A 51-year-old female client tells the nurse in-charge that she has found a painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client's lump is cancerous?

Correct Answer: B

Rationale: Correct Answer: B - Nonmobile mass with irregular edges Rationale: 1. Nonmobile mass indicates fixed growth, common in cancerous tumors. 2. Irregular edges suggest rapid, abnormal cell growth, characteristic of cancer. 3. These features raise suspicion for malignancy and warrant further investigation. Summary: A: Eversion of the right nipple and mobile mass - Typically seen in benign conditions like fibroadenomas. C: Mobile mass that is soft and easily delineated - Likely a benign cyst. D: Nonpalpable right axillary lymph nodes - Presence of palpable lymph nodes would suggest metastasis, not primary breast cancer.

Correct Answer: B

Rationale: The correct answer is B: Osteoarthritis is a localized disease, while rheumatoid arthritis is systemic. In osteoarthritis, the degeneration of joint cartilage primarily affects specific joints, causing localized pain and stiffness. In contrast, rheumatoid arthritis is an autoimmune disease that affects the entire body, leading to inflammation in multiple joints and potentially impacting other organs. This fundamental difference in the scope of the diseases is crucial in distinguishing between them. Choices A, C, and D are incorrect because they do not accurately describe the main difference between rheumatoid arthritis and osteoarthritis.

Correct Answer: C

Rationale: The correct answer is C (16:00) because NPH insulin typically peaks around 4-12 hours after administration. Since NPH insulin was given at 7 a.m., the peak effect would likely occur around 4 p.m. This timing increases the risk of hypoglycemia as the insulin's potency is at its highest, potentially causing a sudden drop in blood sugar levels. The other choices (A, B, and D) are incorrect because they do not align with the expected peak time for NPH insulin, which is crucial in determining the client's vulnerability to hypoglycemia.

Correct Answer: D

Rationale: The correct answer is D: bilateral hearing loss. Aspirin, when used in high doses and for prolonged periods, can cause damage to the cochlea, leading to hearing loss. This is known as aspirin-induced hearing loss. Weight gain (choice A) is not a common adverse reaction of aspirin therapy. Fine motor tremors (choice B) are not typically associated with aspirin use. Respiratory acidosis (choice C) is not a recognized adverse reaction of aspirin therapy. Therefore, the most relevant and correct adverse reaction to prolonged aspirin therapy among the options provided is bilateral hearing loss.

Correct Answer: C

Rationale: The correct answer is C. Spontaneous wrist flexion can indicate damage to the recurrent laryngeal nerve, a complication of thyroidectomy that can lead to vocal cord paralysis and airway compromise. This is a critical concern post-thyroidectomy as it can affect the client's ability to breathe effectively. Choice A: Vital signs within normal limits, no immediate concern. Choice B: Supporting head and neck is a protective measure and is expected post-thyroidectomy. Choice D: Drowsiness and sore throat are common postoperative symptoms, not immediate concerns for airway compromise. In summary, choice C is the correct answer as it indicates a potential airway compromise, which is a priority post-thyroidectomy.