A nurse s teaching a group of clients about modifiable risk factors for cardiovascular disease. Which of the following should the nurse include in the teaching? (Select All that Apply).

A) Daily, during the shower or bath:
This is incorrect. Performing a breast self-examination (BSE) daily is not necessary. The goal of BSE is to check for any changes over time, not to examine the breasts every day. It's more effective to perform the exam regularly at a consistent time each month.

B) One week after the menstrual period:
This is incorrect. This instruction is relevant for pre-menopausal women, where the hormonal changes associated with the menstrual cycle can cause breast tissue to feel lumpy or swollen. The best time for them to perform a BSE is one week after the menstrual period ends when the breasts are least likely to be swollen or tender. However, for postmenopausal women, this is not necessary, as their hormonal levels are stable throughout the month.

C) On the same day every month:
This is the correct answer. For postmenopausal women, who no longer have menstrual cycles, the best time to perform a breast self-exam is on the same day every month. This ensures consistency and makes it easier for the client to notice any changes in the breast tissue over time. The day chosen should be one that is convenient and easy to remember, and it does not matter whether it is during the shower or bath, as long as the examination is done regularly.

D) Weekly, at the client's convenience:
This is incorrect. While performing a BSE weekly is not necessary, the key is consistency rather than frequency. Performing the exam monthly is sufficient, and it should be on a specific day each month, rather than at the client’s convenience on an irregular basis.

A) Suprasternal notch:
This is incorrect. The suprasternal notch is a depression located at the top of the sternum, just above the manubrium. While this is an important landmark for palpating the trachea and assessing other structures in the thoracic region, it is not the point where the trachea bifurcates.

B) Xiphoid process:
This is incorrect. The xiphoid process is the small, pointed lower portion of the sternum. It is located at the inferior end of the sternum and does not play a role in the bifurcation of the trachea. The trachea bifurcates much higher in the thoracic region.

C) Costal angle:
This is incorrect. The costal angle is formed by the meeting of the costal margins of the ribs at the lower end of the ribcage. While it is an important anatomical landmark, it is not related to the bifurcation of the trachea.

D) Sternal angle:
This is the correct answer. The sternal angle (also known as the angle of Louis) is located at the junction between the manubrium and the body of the sternum, approximately at the level of the second rib. This is the anatomical landmark where the trachea bifurcates into the right and left mainstem bronchi, usually around the level of the T4 to T5 vertebrae. It is an important reference point during respiratory assessments.