What assessment finding suggests that a patient may have fibrocystic breast changes?

Correct Answer: C

Rationale: Fibrocystic breast changes typically present with breast pain and a cyclic pattern of nodularity and/or lumps in the breast tissue. The characteristic assessment finding that suggests fibrocystic breast changes is the firm, ropy feel of the breast tissue under the skin. This texture is due to the presence of fibrous tissue and cysts within the breast, which can be felt during the physical examination. While nipple discharge and skin changes like peau d’orange can be associated with different breast conditions, the firm and ropy feel of the breast tissue is more specific to fibrocystic changes.

Correct Answer: A

Rationale: Aromatase inhibitors, such as anastrozole (Arimidex), are commonly used in hormone receptor-positive breast cancer treatment. They work by blocking the enzyme aromatase, which helps in the production of estrogen in postmenopausal women. By reducing estrogen levels, aromatase inhibitors help in slowing down or stopping the growth of hormone receptor-positive breast cancer cells. Therefore, when teaching a patient about aromatase inhibitors, the nurse would include information about anastrozole as it is a pertinent medication in the management of hormone receptor-positive breast cancer. Fulvestrant, tamoxifen, and pembrolizumab are not aromatase inhibitors; they work through different mechanisms in breast cancer treatment.

Correct Answer: D

Rationale: Deontologic theory, also known as deontological ethics, focuses on the duty to follow moral rules and obligations regardless of the consequences. In this scenario, initiating resuscitative measures on a 90-year-old patient with terminal cancer reflects a commitment to upholding the duty to provide care and uphold the sanctity of life. Despite the patient's poor prognosis, the nurse is ethically bound to provide care according to established principles and guidelines, emphasizing duty over outcome. This aligns with the Deontologic theory's emphasis on following moral rules and obligations without consideration of the consequences.

Correct Answer: C

Rationale: The patient in option C is the most likely to seek prenatal care. This is because she is in her first pregnancy, indicating that she may be more inclined to seek medical guidance and support for the first time experience of pregnancy. Furthermore, the fact that she has access to a free prenatal clinic suggests that she has the resources and opportunity to obtain proper prenatal care, which can significantly benefit her and her baby's health. In contrast, the patients in the other options either demonstrate risky behaviors (such as drug and alcohol abuse in option B) or have previously given birth without professional medical assistance (as indicated in option D), which may indicate lower likelihood of seeking prenatal care. The patient in option A also demonstrates denial of pregnancy, which could delay seeking necessary prenatal care.

Correct Answer: A

Rationale: The correct response based on the ethical principle of nonmaleficence, which refers to the duty to do no harm, is to tell the patient that she will have to wait until she has progressed further on the vaginal exam and then perform an amniotomy. In this scenario, breaking the patient's water prematurely could introduce risks and potential harm without clear medical necessity. Performing an amniotomy too early could increase the risk of infection or cause umbilical cord prolapse, which can be harmful to both the mother and the baby. Therefore, it is important for the nurse to wait until the patient has progressed further in labor before considering an amniotomy.