A nurse is providing discharge teaching to a client following a modified left radical mastectomy with breast expander. Which of the following statements by the client indicates an understanding of the teaching?

"I should expect less than 25 mL of secretions per day in the drainage devices."

"I will perform strength-building arm exercises using a 15-pound weight."

"I will keep my left arm flexed at the elbow as much as possible."

"I will have to wait 2 months before additional saline can be added to my breast expander."

Answer and Explanation

The Correct Answer is A

A. Less than 25 mL of secretions per day in the drainage devices is an expected finding after surgery. The nurse should instruct the client to monitor the drainage and report if the output exceeds this amount, as it could indicate a complication.

B. Performing strength-building arm exercises using a 15-pound weight is not recommended immediately after surgery. The client should start with gentle range-of-motion exercises and gradually increase the intensity, but heavy weightlifting should be avoided in the early recovery period.

C. Keeping the left arm flexed at the elbow for prolonged periods is not recommended. The client should be encouraged to perform exercises to prevent stiffness and improve mobility in the affected arm, but excessive flexion can lead to contractures.

D. The client may begin the process of saline expansion in the breast expander soon after surgery, typically within a few weeks. Waiting 2 months may be too long, as expansion is often started earlier to avoid complications such as capsular contracture.

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Correct Answer is B

Explanation

A. Loss of peripheral vision is associated with impairment of the optic nerve (cranial nerve II), not the vestibulocochlear nerve. The vestibulocochlear nerve is responsible for hearing and balance, not vision.

B. Disequilibrium with movement is a classic sign of impaired function of the vestibulocochlear nerve (cranial nerve VIII). This nerve has two branches: the cochlear branch (responsible for hearing) and the vestibular branch (responsible for balance). Damage to the vestibular branch can cause dizziness, vertigo, and difficulty maintaining balance.

C. Inability to smell is associated with impairment of the olfactory nerve (cranial nerve I), not the vestibulocochlear nerve.

D. Deviation of the tongue from midline is typically seen with impairment of the hypoglossal nerve (cranial nerve XII), not the vestibulocochlear nerve.

A. Generalized rash B. Elevated platelet count C. Decreased total bilirubin D. Hypertension

Correct Answer is A

Explanation

A. Generalized rash is a common finding in toxic shock syndrome (TSS). The rash often appears as a sunburn-like rash and can progress to desquamation (peeling of the skin).

B. Elevated platelet count is not typically associated with toxic shock syndrome. In fact, thrombocytopenia (low platelet count) is more commonly seen in TSS.

C. Decreased total bilirubin is not associated with toxic shock syndrome. Bilirubin levels may be affected in cases of liver dysfunction, but TSS does not typically cause a decrease in bilirubin.

D. Hypertension is not a common finding in toxic shock syndrome. TSS often causes hypotension (low blood pressure) due to the systemic inflammatory response and shock.

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A nurse is providing discharge teaching to a client following a modified left radical mastectomy with breast expander. Which of the following statements by the client indicates an understanding of the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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