A 42 year-old patient tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. She says that she is afraid that she has cancer. Which assessment finding would most strongly suggest that this patients lump is cancerous?

Correct Answer: B

Rationale: A nonmobile mass with irregular edges would most strongly suggest that the patient's lump is cancerous. Breast cancer lumps typically do not move easily and have irregular, poorly defined edges. These characteristics are concerning because they can indicate an invasive and aggressive growth pattern. Additionally, the fact that the lump is painless is another feature that raises suspicion for malignancy. It is important for the patient to undergo further evaluation, possibly including a mammogram, ultrasound, and biopsy, to determine the nature of the lump and provide appropriate treatment.

Correct Answer: A

Rationale: The correct instruction for the nurse to provide to the patient is that the patient should discuss this new herbal remedy with her ophthalmologist promptly. This is essential because herbal remedies can interact with prescription medications or affect the patient's eye condition. The ophthalmologist can provide guidance on the safety and effectiveness of the herbal remedy in relation to the patient's glaucoma treatment plan. It is crucial for healthcare providers to be aware of all treatments the patient is receiving to ensure coordinated and optimal care.

Correct Answer: B

Rationale: A fibroadenoma is a benign breast tumor commonly found in young women. In most cases, a fibroadenoma does not require radiation therapy. However, the patient might be referred for a biopsy to confirm the diagnosis and rule out any potential malignancy. While fibroadenomas can be related to hormonal changes in the body, they are not directly linked to the use of oral contraceptives. Recognizing this implication of the patient's diagnosis is essential for providing appropriate care and follow-up.

Correct Answer: D

Rationale: Allergic rhinitis, also known as hay fever, is a condition characterized by inflammation in the nasal passages triggered by allergens such as pollen, dust mites, or animal dander. Modifying the patient's environment to reduce exposure to these allergens can significantly help improve the breathing pattern in patients with allergic rhinitis. This can include measures such as using air purifiers, keeping indoor humidity levels low, avoiding exposure to pollen by keeping windows closed during peak seasons, and regularly cleaning bedding to reduce dust mites.

Correct Answer: C

Rationale: The most appropriate action for the home health nurse to take in this situation where a patient reports distortions when looking at an Amsler grid is to arrange for the patient to be assessed for macular degeneration. Distortions in straight lines on an Amsler grid are a common early symptom of macular degeneration, a progressive eye condition that affects central vision. Macular degeneration is a leading cause of vision loss in older adults, making assessment and early intervention crucial in preserving vision. It is important for the nurse to take the patient's symptoms seriously and facilitate timely evaluation and management to prevent further vision loss. This would involve referring the patient to an ophthalmologist or an eye care specialist for a comprehensive evaluation and appropriate treatment.

Correct Answer: A

Rationale: The statement "If I get a blue color that means the test is negative" given by the patient indicates the need for further education. This is incorrect information because a blue color in the guaiac test indicates a positive result, which means the presence of fecal occult blood. The patient should be taught that a positive result indicates the need for further evaluation and follow-up with their healthcare provider. Proper understanding of the test results is vital to ensure accurate interpretation and appropriate management. Further clarification and education are necessary to correct this misconception and guide the patient towards understanding the significance of a positive result.

Correct Answer: C

Rationale: The nurse's best response is option C - "AIDS isn't transmitted by casual contact." This response is accurate and provides the necessary information to address the friend's concern. It is important to educate the friend that HIV/AIDS is not transmitted through casual contact such as visiting a patient in the hospital. By stating this fact clearly, the nurse can help alleviate any unfounded fears or misconceptions the friend may have about contracting HIV while visiting the patient. This response promotes understanding and helps reduce stigma associated with HIV/AIDS, while also emphasizing the importance of accurate information in preventing the spread of the virus.

Correct Answer: A

Rationale: Neoplasms can cause pathophysiologic events such as intracranial hemorrhage and increased intracranial pressure (ICP) due to expansion of the mass within the confined space of the skull. Intracranial hemorrhage can occur as the neoplasm damages blood vessels in the brain or causes them to become more fragile. Increased ICP can result from the growing mass causing compression of surrounding structures and obstructing the flow of cerebrospinal fluid, leading to symptoms such as headaches, nausea, vomiting, and changes in mental status.

Correct Answer: D

Rationale: Nocturnal penile tumescence tests are used to assess erectile dysfunction in men who are unable to engage in sexual activity. It measures the frequency and strength of erections that occur during sleep, which can provide valuable information about a man's erectile function and whether there may be underlying physiological causes for his inability to engage in sexual activity. This test can help determine if the patient's erectile dysfunction is due to physical or psychological factors. A sperm count, ejaculation capacity tests, and engorgement tests are not typically ordered to assess sexual functioning in this case.