During a clinical breast examination, the nurse palpates a well-defined, firm, mobile lump in a 60-year-old woman's left breast. The nurse notifies the primary care provider. What would the nurse anticipate the care provider to prescribe next?

mammogram

hormone receptor status

fine-needle aspiration

genetic testing for BRCA

Answer and Explanation

The Correct Answer is A

A. Mammogram

A mammogram is typically the next step in the diagnostic process when a breast lump is detected during a clinical breast examination. Mammography allows for further evaluation of the lump and surrounding breast tissue to determine its characteristics, such as size, shape, and density. It is an important tool for detecting breast abnormalities, including masses and calcifications, which can help in diagnosing breast cancer.

B. Hormone receptor status

While hormone receptor status testing may be part of the diagnostic workup for breast cancer, it is usually not the immediate next step after discovering a breast lump during a clinical examination. Hormone receptor status testing is typically performed after a confirmed diagnosis of breast cancer to guide treatment decisions, such as the use of hormone therapy.

C. Fine-needle aspiration

Fine-needle aspiration (FNA) may be used in conjunction with other diagnostic tests, such as mammography or ultrasound, to further evaluate a breast lump. However, it is not typically the first step in the diagnostic process, especially if a lump is found during a clinical breast examination. FNA involves using a thin needle to extract cells or fluid from the lump for examination under a microscope to determine if it is benign or malignant.

D. Genetic testing for BRCA

Genetic testing for BRCA mutations is typically not the immediate next step after finding a breast lump during a clinical examination. Genetic testing for BRCA mutations is usually recommended for individuals with a strong family history of breast or ovarian cancer or those who meet specific criteria based on personal or family history. It is not typically the initial diagnostic step in evaluating a breast lump.

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Correct Answer is C

Explanation

A. Postterm labor:

Postterm labor refers to labor that occurs after 42 weeks of gestation. While stress and trauma can contribute to preterm labor, there isn't a direct association between violence during pregnancy and postterm labor.

B. Chorioamnionitis:

Chorioamnionitis is an infection of the fetal membranes (chorion and amnion) and amniotic fluid. While violence during pregnancy doesn't directly cause chorioamnionitis, infections can occur if there are injuries sustained during violent episodes or if there's poor prenatal care due to the effects of violence.

C. Gestational hypertension:

Gestational hypertension, also known as pregnancy-induced hypertension, is characterized by high blood pressure that develops during pregnancy. Chronic stress and anxiety resulting from violence during pregnancy can contribute to elevated blood pressure levels, potentially leading to gestational hypertension.

D. Placenta previa:

Placenta previa occurs when the placenta partially or completely covers the cervix, increasing the risk of bleeding during pregnancy and delivery. While violence during pregnancy doesn't directly cause placenta previa, it can indirectly impact placental health and function due to stress-induced physiological changes.

A. 24 hours before birth and 24 hours after birth B. at 28 weeks' gestation and again within 72 hours after birth C. at 32 weeks' gestation and immediately before discharge D. in the first trimester and within 2 hours of birth

Correct Answer is B

Explanation

A. 24 hours before birth and 24 hours after birth:

This option suggests administering Rho(D) immune globulin (RhIg) both before and after birth. However, the standard recommendation is to administer RhIg at 28 weeks' gestation and again within 72 hours after birth. Administering RhIg before birth in this manner is not a standard practice for preventing Rh isoimmunization.

B. At 28 weeks' gestation and again within 72 hours after birth:

This is the correct choice. Administering RhIg at 28 weeks' gestation helps prevent sensitization of the Rh-negative mother to Rh-positive fetal blood cells that may have entered her circulation during pregnancy. Administering it again within 72 hours after birth helps prevent sensitization from any Rh-positive fetal blood cells that may have entered the mother's circulation during delivery.

C. At 32 weeks' gestation and immediately before discharge:

Administering RhIg at 32 weeks' gestation is not the standard recommendation. The standard timing is at 28 weeks' gestation to cover the critical period of sensitization during pregnancy. Administering it immediately before discharge may not provide adequate protection if sensitization has already occurred during pregnancy.

D. In the first trimester and within 2 hours of birth:

Administering RhIg in the first trimester is not a routine practice unless there is a specific indication, such as miscarriage or invasive procedures that may lead to fetal-maternal hemorrhage. Administering it within 2 hours of birth alone does not provide adequate protection against sensitization during pregnancy. The standard recommendation is to administer RhIg at 28 weeks' gestation and again within 72 hours after birth to cover the critical periods of sensitization during pregnancy and delivery.

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During a clinical breast examination, the nurse palpates a well-defined, firm, mobile lump in a 60-year-old woman's left breast. The nurse notifies the primary care provider. What would the nurse anticipate the care provider to prescribe next?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is presenting a class at a local community health center on violence during pregnancy. Which possible complication would the nurse include?

Correct Answer is C

Explanation

It is determined that a client's blood Rh is negative and her partner's is Rh positive. To help prevent Rh isoimmunization, the nurse would expect to administer Rho(D) immune globulin at which time?

Correct Answer is B

Explanation

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