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: D

Rationale: Radical trachelectomy is a surgical procedure that involves the removal of the cervix while preserving the uterus. This procedure is often offered to young women diagnosed with early-stage cervical cancer who wish to preserve their fertility and have children in the future. By removing the cervix and part of the upper vagina, while leaving the uterus intact, radical trachelectomy offers these patients a chance at preserving their ability to conceive and carry a pregnancy to term. It is a fertility-sparing option in the management of cervical cancer, particularly in younger patients like the 25-year-old mentioned in the question.

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: This response shows empathy and allows the patient to express their thoughts and feelings without feeling rushed or pressured. By asking the patient if there is anything they want to say, you are showing that you are there to listen and support them during this difficult time. It is important to give the patient the space and opportunity to communicate their emotions and concerns. Offering advice or making assumptions about the patient's feelings may not be as helpful as simply providing a listening ear.

Correct Answer: A

Rationale: A. Using a lip lubricant can help keep the lips moist and prevent further irritation caused by the yeast infection.

Correct Answer: A

Rationale: At present, the most reliable method for verification of placement of small-bore feeding tubes is x-ray examination. X-ray allows for direct visualization of the tube's placement within the gastrointestinal tract, ensuring it is correctly positioned in the stomach without any risk of inadvertent placement in the lungs, pharynx, or esophagus. This method provides a definitive confirmation of tube placement, which is crucial for patient safety during enteral feeding. While pH testing and aspiration of contents can be useful as supplementary methods, x-ray remains the gold standard for verifying tube placement due to its precision and accuracy. Auscultation, on the other hand, is no longer recommended as a reliable method for tube placement verification, as it may lead to misinterpretation of sounds and potential errors in placement assessment.

Correct Answer: A

Rationale: External otitis, also known as swimmer's ear, is an infection of the outer ear canal. It is often characterized by aural tenderness, which means that the ear is sensitive to touch and can be painful, especially when pressure is applied to the area. This tenderness is a hallmark symptom of external otitis and helps differentiate it from other ear conditions. Other common symptoms of external otitis include ear pain, itchiness, redness, and swelling of the ear canal. External otitis is usually not accompanied by a high fever, and it is not typically related to an upper respiratory infection. Using cotton-tipped applicators to clean the ear can actually increase the risk of developing external otitis by disrupting the natural protective barrier of the ear canal.

Correct Answer: A

Rationale: The order in which the structures of the large intestine are listed starting with the first portion is as follows: cecum (the pouch where the large intestine begins), ascending colon (runs vertically up the right side of the abdomen), transverse colon (crosses horizontally from the right side of the abdomen to the left), descending colon (descends vertically down the left side of the abdomen), sigmoid colon (the S-shaped curve that leads into the rectum), and rectum (the final portion where feces are stored before being eliminated from the body). Therefore, option A provides the correct order of structures in the large intestine during elimination.

Correct Answer: A

Rationale: Vaginal examination of the cervix may result in perforation of the placenta and subsequent hemorrhage in a patient admitted with suspected placenta previa. It is important to avoid any unnecessary manipulation of the cervix to prevent complications. Assessing cervical dilation and effacement should be avoided until placenta previa is ruled out to prevent harm to the patient.