Which assessment finding in a 36-year-old client is most indicative for further evaluation?

A breast lump that is small, mobile and rubbery in consistency.

A breast nodule that is 1 cm in size, nontender, and fixed.

Bilateral breast nodules that are tender with palpation.

A breast lump that increases in size before the menstrual period.

Answer and Explanation

The Correct Answer is B

A. A small, mobile, rubbery lump is often benign, such as a fibroadenoma.

B. A nontender, fixed breast nodule is concerning for malignancy, and further evaluation is necessary, such as imaging or biopsy.

C. Tender, bilateral nodules are commonly seen in benign conditions like fibrocystic breast changes, especially related to the menstrual cycle.

D. A lump that changes in size before menstruation is also typical of benign conditions like fibrocystic changes.

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Correct Answer is B

Explanation

A. Orthopnea: Orthopnea is difficulty breathing when lying flat, but the client's description of waking up suddenly points to paroxysmal nocturnal dyspnea.

B. Paroxysmal nocturnal dyspnea: This is the correct answer. Paroxysmal nocturnal dyspnea occurs when a client with heart failure wakes up at night feeling suffocated due to fluid redistribution and pulmonary congestion.

C. Pulsus alternans: Pulsus alternans refers to alternating strong and weak heartbeats and is not related to the client's description of nocturnal dyspnea.

D. Acute bilateral pleural effusion: While pleural effusion can cause respiratory symptoms, paroxysmal nocturnal dyspnea is more specific to heart failure.

A. Client who describes intense squeezing pressure across the chest. B. Client who reports moderate pain that is worse on inspiration. C. Client who reports cramping substernal pain. D. Client who describes pain as a dull ache.

Correct Answer is A

Explanation

A. This description is indicative of possible myocardial infarction (MI), a life-threatening emergency. Immediate evaluation and intervention, such as administering oxygen, obtaining an EKG, and providing pain relief, are crucial to prevent further damage to the heart and reduce mortality.

B. Moderate pain worse on inspiration suggests pleuritic pain, often associated with conditions like pleuritis or pulmonary embolism, which are serious but generally not as immediately life-threatening as an MI.

C. Cramping substernal pain may indicate a gastrointestinal issue, such as gastroesophageal reflux disease (GERD), which is less urgent than a potential MI.

D. A dull ache may be related to musculoskeletal or gastrointestinal issues and does not suggest the immediate need for intervention seen in MI.

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Which assessment finding in a 36-year-old client is most indicative for further evaluation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who has chronic heart failure tells the nurse, "I was fine when I went to bed, but I woke up in the middle of the night feeling like I was suffocating!" The nurse will document this assessment finding as

Correct Answer is B

Explanation

An emergency department nurse triages clients who present with chest discomfort. Which client would the nurse plan to assess first?

Correct Answer is A

Explanation

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