ATI RN · Obstetrics and Pediatrics · Maternity and Pediatric Nursing 4th Edition Test Bank

Option D: A painless mass in the breast is the primary sign of breast cancer, often detected during self-examination or clinical evaluation. This mass may be hard, irregular, and not associated with pain, making it a critical indicator for further diagnostic evaluation and intervention.

Option A: A bloody discharge from the nipple can occur in various conditions, including benign breast diseases, and is not the primary sign of breast cancer.

Option B: A retraction of the nipple may indicate underlying pathology but is not the most common initial sign of breast cancer compared to a palpable mass.

Option C: A dimpling of the skin over the lesion can be a sign of advanced breast cancer but is not the primary sign, as many cases present with a painless mass first.

Takeaways: The primary sign of breast cancer is a painless mass in the breast, which necessitates prompt evaluation and management to determine the appropriate course of action.

Option B: Communicating hydrocephalus is characterized by the presence of cerebrospinal fluid (CSF) that can flow freely between the ventricles and the subarachnoid space, but is hindered by malformations of the arachnoid villi, preventing proper absorption. This condition leads to increased intracranial pressure without obstruction in the CSF pathways.

Option A: Non-communicating hydrocephalus involves a blockage in the CSF pathways, preventing normal flow and absorption, which does not align with the description of malformation of arachnoid villi.

Option C: Obstructive hydrocephalus specifically refers to a physical blockage in the CSF pathways, which contradicts the scenario of malformation of arachnoid villi where no obstruction exists.

Option D: The phrase

Option A: limit or stop progression of the curvature. This is the primary goal of scoliosis therapy, as early intervention can help manage the curvature and prevent further complications. Treatment may include observation, bracing, or surgical options depending on the severity and progression of the condition.

Option B: prepare the child for surgery. While surgery may be necessary in severe cases, it is not the initial goal of therapy. The focus is on monitoring and managing the curvature first.

Option C: minimize the psychosocial complications of prolonged immobilization. Although psychosocial aspects are important, the immediate goal of scoliosis treatment is to address the curvature itself rather than focusing solely on psychosocial implications.

Option D: develop a pain management protocol that will minimize complications of medications. Pain management is a component of care but not the primary goal in treating scoliosis, which centers on controlling the curvature's progression.

Takeaways: The main objective in managing scoliosis is to limit or stop progression of the curvature, which may involve various interventions including bracing or surgery if necessary, emphasizing the importance of early detection and treatment to optimize outcomes.

Option C: Fluid replacement should be planned based on the understanding that insensible losses in an afebrile person are normally not greater than 600ml/24hr. This value accounts for normal physiological processes, including evaporation through the skin and respiratory tract, which are critical in maintaining fluid balance, especially in febrile patients experiencing increased losses due to diaphoresis.

Option A: 300ml/24hr underestimates the typical insensible losses in an afebrile individual, as this amount is too low for normal physiological functioning.

Option B: 900ml/24hr exceeds the expected insensible losses for an afebrile person, which typically does not reach this level under normal conditions.

Option D: 1200ml/24hr significantly overestimates insensible losses, as this figure is not supported by standard physiological data for an afebrile individual.

Takeaways: Understanding that insensible losses in an afebrile person are normally not greater than 600ml/24hr is crucial for effective fluid management, especially in cases of increased loss due to conditions like fever and diaphoresis, which requires appropriate fluid replacement strategies to maintain hydration.

Option B: Paresthesia of the legs is the initial neurological symptom of Guillain-Barré Syndrome, often presenting as tingling or numbness. This symptom typically occurs in a symmetrical pattern and may precede muscle weakness, making it a key indicator for early diagnosis and intervention in affected patients.

Option A: Absent tendon reflexes can occur later in the disease process but are not the initial symptom. Reflexes may be diminished or absent as the syndrome progresses, but they do not present first.

Option C: Dysrhythmias are not a primary neurological symptom of Guillain-Barré Syndrome. While autonomic dysfunction can occur, it typically manifests after initial neurological symptoms like paresthesia.

Option D: Transient hypertension is not a recognized initial symptom of Guillain-Barré Syndrome. The syndrome primarily affects the peripheral nervous system and presents with neurological symptoms rather than cardiovascular changes initially.

Takeaways: Paresthesia of the legs serves as the hallmark initial symptom of Guillain-Barré Syndrome, highlighting the need for prompt recognition and management of neurological symptoms to prevent further complications.