The nurse is providing care for a patient who had a mastectomy for breast cancer 2 days ago. What should the nurse include in the daily care?
Empty the drain device every shift.
Minimize use of the affected arm.
Measure the circumference of both arms.
Place the affected arm below the level of the heart.
The Correct Answer is A
Choice A reason: Emptying the drain device every shift is important to prevent infection and accumulation of fluid, which can impede healing.
Choice B reason: Minimizing use of the affected arm is not recommended; rather, gentle exercises to promote circulation and prevent lymphedema are usually encouraged.
Choice C reason: Measuring the circumference of both arms can be part of monitoring for lymphedema, but it is not the priority in immediate post-mastectomy care.
Choice D reason: Placing the affected arm below the level of the heart is not recommended as it can increase swelling; elevation is usually advised.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Clang association involves speech governed by words that sound alike rather than having a logical connection, which is not demonstrated here.
Choice B reason: Neologism is the creation of new words or phrases that others may not understand, which fits the use of "muxtranks."
Choice C reason: Echolalia is the repetition of another person's spoken words, which is not the case here.
Choice D reason: Word salad refers to a jumble of words that is incoherent, but "muxtranks" is a consistent term used by the client, indicating neologism.
Correct Answer is C
Explanation
Choice A reason: While injury and age can be risk factors, they are not the greatest contributors to RA, which is an autoimmune disease.
Choice B reason: Heat therapy can help relieve pain in some cases, but it is not always the best response for acutely inflamed joints; cold therapy is often recommended to reduce inflammation.
Choice C reason: RA can affect multiple body systems beyond the joints, including the cardiovascular and respiratory systems, so it is essential to monitor all body systems.
Choice D reason: Exercise is actually beneficial for patients with RA to maintain joint function and muscle strength; rest is important, but should be balanced with physical activity.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today