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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is A
Explanation
A. Stress incontinence with feeling of low abdominal pressure.
Cystocele and rectocele repairs are often performed to address pelvic organ prolapse, which can lead to symptoms such as stress incontinence. Stress incontinence is characterized by the leakage of urine during activities that increase intra-abdominal pressure, such as coughing, sneezing, laughing, or lifting. The feeling of low abdominal pressure is consistent with the symptoms experienced by women with cystocele and rectocele, as the prolapse of pelvic organs can cause sensations of pressure or fullness in the lower abdomen.
B. Menstrual irregularities and hirsutism on the chin:
These symptoms are more indicative of hormonal imbalances, such as polycystic ovary syndrome (PCOS), which is characterized by irregular menstrual cycles, hirsutism (excessive hair growth), and other symptoms related to androgen excess. These symptoms are not typically associated with cystocele and rectocele repairs or the number of children a woman has.
C. Heavy leukorrhea with vulvar pruritus:
Leukorrhea refers to vaginal discharge, and vulvar pruritus refers to itching of the external genitalia. These symptoms are more suggestive of vaginal infections or other gynecological conditions unrelated to cystocele and rectocele repairs or the number of children a woman has.
D. Sporadic vaginal bleeding accompanied by chronic pelvic pain:
Sporadic vaginal bleeding and chronic pelvic pain may be indicative of various gynecological conditions, such as uterine fibroids, endometriosis, or cervical dysplasia. However, they are not typically associated with cystocele and rectocele repairs or the number of children a woman has.

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