6 Quiz HA
Peau d'orange
conditions in which the skin is dimpled, resembling the skin of an orange
After assessing the breasts of a female client, the nurse should explain to the client that most breast tumors occur in the
upper outer quadrant. Chapter 20: Assessing Breasts and Lymphatic System - Page 422
The nurse is assessing a client's breath sounds. Where should the nurse expect to hear bronchovesicular sounds?
Chapter 19: Assessing Thorax and Lungs - Page 397
The nurse observes the client sitting at the side of the bed in the position shown. What health problem should the nurse suspect the client is experiencing?
Chronic obstructive pulmonary disease Chapter 19: Assessing Thorax and Lungs - Page 394
Hidradenitis suppurativa
female - axillary dz; male -anogenital dz obesity; abscess, fibrosis.. tx: intralesional triamcinolone, I&D
Acanthosis nigricans
thickening and darkening of skin near axillary region, A/w Diabetes Type II and gastric carcinoma
When should a woman conduct self breast examination with respect to her menses?
5 to 7 days following her menses [Chapter 20: Assessing Breasts and Lymphatic System.]
A 23-year-old computer programmer comes to the office for an annual examination. She has recently become sexually active and wants to start oral contraception. Her only complaint is that the skin in her armpits has become darker. She states it looks like dirt; she scrubs her skin nightly with soap and water, but the colour stays. Her past medical symptoms consist of acne and mild obesity. Her periods have been irregular for 3 years. Her mother has type 2 diabetes and her father has high blood pressure. The client denies tobacco but drinks four to five drinks on Friday and Saturday nights. She denies any illegal drug use. Examination shows a mildly obese woman breathing comfortably. Her vital signs are unremarkable. Inspection of the axillae reveals dark velvet-like skin. Her annual examination is otherwise unremarkable. What disorder of the breast or axilla is she most likely to have?
Acanthosis nigricans [ Chapter 20: Assessing Breasts and Lymphatic System - Page 424]
A 62-year-old construction worker presents to the clinic reporting almost a chronic cough and occasional shortness of breath that have lasted for almost 1 year. Although symptoms have occasionally worsened with a cold, they have stayed about the same. The cough has occasional mucus drainage but never any blood. He denies any chest pain. He has had no weight gain, weight loss, fever, or night sweats. His past medical history is significant for high blood pressure and arthritis. He has smoked two packs a day for the past 45 years. He drinks occasionally but denies any illegal drug use. He is married with two children. He denies any foreign travel. His father died of a heart attack and his mother died of Alzheimer's disease. Examination reveals a man looking slightly older than his stated age. His blood pressure is 130/80 and his pulse is 88. He is breathing comfortably with respirations of 12. His head, eyes, ears, nose, and throat examinations are unremarkable. His cardiac examination is normal. On examination of his chest, the diameter seems enlarged. Breath sounds are decreased throughout all lobes. Rhonchi are heard over all lung fields. There is no area of dullness and no increased or decreased fremitus. What thorax or lung disorder is most likely causing his symptoms?
Chronic obstructive pulmonary disease (COPD) Chapter 19: Assessing Thorax and Lungs - Page 390-402
Which of the following muscles is primarily responsible for thoracic cavity enlargement?
Diaphragm Chapter 19: Assessing Thorax and Lungs - Page 385
While examining a client's breasts, a nurse notices milky discharge from the nipple. The client explains that she recently had a baby and is currently breastfeeding. The nurse understands that which type of tissue in the breast is responsible for allowing milk production? fibrous Fatty Glandular Lymphatic
Glandular [ Chapter 20: Assessing Breasts and Lymphatic System - Page 411]
The nurse is assessing a 15 year old male and finds soft, fatty enlargement of breast tissue. The nurse would document this as what?
Gynecomastia [ Chapter 20: Assessing Breasts and Lymphatic System - Page 420]
The nurse notes that a client's left breast feels significantly warmer than the right breast. What should the nurse consider is occurring with this client? -Breast cancer -Inflammation -Fibrocystic breast disease -Extramammary duct location
Inflammation
Which action by a nurse demonstrates the proper sequence for auscultation of the lung fields?
Listen at each site for at least one complete respiratory cycle ** Chapter 19: Assessing Thorax and Lungs - Page 397
A 43-year-old store clerk comes to the office upset because she has found an enlarged lymph node under her left arm. She states she found it yesterday when she was feeling pain under her arm during movement. She states the lymph node is about an inch long and is very painful. She checks her breasts monthly and gets a yearly mammogram (her last was 2 months ago); until now everything has been normal. She states she is so upset because her mother died in her 50s of breast cancer. The client does not smoke, drink, or use illegal drugs. Her father is in good health. Examination shows a tense woman appearing her stated age. Visual inspection of her left axilla reveals a tense red area with no surrounding scarring. On palpation, the examiner feels a 2-cm tender movable lymph node underlying hot skin. Other shoddy nodes are also in the area. Visualization of both breasts is normal. Palpation of her right axilla and both breasts is unremarkable. Examination of the left arm reveals a scabbed-over superficial laceration over her left hand. Upon questioning, the client remembers that she cut her hand gardening last week. What disorder of the axilla is most likely responsible for her symptoms? -Breast cancer -Lymphadenopathy of infectious origin -Hidradenitis suppurativa
Lymphadenopathy of infectious origin [ Chapter 20: Assessing Breasts and Lymphatic System - Page 424]
A client who just underwent hip replacement surgery reports pain at a 10 on a scale of 0 to 10 and receives 4 mg of morphine. A nurse on the orthopedic unit enters the client's room and finds that the client has a respiratory rate of 7 breaths/min. The client is groggy and hard to arouse. What could be contributing to the client's findings?
Opiates, which may cause hypoventilation Chapter 19: Assessing Thorax and Lungs - Page 403
A triage nurse is working in the emergency department of a busy hospital. Four patients have recently been admitted. Patient A has an arrhythmia diagnosed as atrial fibrillation; Patient B is in chronic congestive heart failure; Patient C is assessed and found to have a probable pulmonary embolism; Patient D complains of chest pain relieved by nitroglycerin and rest. Which patient would be the nurse's highest priority?
Patient C
A 47-year-old receptionist comes to the office with fever, shortness of breath, and a productive cough with golden sputum. She says she had a cold last week and her symptoms have only worsened despite using over-the-counter cold remedies. She denies any weight gain, weight loss, or cardiac or gastrointestinal symptoms. Her past medical history includes type 2 diabetes for 5 years and high cholesterol level. She takes an oral medication for both diseases. She has had no surgeries. She denies tobacco, alcohol, or drug use. Her mother has diabetes and high blood pressure. Her father passed away from colon cancer. Examination reveals a middle-aged woman appearing her stated age. She looks ill and her temperature is elevated at 101 degrees Farenheit. Her blood pressure and pulse are unremarkable. Her head, eyes, ears, nose, and throat examination are unremarkable except for edema of the nasal turbinates. On auscultation she has decreased air movement and coarse crackles are heard over the left lower lobe. There is dullness on percussion, increased fremitus during palpation, and egophony and whispered pectoriloquy on auscultation. What disorder of the thorax or lung best describes her symptoms?
Pneumonia
The lateral lymph nodes are located along the upper humerus and drain most of the arm.
True [ Chapter 20: Assessing Breasts and Lymphatic System - Page 411]
The nurse prepares to assess a client's breath sounds. Where should bronchial sounds occur?
[ Chapter 19: Assessing Thorax and Lungs - Page 401