The nurse is using inspection to assess the breasts of a female client. Which finding should the nurse document?

palpable lymph nodes

Symmetry.

breast sensitivity

Tenderness

Answer and Explanation

The Correct Answer is B

A. Palpable lymph nodes are assessed through palpation, not inspection. The nurse would use their hands to feel for lymph nodes in areas such as the axilla (armpit) and supraclavicular regions. This is a tactile examination and therefore not documented as part of the inspection.
B. Symmetry refers to the visual observation of whether the breasts are equal in size and shape. During the inspection phase, the nurse notes whether the breasts appear symmetrical or if there are any visible asymmetries.
C. Breast sensitivity is typically assessed through palpation or the client’s report of symptoms rather than through inspection alone. Sensitivity involves asking the client about their experience of pain or discomfort in the breasts, which cannot be observed visually.
D. Tenderness is assessed through palpation, where the nurse would gently press on the breast tissue to determine if the client experiences pain. Tenderness is not a visual finding and therefore is not documented during the inspection phase.

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Correct Answer is D

Explanation

A. Diabetic neuropathy is a type of nerve damage that occurs due to prolonged high blood sugar levels associated with diabetes. While diabetic neuropathy can cause pain, it's usually more generalized and affects extremities rather than specific areas like the mouth and teeth.
B. Postherpetic neuralgia is a condition that occurs as a complication of shingles (herpes zoster). It involves persistent nerve pain in the area where the shingles rash occurred, typically affecting the skin. The pain is usually described as burning or aching rather than stabbing, and it is localized to the area previously affected by the rash.
C. Visceral pain originates from the internal organs (viscera) and is typically described as a deep, aching, or cramping pain. It is often associated with conditions like gastrointestinal or gynecological issues.
D. Trigeminal neuralgia is a condition characterized by sudden, severe, sharp, stabbing pain along the distribution of the trigeminal nerve, which innervates the face. The pain can be triggered by activities such as brushing teeth, talking, or touching the face.

A. Cyclic pain B. Noncyclic C. Fibrocystic breast D. Breast cancer

Correct Answer is B

Explanation

A. Cyclic breast pain is related to the menstrual cycle and typically follows a pattern in relation to hormonal changes. It often starts in the luteal phase of the cycle and resolves with the onset of menstruation. Since the described pain is not associated with the menstrual cycle, this term is not appropriate for the given scenario.
B. Noncyclic breast pain is pain that is not related to the menstrual cycle and does not have a specific, cyclical pattern. It is often described as occurring independently of hormonal changes and can be associated with a variety of other factors, including infections, injuries, or other conditions affecting the breast tissue.
C. Fibrocystic breast changes refer to a condition characterized by lumpy, tender breasts with pain often related to hormonal changes. The pain and lumps can vary with the menstrual cycle, so it does not fit the description of noncyclic pain that is independent of the menstrual cycle.
D. While breast cancer can present with pain, particularly in advanced stages or in the presence of a mass, the term "breast cancer" is not used to describe the nature of the pain itself. It is a diagnosis rather than a descriptive term for pain characteristics.

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The nurse is using inspection to assess the breasts of a female client. Which finding should the nurse document?

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Naxlex Comprehensive Predictor Exams

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