The nurse instructs a female client on breast self-examination. Why does the nurse recommend the pattern shown for the client to use?

It is easiest for the client to learn

It takes the least amount of time

It causes the least amount of pain

It is the best technique to detect masses

Answer and Explanation

The Correct Answer is D

A. It is easiest for the client to learn: While the ease of learning is important, the primary goal is effective detection of masses.

B. It takes the least amount of time: The time taken is less critical than the effectiveness of the technique in detecting abnormalities.

C. It causes the least amount of pain: Minimizing pain is not the main reason for choosing a particular technique; effectiveness in detecting masses is more critical.

D. It is the best technique to detect masses: The recommended pattern, often the vertical strip or circular pattern, is chosen because it is the most effective way to systematically cover the breast tissue and increase the likelihood of detecting abnormalities or masses.

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Correct Answer is C

Explanation

Rationale:
A. Fever: While fever might be a symptom of infection, it is not specific to inner ear infections.

B. Headache: This can be a symptom associated with inner ear infections, but vertigo is a more specific concern.

C. Vertigo: Inner ear infections often cause vertigo (dizziness or spinning sensations), so interventions for managing vertigo are crucial.

D. Rhinorrhea: This symptom is more commonly associated with upper respiratory infections rather than inner ear infections.

A. Wait until the end of the physical assessment to reassess the radial pulse. B. Reassess the client's pedal pulse on the other foot. C. Assess the client's 51 and 52 sounds for regularity. D. Assess the client's apical pulse for a full minute.

Correct Answer is ["A","D"]

Explanation

A. Wait until the end of the physical assessment to reassess the radial pulse: If the radial pulse is irregular, it is important to reassess it to confirm irregularity. However, waiting until the end of the assessment is not recommended; it is better to reassess promptly.

B. Reassess the client's pedal pulse on the other foot: This is not related to assessing the regularity of the radial pulse.

C. Assess the client's 51 and 52 sounds for regularity: These terms are not standard in assessing pulse regularity; the focus should be on the apical pulse for an irregular radial pulse.

D. Assess the client's apical pulse for a full minute: The apical pulse should be assessed for a full minute to accurately determine the heart rate and rhythm, especially if the radial pulse is irregular.

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The nurse instructs a female client on breast self-examination. Why does the nurse recommend the pattern shown for the client to use?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When planning care for a client with an inner ear infection, the nurse will need to include interventions for which of the following potential problems?

Correct Answer is C

Explanation

During a physical assessment, the nurse should implement which actions initially when determining if a client's radial pulse is irregular? (Select all that apply.)

Correct Answer is ["A","D"]

Explanation

A patient is unable to taste in the 2/3 anterior of his tongue. Which cranial nerve is affected?

The nurse notes a break in the skin, which appears blister-like, it looks superficial with loss up to the dermis layer. The nurse would interpret this finding as indicating which stage of

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When performing a head-to-toe assessment, during which part would the nurse evaluate cranial nerve (CN) IX, X, and XII?

When applying the principle of ABC (airway, breathing, circulation) prioritization, which complication is priority for the nurse to address?

Which individual typically would be responsible for collecting the subjective data on a client during the initial comprehensive assessment?

The nurse is conducting a physical examination of the abdomen. What is the nurse's best action to ensure she can hear bowel sounds?

When teaching students how to perform an assessment, the nurse informs the students that the reason this information needs to be accurate and complete is: