When assessing the breast, the nurse would teach the patient to palpate which of the following areas?
Upper outer quadrant
Lower inner quadrant
Upper inner quadrant
Tail of spence
Correct Answer : A,B,C
The nurses would teach the patient to palpate all four quadrants of the breast, including the upper outer quadrant, lower inner quadrant, and upper inner quadrant, as well as the tail of Spence, which is the extension of breast tissue into the axilla (armpit). It's important for the patient to be familiar with their own breast tissue and report any changes or abnormalities to their healthcare provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The appropriate next step would be to auscultate for another 4 minutes. The absence of bowel sounds for one minute does not necessarily indicate a surgical emergency, as bowel sounds may be affected by various factors such as the client's diet, medications, and level of activity. Listening for another minute may not provide enough information to make an accurate assessment, so it is recommended to listen for a longer period. If after the additional 4 minutes, there are still no bowel sounds heard, the nurse should notify the physician to further evaluate the client. Listening posteriorly may also provide additional information, but it should be done after the nurse has completed listening to all four quadrants of the abdomen anteriorly.
Correct Answer is C
Explanation
Objective data are measurable and observable findings that can be obtained through physical examination, laboratory tests, or other diagnostic procedures.
Option A is subjective data because it is information reported by the patient and may not be entirely accurate. Option Bis also subjective data because it is the patient's perception of their weight loss, which may not be an accurate reflection of actual weight loss.
Option Dis also subjective data because it relies on the patient's self-report of their alcohol intake, which may not be entirely accurate.
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