1. 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?: After menopause, the glandular
and fat tissue atrophies, causing breast size and elasticity to diminish,
resulting in breast that sag
2. The mother of a 10-year-old boy asks the nurse to discuss the
recognition of puberty. The nurse should reply by saying?: the first sign of
puberty is enlargement of the testes
3. A patient has bilateral pitting edema of the feet. While assessing the
peripheral vascular system, the nurse's primary focus should be::
venous function of the lower extremitites
4. During an examination, the nurse notes severe nystagmus in both eyes
of a patient. Which of the following conclusions is correct?: this may
indicate disease of the cerebellum or brainstem
5. When performing a musculoskeletal assessment, the nurse knows
the correct approach for the examination should be:: proximal to distal
,6. A 43-year-old woman is at the clinic for a routine examination. She
reports that she has had a breast lump in her right breast for years.
Recently, it has begun to change in consistency and is becoming harder.
She reports that
5 years ago her physician evaluated the lump and determined that it "was
nothing to worry about." The examination validates the presence of a mass
in the right appear upper outer quadrant at 1 o'clock, approximately 5 cm
form the nipple. It is frim, mobile, nontender, with borders that are not well
defined. The nurse's recommendation to her is:: Because of the change in
consistency of the lump, it should be further evaluated by a physician
7. The nurse practitioner is examining a 3-month-old infant. While holding
the thumbs on the infant's inner-mid-thighs and the fingers outside on the
hips, touching the greater trochanter, the nurse practitioner adducts the
legs until the nurse practitioner's thumbs touch and then abducts the legs
until the infant's knees touch the table. The nurse practitioner does not
note any "clunking" sounds and is confident to record a:: Negative
Ortolani's sign
8. A patient's mother has noticed that her son, who has been to a new
babysitter, has some blisters and scabs on his face and buttocks. On
,exami- nation, the nurse notices moist, thin-roofed vesicles with a thin
erythematous base and suspects:: Impetigo
, 9. The nurse is testing superficial reflexes on an adult patient. When
stroking up the lateral side of the sole and across the ball of the foot, the
nurse notices the plantar flexion of the toes. How would the nurse
document this finding?: Plantar reflex present
10.A woman is in the family planning clinic seeking birth control
information. She states that her breasts "change all month long" and that
she is worried that this is unusual. What is the nurse's best response?: Tell
her that, because of the changing hormones during the monthly
menstrual cycle, cyclic breast changes are common.
11.A patient states during the interview that she noticed a new breast lump
in the shower a few days ago. It was on her left breast near her axilla. The
RN should plan to:: palpate the unaffected breast first
12.1. A 16-yr-old girl is being seen at clinic for gastrointestinal complaints
and weight loss. Nurse determines that many of her complaints may be
related to erratic eating patterns, eating predominantly fast foods, + high
caffeine intake. In this situation, which is most appropriate when collecting
current dietary intake information?: Have the patient complete a food
diary for 3 days=2 weekdays + 1 weekend day
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