A 56-year-old female client has discovered a new breast lump. The practical nurse (PN) recognizes that this client's greatest risk for a diagnosis of breast cancer is related to which factor?

She is postmenopausal and has been using herbal estrogen replacement therapy for four years.

There is a history of fibrocystic breast changes and she describes the lump as painful.

The client is of normal weight and height and has had three children before age 28.

She describes the lump as non-tender and says her mother died of breast cancer.

Answer and Explanation

The Correct Answer is D

A. While postmenopausal use of herbal estrogen may be a risk factor for breast cancer, it is not as significant as having a family history of the disease.
B. A history of fibrocystic changes and a painful lump are not as strong a risk factor for breast cancer as a family history of the disease.
C. Being of normal weight, height, and having children at a younger age are generally considered protective factors rather than risk factors for breast cancer.
D. A non-tender lump combined with a family history of breast cancer (mother with breast cancer) is the most significant risk factor for developing breast cancer.

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Correct Answer is ["B","D","E"]

Explanation

A. Subdural hemorrhage
The head CT was negative for bleeding or edema, making a subdural hemorrhage unlikely.
B. Respiratory distress
Given the history of drowning and the current signs of respiratory acidosis (pH 7.31, PaCO2 51), the child is at high risk for respiratory complications, including distress.
C. Hyperthermia
Hyperthermia is not a typical immediate complication following drowning in cool water, and the current body temperature of the child is within the normal range.
D. Cerebral edema
Although the initial CT scan is negative for edema, secondary cerebral edema can develop hours after the incident, especially in cases of significant hypoxemia.
E. Acute asphyxia
The initial incident of drowning and the resultant hypoxemia (as indicated by abnormal blood gases) place the child at risk for complications related to acute asphyxia.
F. Hypertension
The child's blood pressure is currently within normal limits, and hypertension is not a common immediate complication following drowning.

A. Feel for a carotid pulse. B. Bring a glucometer to the room. C. Obtain emergency help. D. Check the blood pressure.

Correct Answer is C

Explanation

A. Feeling for a carotid pulse is part of the assessment process but is not the first step in responding to an unresponsive client. Immediate action to summon emergency help is the priority.
B. Bringing a glucometer to the room is not appropriate at this stage. While checking blood glucose might be necessary, the first step is to get emergency assistance.
C. Obtaining emergency help is the most critical first step when encountering an unresponsive client. Emergency help ensures that appropriate interventions are initiated promptly.
D. Checking the blood pressure is part of a complete assessment but is not the most urgent action. The priority is to call for emergency assistance rather than performing further assessments.

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A 56-year-old female client has discovered a new breast lump. The practical nurse (PN) recognizes that this client's greatest risk for a diagnosis of breast cancer is related to which factor?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Exhibits Review H and P, nurse's note, laboratory results, prescriptions, and imaging studies. What complications should the practical nurse (PN) monitor for in the next 6 to 8 hours? Select all that apply.

Correct Answer is ["B","D","E"]

Explanation

The practical nurse (PN) and unlicensed assistive personnel (UAP) enter a client's room and find the client lying on the bed. The PN determines that the client is unresponsive. Which instruction should the PN give the UAP first?

Correct Answer is C

Explanation

The practical nurse (PN) is reviewing home care instructions with the mother of a young girl with a urinary tract infection (UTI). Which information reported by the mother demonstrates understanding of home care for the child?

The practical nurse (PN) is turning a dependent bedridden client without assistance. Which action will best ensure the client's safety?

In which client situation should the practical nurse assess for the presence of Cheyne-Stokes respirations?

Which intervention should the practical nurse (PN) reinforce for a client with pruritis?

The practical nurse (PN) is assigning care for a group of clients on the urology medical unit. What client care interventions should the PN assign to the unlicensed assistive personnel (UAP)? Select all that apply.

The practical nurse (PN) is assisting with data collection for clients who have been admitted to the emergency department. What clients should the PN report to the nurse for further intervention for possible family violence? Select all that apply.

During a nonstress test of a 38-week client, the practical nurse (PN) observes the fetal heart rate increases 15 beats above baseline lasting 10 seconds twice during a 20-minute tracing. Which finding should the PN document in the electronic medical record?