A nurse is examining a male client within normal weight range who is questioning about the cause of his enlarged breasts. Which course of action best describes how the nurse should address the client's bilateral gynecomastia?
Inform the client that his breast enlargement is benign, and normal for an adult male
Recommend that he alter his diet to include fewer fats and more lean proteins
Explain that this condition may be the result of hormonal changes, and recommend that he see his physician
Explain that gynecomastia in men usually associated with prostate enlargement and recommend that he be screened
The Correct Answer is C
A) Inform the client that his breast enlargement is benign, and normal for an adult male:
Although gynecomastia is common and often benign, it is not always normal for adult males to experience breast enlargement. The condition can be related to various factors such as hormonal imbalances, medications, or underlying health issues. It is important not to reassure the client without further assessment, as gynecomastia may need to be evaluated by a healthcare provider to rule out any medical conditions.
B) Recommend that he alter his diet to include fewer fats and more lean proteins:
While diet can have an impact on overall health, the enlargement of the breasts in males (gynecomastia) is typically not related to fat intake. This recommendation is not appropriate for addressing the root cause of gynecomastia, which often involves hormonal changes rather than diet alone. A dietary change may not resolve the underlying condition, and medical evaluation is warranted.
C) Explain that this condition may be the result of hormonal changes, and recommend that he see his physician:
This is the most appropriate response. Gynecomastia is often caused by hormonal imbalances, particularly an imbalance between estrogen and testosterone. It can occur during puberty, in older age, or as a result of certain medications or medical conditions. The nurse should advise the client to consult a physician for further evaluation and diagnosis, as appropriate treatment depends on the underlying cause.
D) Explain that gynecomastia in men is usually associated with prostate enlargement and recommend that he be screened:
This is not accurate. While prostate issues can affect male hormones, gynecomastia is typically not directly associated with prostate enlargement. The condition is more often linked to hormonal changes involving estrogen or testosterone, not necessarily prostate problems. Recommending prostate screening would not address the underlying cause of gynecomastia and is not the most relevant next step in care.
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Related Questions
Correct Answer is D
Explanation
A) The presence of cerumen in the ear canal:
This is incorrect. The presence of cerumen (earwax) in the ear canal is not inherently abnormal. In fact, cerumen is a natural substance produced by the body to protect and clean the ear canal. While excessive buildup can lead to blockages or hearing impairment, some amount of cerumen is normal and does not indicate an abnormal finding.
B) A shiny, pearly white color tympanic membrane:
This is incorrect. A shiny, pearly white tympanic membrane is a normal finding. This color and appearance indicate a healthy, intact eardrum. The tympanic membrane should be translucent with a smooth surface and this typical pearly appearance in a healthy ear.
C) A clear presence of a cone of light:
This is incorrect. The cone of light is a normal finding during otoscopic examination. It is a reflection of the otoscope light off the tympanic membrane and should be visible in the anterior-inferior quadrant of the tympanic membrane. The presence of the cone of light suggests that the eardrum is intact and in a normal position.
D) A yellow or amber color to the tympanic membrane:
This is the correct answer. A yellow or amber color of the tympanic membrane suggests the presence of fluid behind the eardrum, which may indicate an ear infection or otitis media. This color change is considered abnormal and should prompt further investigation, as it can be a sign of inflammation, infection, or the accumulation of fluid in the middle ear.
Correct Answer is C
Explanation
A) S2 indicates the beginning of diastole:
While S2 does coincide with the end of systole and the beginning of diastole, this statement is not the most specific or accurate way to describe the S2 heart sound. S2 marks the closure of the semilunar valves (the aortic and pulmonic valves), which occurs at the end of systole, just before diastole begins. While it is true that the S2 sound occurs as the heart transitions from systole to diastole, the closure of the semilunar valves is the more specific cause of S2.
B) S2 coincides with the carotid artery pulse:
This statement is not accurate. S2 does not exactly coincide with the carotid pulse. The S2 sound is heard slightly after the pulse due to the time it takes for the mechanical contraction of the heart to produce the sound. The carotid pulse typically corresponds more closely with the closure of the atrioventricular (AV) valves and the beginning of systole (S1), not S2. The timing of S2 and the carotid pulse can be close, but they are not perfectly synchronized.
C) S2 is caused by the closure of the semilunar valves:
This is the correct explanation. S2 is the heart sound produced by the closure of the semilunar valves (the aortic and pulmonic valves). The closing of these valves marks the end of systole and the beginning of diastole. S2 is typically described as having two components: the A2 sound (closure of the aortic valve) and the P2 sound (closure of the pulmonic valve). In some cases, particularly during inspiration, A2 and P2 may be heard separately, producing a split S2 sound.
D) S2 is louder than an S1:
This statement is not accurate. In general, S1 is louder than S2 at the apex of the heart (the lower part of the chest). S2 is louder than S1 at the base of the heart (near the sternum), particularly over the aortic and pulmonic areas. The loudness of heart sounds varies based on the location of auscultation, but it is not universally true that S2 is always louder than S1. The intensity of each sound depends on various factors, including the position of the listener and the health of the heart valves.
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