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. Mammogram

A mammogram is typically the next step in the diagnostic process when a breast lump is detected during a clinical breast examination. Mammography allows for further evaluation of the lump and surrounding breast tissue to determine its characteristics, such as size, shape, and density. It is an important tool for detecting breast abnormalities, including masses and calcifications, which can help in diagnosing breast cancer.

B. Hormone receptor status

While hormone receptor status testing may be part of the diagnostic workup for breast cancer, it is usually not the immediate next step after discovering a breast lump during a clinical examination. Hormone receptor status testing is typically performed after a confirmed diagnosis of breast cancer to guide treatment decisions, such as the use of hormone therapy.

C. Fine-needle aspiration

Fine-needle aspiration (FNA) may be used in conjunction with other diagnostic tests, such as mammography or ultrasound, to further evaluate a breast lump. However, it is not typically the first step in the diagnostic process, especially if a lump is found during a clinical breast examination. FNA involves using a thin needle to extract cells or fluid from the lump for examination under a microscope to determine if it is benign or malignant.

D. Genetic testing for BRCA

Genetic testing for BRCA mutations is typically not the immediate next step after finding a breast lump during a clinical examination. Genetic testing for BRCA mutations is usually recommended for individuals with a strong family history of breast or ovarian cancer or those who meet specific criteria based on personal or family history. It is not typically the initial diagnostic step in evaluating a breast lump.

A. Have the technician come back later on. B. Notify the surgeon to obtain the specimen via a cut-down procedure. C. Tell the technician to obtain the specimen from the client's left arm. D. Stop the technician immediately.

Correct Answer is C

Explanation

A. Have the technician come back later on:

This option suggests delaying the blood draw until a later time when the IV line is removed or after the infusion is completed. While this may seem like a reasonable approach to avoid interfering with the IV line, it could lead to unnecessary delays in obtaining essential laboratory test results.

B. Notify the surgeon to obtain the specimen via a cut-down procedure:

This option involves a more invasive procedure, called a cut-down, which is typically reserved for situations where peripheral venous access is challenging or impossible. It involves making an incision to expose a vein for direct cannulation. This approach is not warranted in this scenario, where obtaining blood from the opposite arm is a standard and less invasive practice.

C. Tell the technician to obtain the specimen from the client's left arm:

This option is the most appropriate response. It instructs the technician to draw blood from the client's left arm, which is free from the IV line. Drawing blood from the opposite arm minimizes the risk of complications associated with interfering with the IV infusion.

D. Stop the technician immediately:

While stopping the technician immediately may prevent them from proceeding with the incorrect approach, it lacks specific guidance on how to proceed correctly. It's essential to provide clear instructions to the technician to draw blood from the opposite arm rather than simply halting the procedure without further direction.

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

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Correct Answer is C

Explanation

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