The nurse is examining a female client who states she has no complaints and has not had a physical examination for over 5 years. The nurse palpates enlarged lymph nodes in the axilla. Which finding is most important for the nurse to describe when reporting to the healthcare provider?

Recent over-the-counter infection cures.

Amount of daily caffeine consumption.

Number of indoor cats at home.

Nontender, firm lymph nodes.

Answer and Explanation

The Correct Answer is D

A. Information about over-the-counter treatments might be relevant but is less critical than the physical findings.
B. Daily caffeine consumption is unlikely to be directly related to the presence of enlarged lymph nodes.
C. Having indoor cats might be relevant if there was suspicion of an infection like toxoplasmosis, but this is not the most immediate concern.
D. Nontender, firm lymph nodes, especially when persistent and not related to a known infection, can be concerning and may indicate malignancy or other serious conditions. This finding should be promptly reported to the healthcare provider for further investigation.

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Correct Answer is D

Explanation

A. While an ultrasound may be indicated if discrete masses were present or if the lumpiness persisted after menstruation, it is not necessary in this scenario where generalized lumpiness is common before menstruation.
B. Although breast tenderness and lumpiness are often normal findings related to the menstrual cycle, the nurse should not dismiss the client’s concerns without follow-up. Annual evaluations are important, but this does not address the immediate concern.
C. Mammography is generally not recommended for adolescent clients due to the density of breast tissue and the typical benign nature of breast changes in this age group.
D. Rechecking the breast exam after the client’s menstrual period is appropriate because the lumpiness and tenderness are likely related to hormonal changes and may resolve after menstruation. This approach helps differentiate normal cyclic changes from potential abnormalities.

A. Obtain a drug urine screen to verify the legitimacy of the client's stated history. B. Ask specifically about alcohol, marijuana, cocaine, heroin, and amounts. C. Use the term illegal or illicit to describe street drugs. D. Allow the client to decline answering social questions.

Correct Answer is B

Explanation

A. While a drug urine screen may be part of preoperative testing, it is not appropriate as the primary method for gathering a client's substance use history. Trust and accuracy in self-reporting should be encouraged.
B. Asking specifically about alcohol, marijuana, cocaine, heroin, and amounts helps the nurse gather detailed information on the client's substance use, which is critical for safe anesthesia and surgical planning. Using specific terms rather than general or stigmatizing language promotes open communication.
C. The terms "illegal" or "illicit" might carry stigma, potentially leading the client to withhold information. Using neutral, non-judgmental language is more effective.
D. While clients can decline to answer, the nurse should explain the importance of accurate health information for their safety and care. Encouraging open dialogue is better than allowing clients to skip important questions without understanding the implications.

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The nurse is examining a female client who states she has no complaints and has not had a physical examination for over 5 years. The nurse palpates enlarged lymph nodes in the axilla. Which finding is most important for the nurse to describe when reporting to the healthcare provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An adolescent female client comes to the clinic troubled by breast tenderness before her menstrual periods. On examination, the nurse notes generalized lumpiness of both breasts with no discrete masses and no nipple discharge. Which action should the nurse take?

Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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