After a mastectomy, which activity should the client be instructed to avoid?

Correct Answer: C

Rationale: In this scenario, option C) "Wearing clothing with snug sleeves to support the tissue of the arm on the operative side" is the correct choice. After a mastectomy, it is important for the client to wear loose-fitting clothing to prevent constriction and support the arm on the operative side. Tight clothing can impede lymphatic drainage and increase the risk of lymphedema, a common complication post-mastectomy. Option A) "Emptying surgical drains twice a day and as needed" is a necessary post-operative task to prevent fluid buildup but not directly related to activity restriction. Option B) "Lifting more than 4.5 kg (10 lb) or reaching above her head until given permission by her surgeon" is crucial advice to prevent strain on the surgical site and promote proper healing. Option D) "Immediately reporting inflammation that develops at the incision site or in the affected arm" is also important for early detection of infection but not directly related to activity restrictions post-mastectomy. Educationally, understanding these activity restrictions and precautions post-mastectomy is crucial for nurses and healthcare providers to ensure optimal recovery and prevent complications for their clients. Proper patient education on these matters can significantly impact the client's quality of life and overall health outcomes.

Correct Answer: C

Rationale: In the context of maternal health issues in the US, understanding risk factors for conditions like fibroadenoma of the breast is crucial for healthcare providers. In this question, the correct answer is C) 16-year-old girl. The rationale behind this is that fibroadenomas are more common in younger women, typically under the age of 30. Hormonal fluctuations during puberty can contribute to the development of fibroadenomas in adolescents. Option A) 38-year-old woman and option B) 50-year-old woman are less likely to develop fibroadenomas as they are older, and these growths are more common in younger individuals. Option D) 27-year-old woman falls within the typical age range for developing fibroadenomas, but compared to a 16-year-old, the risk is lower. Educationally, this question highlights the importance of understanding age-related risk factors in maternal health. It emphasizes the need for healthcare providers to be aware of the demographics most susceptible to certain conditions to provide appropriate care and guidance.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Paget disease. Paget disease of the breast is a rare form of breast cancer that starts in the ducts of the nipple and spreads to the nipple surface and areola. While it is a form of breast cancer, it does not significantly increase the risk of developing breast cancer in other parts of the breast tissue. Conversely, options A, B, and D all represent conditions that are associated with an increased risk of breast cancer. BRCA1 and BRCA2 gene mutations are well-known risk factors for hereditary breast and ovarian cancer. Li-Fraumeni syndrome is a rare genetic disorder that predisposes individuals to multiple types of cancer, including breast cancer. Cowden syndrome is another genetic condition linked to an increased risk of breast cancer, along with other types of cancer. Educationally, understanding the various risk factors for breast cancer is crucial for healthcare providers working in maternal health. By recognizing the genetic mutations and syndromes that elevate breast cancer risk, healthcare professionals can provide targeted screening, prevention strategies, and counseling to help clients make informed decisions about their health.

Correct Answer: D

Rationale: In this scenario, the correct answer is option D, the 19-year-old woman who had a ruptured uterus after giving birth to her first child. This young woman is at the greatest risk for psychologic complications after hysterectomy due to the traumatic experience of a ruptured uterus during childbirth. This life-threatening event can lead to significant emotional distress, fear, and anxiety, which may persist even after the hysterectomy procedure. The emotional trauma associated with such a critical event can have long-lasting effects on mental health. Option A, the 55-year-old woman with abnormal bleeding and pain, may have physical health concerns that necessitate a hysterectomy, but she is not necessarily at the greatest risk for psychologic complications compared to the young woman in option D. Option B, the 46-year-old woman who has just been promoted at work, is experiencing a positive life event and does not have any clear risk factors for psychologic complications after hysterectomy. Option C, the 62-year-old widow with friends who had uncomplicated hysterectomies, may have social support but lacks individual risk factors for psychologic complications after the surgery. In an educational context, it is crucial to understand the psychologic implications of surgical procedures, especially those related to reproductive health. Providers should be aware of the potential psychological impact of hysterectomy on patients and offer appropriate support and resources to address any emotional challenges that may arise post-surgery. Awareness of individual risk factors, such as traumatic childbirth experiences, can help healthcare professionals tailor their care to meet the unique needs of each patient.

Correct Answer: D

Rationale: The correct answer is D) Limit staff or visitor exposure to 30 minutes or less in an 8-hour period. This precaution is crucial during internal radiation therapy for cervical cancer to minimize radiation exposure to healthcare workers and visitors. Prolonged exposure can increase the risk of radiation-related side effects. It is essential for nurses to strictly enforce this time limit to ensure the safety of all involved. Option A) is incorrect because wearing gloves alone is not sufficient protection against radiation exposure. Option B) is incorrect as using a lead-lined bedpan is not necessary during internal radiation therapy. Option C) is incorrect as there is no need for an enema before inserting the implant in this context. In an educational context, understanding proper radiation safety measures is essential for nurses caring for clients undergoing radiation therapy. By following the correct precautions, healthcare workers can ensure the well-being of both the patient and themselves, highlighting the importance of adherence to safety protocols in clinical practice.