When performing a clinical breast examination, which would the nurse do first?

Inspect the breasts.

Palpate the axillary area.

Compress the nipple for a discharge.

Palpate the breasts.

Answer and Explanation

The Correct Answer is A

A. Inspect the breasts:

Inspecting the breasts visually is usually the first step in a clinical breast examination. The nurse observes the size, shape, symmetry, and skin characteristics of the breasts, including any visible abnormalities such as dimpling, puckering, or changes in skin texture or color.

B. Palpate the axillary area:

Palpating the axillary (underarm) area is typically done after inspecting the breasts. This allows the nurse to assess for any enlarged lymph nodes or palpable masses in the axillary region, which could indicate pathology or breast cancer metastasis.

C. Compress the nipple for a discharge:

If there are concerns about nipple discharge, this step may follow breast palpation. By gently compressing the nipple, the nurse can assess for any abnormal discharge, such as bloody or spontaneous discharge, which may warrant further investigation.

D. Palpate the breasts:

Palpating the breasts is usually performed after visual inspection and axillary palpation. During breast palpation, the nurse systematically examines each breast using circular motions with varying pressure to detect any lumps, masses, or areas of tenderness. This thorough palpation helps identify any abnormalities within the breast tissue.

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Correct Answer is A

Explanation

A. Bleeding after intercourse

Endometrial polyps can cause bleeding after intercourse (postcoital bleeding) due to irritation or trauma to the polyps during sexual activity. This symptom occurs because the polyps protrude into the uterine cavity and are easily disturbed by movement or contact.

B. Vaginal discharge

While vaginal discharge can be a symptom of various gynecological conditions, it is not typically associated specifically with endometrial polyps. Instead, other conditions like bacterial vaginosis or vaginal infections are more commonly linked to vaginal discharge.

C. Irregular, acyclic bleeding

Endometrial polyps can cause irregular, acyclic bleeding, but this symptom is less specific compared to bleeding after intercourse. Irregular bleeding can occur due to hormonal changes, uterine fibroids, or other gynecological conditions as well.

D. Bleeding between menses

Bleeding between menstrual periods (intermenstrual bleeding) can occur with endometrial polyps, but it is not as specific a manifestation as bleeding after intercourse. Intermenstrual bleeding can also be caused by hormonal imbalances, cervical or uterine infections, or other underlying conditions.

A. disseminated intravascular coagulation (DIC) B. elevated platelet count C. elevated liver enzymes D. hyperglycemia

Correct Answer is C

Explanation

A. Disseminated intravascular coagulation (DIC):

DIC is a serious condition characterized by abnormal clotting throughout the body's blood vessels, leading to both bleeding and clotting simultaneously. While it can occur in severe cases of HELLP syndrome, it is not a specific finding used to diagnose HELLP syndrome. Instead, it's a complication that can develop due to various underlying conditions, including HELLP syndrome.

B. Elevated platelet count:

In HELLP syndrome, platelet count is typically decreased, not elevated. HELLP syndrome stands for Hemolysis, Elevated Liver enzymes, and Low Platelets. The low platelet count is a key diagnostic feature of HELLP syndrome and contributes to the risk of bleeding complications.

C. Elevated liver enzymes:

Elevated liver enzymes, particularly elevated levels of AST (aspartate aminotransferase) and ALT (alanine aminotransferase), are hallmark features of HELLP syndrome. Liver involvement is a significant component of this syndrome, and elevated liver enzymes are part of the diagnostic criteria.

D. Hyperglycemia:

While hyperglycemia can occur in various conditions, it is not a characteristic finding of HELLP syndrome. HELLP syndrome primarily affects the liver, blood clotting factors, and platelets, leading to features such as elevated liver enzymes, low platelet count, and hemolysis (destruction of red blood cells).

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When performing a clinical breast examination, which would the nurse do first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a female client and suspects that the client may have endometrial polyps based on which clinical manifestation?

Correct Answer is A

Explanation

A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding?

Correct Answer is C

Explanation

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