Chapter 6

A woman's breast examination reveals a small mass. Which of the following characteristics would lead the nurse to suspect that the mass is malignant? Select all that apply.

• Hard on palpation • Skin dimpling • Painless

Which factors contribute to the development of breast cancer?

• High breast density • Hormonal factors • Aging • Family history

A female client with a malignant tumor of the breast has to undergo chemotherapy for a period of 6 months. Which of the following side effects should the nurse monitor for when caring for this client?

Constipation

When counseling a woman with monthly breast pain, what dietary recommendations should the nurse provide?

"Eat plenty of fruits, vegetables, and whole grains, and follow a low-fat diet."

How should the nurse counsel a postpartum patient on how to prevent mastitis?

"Wash your hands thoroughly, and let your breasts dry after each feeding."

When counseling a patient on how to prepare for her first mammogram, what should the nurse include?

"Don't wear any powder, deodorant, or jewelery."

After teaching a woman about breast self-examination, which statement indicates that the teaching was successful?

"I'll do the check a week after my period."

Which of the following is TRUE regarding the treatment of breast cancer?

Often, the first treatment option for breast cancer is surgery.

Which of the following would the nurse expect to find when assessing the breasts of a client with fibrocystic breast disease?

Soft mass

A small amount of breast milk is obtained for culture and sensitivity testing from a client with mastitis. The nurse would expect the results to identify which organism as the most likely cause?

Staphylococcus aureus

A breast tumor is most likely found in what part of the breast?

The upper outer quadrant

A client with breast cancer is scheduled to undergo chemotherapy with aromatase inhibitors. Which of the following best reflects the rationale for using this group of drugs?

They lower the level of estrogen in the body blocking the tumor's ability to use it

A client complains of having tender and painful breasts, often feeling multiple lumps within her breast tissue. The nurse would need to gather additional information about which of the following?

Timing of symptoms in relation to the menstrual cycle

An OB/GYN nurse is teaching a new female client how to perform breast self-examination. Which of the following is a recommended step for this examination?

To examine the right breast, put a pillow or folded towel under the right shoulder

A client with breast cancer is to receive immunotherapy. The nurse would expect the client to receive which of the following?

Trastuzumab

A client with a fibroadenoma is being scheduled for diagnostic testing. Which of the following would the nurse expect as most likely?

Ultrasound

A woman is crying because she just recently received the results of her biopsies, and they confirm that she has invasive breast cancer. Which response by the nurse is the most appropriate?

Listen to the woman talk and remain silent for a while

A patient who came to the clinic after finding a mass in her breast is scheduled for a diagnostic breast biopsy. What is it important for the nurse to do?

Acknowledge the fear the patient is experiencing

Which breast disorder is NOT benign?

Paget's disease

During a follow-up visit, a female client who underwent a mastectomy asks the nurse if she can work in her backyard or at least do some household work. Which suggestion would be most appropriate?

Wear gloves and protective clothing to avoid any injuries

A client complains of lumpy, tender breasts, particularly during the week before menses. She complains of pain that often dissipates after the onset of menses. The nurse suspects the client has fibrocystic breast changes. Which of the following should the nurse do next?

Perform a breast examination.

The nurse is giving an educational event for a local women's group on self-examination of the breast. The nurse tells the women's group to raise their arms and inspect their breasts in a mirror. A member of the women's group asks the nurse why she needs to do this. What is the nurse's best response?

"It will help to observe for dimpling."

The nurse is teaching a client with mastitis about care measures. Which client statement indicates effective teaching?

"I can use warm soaks to my breast to relieve the discomfort."

When preparing a teaching plan for a woman with mastitis, which of the following would the nurse include?

Applying warm compresses to the affected breast

What does the American Cancer Society (ACS) say about breast self-examination (BSE)?

a monthly BSE is optional

It is recommended that a 48-year-old female client with breast cancer undergo a sentinel lymph node biopsy before a lumpectomy. The client asks the nurse the reason for removing the sentinel lymph node. Which of the following statements would the nurse state?

"It will prevent lymphedema, which is a common side effect."

While performing a clinical breast examination, the nurse notes a firm and rubbery nodule that is well circumscribed and moves freely. How should the nurse counsel the patient?

"It's most likely a fibroadenoma, but we may need to do a biopsy."

You are caring for a 52-year-old woman whose sisters and mother died of breast cancer. The patient states, "My doctor wants me to take tamoxifen to help prevent breast cancer. What do you think?" What would be your best response?

"Tamoxifen reduces the incidence."

A 52-year-old female client with an estrogen receptors positive (ER+) breast cancer is undergoing hormonal therapy. While taking a selective estrogen receptor modulator (SERM), the client begins to experience hot flashes. What should the nurse do next?

Document the hot flash in the patient's chart

In which of the follow patients would the nurse first suspect cancer?

A 45-year-old with thickening in one breast with nipple irritation and retraction and a pink discharge

According to the American Cancer Society, a woman in her 20s or 30s with no symptoms or family history of breast cancer should have a clinical breast examination once every ____ years.

3

While interviewing a woman before her yearly examination, the nurse learns that she stopped breastfeeding over a year ago but occasionally has pain on one side behind her left nipple not related to her period. Upon examination, the nurse does not palpate any lumps but finds the left nipple retracted with a greenish discharge. What would the nurse first suspect?

Duct ectasia

A client arrives at the health care facility complaining of a lump that she felt during her breast self-examination. Upon diagnosis, the physician suspects fibroadenomas. Which of the following questions should the nurse ask when assessing the client?

Are you lactating?

A female client is diagnosed with breast abscess. Although she has been allowed to breast-feed her newborn, she decides to terminate breast-feeding. Which of the following would be most appropriate in this situation?

Assist the client to pump the breasts to remove breast milk

A woman has been treated for a tumor of the left breast that has not responded to chemotherapy. The woman has just found out that she has the BRCA mutations and discusses her options with her physician. What treatment would be most difficult for this woman?

Bilateral mastectomy

In the United States, what type of cancer accounts for one-third of cancer diagnoses and is the most common cancer in women?

Breast Cancer

After teaching a group of students about the signs and symptoms of breast cancer, the instructor determines that additional teaching is needed when the group identifies which of the following?

Breast symmetry

A client has undergone a mastectomy for breast cancer. Which of the following instructions should the nurse include in the postsurgery client-teaching plan?

Elevate the affected arm on a pillow

Mammography is recommended for a client diagnosed with intraductal papilloma. Which of the following factors should the nurse ensure when preparing the client for a mammography?

Client has not applied deodorant on the day of testing.

A nurse is caring for a client who has just had her intraductal papilloma removed through a surgical procedure. What instructions should the nurse give this client as part of her care?

Continue monthly breast self-examinations.

A nurse is caring for a female client undergoing radiation therapy after her breast surgery. The client is refusing to eat and states she does not have a desire to eat at this time. The nurse would do which of the following first?

Continue to monitor the client

A 41-year-old female client arrives at a health care setting complaining of dull nipple pain with a burning sensation, accompanied by pruritus around the nipple. The physician suspects mammary duct ectasia. Which of the following orders should the nurse question?

Cool compresses to the affected areas

Which of the following would the nurse include in the plan of care for a client diagnosed with breast cancer who has undergone a mastectomy?

Encouraging the client to perform arm exercises

What is the most common breast mass in women?

Fibroadenoma

Edema and enlargement in the ducts and glands of the breast that occur as effects of hormones are called

Fibrocystic breast changes

While performing a clinical breast examination on a client, the nurse inspects the breasts with the client in various positions. Place the following positions in their proper sequence.

Hands placed on the hips Arms resting at the sides Hands on hips while standing Arms raised over the head

When reviewing a woman's history, the nurse identifies which factor as increasing the client's risk for breast cancer?

History of ovarian cancer

During a routine physical examination, a firm mass is palpated in the right breast of a 35-year-old woman. Which finding or client history would suggest cancer of the breast as opposed to fibrocystic disease?

Increased vascularity of the breast

A 62-year-old female client arrives at a health care facility complaining of skin redness in the breast area, along with skin edema. The physician suspects inflammatory breast cancer. Which of the following is a symptom of inflammatory breast cancer that the nurse should assess for?

Increased warmth of the breast

A client diagnosed with fibroadenoma is worried about her chances of developing breast cancer. She also asks the nurse about various breast disorders and their risks. Which of the following benign breast disorders should the nurse include as having the greatest risk for the development of breast cancer?

Intraductal papilloma

The nurse is developing a presentation for a local women's health center about breast cancer. Which of the following would the nurse include as being the most common type of breast cancer?

Invasive ductal carcinoma

What is the most common type of breast cancer, accounting for approximately 85% of cases?

Invasive ductal carcinoma

The nurse is providing care to a client who has had surgery as treatment for breast cancer. The nurse would be alert for the development of which of the following?

Lymphedema

A nurse is preparing a presentation for a health fair about preventing breast cancer. Which of the following would the nurse include?

Maintain an ideal weight

A client is considering breast augmentation. Which of the following would the nurse recommend to the client to ensure that there are no malignancies?

Mammogram

A woman who is 6 months postpartum calls the clinic and reports flu-like symptoms, an elevated temperature, and pain and redness throughout her left breast. What would the nurse first suspect?

Mastitis

During a recent visit to the clinic a woman presents with erythema of the nipple and areola on the right breast. She states this started several weeks ago and she was fearful of what would be found. The nurse suspects

Paget's Disease

45-year-old woman comes into the OB/GYN clinic for her yearly check-up. The woman mentions to the nurse that she has a dimpling of the right breast that has occurred in the last 2 weeks. She has not performed a self-breast examination. What assessment would be appropriate for the nurse to make?

Palpate the area for a breast mass

A woman is scheduled to undergo a modified radical mastectomy. Which of the following would the nurse include when describing this surgery to the client?

Removal of breast tissue, axillary nodes, and some chest muscles

A nurse is educating a client on the technique for performing breast self-examination. Which of the following instructions should the nurse include in the teaching plan with regard to the different degrees of pressure that need to be applied on the breast?

hard pressure applied near the ribs

How should the nurse instruct a woman to perform a breast self-examination? Select all that apply.

• "You will need to visually inspect both breasts and palpate them for changes." • "It doesn't matter which pattern you use to palpate the breast as long as you cover the entire breast." • "Look for any changes in shape, size, contour, or symmetry between the breasts, as well as any skin discoloration."

A 33-year-old female client complains of yellow nipple discharge and a pain in her breasts a week before menses that dissipates on the onset of menses. Diagnosis reveals that the client is experiencing fibrocystic breast changes. Which of the following instructions should the nurse offer the client to help alleviate the condition? Select all that apply

• Avoid caffeine. • Maintain a low-fat diet. • Take diuretics as recommended

Lumpectomy is a treatment option for clients diagnosed with breast cancer with tumors smaller than 5 cm. For which of the following clients is lumpectomy contraindicated? Select all that apply.

• Client who has had previous radiation to the affected breast • Client whose connective tissue is reported to be sensitive to radiation • Client whose surgery will not result in a clean margin of tissue

A nurse is assigned to educate a group of women on cancer awareness. Which of the following are the modifiable risk factors for breast cancer? Select all that apply.

• Failing to breastfeed for up to a year after pregnancy • Postmenopausal use of estrogen and progestins • Not having children until after age 30

Which of the following are modifiable risk factors for breast cancer? Select all that apply.

• Smoking • Sedentary lifestyle • Alcohol consumption • Obesity • Duration of breastfeeding

A 38-year-old female client has to undergo lymph node surgery in conjunction with mastectomy. The client is likely to experience lymphedema due to the surgery. Postsurgery, which of the following factors will make the client more susceptible to lymphedema? Select all that apply

• Use of the affected arm for drawing blood or measuring blood pressure • Engaging in activities like gardening without using gloves • Not wearing a well-fitted compression sleeve