A 52-year old female tells the nurse 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: C

Rationale: A non-mobile mass with irregular edges is a strong indicator of a cancerous lump in the breast. Cancerous lumps often feel fixed or attached to the surrounding tissue and may have irregular shapes rather than smooth, round contours. The lack of mobility and irregular edges increase suspicion for malignancy and warrant further investigation, such as imaging studies and biopsies. It is important for this patient to follow up with a healthcare provider promptly for further evaluation and appropriate management.

Correct Answer: C

Rationale: The correct action for the LPN to take in this situation is to inform the registered nurse. The patient's statement indicates a high level of fear and anxiety about the surgery and their potential outcome. It is important to involve the registered nurse, who can provide further assessment, support, and interventions to address the patient's concerns appropriately. Simply reassuring the patient or providing statistics about national surgery death rates may not address the underlying fear and may require additional support and intervention. Asking the family to comfort the patient may not be the most appropriate immediate action as the patient's concerns are specific and may require professional support. Bringing the registered nurse into the situation allows for a comprehensive approach to addressing the patient's emotional needs before the surgery.

Correct Answer: A

Rationale: Pulmonary edema is a condition where fluid accumulates in the air sacs of the lungs, leading to difficulty breathing. The primary underlying disorder of pulmonary edema is often decreased left ventricular pumping. When the left ventricle of the heart fails to effectively pump blood to the rest of the body, it can lead to a backlog of blood in the pulmonary circulation. This increase in pressure in the pulmonary circulation can cause fluid to leak out of the capillaries and into the alveoli of the lungs, resulting in pulmonary edema. Therefore, decreased left ventricular pumping is a key factor in the development of pulmonary edema.

Correct Answer: A

Rationale: Furosemide is a loop diuretic commonly used to help the body get rid of excess salt and water through increased urine output. By inhibiting the reabsorption of sodium and chloride in the loop of Henle in the kidneys, furosemide promotes the excretion of water, sodium, chloride, and other electrolytes. Therefore, the nurse would evaluate the medication as effective if the patient experiences increased urine output, as it indicates that the furosemide is working to eliminate excess fluids from the body.

Correct Answer: A

Rationale: Enalapril maleate (Vasotec) is an angiotensin-converting enzyme (ACE) inhibitor. The main action of ACE inhibitors like enalapril is to decrease the levels of angiotensin II in the body. Angiotensin II is a potent vasoconstrictor that plays a role in regulating blood pressure, stimulating aldosterone secretion, and promoting sodium and water retention. By inhibiting the conversion of angiotensin I to angiotensin II, enalapril reduces vasoconstriction and aldosterone secretion, leading to vasodilation, decreased blood pressure, and ultimately decreased levels of angiotensin II. This mechanism allows for the dilation of arterioles and veins, reduction in cardiac afterload, and ultimately decreases the workload of the heart.