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: The correct answer is C: Non-mobile mass with irregular edges. A non-mobile mass with irregular edges is more likely to be cancerous as it indicates potential infiltration into surrounding tissues. This finding raises suspicion for malignancy as cancerous lumps tend to have irregular shapes due to their invasive nature. In contrast, options A and B describe characteristics of benign masses, such as mobile, soft, and easily delineated. Option D indicates no palpable lymph nodes, which does not directly correlate with the characteristics of the breast lump. Therefore, option C is the most concerning and indicative of a potentially cancerous lesion based on the assessment findings provided.

Correct Answer: C

Rationale: Correct Answer: C - Dryness of mouth Rationale: 1. Trihexyphenidyl is an anticholinergic medication commonly used to treat Parkinson's disease. 2. Anticholinergic drugs inhibit the parasympathetic nervous system, leading to decreased secretions. 3. Dryness of mouth (xerostomia) is a common side effect of anticholinergic medications. 4. Excessive salivation, bradycardia, and constipation are not typically associated with anticholinergic drugs, making them incorrect choices.

Correct Answer: A

Rationale: The correct answer is A: A urine output of 400 ml in 8 hours indicates a fluid and electrolyte imbalance induced by chemotherapy. Chemotherapy can cause renal damage, leading to decreased urine output. This can result in fluid retention and electrolyte imbalances. Choice B is incorrect because a serum potassium level of 3.6 mEq/L is within the normal range. Choice C is incorrect as the blood pressure readings provided are within the normal range. Choice D is incorrect as dry oral mucous membranes and cracked lips are more indicative of dehydration rather than a fluid and electrolyte imbalance induced by chemotherapy.

Correct Answer: C

Rationale: Step-by-step rationale: 1. Providing oral care does not directly address fluid balance or hydration status. 2. Oral care focuses on maintaining oral hygiene and preventing infections. 3. Choices A, B, and D all involve fluid intake to address dehydration. 4. Offering large amounts of fluid, enteral or parenteral fluids, and small volumes at frequent intervals all aim to correct the patient's condition by replenishing lost fluids. Summary: Choice C is incorrect because oral care does not directly address the patient's dehydration. Choices A, B, and D are better options as they focus on fluid replacement to correct the patient's condition.

Correct Answer: B

Rationale: The correct answer is B: maintain blood pressure control. After PTCA, the priority goal is to ensure stable hemodynamics. Maintaining blood pressure control is crucial to prevent complications such as bleeding or thrombosis. Choices A, C, and D are incorrect because preventing fluid volume deficit, decreasing myocardial contractility, and minimizing dyspnea are not immediate priorities post-PTCA. Oxygenation and hemodynamic stability take precedence over these concerns.

Correct Answer: A

Rationale: The correct answer is A because narcotics in high doses can depress the respiratory rate and cough reflex, which can be especially dangerous for a laryngectomy patient due to the risk of airway compromise. Low doses can provide pain relief without significant respiratory depression. Choices B and C are incorrect because narcotics typically do not increase respiratory tract secretions or cause stomal edema. Choice D is incorrect because while narcotics can potentially cause addiction, this is not the primary reason for giving low doses to laryngectomy patients.

Correct Answer: D

Rationale: The correct answer is D: An adrenal adenoma. Adrenal adenoma is the most common cause of primary hyperaldosteronism, also known as Conn's syndrome. Adrenal adenomas are benign tumors that cause overproduction of aldosterone, leading to increased sodium retention and potassium excretion. This results in hypertension and hypokalemia. Excessive sodium intake (A) and deficient potassium intake (B) are not direct causes of hyperaldosteronism. A pituitary adenoma (C) is associated with other hormone imbalances, such as Cushing's syndrome or acromegaly, but not hyperaldosteronism.

Correct Answer: B

Rationale: The correct answer is B because the patient's Body Mass Index (BMI) indicates obesity, putting them at higher risk for surgical complications. Obesity is associated with increased risks of infections, delayed wound healing, respiratory issues, and cardiovascular problems post-surgery. Monitoring this patient closely is crucial. Choice A is less likely to have increased surgical complications due to age and condition. Choice C, a 12-year-old, is less likely to have significant surgical complications compared to adults. Choice D, a 17-year-old with gallstones, may have risks but the BMI of the patient in choice B indicates a higher risk.

Correct Answer: A

Rationale: Step 1: Pulmonary edema is caused by fluid accumulation in the lungs due to increased pressure in the pulmonary vasculature. Step 2: Decreased left ventricular pumping leads to congestive heart failure, causing increased pressure in pulmonary circulation. Step 3: This increased pressure forces fluid from the capillaries into the alveoli, causing pulmonary edema. Step 4: Increased left atrial contractility (B) would not directly lead to pulmonary edema. Step 5: Decreased right ventricular elasticity (C) and increased right atrial pressure (D) are not directly related to the pathophysiology of pulmonary edema. Summary: The correct answer is A because decreased left ventricular pumping directly contributes to the increased pressure in the pulmonary circulation that leads to pulmonary edema. Choices B, C, and D do not align with the primary underlying disorder of pulmonary edema.