Which assessment finding in a 36-year-old client is most indicative for further evaluation?

A breast lump that is small, mobile and rubbery in consistency.

A breast nodule that is 1 cm in size, nontender, and fixed.

Bilateral breast nodules that are tender with palpation.

A breast lump that increases in size before the menstrual period.

Answer and Explanation

The Correct Answer is B

A. A small, mobile, rubbery lump is often benign, such as a fibroadenoma.

B. A nontender, fixed breast nodule is concerning for malignancy, and further evaluation is necessary, such as imaging or biopsy.

C. Tender, bilateral nodules are commonly seen in benign conditions like fibrocystic breast changes, especially related to the menstrual cycle.

D. A lump that changes in size before menstruation is also typical of benign conditions like fibrocystic changes.

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Correct Answer is C

Explanation

A. Mild hyponatremia (Sodium < 135 mEq/L) typically does not produce distinctive ECG changes. This value is unlikely to correlate with the presence of U waves.

B. Hyperkalemia (Potassium > 5.0 mEq/L) is associated with peaked T waves, widened QRS complexes, and flattened or absent P waves, not U waves.

C. Hypokalemia (Potassium < 3.5 mEq/L) is the primary cause of U waves. A potassium level of 2.1 mEq/L is significantly low and can result in ECG changes, including U waves, ST segment depression, and prolonged QT intervals. These changes reflect altered ventricular repolarization.

D. Hypermagnesemia (Magnesium > 2.5 mEq/L) can cause ECG changes such as prolonged PR and QRS intervals, bradycardia, and heart block. However, such an extreme magnesium level of 18 mEq/L would cause severe toxicity and is not associated with U waves.

A. Urine output over 8 hours is 250 mL less than the fluid intake. B. The client complains of a headache with a pain level 5 of 10 (0-10 scale). C. The client cannot move there left arm or leg when asked to do so. D. Tremors are noted when the client extends the arms.

Correct Answer is C

Explanation

A. A urine output lower than fluid intake over 8 hours is important to monitor but does not require immediate intervention compared to neurological deficits.

B. A headache rated 5/10 is a symptom of hypertensive emergency but not as critical as a loss of motor function, which indicates possible stroke.

C. Inability to move the left arm or leg is a neurological deficit suggestive of a stroke, which is a medical emergency requiring immediate reporting and intervention.

D. Tremors when extending the arms may indicate a less acute neurological or metabolic issue and are not as urgent as paralysis.

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Which assessment finding in a 36-year-old client is most indicative for further evaluation?

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