A patient is concerned about her risk for breast cancer. Following the initial history, the nurse identifies which of the following as a high risk factor for breast cancer?
1. History of late menarche and early menopause
2. Sister with premenopausal breast cancer
3. Mother with fibrocystic breast disease
4. Multiparity
2
Rationale 1: Early menarche combined with late menopause is a breast cancer risk.
Rationale 2: Premenopausal breast cancer in a first-degree relative is associated with increased risk of breast cancer, as are nulliparity and age over 30 at first childbearing.
Rationale 3: Fibrocystic breast disease is not a breast cancer risk factor.
Rationale 4: Multiparity is not a breast cancer risk factor.
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The nurse is providing hand and foot care to a patient and notices the patient has extremely hard nails. Who is the person best prepared to provide nail care for patients with extremely hard nails?
a. Physician b. RN c. CNA d. Podiatrist
Health care regulatory agencies, national think tanks, and government agencies expect health care organizations to incorporate cultural competence into policies and practices to ensure effective communication, patient safety and quality, and patient-
centered care. Some examples of such organizational policies and practices include which of the following? (Select all that apply.) a. Instituting a requirement for all staff to be trained in cultural competence b. Maintaining the traditional description of family in written policies c. Enforcing strict visitation policies and practices d. Ensuring that persons who are deaf or speak limited English have access to an interpreter e. Embedding health literacy principles in written and verbal communication
A nurse working on the unit budget would recognize that the resources needed to deliver quality health care such as nurses, practitioners, medical records, buildings, and pharmaceuticals are considered which aspects of health care?
a. Process c. Organization b. Structure d. Practice
What etiology of abdominal pain is most likely causing his symptoms?
A 22-year-old law student comes to your office, complaining of severe abdominal pain radiating to his back. He states it began last night after hours of heavy drinking. He has had abdominal pain and vomiting in the past after drinking but never as bad as this. He cannot keep any food or water down, and these symptoms have been going on for almost 12 hours. He has had no recent illnesses or injuries. His past medical history is unremarkable. He denies smoking or using illegal drugs but admits to drinking 6 to 10 beers per weekend night. He admits that last night he drank something like 14 drinks. On examination you find a young male appearing his stated age in some distress. He is leaning over on the examination table and holding his abdomen with his arms. His blood pressure is 90/60 and his pulse is 120. He is afebrile. His abdominal examination reveals normal bowel sounds, but he is very tender in the left upper quadrant and epigastric area. He has no Murphy's sign or tenderness in the right lower quadrant. The remainder of his abdominal examination is normal. His rectal, prostate, penile, and testicular examinations are normal. He has no inguinal hernias or tenderness with that examination. Blood work is pending. A) Peptic ulcer disease B) Biliary colic C) Acute cholecystitis D) Acute pancreatitis