A nurse is teaching a female young adult client about performing a breast self-examination. Which of the following instructions should the nurse include in the teaching?
"Report a firm ridge below the breasts to the provider."
"Keep your arm relaxed at your side on the side you are examining."
"Use your thumb and forefinger to palpate each breast for lumps."
"Use firm pressure to palpate near the area of the ribs and chest wall."
The Correct Answer is D
A. "Report a firm ridge below the breasts to the provider." A firm ridge along the bottom curve of the breast can be normal. It’s important to distinguish between normal breast tissue and abnormal lumps. Encouraging clients to report any changes or new lumps to the provider is more appropriate.
B. "Keep your arm relaxed at your side on the side you are examining." The correct technique involves raising the arm on the side being examined to help spread out the breast tissue, making it easier to palpate for lumps and abnormalities.
C. "Use your thumb and forefinger to palpate each breast for lumps." The correct technique involves using the pads of the fingers (not the thumb and forefinger) to palpate the breast in a systematic pattern, such as circular motions or vertical strips, to thoroughly check all areas of the breast.
D. "Use firm pressure to palpate near the area of the ribs and chest wall." Using firm pressure is appropriate for palpating deeper tissues closer to the ribs and chest wall, as this helps detect lumps that may not be superficial.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Ask the client to tilt her head back when swallowing. Tilting the head back can increase the risk of aspiration. Clients with dysphagia should be instructed to tuck their chin to their chest when swallowing.
B. Offer the client larger portions of food during the meal. Smaller portions are safer for clients with dysphagia to reduce the risk of choking and aspiration.
C. Use spoons, instead of cups, when serving liquids to the client. This is correct. Using spoons can help control the amount of liquid the client receives, reducing the risk of aspiration.
D. Encourage the client to complete the meal within 15 min. Rushing a meal increases the risk of choking and aspiration. Clients with dysphagia should eat slowly and take small bites.
Correct Answer is C
Explanation
A. Whole grain cereal: Not recommended. Whole grains can be high in insoluble fiber, which may worsen diarrhea.
B. Chocolate ice cream: Not recommended. Ice cream, especially chocolate-flavored, contains dairy and fat, which may exacerbate diarrhea.
C. Sliced bananas: Bananas are easy to digest, provide potassium, and can help firm up stools.
D. Hot coffee: Not recommended. Coffee is a stimulant and can irritate the gastrointestinal tract, potentially worsening diarrhea.
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