The nurse is performing a breast examination on a client. The nurse understands that examining the upper outer quadrant of the breast is especially important because this part is:

The location of most breast tumors.

More prone to Injury and calcifications than other locations in the breast

The largest quadrant of the breast

Where most of the suspensory ligaments attach

Answer and Explanation

The Correct Answer is A

A. The location of most breast tumors: This choice is correct. The upper outer quadrant of the breast is the most common site for breast tumors. This area has a higher concentration of glandular tissue, making it more susceptible to the development of tumors. Therefore, thorough examination of this area is crucial during breast examinations.

B. More prone to Injury and calcifications than other locations in the breast: While injuries can occur in any part of the breast, the statement about calcifications is not accurate. Calcifications in breast tissue can occur in various areas and are not specific to the upper outer quadrant.

C. The largest quadrant of the breast: This statement is not accurate. The breast quadrants are not distinguished by size; they are anatomical divisions used for reference during breast examinations. Each quadrant has its significance for examination purposes, but none is considered the largest.

D. Where most of the suspensory ligaments attach: The suspensory ligaments, also known as Cooper's ligaments, provide structural support to the breast tissue. While they are essential for breast anatomy, they are not concentrated in the upper outer quadrant exclusively. These ligaments are distributed throughout the breast tissue.

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Correct Answer is ["C","D"]

Explanation

A. Increased temperature: Fluid overload typically doesn't cause an increased temperature. Infections or other inflammatory processes are more likely causes of elevated body temperature.

B. Increased hematocrit: Fluid overload usually results in dilution of blood components, leading to a decreased hematocrit (lower concentration of red blood cells in the blood). An increased hematocrit is not a typical finding in fluid overload.

C. Blood pressure 180/100: Elevated blood pressure can be associated with fluid overload, especially if the overload is chronic. This is a correct assessment finding that requires intervention and monitoring.

D. Respiratory rate 32: An increased respiratory rate can be a sign of respiratory distress, which may occur in severe cases of fluid overload, especially if it leads to pulmonary edema. This is a correct assessment finding that requires intervention and further evaluation.

E. Heart rate 120 bpm: An increased heart rate can be a compensatory mechanism in response to fluid overload, especially if the heart is trying to maintain cardiac output. However, this heart rate alone is not specific enough to confirm fluid overload. Other signs and symptoms, such as edema, increased blood pressure, and respiratory distress, are more indicative of fluid overload.

A. indicates turbulent blood flow through a valve. B. is an extra sound due to blood entering an inflexible chamber. C. means that there is some inflammation around the heart. D. is a high-pitched sound due to a narrow valve.

Correct Answer is A

Explanation

A. Indicates turbulent blood flow through a valve:

This statement is correct. A heart murmur is an abnormal sound during the heartbeat cycle, often indicating turbulent blood flow through a valve. Murmurs can result from various factors such as valve disorders, structural abnormalities, or other heart conditions.

B. Is an extra sound due to blood entering an inflexible chamber:

This statement is not accurate. Heart murmurs are primarily associated with turbulent blood flow rather than an extra sound related to an inflexible chamber.

C. Means that there is some inflammation around the heart:

This statement is incorrect. Heart murmurs are not specifically related to inflammation around the heart. They are primarily caused by issues with blood flow through the heart valves.

D. Is a high-pitched sound due to a narrow valve:

This statement is a bit oversimplified. While murmurs can sometimes be associated with narrow valves (stenosis), they can also result from various other valve abnormalities or conditions, and not all murmurs are high-pitched. The pitch and characteristics of a murmur can provide clues about its cause, but they are not the sole indicators.

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The nurse is performing a breast examination on a client. The nurse understands that examining the upper outer quadrant of the breast is especially important because this part is:

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Naxlex Comprehensive Predictor Exams

The nurse is assessing a client diagnosed with fluid overload. The nurse should implement priority interventions for which of the following assessment findings? (Select all that apply.)

Correct Answer is ["C","D"]

Explanation

A client was recently diagnosed with a heart murmur and is asking the nurse for more information. The nurse will educate the client that a heart murmur:

Correct Answer is A

Explanation

The nurse recognizes that the following statement is true regarding the internal structures of the breast: The breast is made up of:

The nurse is completing an assessment on a client suspected of having a transient ischemic attack. Which of the following techniques should the nurse use to assess the client's carotid arteries?

The nurse is preparing to auscultate for heart sounds on a client. Which of the following technique should be used by the nurse?

The nurse is auscultating heart sounds on a client and hears an extra sound late in diastole, just before the S1. How should the nurse document this finding?

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The nurse explains the different parts of the ear to a client while teaching the client how to administer eardrops. The nurse pulls the upper ear that consists of movable cartilage and skin up and back and recognizes that this part is called the:

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