Chapter 51: Breast Disorders ANS

4. Which assessment finding in a 36-year-old patient is most indicative of a need for further evaluation?

A breast nodule that is 1 cm in size, nontender, and fixed

14. Which information will the nurse include in patient teaching for a 36-year-old patient who is scheduled for stereotactic core biopsy of the breast?

A local anesthetic will be given before the biopsy specimen is obtained.

28. When using the accompanying illustration to teach a patient about breast self-examination, the nurse will include the information that most breast cancers are located in which part of the breast?

1

24. A patient has had left-sided lumpectomy (breast-conservation surgery) and an axillary lymph node dissection. Which nursing intervention is appropriate to delegate to a licensed practical/vocational nurse (LPN/LVN)?

Administering an analgesic 30 minutes before scheduled arm exercises

15. A student nurse prepares a list of teaching topics for a patient with a new diagnosis of breast cancer. Which item should the charge nurse suggest that the student nurse omit from the teaching topic list about breast cancer diagnostic testing?

CA 15-3 level testing

17. Which information should the nurse include in teaching a patient who is scheduled for external beam radiation to the breast?

Careful skin care in the radiated area will be necessary.

11. A 33-year-old patient has a saline breast implant inserted in the outpatient surgery area. Which instruction will the nurse include in the discharge teaching?

Check wound drains for excessive blood or a foul odor.

8. After a 48-year-old patient has had a modified radical mastectomy, the pathology report identifies the tumor as an estrogen-receptor positive adenocarcinoma. The nurse will plan to teach the patient about

tamoxifen (Nolvadex).

7. The nurse will teach a patient with metastatic breast cancer who has a new prescription for trastuzumab (Herceptin) that

the patient should call if she notices ankle swelling.

1. The nurse teaching a young womens community service group about breast self-examination (BSE) will include that

performing BSE after the menstrual period is more comfortable.

27. The outpatient clinic receives telephone calls from four patients. Which patient should the nurse call back first?

50-year-old with stage 2 breast cancer who is receiving doxorubicin (Adriamycin) and has ankle swelling and fatigue

19. The nurse is admitting a patient scheduled this morning for lumpectomy and axillary lymph node dissection. Which action should the nurse take first?

Ask the patient to describe what she knows about the surgery.

21. Which action will the nurse include in the plan of care for a patient with right arm lymphedema?

Assist with application of a compression sleeve.

2. During a well woman physical exam, a 43-year-old patient asks about her risk for breast cancer. Which question is most pertinent for the nurse to ask?

At what age did you start having menstrual periods?

3. A 51-year-old patient with a small immobile breast lump is considering having a fine-needle aspiration (FNA) biopsy. The nurse explains that an advantage to this procedure is that

FNA is done in the outpatient clinic and results are available in 1 to 2 days.

10. The nurse provides discharge teaching for a 61-year-old patient who has had a left modified radical mastectomy and lymph node dissection. Which statement by the patient indicates that teaching has been successful?

I will avoid reaching over the stove with my left hand.

18. Which patient statement indicates that the nurses teaching about tamoxifen (Nolvadex) has been effective?

I will call if I have any eye problems.

13. A patient newly diagnosed with stage I breast cancer is discussing treatment options with the nurse. Which statement by the patient indicates that additional teaching may be needed?

Mastectomy is the best choice to decrease the chance of cancer recurrence.

9. Which nursing action should be included in the plan of care for a patient returning to the surgical unit following a left modified radical mastectomy with dissection of axillary lymph nodes?

Post a sign at the bedside warning against venipunctures or blood pressures in the left arm.

23. The nurse notes bilateral enlargement of the breasts during examination of a 62-year-old man. Which action should the nurse take first?

Question the patient about medications being currently used.

12. The nurse is providing preoperative teaching about the transverse rectus abdominis musculocutaneous (TRAM) procedure to a patient. Which information will the nurse include?

Recovery from the TRAM surgery takes at least 6 to 8 weeks.

20. When the nurse is working in the womens health care clinic, which action is appropriate to take?

Teach a 28-year-old with a BRCA-1 mutation about magnetic resonance imaging (MRI).

26. A patient who is scheduled for a lumpectomy and axillary lymph node dissection tells the nurse, I would rather not know much about the surgery. Which response by the nurse is best?

Tell me what you think is important to know about the surgery.

6. A 58-year-old woman tells the nurse, I understand that I have stage II breast cancer and I need to decide on a surgery, but I feel overwhelmed. What do you think I should do? Which response by the nurse is best?

Tell me what you understand about the surgical options that are available.

5. A 53-year-old woman at menopause is discussing the use of hormone therapy (HT) with the nurse. Which information about the risk of breast cancer will the nurse provide?

The patient and her health care provider must weigh the benefits of HT against the risks of breast cancer.

25. The nurse is caring for a 52-year-old patient with breast cancer who is receiving chemotherapy with doxorubicin (Adriamycin) and cyclophosphamide (Cytoxan). Which assessment finding is most important to communicate to the health care provider?

The patients apical pulse is irregular.

22. A 36-year-old who has a diagnosis of fibrocystic breast changes calls the nurse in the clinic with symptoms. Which is most important to report to the health care provider?

There is an area on the breast that is hot, pink, and tender to touch.

16. The nurse will anticipate teaching a 56-year-old patient who is diagnosed with lobular carcinoma in situ (LCIS) about

tamoxifen (Nolvadex)