A 36-yr-old client who has a diagnosis of fibrocystic breast changes calls the nurse in the clinic reporting symptoms. Which information is likely to change the treatment plan?

The lumps are smaller and less painful after starting oral contraceptives.

The lumps get more painful before the clients menstrual period.

Firm and moveable lumps are in the upper outer breast quadrants.

An area on the breast is hot, pink, and tender to the touch.

Answer and Explanation

The Correct Answer is D

A. A reduction in lump size and pain with oral contraceptives is expected and does not indicate a need to change the treatment plan.

B. Increased lump pain before menstruation is typical for fibrocystic changes and not a cause for concern.

C. Firm, movable lumps in the upper outer breast quadrants are characteristic of fibrocystic changes and do not suggest an alternative condition.

D. An area that is hot, pink, and tender indicates inflammation or possible infection (e.g., mastitis or abscess), requiring further evaluation and potentially altering the treatment plan.

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Correct Answer is C

Explanation

A. Blood glucose elevation is a concern for statins, but it is not a primary reason for questioning the order.

B. A history of high cholesterol is common and would not trigger concern regarding lovastatin.

C. Lovastatin can cause liver toxicity, so elevated liver enzymes are a contraindication or cause for concern when prescribing this medication. The nurse should verify this before starting the medication.

D. A history of peptic ulcers is unrelated to the use of lovastatin and would not be a concern in this case.

A. Increase IV fluid infusion per protocol. B. Lower the head of the clients bed in Trendelenburg position C. Document CVP and continue to monitor. D. Administer IV diuretic medications.

Correct Answer is D

Explanation

A. Increasing IV fluids would exacerbate the client's fluid overload and worsen heart failure symptoms.

B. Trendelenburg positioning is typically used for shock management, but this client’s fluid overload needs to be addressed first.

C. Monitoring is important but does not address the immediate need to manage fluid overload.

D. The client's elevated CVP, PAWP, and BNP levels indicate fluid overload and heart failure with reduced ejection fraction. The priority is to reduce fluid overload by administering IV diuretics, which will help reduce the pressure in the heart and lungs, improving oxygenation and decreasing the risk of pulmonary edema.

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A 36-yr-old client who has a diagnosis of fibrocystic breast changes calls the nurse in the clinic reporting symptoms. Which information is likely to change the treatment plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After reviewing the client's chart upon admission to the unit, the nurse consults the healthcare provider about a new order for lovastatin (Mevacor). What triggered the nurse's action?

Correct Answer is C

Explanation

Correct Answer is D

Explanation

A client who has been receiving diuretic therapy is admitted to the emergency department with a serum potassium level of 3.0 mEq/L. The nurse should alert the health care provider immediately that the client is on which medication?

A nurse is reviewing the chart of a new client in the family medicine clinic and notes that the client is identified as "George Smith." The nurse enters the room and finds a woman in a skirt. What action by the nurse is best?

The nurse is caring for a client after a heart catheterization. What complication must the nurse intervene for immediately?

The post anesthesia care unit (PACU) charge nurse notes vital signs on four postoperative clients. Which client would the nurse assess first?

The nurse is preparing to administer adenosine (Adenocard) to a client experiencing supraventricular tachycardia. When giving this medication, what is important to remember?

The nurse is caring for a client who has frequent gastric pain and dyspepsia. Which procedure would the nurse expect the health care provider to order to make an accurate diagnosis?

The nurse is taking a history of a 68-year-old woman. What assessment findings would indicate a high risk for the development of breast cancer? (Select all that apply.)

A nurse assesses a client admitted to the cardiac unit. Which statement by the client alerts the nurse to the possibility of right- sided heart failure?