A nurse is examining a male client within normal weight range who is questioning about the cause of his enlarged breasts. Which course of action best describes how the nurse should address the client's bilateral gynecomastia?

Inform the client that his breast enlargement is benign, and normal for an adult male

Recommend that he alter his diet to include fewer fats and more lean proteins

Explain that this condition may be the result of hormonal changes, and recommend that he see his physician

Explain that gynecomastia in men usually associated with prostate enlargement and recommend that he be screened

Answer and Explanation

The Correct Answer is C

A) Inform the client that his breast enlargement is benign, and normal for an adult male:
Although gynecomastia is common and often benign, it is not always normal for adult males to experience breast enlargement. The condition can be related to various factors such as hormonal imbalances, medications, or underlying health issues. It is important not to reassure the client without further assessment, as gynecomastia may need to be evaluated by a healthcare provider to rule out any medical conditions.

B) Recommend that he alter his diet to include fewer fats and more lean proteins:
While diet can have an impact on overall health, the enlargement of the breasts in males (gynecomastia) is typically not related to fat intake. This recommendation is not appropriate for addressing the root cause of gynecomastia, which often involves hormonal changes rather than diet alone. A dietary change may not resolve the underlying condition, and medical evaluation is warranted.

C) Explain that this condition may be the result of hormonal changes, and recommend that he see his physician:
This is the most appropriate response. Gynecomastia is often caused by hormonal imbalances, particularly an imbalance between estrogen and testosterone. It can occur during puberty, in older age, or as a result of certain medications or medical conditions. The nurse should advise the client to consult a physician for further evaluation and diagnosis, as appropriate treatment depends on the underlying cause.

D) Explain that gynecomastia in men is usually associated with prostate enlargement and recommend that he be screened:
This is not accurate. While prostate issues can affect male hormones, gynecomastia is typically not directly associated with prostate enlargement. The condition is more often linked to hormonal changes involving estrogen or testosterone, not necessarily prostate problems. Recommending prostate screening would not address the underlying cause of gynecomastia and is not the most relevant next step in care.

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Correct Answer is B

Explanation

A) Frontal sinusitis:
This is incorrect. Frontal sinusitis typically causes pain and tenderness in the forehead area, above the eyes, and along the brow ridge. While frontal sinusitis can lead to headaches and facial pain, it generally does not cause pain in the teeth, cheeks, or nasal discharge as specifically as maxillary sinusitis. Pain in the cheeks and upper teeth, along with purulent nasal discharge, is more characteristic of maxillary sinus involvement.

B) Maxillary sinusitis:
This is the correct answer. Maxillary sinusitis is the inflammation or infection of the maxillary sinuses, which are located behind the cheeks. Common symptoms include throbbing pain in the cheeks, teeth, and upper jaw, swollen turbinates (the structures inside the nose that help with airflow and filtering), and purulent nasal discharge. These symptoms match the description provided, making maxillary sinusitis the most likely diagnosis.

C) Nasal fracture:
This is incorrect. A nasal fracture typically presents with pain, swelling, bruising, and sometimes deformity of the nose, often accompanied by epistaxis (nosebleeds). While a nasal fracture can cause pain, it would not typically cause the throbbing pain in the face, teeth, and cheeks, nor would it be associated with swollen turbinates and purulent nasal discharge as seen in sinusitis.

D) Nasal polyps:
This is incorrect. Nasal polyps are non-cancerous growths that form in the nasal passages or sinuses due to chronic inflammation. They often cause nasal obstruction, reduced sense of smell, or frequent sinus infections. However, they do not typically cause the throbbing facial pain, particularly in the teeth and cheeks, that is characteristic of maxillary sinusitis. They also do not cause the purulent discharge seen in sinus infections.

A. Demonstrate that both arteries will be palpated simultaneously to compare amplitude B. Instruct the client take a deep breath and "hold" while the nurse briefly auscultates C. Discuss that a light will be directed at the neck to observe for pulsations of the artery D. Show the client the diaphragm of the stethoscope that will be placed on the neck

Correct Answer is B

Explanation

A) Demonstrate that both arteries will be palpated simultaneously to compare amplitude: This is not recommended. Palpating both carotid arteries simultaneously can cause a decrease in blood flow to the brain, potentially leading to dizziness or syncope. It is important to palpate one carotid artery at a time to avoid reducing blood flow to the brain, especially in clients with cardiovascular disease or those at risk of stroke.

B) Instruct the client to take a deep breath and "hold" while the nurse briefly auscultates: This is the correct approach. Instructing the client to hold their breath helps minimize any interference from respiratory sounds while auscultating the carotid arteries for bruits. This technique ensures that breath sounds do not mask any abnormal vascular sounds, such as bruits, which could indicate a blockage or narrowing of the carotid arteries.

C) Discuss that a light will be directed at the neck to observe for pulsations of the artery: Observing pulsations with light is not an appropriate technique for assessing the carotid arteries. Pulsations may be visible in some cases, but palpation and auscultation are the more reliable methods for evaluating the carotid arteries for abnormalities such as bruits or reduced pulse amplitude.

D) Show the client the diaphragm of the stethoscope that will be placed on the neck: While it is appropriate to explain the process to the client, the action of showing the stethoscope is unnecessary at this stage. The focus should be on instructing the client to hold their breath for proper auscultation to listen for any abnormal vascular sounds.

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A nurse is examining a male client within normal weight range who is questioning about the cause of his enlarged breasts. Which course of action best describes how the nurse should address the client's bilateral gynecomastia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client complaining of throbbing pain in the face, teeth, and cheeks. Upon palpation, the nurse notes swollen turbinates and a purulent discharge the nose. The nurse should recognize that the client's symptoms best correlate with which problem?

Correct Answer is B

Explanation

A nurse is assessing the carotid arteries of a client diagnosed with cardiovascular disease. What action should be performed next by the nurse when assessing the carotid arteries in this client?

Correct Answer is B

Explanation

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