Chapter 20: Assessing Breasts and Lymphatic System (Review Questions)

At puberty, the female breasts enlarge in response to estrogen and A. Progesterone B. Aldosterone C. Lactogen D. Prolactin

A. Progesterone

Which life style behaviors do nurses ask about to identify patients with risk factors for breast cancer? Select all that apply. a. Obesity after age 50 b. Smoking more than one pack of cigarettes a day c. Never having given birth to a viable infant d. Drinking two to five alcoholic beverages a day e. Estrogen replacement therapy for more than 5 years f. High blood pressure for more than 3 years

A, C, D, E

The nurse observes an orange peel appearance, or peau d'orange, of the areolae of a client's breasts. The nurse should explain to the client that this is most likely due to A. blocked lymphatic drainage B. fibrocystic breast disease C. fibroadenomas D. radiation therapy

A. blocked lymphatic disease

The nurse has discussed the risks for breast cancer with a group of high school seniors. The nurse determines that one of the students needs further instructions when the student says that one risk factor is A. having a baby before the age of 20 years B. a family history of breast cancer C. consumption of a high-fat diet D. late menopause

A. having a baby before the age of 20 years

The lymph nodes that are responsible for drainage from the arms are the A. lateral lymph nodes B. central lymph nodes C. anterior lymph nodes D. posterior lymph nodes

A. lateral lymph nodes

The functional part of the breast that allows for milk production consists of tissue termed A. Fibrous B. Glandular C. Adipose D. Lactiferous

B. Glandular

The nurse is assessing an adult male client when the nurse observes gynecomastia in the client. The nurse should ask the client if he is taking any medications for A. inflammation B. liver disorder C. infection D. ulcers

B. liver disorder

The nurse observes dimpling in an adult female client's breasts. The nurse should explain to the client that dimpling of the breast may indicate a A. fibroadenoma B. tumor C. genetic deviation D. fibrocystic breast

B. tumor

.During breast assessment, the nurse should consider the client's culture because A. breast cancer has a low mortality rate in Canada B. Canadian women have higher risk factors for breast cancer than other cultures C. African American women may not engage in breast cancer screenings D. African American women should begin screening at an earlier age

C. African American women may not engage in breast cancer screenings

After assessing the breasts of a female client, the nurse should explain to the client that most breast tumors occur in the A. Upper inner quadrant B. Lower inner quadrant C. Upper outer quadrant D. Lower outer quadrant

C. Upper outer quadrant

The nurse is preparing to examine the breasts of a female client who had a left radical mastectomy 3 years ago. When examining the client, the nurse observes redness at the scar area. The nurse should explain to the client that this may be indicative of A. additional tumors B. poor lymphatic drainage C. an infectious process D. metastasis to the right breast

C. an infectious process

A female client tells the nurse that her breasts become lumpy and sore before menstruation but get better at the end of the menstruated cycle. The nurse should explain to the client that these symptoms are often associated with A. malignant tumors B. fibroadenoma C. fibrocystic breasts D. increased estrogen production

C. fibrocystic breasts

The nurse is assessing a 50-year-old client's breasts and observes a spontaneous discharge of fluid from the left nipple. The nurse should A. document this as a normal finding B. ask the client if she has had retracted nipples C. refer the client for a cytology examination D. determine whether the client wears a supportive bra

C. refer the client for a cytology examination

The nurse is caring for a female client who has received a diagnosis of fibrocystic breast disease. The nurse has instructed the client about the disease. The nurse determines that the client needs further instructions when the client says she should avoid drinking. A. regular coffee B. regular tea C. diet colas D. grapefruit juice

D. grapefruit juice

Elevated sebaceous glands, known as Montgomery glands, are located in the breast's A. Nipples B. Hair follicles C. Lactiferous ducts D. Areolas

D. Areolas

Fibrous tissue that provides support for the glandular tissue of the breasts is termed A. Lateral ligaments B. Wharton ligaments C. Pectoral ligaments D. Cooper ligaments

D. Cooper ligaments

The size and shape of the breasts in females are related to the amount of A. Glandular tissue B. Fibrous tissue C. Lactiferous ducts D. Fatty tissue

D. Fatty tissue

The nurse is working with a community group to set up teaching programs to increase awareness among African American women about preventive screening techniques for breast cancer. In the teaching program, the nurse should plan to include A. local female physicians who work with cancer clients B. hospital clinic workers from various racial backgrounds C. nurses who work in outpatient centers D. breast cancer patients of the same race

D. breast cancer patients of the same race

The nurse is caring for an adult female client when the client tell the nurse that she has had a clear discharge from her nipples for the past month. The nurse should ask the client if she has been taking A. antidepressants B. antibiotics C. insulin D. contraceptives

D. contraceptives

A client has had a recent mastectomy and visits the clinic for a postoperative evaluation. The client tells the nurse that she has been depressed and feels as if she is less of a woman. The most appropriate nursing diagnosis for this client is A. ineffective individual coping related to mastectomy B. fear of additional breast cancer related to the presence of risk factors C. PC: hematoma after mastectomy D. disturbed body image related to mastectomy

D. disturbed body image related to mastectomy

The nurse plans to instruct an adult female client with regular menstrual cycles, who is not taking oral contraceptives, about breast self-examination. The nurse should plan to instruct the client to perform breast self-examination A. during menstruation B. on the same day every month C. midway between the cycles D. right after menstruation

D. right after menstruation

A nurse becomes suspicious that a patient may have breast cancer based on which abnormal finding? a. An irregularly shaped hard mass in one breast b. Bilateral, small, nontender nodes close to the surface c. Multiple rubbery-feeling lumps with well-defined borders d. A mobile, firm lump located in the upper outer quadrant of the left breast

a. An irregularly shaped hard mass in one breast

During a breast examination of a male patient, the nurse recognizes which finding as normal? a. Bilateral nontender flat breasts with symmetric nipple and areolar areas b. A fibrous layer of subcutaneous breast tissue that is thicker than in women c. Breast tenderness on the dominant side but not on the other side d. Bilateral symmetry of breasts with absence of hair in the areolar areas

a. Bilateral nontender flat breasts with symmetric nipple and areolar areas

A nurse performing a breast examination on a female patient places the patient in a supine position, places a pillow under the right shoulder, and asks the patient to place her right lower arm above her head. What is the reason for this position? a. Flatten the breast tissue evenly over the chest wall. b. Help the patient to relax and feel more comfortable. c. Reveal lumps deep in the breast more easily. d. Expose any drainage from the nipples.

a. Flatten the breast tissue evenly over the chest wall

A nurse is performing a breast examination of a patient who complains of pain in both breasts that occurs around the time of her menstrual period. The nurse expects which findings during the breast examination? a. Masses in the breasts that are round, soft, mobile, and well-delineated b. Masses in the breasts that are round, firm, mobile, and well-delineated c. Masses in the breasts that are irregular, hard, and fixed d. Breast tissue that is red, edematous, tender, and warm to the touch

a. Masses in the breasts that are round, soft, mobile, and well-delineated

Based on the history, a nurse determines that the patient with which finding requires further assessment? a. Occasional discharge from nipples b. Supernumerary nipples along the milk line c. Rash in the axillae associated with change in deodorant d. Mild breast swelling that fluctuates with the menstrual cycle

a. Occasional discharge from nipples

Which statement by a 40-year old man would be most indicative of possible breast cancer? a. "I had embarrassing breast enlargement when I was a teenager." b. "I think I felt a hard spot in my left breast, but it does not hurt." c. "My right breast has always been a little smaller than the left." d. "My father's breasts got larger after he was older."

b. "I think I felt a hard spot in my left breast, but it does not hurt."

In a presentation on breast cancer risk factors, a nurse would be accurate in making which statement? a. "Women who breastfeed their children are at increased risk of breast cancer." b. "Women who are more than 30% overweight are at increased risk of breast cancer." c. "African American women have the highest risk of breast cancer." d. "Women who have children before age 30 are at increased risk of breast cancer."

b. "Women who are more than 30% overweight are at increased risk of breast cancer."

In reviewing the charts of several patients in the clinic, a nurse recognizes which patient as being at highest risk of breast cancer? a. A woman who had her first child at age 26 b. A woman who reached menopause at age 58 c. A woman who breastfed all four of her children d. A woman who states that she reached menarche at age 14

b. A woman who reached menopause at age 58

What technique does a nurse use when performing a breast examination on a patient who has had a mastectomy? a. Excludes palpation of the axillary area where there was lymph node dissection b. Inspects and palpates both the operative and the nonoperative sides c. Avoids palpating the scar to prevent causing the patient any discomfort d. Palpates only the muscle tissue on the affected side

b. Inspects and palpates both the operative and the nonoperative sides

A patient had a left radical mastectomy last year. The nurse assesses for painless and nonpitting swelling of the arm on that side. Which complication of a mastectomy is the nurse assessing for? a. Infection b. Lymphedema c. Inflammation d. Lymphoma

b. Lymphedema

What is the purpose of asking a female to lean forward during the breast examination? a. To accentuate the Montgomery glands b. To observe for symmetry of the suspensory ligaments c. To compare nipple symmetry d. To identify any breast masses in the subcutaneous tissues

b. To observe for symmetry of the suspensory ligaments

The nurse would give immediate attention to the patient who presents with which complaint? a. Bilateral breast swelling b. Unilateral nipple discharge c. A breast lump that changes during the menstrual cycle d. Unequal breast size

b. Unilateral nipple discharge

In teaching a patient about breast self-examination, why does the nurse emphasize palpation of the axillary areas? a. Because deep muscles in that area can mask changes b. Because some patients avoid this area because of tenderness c. Because most lymph draining from the breast flows through this area d. Because supporting ligaments in this area may present as tissue changes

c. Because most lymph draining from the breast flows through this area

When examining the lymph nodes of an adult female patient, the nurse recognizes which finding as normal? a. Visible superficial nodes b. Palpable supraclavicular nodes c. Nonpalpable lymph nodes in the axilla d. Enlarged, fixed nodes in the neck

c. Nonpalpable lymph nodes in the axilla

The nurse notices dimpling of the skin surrounding a palpable mass in the right breast of a female patient. What is the most appropriate action for the nurse to take next? a. Record this as an expected finding. b. Palpate the area of dimpling for pain. c. Palpate the borders of the area of dimpling for irregularity. d. Tell the patient that dimpling indicates the mass is benign.

c. Palpate the borders of the area of dimpling for irregularity

In assessing the breast of a male patient, the nurse places him in which position? a. Standing with hands over the head b. Supine with the hand on the side being examined placed behind the head c. Sitting with arms at the side d. Bending forward 45 degrees at the waist

c. Sitting with arms at the side

During a breast examination of a healthy female, the nurse recognizes which finding as normal? a. Asymmetrical venous pattern b. Unequal nipple size c. Supernumerary nipples along the milk line d. Pink discharge from one nipple when manipulated

c. Supernumerary nipples along the milk line

In assessing a patient with lymphedema after a mastectomy, the nurse expects which finding? a. Fragile, thin, pale skin covering the area of lymphedema b. Several brownish-red discolorations in the center of the affected arm c. Unilateral nonpitting edema of the affected arm d. Pitting edema of affected arm

c. Unilateral nonpitting edema of the affected arm

While giving a presentation about breast health, a nurse informs patients about which recommendation? a. Women in their 30s should have annual clinical breast examinations. b. Women at high risk of breast cancer should have semiannual mammograms. c. Women who are postmenopausal require clinical breast examination every 5 years. d. A screening mammogram is recommended for all women beginning at age 50 years.

d. A screening mammogram is recommended for all women beginning at age 50 years.

What instructions does the nurse give a female patient when she is learning to perform breast self-examination? a. Press the pads of the fingers firmly to compress breast tissue against the rib cage. b. Lie in front of a mirror and observe for dimpling of the skin. c. Lift the fingers from the chest wall during palpation to better define the breast tissue. d. Apply gentle pressure while moving the fingers in a pattern across the breast.

d. Apply gentle pressure while moving the fingers in a pattern across the breast

A patient comes to the clinic because she found a mass in her left breast that is present during and after her menstrual periods. On palpation the nurse finds a mass in the left breast that is round, rubbery, mobile, and nontender. This finding is consistent with which breast disorder? a. Fibrocystic breast disease b. Invasive breast cancer c. Mastitis d. Fibroadenoma

d. Fibroadenoma

A patient comes to the clinic complaining of a new onset of nipple discharge. After inspection of the breast and discharge, what action of the nurse has the highest priority? a. Palpating both breasts comparing amount of discharge b. Asking the patient about breast pain c. Asking the patient to raise her arms and comparing the movement of the breasts d. Obtaining a specimen of the discharge for cytology

d. Obtaining a specimen of the discharge for cytology

Which technique does a nurse use to palpate the patient's axillary lymph nodes? a. With the patient sitting, the nurse places fingers of both hands deep into the axilla, one hand on either side, and firmly pushes the axillary tissue toward the center to feel for enlarged nodes. b. With the patient lying supine with arms at the sides, the nurse uses the tips of the fingers of one hand to palpate the axilla moving from the posterior to the anterior aspect of the axilla to feel for enlarged nodes. c. With the patient lying supine with the hand behind the head of the side being assessed, the nurse uses the pads of fingers of one hand to systematically palpate the axilla using small circular motions to feel for enlarged nodes. d. With the patient sitting, the nurse places fingers of one hand deep into the axilla and firmly slides the fingers along the patient's middle, anterior, and posterior of the axilla to feel for enlarged nodes.

d. With the patient sitting, the nurse places fingers of one hand deep into the axilla and firmly slides the fingers along the patient's middle, anterior, and posterior of the axilla to feel for enlarged nodes.