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NSG 460 Exam 4 Chapters 17, 26 | Questions And Answers Latest {} A+ Graded | 100% Verified
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NSG 460 Exam 4 Chapters 17, 26 | Questions And Answers Latest {2024- 2025} A+ Graded | 100% Verified
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NSG 460 Exam 4 Chapters 17, 26 | Questions And Answers Latest {2024-2025} A+ Graded | 100% Verified
The nurse is assessing a patient who reports purulent nipple discharge. What is the likely cause of this
condition?
1.Use of oral contraceptives or diuretics
2.Presence of nodules in the papillary duct
3. Stagnation of cellular debris in the ducts
4. Presence of an early lesion in Paget disease - 3. Stagnation of cellular debris in the ducts
Mammary duct ectasia is a condition in which the subareolar ducts produce sticky, purulent discharge.
This discharge is caused by stagnation of cellular debris and secretions in the ducts, leading to
obstruction, inflammation, and infection. Certain medications, such as oral contraceptives and diuretics,
can cause clear nipple discharge. An early lesion in Paget disease causes unilateral, clear, yellow
discharge. An intraductal papilloma is a benign tumor that arises in the papillary ducts. The nodules in
the papillary duct may lead to serous or serosanguineous discharge.
The nurse is caring for a patient with benign fibrocystic breast disease. What does the nurse expect to
find in this patient? Select all that apply.
1. Presence of multiple tender masses
2 . Presence of irregularly shaped lumps
3. Presence of dull, heavy, cyclic pain
4. Presence of constant growth of lumps
5 . Presence of cysts and fibroadenomas - 1, 3, 5: A patient with benign fibrocystic breast disease has
multiple tender masses. The patient has significant lumpiness or nodularity, which may be cyclic or
noncyclic. The patient also has mastalgia or pain, which may be dull, heavy, and cyclic as the nodules
enlarge. Palpation reveals the presence of dominant lumps, which may be cysts or fluid-filled sacs and
fibroadenomas. The lumps detected in fibrocystic breast disease are round and lobular, whereas the
lumps detected in cancer are irregular in shape. Lumps in fibroadenoma grow quickly and constantly,
while the lumps in benign fibrocystic breast disease may increase or decrease rapidly in size. The change
in size is cyclic with the menstrual period.
The nurse is assessing a 13-year-old male patient who is concerned about the sudden enlargement of his
breasts. Which responses by the nurse are appropriate? Select all that apply.
,1 . "It is a normal but temporary occurrence at your age."
2. "If the enlargement is only on one side, it is a cause for concern."
3. "The enlargement will go away and may reappear in old age."
4. "Further investigation may be needed for further diagnosis."
5. "The enlargement is the result of a normal growth of breast tissue." - 1, 3, 5. The normal male breast
is a rudimentary structure consisting of a thin disk of undeveloped tissue beneath the nipple.
Gynecomastia or enlargement of the breast in the male is common during adolescence. It is temporary
and will gradually recede. It may reappear in old age due to testosterone deficiency. The nurse reassures
the patient that the condition is normal and temporary during adolescence. Gynecomastia is a benign
growth and feels like a smooth, firm, and movable disk. The enlargement may be unilateral or bilateral
and is not a cause for concern, because it is temporary. Further investigation is not required, because
this is a normal occurrence.
The nurse is doing a vaginal examination in a patient with menorrhagia. In which position should the
patient be placed to best assess the vagina?
1. Sitting position
2. Standing position
3. Side-lying position
4. Lithotomy position - 4. Lithotomy position
During the vaginal examination, a patient should be placed in the lithotomy position. In this position, the
patient's feet are at the level of the hips, and the perineum is at the edge of the table. This position
provides good visual and physical access to the perineum. The perineum is not adequately exposed in
the sitting, standing, or side-lying positions. The patient should be in the sitting position while the nurse
is explaining the examination and how the procedure will proceed. Thus, the nurse cannot do a vaginal
examination in these positions. The nurse, not the patient, should be in a standing position while
assessing the vagina, because it provides good visual and physical access to the patient's perineum,
which eases the examination procedure. The patient should be placed in a right or left side-lying
position after the procedure. These positions help the patient relax.
Which instructions should the nurse provide to a patient regarding a pelvic examination?
1. "Do not douche or have intercourse 24 hours before the examination."
2. "You can hold your breath during the examination if you feel uncomfortable."
3. "It is best if you do not view the procedure because you may find it disturbing."
4. "You will have to remove all clothing including shoes and socks before the examination." - 1.
, The nurse instructs the patient to avoid douching 24 hours before the pelvic examination, because
douching can wash away surface cells. Vaginal intercourse can cause inflammation of the tissue, which
can interfere with a Pap test. The nurse does not ask the patient to hold her breath if she feels
uncomfortable, but stops the examination. The patient can wear her shoes and socks during the
examination if she prefers to do so. The procedure should not be characterized as disturbing, and the
nurse can use a mirror during the pelvic examination so that the patient gets a full view of her genitalia.
Which is an abnormal assessment finding in a female patient?
1.The cervix is pink.
2. Bartholin glands are not palpable.
3. Ovaries are smooth, firm, and nontender on palpation.
4. The cervix and uterus are fixed and tender on internal palpation - 4.
Fixed and tender uterus and cervix indicate endometriosis in a patient. Smooth, firm, and nontender
ovaries on palpation are a normal finding in a healthy patient. Bartholin glands would be palpable in the
case of Bartholin duct cysts or gland abscesses. Normal Bartholin glands are not palpable. The cervix is
normally pink. Redness of the cervix would be an abnormal finding.
While examining the external genitalia of a patient, the nurse notices pink-colored, soft, pointed papules
around the anus and vulva. Which abnormality would the nurse document in the patient's examination
report?
1. Genital warts
2. Herpes genitalis
3. Syphilitic chancre
4. Contact dermatitis - 1.
The nurse documents that the patient has genital warts. Human papillomavirus (HPV) causes genital
warts, which are characterized by red- or pink-colored, soft, pointed, moist papules around the cervix,
vagina, introitus, anus, and vulva. Clusters of small, shallow vesicles with erythema emerging around the
genital areas and inner thigh are characteristics of herpes genitalis infection. A red-colored, round or
oval, superficial ulcer in the inguinal area with a yellowish serous discharge is indicative of a syphilitic
chancre. Red-colored, swollen vesicles with intense itching, thickening of skin, and excoriations from
scratching in the genital areas indicate contact dermatitis.
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