While obtaining a health history from the mother of a 1-year-old child, the nurse notices that the baby has had a bottle in his mouth the entire time. The mother states, "It makes a great pacifier." The best response by the nurse would be:

Correct Answer: D

Rationale: Correct Answer - D: "Prolonged use of a bottle can increase the risk for tooth decay and ear infections." Rationale: 1. Prolonged bottle use can lead to tooth decay due to exposure to sugars in milk or formula. 2. The constant sucking can also cause ear infections by pushing bacteria into the Eustachian tubes. 3. It is important for the nurse to educate the mother on these risks to promote the child's health. Summary of Other Choices: A: Incorrect. Encouraging the mother that bottles make good pacifiers does not address the potential health risks associated with prolonged bottle use. B: Incorrect. While it's true that bottle use may be better for teeth than thumb-sucking, it still poses risks for tooth decay and ear infections. C: Incorrect. The contents of the bottle do not negate the risks associated with prolonged bottle use.

Correct Answer: C

Rationale: The correct technique for auscultating the chest in an adult is to firmly hold the diaphragm of the stethoscope against the chest. This allows for optimal transmission of sound and better detection of abnormal lung or heart sounds. Instructing the patient to take deep, rapid breaths (Choice A) may interfere with accurate auscultation. Breathing through the nose (Choice B) does not impact the technique. Lightly holding the bell of the stethoscope (Choice D) may lead to poor sound transmission and decreased sensitivity in detecting faint sounds.

Correct Answer: B

Rationale: The correct answer is B: The location of most breast tumors. This is because statistically, the upper outer quadrant of the breast is where the majority of breast tumors are found. This area is more glandular and has more breast tissue, making it a common site for tumors to develop. It is important to focus on this area during a breast examination to detect any abnormalities early. A: The largest quadrant of the breast - This is not the reason why examining the upper outer quadrant is important for detecting breast tumors. C: Where most of the suspensory ligaments attach - While true, this is not the primary reason for focusing on the upper outer quadrant during a breast examination. D: More prone to injury and calcifications than other locations in the breast - While calcifications can occur in this area, it is not the primary reason for its importance in detecting breast tumors.

Correct Answer: C

Rationale: Step-by-step rationale for why choice C is correct: 1. Asymmetry of breast size is not uncommon, as breasts are typically not perfectly symmetrical. 2. The nurse should verify that the change is not new to rule out any concerning underlying issues. 3. This step is important to ensure the asymmetry is not a new development, which could indicate a potential problem. 4. By verifying that the change is not new, the nurse can provide appropriate care or further evaluation if needed. Summary of why the other choices are incorrect: A: Breasts do not need to always be symmetric; natural variation exists. B: Breastfeeding can cause temporary asymmetry, but the nurse should still verify the change is not new. D: Asymmetry is not necessarily indicative of inflammation or growth; verifying the change's timeline is crucial.

Correct Answer: C

Rationale: The correct answer is C: 'Do you have any history of problems with your heart?' Rationale: 1. Difficulty sleeping and waking up feeling breathless can be indicative of cardiac issues like heart failure or arrhythmias. 2. Asking about a history of heart problems is crucial to assess the patient's risk factors and determine the need for further cardiac evaluation. 3. This response shows the nurse's understanding of the potential seriousness of the symptoms and the need to investigate cardiac health. Summary: - Option A (Electrocardiogram) is not the best initial response as it jumps to a specific test without gathering more information. - Option B (Hot at night) dismisses the symptoms without considering underlying health issues. - Option D (Sinus or respiratory infection) does not address the potential cardiac cause of the symptoms.