The nurse is developing the discharge plan for a woman who has had a left-sided radical mastectomy. The nurse is including instructions for ways to minimize lymphedema. Which statement by the client indicates the need for additional instruction?

"I need to avoid driving to and from work every day."

"Any blood pressures need to be taken in my right arm."

"I need to wear gloves when doing any gardening."

"I should wear clothing with elasticized sleeves."

Answer and Explanation

The Correct Answer is D

A. "I need to avoid driving to and from work every day."

This statement indicates a misunderstanding of how to minimize lymphedema. Driving itself does not directly contribute to lymphedema. However, activities that involve prolonged or repetitive use of the affected arm, such as gripping the steering wheel while driving for long periods, may increase the risk of developing lymphedema. The nurse should clarify that while driving is generally acceptable, the client should take breaks and perform arm exercises during long drives to promote circulation.

B. "Any blood pressures need to be taken in my right arm."

This statement demonstrates correct understanding. Taking blood pressure measurements, administering injections, or obtaining blood samples from the unaffected arm helps prevent trauma or injury to the arm at risk for lymphedema. This practice helps avoid disrupting lymphatic flow and reduces the risk of developing lymphedema in the affected arm.

C. "I need to wear gloves when doing any gardening."

Wearing gloves during gardening is a recommended precaution to minimize the risk of injury and infection, especially if the client has undergone lymph node removal. This statement reflects appropriate understanding and adherence to preventive measures to protect the affected arm from cuts, scratches, and potential infection that could exacerbate lymphedema.

D. "I should wear clothing with elasticized sleeves."

This statement indicates a misunderstanding of how to minimize lymphedema. While elasticized sleeves or compression garments can help manage lymphedema by providing gentle compression and support to the affected arm, wearing tight or constrictive clothing, including elasticized sleeves, can potentially restrict lymphatic flow and exacerbate lymphedema. The nurse should clarify that loose-fitting clothing is preferable to allow unrestricted movement and circulation in the affected arm.

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Correct Answer is D

Explanation

A. Developing most often in women in their 30s:

Stress incontinence can affect women of various ages, not specifically those in their 30s. While childbirth and hormonal changes associated with aging can increase the risk of stress incontinence, it is not limited to any particular age group.

B. Feeling a strong need to void:

This characteristic is more indicative of urgency incontinence, also known as overactive bladder (OAB), where there is a sudden, strong urge to urinate that is difficult to control. It is different from stress incontinence, which is triggered by physical movements or activities that increase pressure on the bladder.

C. Passing a large amount of urine:

This choice does not specifically describe a characteristic of stress incontinence. Stress incontinence involves the leakage of small amounts of urine during activities such as coughing, sneezing, laughing, or exercising, rather than the passage of a large amount of urine at once.

D. Sneezing as an initiating stimulus:

This is the correct characteristic of stress incontinence. Stress incontinence is characterized by the leakage of urine during physical activities or movements that increase intra-abdominal pressure, such as coughing, sneezing, laughing, lifting, or exercising. Sneezing is a common initiating stimulus for stress incontinence episodes.

A. alcohol B. heroin C. marijuana D. cocaine

Correct Answer is D

Explanation

A. Alcohol:

Alcohol consumption during pregnancy can lead to a range of adverse effects on the fetus, collectively known as fetal alcohol spectrum disorders (FASDs). However, the symptoms described in the scenario—tachycardia, hypertension, and evidence suggesting vasoconstriction—are not typical of alcohol use. While alcohol can lead to hypertension in chronic heavy drinkers, it is not commonly associated with tachycardia and vasoconstriction in the same way that stimulant drugs like cocaine are.

B. Heroin:

Heroin is an opioid drug that depresses the central nervous system, leading to effects such as respiratory depression, sedation, and decreased heart rate. While heroin use during pregnancy can have serious consequences for both the mother and the fetus, including neonatal withdrawal syndrome (neonatal abstinence syndrome), it is not typically associated with tachycardia, hypertension, and vasoconstriction. Therefore, heroin is less likely to be the substance causing the symptoms described in the scenario.

C. Marijuana:

Marijuana use during pregnancy has been associated with various adverse outcomes, including low birth weight and neurodevelopmental issues in children. However, the symptoms described—tachycardia, hypertension, and evidence suggesting vasoconstriction—are not typical of marijuana use. Marijuana is more commonly associated with effects such as relaxation, increased heart rate (tachycardia), and vasodilation (not vasoconstriction). Therefore, marijuana is less likely to be the substance causing the symptoms described in the scenario.

D. Cocaine:

Cocaine is a potent stimulant drug that acts on the central nervous system and cardiovascular system, leading to effects such as tachycardia, hypertension, and vasoconstriction. These symptoms are consistent with acute cocaine intoxication. Cocaine use during pregnancy can have serious adverse effects on both the mother and the fetus, including increased risk of miscarriage, preterm labor, placental abruption, and fetal growth restriction. Therefore, given the symptoms described in the scenario, cocaine is the substance that the nurse would question the woman about.

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The nurse is developing the discharge plan for a woman who has had a left-sided radical mastectomy. The nurse is including instructions for ways to minimize lymphedema. Which statement by the client indicates the need for additional instruction?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After teaching a local woman's group about incontinence, the nurse determines that the teaching was successful when the group identifies which characteristic of stress incontinence?

Correct Answer is D

Explanation

Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?

Correct Answer is D

Explanation

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