The outpatient clinic receives telephone calls from four patients. Which patient should the nurse call back first?
a. 57-year-old with ductal ectasia who has sticky multicolored nipple discharge and severe nipple itching
b. 21-year-old with a family history of breast cancer who wants to discuss genetic testing for the BRCA gene
c. 40-year-old who still has left side chest and arm pain 2 months after a left modified radical mastectomy
d. 50-year-old with stage 2 breast cancer who is receiving doxorubicin (Adriamycin) and has ankle swelling and fatigue
ANS: D
Although all the patients have needs that the nurse should address, the patient who is receiving a cardiotoxic medication and has symptoms of heart failure should be assessed by the nurse first. BRCA testing may be appropriate for the 21-year-old, but it does not need to be done immediately. Chest and arm pain are normal up to 3 months after mastectomy. Nipple discharge and itching is a common finding with ductal ectasia.
You might also like to view...
A nurse in the ICU observes paradoxical irritability, meningeal irritability, and nuchal rigidity in a 5-year-old girl. She suspects meningitis. What other finding or findings would support this belief? Select all that apply
A) Positive Babinski reflex B) Positive Moro reflex C) Positive Brudzinski's sign D) Positive Kernig's sign
A client with sickle cell disease informs the nurse that he is having chest pain. The nurse hears the client coughing, wheezing, and breathing rapidly. What does the nurse suspect is occurring with this client?
A) Vaso-occlusive crisis B) Pneumocystis pneumonia C) Acute chest syndrome D) Acute muscular strain
Four hours after his fractured radius was fit with a cast, a 20-year-old man has returned to the cast clinic stating that his arm "hurts even more than when I broke it
" The nurse's gentle manipulation of the patient's fingers causes his excruciating pain. What action should the nurse take? A) Administer 5 mg oxycodone PO. B) Apply warm compresses the patient's hand and reassess in 15 minutes. C) Document the patient's complaint and implement distraction techniques. D) Report the patient's symptoms to the primary care provider.
The nurse is caring for an infant receiving tube feedings exclusively. An important nursing intervention for this infant is
1. keeping the mouth suctioned andfree of secretions. 2. providing a pacifier for non-nutritivesucking. 3. putting small amounts of formula onthe infant's lips. 4. giving glycerin suppositories asneeded to maintain bowel function.