A client develops edema of the left arm and hand following a left radical mastectomy. The nurse explains the cause of the edema. Which explanation is correct?

Lymph structures were removed and fluid cannot move out of the area easily.

There is still too much swelling in the area of the surgery and fluid is accumulating.

The veins were removed from the axilla during surgery and there is poor circulation now.

You will need to wear a compression bandage to help fluids move from the area.

Answer and Explanation

The Correct Answer is A

Choice A reason: Lymph structures were removed and fluid cannot move out of the area easily is the correct explanation because a radical mastectomy involves the removal of the breast, the underlying chest muscles, and the lymph nodes in the axilla. The lymph nodes are part of the lymphatic system, which is responsible for draining excess fluid from the tissues and returning it to the bloodstream. When the lymph nodes are removed, the fluid cannot be drained properly and accumulates in the affected arm and hand, causing edema.

Choice B reason: There is still too much swelling in the area of the surgery and fluid is accumulating is not the correct explanation because it does not address the underlying cause of the edema. Swelling is a normal response to surgery, but it usually subsides within a few days or weeks. The edema caused by lymph node removal is chronic and persistent, and it does not improve with time.

Choice C reason: The veins were removed from the axilla during surgery and there is poor circulation now is not the correct explanation because it is not true. The veins are not removed during a radical mastectomy, only the lymph nodes are. The veins are part of the circulatory system, which carries blood throughout the body. The blood flow to the arm and hand is not affected by the surgery, unless there is a complication such as a blood clot or an infection.

Choice D reason: You will need to wear a compression bandage to help fluids move from the area is not the correct explanation because it is a treatment, not a cause. A compression bandage is a type of elastic bandage that applies pressure to the arm and hand, which helps to reduce the swelling and prevent further fluid accumulation. However, it does not address the root cause of the edema, which is the removal of the lymph nodes.

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Correct Answer is B

Explanation

Choice A reason: "I was short of breath when I walked around the block yesterday." is not the most significant statement because it is a common symptom of chronic bronchitis, but it does not indicate the severity or the progression of the condition. Shortness of breath is caused by the inflammation and narrowing of the airways, which reduce the airflow and oxygen delivery to the lungs.

Choice B reason: "I have a loose sounding cough every day when I get up in the morning." is the most significant statement because it indicates the presence of excessive mucus production, which is a hallmark of chronic bronchitis. Mucus traps bacteria and other irritants, which can lead to infections and further inflammation of the airways. A chronic cough is defined as a cough that lasts for at least three months in two consecutive years.

Choice C reason: "My respiratory secretions are greenish-yellow colored today." is not the most significant statement because it is a sign of a possible infection, but it does not necessarily indicate chronic bronchitis. Greenish-yellow colored sputum can be caused by various respiratory conditions, such as pneumonia, tuberculosis, or cystic fibrosis.

Choice D reason: "My feet are swollen and painful at the end of the afternoon." is not the most significant statement because it is a sign of a possible complication of chronic bronchitis, but it does not directly relate to the condition. Swollen and painful feet can be caused by right-sided heart failure, which can result from chronic bronchitis. Chronic bronchitis can increase the pressure in the pulmonary arteries, which can strain the right ventricle and cause it to fail. This can lead to fluid retention and edema in the lower extremities.

A. Hyperplasia B. Metaplasia C. Neoplasia D. Dysplasia

Correct Answer is B

Explanation

Choice A reason: Hyperplasia is not the best term because it is a condition where the number of cells in a tissue or organ increases, which can be caused by various factors, such as hormones, inflammation, or stress. Hyperplasia does not involve the change of cell type, but the increase of cell number.

Choice B reason: Metaplasia is the best term because it is a condition where the type of cells in a tissue or organ changes, usually in response to chronic irritation or injury. Metaplasia involves the replacement of one type of cell with another type of cell that is more resistant to the harmful stimulus, but less specialized in function. Metaplasia can occur in the bronchi, which are the airways that branch from the trachea to the lungs, and are normally lined with ciliated columnar cells, which are cells that have hair-like projections that help to move mucus and foreign particles out of the respiratory tract. Metaplasia can replace the ciliated columnar cells with stratified squamous epithelial cells, which are cells that have multiple layers and a flat shape, and are more durable, but less effective in clearing the airways.

Choice C reason: Neoplasia is not the best term because it is a condition where the growth of cells in a tissue or organ is abnormal and uncontrolled, which can result in the formation of tumors, which are masses of abnormal cells that can be benign or malignant. Neoplasia does not involve the change of cell type, but the abnormal proliferation of cells.

Choice D reason: Dysplasia is not the best term because it is a condition where the shape, size, and organization of cells in a tissue or organ are abnormal, which can be caused by various factors, such as chronic inflammation, infection, or precancerous changes. Dysplasia does not involve the change of cell type, but the alteration of cell morphology and arrangement.

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A client develops edema of the left arm and hand following a left radical mastectomy. The nurse explains the cause of the edema. Which explanation is correct?

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Naxlex Comprehensive Predictor Exams

The nurse provides care for a client diagnosed with bronchitis. Which statement is most significant during the assessment of a client diagnosed with chronic bronchitis?

Correct Answer is B

Explanation

Which term is best for the nurse to use to describe replacement of ciliated columnar cells to stratified squamous epithelial cells in the bronchi that were diagnosed in a client?

Correct Answer is B

Explanation

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