Week 7 NR 509 Advanced physical assessment quiz

Week 7 physical assessment quiz These are the automatically computed results of your exam. Grades for essay questions, and comments from your instructor, are in the "Details" section below. Date Taken: 11/30/2015 Time Spent: 34 min , 27 secs Points Received: 50 / 50 (100%) Question Type: # Of Questions: # Correct: Multiple Choice 25 25 Grade Details - All Questions Question 1.Question : A 65-year-old patient remarks that she just can’t believe that her breasts sag so much. She states it must be from lack of exercise. What explanation should the nurse offer her? Student Answer: After menopause, only women with large breasts experience sagging. After menopause, sagging is usually due to decreased muscle mass within the breast. After menopause, a diet that is high in protein will help maintain muscle mass, which keeps the breasts from sagging. After menopause, the glandular and fat tissue atrophies, causing breast size and elasticity to diminish, resulting in breasts that sag. Instructor Explanation: After menopause, the glandular tissue atrophies and is replaced with connective tissue. The fat envelope atrophies also, beginning in the middle years and becoming marked in the eighth and ninth decades. These changes decrease breast size and elasticity, so the breasts droop and sag, looking flattened and flabby. Points Received: 2 of 2 Comments: Question 2.Question : During a physical examination, a 45-year-old woman states that she has had a crusty, itchy rash on her breast for about 2 weeks. In trying to find the cause of the rash, which of these would be important for the nurse to determine? Student Answer: Is the rash raised and red? Does it appear to be cyclic? Where did it first appear—on the nipple, the areola, or the surrounding skin? What was she doing when she first noticed the rash, and do her actions make it worse? Instructor Explanation: It is important for the nurse to determine where the rash first appeared. Paget’s disease starts with a small crust on the nipple apex and then spreads to the areola. Eczema or other dermatitis rarely starts at nipple unless it results from breastfeeding. It usually starts on the areola or surrounding skin and then spreads to the nipple. See Table 17-6. Points Received: 2 of 2 Comments: Question 3.Question : The nurse is performing a breast examination. Which of these statements best describes the correct procedure to use when screening for nipple and skin retraction during a breast examination? Have the woman Student Answer: bend over and touch her toes. lie down on her left side and notice any retraction. shift from a supine position to a standing position; notice any lag or retraction. slowly lift her arms above her head and note any retraction or lag in movement. Instructor Explanation: Direct the woman to change position while checking the breasts for skin retraction signs. First ask her to lift her arms slowly over her head. Both breasts should move up symmetrically. Retraction signs are due to fibrosis in the breast tissue, usually caused by growing neoplasms. The nurse should notice if there is a lag in movement of one breast. Points Received: 2 of 2 Comments: Question 4.Question : During an annual physical exam, a 43-year-old patient states that she doesn’t perform monthly breast self-examinations (BSE). 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 Student Answer: BSEs may detect lumps that appear between mammograms. breast self-examination is unnecessary until the age of 50 years. she is correct; mammography is a good replacement for breast self-examination. she doesn’t need to perform breast self-examination as long as a physician checks her breasts yearly. Instructor Explanation: The monthly practice of breast self-examination, along with clinical breast examination and mammograms are complementary screening measures. Mammography can reveal cancers too small to be detected by the woman or by the most experienced examiner. However, interval lumps may become palpable between mammograms. Points Received: 2 of 2 Comments: Question 5.Question : While examining a 75-year-old woman, the nurse notices that the skin over her right breast is thickened and the hair follicles are exaggerated. This condition is known as Student Answer: dimpling. retraction. peau d’orange. benign breast disease. Instructor Explanation: This condition is known as peau d’orange. Lymphatic obstruction produces edema, which thickens the skin and exaggerates the hair follicles. The skin has a pig-skin or orange-peel look, and this condition suggests cancer. Points Received: 2 of 2 Comments: Question 6.Question : During an examination of a 7-year-old girl, the nurse notices that the girl is showing breast budding. What should the nurse do next? Student Answer: Ask her if her periods have started. Assess the girl’s weight and body mass index (BMI). Ask the girl’s mother at what age she started to develop breasts. Nothing; this is a normal finding. Instructor Explanation: Research has shown that girls with overweight or obese BMI levels have a higher occurrence of early onset of breast budding (before age 8 years for African-American girls and age 10 years for white girls) and early menarche. Points Received: 2 of 2 Comments: Question 7.Question : The nurse is discussing breast self-examination with a postmenopausal woman. The best time for postmenopausal women to perform breast self-examination is Student Answer: the same day every month. daily, during the shower or bath. 1 week after her menstrual period. every year with her annual gynecologic examination. Instructor Explanation: Postmenopausal women are no longer experiencing regular menstrual cycles but need to continue to perform breast self-examination on a monthly basis. Choosing the same day of the month is a helpful reminder to perform breast self-examination. Points Received: 2 of 2