During an annual physical examination, a 43-year-old patient states that she does not perform monthly breast self-examinations (BSEs). She tells the nurse that she believes that mammograms "do a much better job than I ever could to find a lump." The nurse should explain to her that:

Correct Answer: A

Rationale: Rationale for Correct Answer (A): 1. BSEs may detect lumps that appear between mammograms, ensuring early detection. 2. Early detection increases the chances of successful treatment and survival. 3. BSEs empower individuals to be proactive in their own health. Summary of Incorrect Choices: B. BSEs are recommended starting at age 20, not 50. C. Mammography and BSE serve different purposes; they are not interchangeable. D. Physician examinations are important but should not replace BSEs for early detection.

Correct Answer: B

Rationale: The diaphragm of a stethoscope is best used to detect high-pitched breath sounds due to its ability to pick up higher frequency sounds. It is designed to transmit sound directly to the ear without amplifying it. High-pitched breath sounds such as wheezes or crackles are best heard using the diaphragm as it is more sensitive to these frequencies. Low-pitched heart murmurs (choice A) are better detected using the bell of the stethoscope as it is designed to pick up lower frequency sounds. Vascular bruits (choice C) are best heard with the bell as well, as they are low-frequency sounds. Extra heart sounds (choice D) may also be better detected using the bell due to their lower pitch. In summary, the diaphragm of a stethoscope is best suited for detecting high-pitched breath sounds, making choice B the correct answer in this scenario.

Correct Answer: B

Rationale: The correct answer is B: Herpes simplex. Frank's presentation of burning erosions on the penis and inguinal adenopathy is classic for genital herpes. Primary syphilis (A) typically presents with a painless chancre at the site of infection. Chancroid (C) presents with painful genital ulcers and inguinal lymphadenopathy. Gonorrhea (D) usually manifests with urethritis and discharge, not erosions on the penis. In this case, the key features of burning erosions and inguinal adenopathy point towards herpes simplex as the most likely diagnosis.

Correct Answer: C

Rationale: The correct answer is C: To evaluate the adequacy of collateral circulation before cannulating the radial artery. The modified Allen test is performed to assess the patency of the ulnar artery and the adequacy of collateral circulation before cannulating the radial artery for procedures like arterial blood gas sampling or arterial line insertion. By compressing both the ulnar and radial arteries and releasing pressure on the ulnar artery, the nurse can observe how quickly the hand regains its color, indicating efficient collateral circulation. Choices A, B, and D are incorrect as they do not align with the purpose of the modified Allen test, which specifically focuses on evaluating collateral circulation in the hand.

Correct Answer: C

Rationale: The correct answer is C because cholecystitis typically presents with tenderness in the right upper quadrant (RUQ) due to inflammation of the gallbladder. The tenderness worsening with inspiration (Murphy's sign) indicates irritation of the peritoneum overlying the inflamed gallbladder. This is a classic finding in cholecystitis. Choices A, B, and D do not describe the characteristic RUQ tenderness with inspiration seen in cholecystitis. Choice A describes a normal abdomen, choice B suggests appendicitis, and choice D points more towards gastritis or pancreatitis.