A 29-year-old nulligravid woman presents to the nurse practitioner with a chief concern of a lump in her breast. On clinical exam, the NP detects a 2 cm x 1 cm nontender, smooth, round, rubbery, mobile mass in the upper outer quadrant of the patient’s right breast. The NP understands this mass is most likely which of the following?
Carcinoma
Clogged duct
Fibroadenoma
Duct ectasia
The Correct Answer is C
Choice A reason: Carcinomas are typically hard, irregular, immobile, and may be associated with skin changes or nipple retraction. While breast cancer must always be ruled out, the described mass lacks the suspicious features of malignancy.
Choice B reason: A clogged duct is usually painful and associated with lactation. It presents as a tender, localized area of swelling and is not typically rubbery or mobile. This patient is nulligravid and not lactating, making this diagnosis unlikely.
Choice C reason: Fibroadenomas are common benign breast tumors in young women. They are typically smooth, round, rubbery, mobile, and nontender. The location in the upper outer quadrant and the described characteristics strongly suggest a fibroadenoma.
Choice D reason: Duct ectasia involves dilation of the milk ducts and may present with nipple discharge, tenderness, or inflammation. It is more common in older women and does not typically present as a discrete, mobile mass.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Excessive iodine intake can paradoxically inhibit thyroid hormone synthesis through the Wolff-Chaikoff effect, leading to hypothyroidism. This autoregulatory mechanism protects against hyperthyroidism but can result in reduced hormone production if iodine levels remain high.
Choice B reason: While iodine intake influences thyroid function, small changes do not “reset” the thyroid system. The thyroid gland responds to iodine availability, but regulation is more complex and involves feedback from TSH and circulating thyroid hormones.
Choice C reason: Iodine deficiency typically leads to hypothyroidism, not hyperthyroidism. In rare cases, iodine deficiency may cause goiter and nodular thyroid disease, which can result in hyperthyroidism, but this is not the usual outcome.
Choice D reason: Iodine is essential for the synthesis of thyroid hormones (T3 and T4). It is directly involved in thyroid regulation, and its absence or excess can significantly impact thyroid function.
Correct Answer is D
Explanation
Choice A reason: This is correct. When slough or eschar obscures the wound bed, the ulcer is classified as unstageable until the base is visible. Accurate staging requires assessment of tissue depth and type.
Choice B reason: This is correct. Pressure ulcers do not progress through stages as they heal. For example, a stage 4 ulcer does not become a stage 3 ulcer during healing. Instead, it is described as a “healing stage 4 ulcer.”
Choice C reason: This is correct. In individuals with dark skin, early signs of pressure injury may present as persistent discoloration rather than visible redness. Recognizing these variations is essential for early detection.
Choice D reason: This is incorrect. The presence of a pressure ulcer may reflect inadequate care, poor mobility support, or lack of access to services. While not always indicative of neglect, it warrants evaluation of the patient’s support system and care environment.
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