Mrs. Flower has had an uneventful recovery from a hysterectomy necessitated by a class III cervical lesion. Two days before going home, she stopped eating, complained of difficulty swallowing, and would not talk. Which of the following actions is most appropriate?

Correct Answer: B

Rationale: The most appropriate action in this scenario is to recommend psychiatric consultation before discharge (Option B). Mrs. Flower's sudden change in behavior, such as stopping eating, difficulty swallowing, and refusal to talk, could indicate psychological distress or a mental health issue post-surgery. A psychiatric consultation can help assess her mental well-being, provide appropriate support, and ensure she receives necessary care for any underlying psychological concerns. Avoiding mention of diet and asking her husband to bring in favored foods (Option A) may overlook the potential psychological or psychiatric aspects of Mrs. Flower's behavior. Monitoring intake and output as a nursing measure (Option C) is important but does not address the underlying psychological issues that may be contributing to her symptoms. Arranging for the dietician to talk with her (Option D) focuses solely on the physical aspect of her symptoms and does not address the need for a comprehensive mental health evaluation. In an educational context, healthcare professionals need to be attuned to both the physical and psychological aspects of patient care, especially in postoperative settings. Recognizing and addressing mental health concerns in patients undergoing significant medical procedures is crucial for providing holistic care and ensuring optimal recovery outcomes. This case underscores the importance of interdisciplinary collaboration and the integration of mental health considerations into overall patient care plans.

Correct Answer: D

Rationale: In the context of breast cancer, it is crucial for students to understand the primary signs for early detection and timely intervention. The correct answer, option D, "A painless mass in the breast," is the primary sign of breast cancer because most breast cancers present as painless lumps or masses. This is a key indicator for individuals to seek medical evaluation promptly. Option A, "A bloody discharge from the nipple," is commonly associated with benign conditions like intraductal papillomas and is only rarely a sign of breast cancer. Option B, "A dimpling of the skin over the lesion," typically occurs in more advanced stages of breast cancer where the tumor has grown and is pulling the skin inward. Option C, "A retraction of the nipple," is often seen in inflammatory breast cancer but is not the primary sign of the disease. Educationally, understanding these signs aids students in recognizing potential symptoms, advocating for regular breast self-exams, clinical screenings, and mammograms. Emphasizing the significance of early detection and the diverse ways breast cancer can manifest is crucial for promoting proactive healthcare practices and improving outcomes.

Correct Answer: B

Rationale: The correct answer is B) Demonstrate sexual feelings in ways other than intercourse. This response is the most appropriate recommendation for a client with prostate cancer dealing with impotency for several reasons. Firstly, engaging in sexual activities beyond intercourse can help maintain intimacy and connection with a partner despite physical limitations. It also allows for exploration of alternative forms of pleasure and satisfaction. This suggestion promotes emotional well-being and can contribute to a positive self-image, which are crucial aspects of coping with the challenges of prostate cancer treatment. Option A) Abstain from any sexual activity is incorrect because it does not address the emotional and psychological aspects of sexuality that are important for overall well-being. Complete abstinence may lead to feelings of isolation and frustration for the client and their partner. Option C) Practice sexual intercourse at least two to three times daily until successful is incorrect as it sets unrealistic expectations and can be physically and emotionally taxing for the client. It does not take into account the physical limitations and side effects of prostate cancer treatment. Option D) Perform pelvic floor retraining exercises is also incorrect as it focuses on a physical intervention that may not directly address the emotional and relational aspects of sexual dysfunction experienced by the client. While pelvic floor exercises can be beneficial for some individuals, they may not be the most appropriate solution in this context. In an educational context, it is important for nurses to provide holistic care that considers the physical, emotional, and psychological needs of clients dealing with reproductive health issues. Understanding the impact of prostate cancer on sexual function and offering supportive strategies, such as the one provided in the correct answer, is crucial for promoting quality of life and overall well-being in patients.

Correct Answer: D

Rationale: In this scenario, option D is of most concern because an irregularly shaped, nontender lump palpable in the left breast raises suspicion of a possible breast mass or tumor. This finding warrants further investigation through diagnostic tests to rule out malignancy. Option A is less concerning as nodules in the upper, outer quadrants of both breasts can be normal breast tissue variations or benign conditions like fibrocystic changes. Option B, bilateral breast tenderness with palpation, is a common symptom related to hormonal changes or benign breast conditions. Option C, slight variation in breast size, is a common occurrence in many individuals and is often not a cause for concern. Educationally, it is important to highlight the significance of conducting thorough breast examinations, recognizing abnormal findings, and promoting regular breast self-exams and screenings for early detection of breast abnormalities. Understanding the implications of different breast exam findings can empower healthcare providers to provide timely and appropriate care to their clients.

Correct Answer: C

Rationale: The correct answer is option C) You will need to call the doctor if you have a fever or chills. This statement is essential to include in the client teaching plan because after a needle biopsy of the prostate gland via the transrectal approach, there is a risk of infection. Fever and chills can be signs of an infection, which should be promptly reported to the healthcare provider for further evaluation and management. Options A, B, and D are incorrect: A) The doctor will call you about the test results in a day or two: This is incorrect as it does not address the immediate post-procedure care or potential complications like infection. B) Serious infections frequently occur as a complication of this test: This is incorrect as it is vague and does not provide specific actionable information for the client. D) It is normal to have rectal bleeding for a few days after the test: This is incorrect as rectal bleeding after the procedure should not be considered normal and should be reported to the healthcare provider. Educational Context: Client education is crucial in ensuring optimal outcomes post-procedure. Providing clear instructions on what symptoms to watch for and when to seek medical help is essential in promoting the client's well-being and timely intervention in case of complications. This empowers the client to take an active role in their healthcare and promotes a culture of safety and informed decision-making.