervene and ask the nurse to clarify the admission orders directly with the physician. It is important to ensure clarity and accuracy when carrying out physician orders, especially in situations where there may be ambiguity or room for misinterpretation. By verifying the orders with the physician, the nurse can help prevent any potential errors or miscommunications that may impact the patient's care.
Which goal is most appropriate for the collaborative problem of wound infection?
- A. The patient will not exhibit further signs of infection.
- B. Maintain the patient’s fluid intake at 1000 mL/8 hour.
- C. The patient will have a temperature of 98.6F within 2 days.
- D. Monitor the patient to detect therapeutic response to antibiotic therapy.
Correct Answer: A
Rationale: The most appropriate goal for the collaborative problem of wound infection is "The patient will not exhibit further signs of infection." This goal directly addresses the issue of controlling and resolving the infection within the wound, leading to the overall improvement in the patient's condition. By ensuring that the patient does not exhibit further signs of infection, healthcare providers can monitor the effectiveness of treatment interventions and prevent any complications that may arise from the infection spreading or worsening. In contrast, options B, C, and D are not directly related to addressing the wound infection itself, making them less appropriate goals for this specific problem.