Chapter 51: Breast Disorders
Which patient statement indicates that the nurse's teaching about tamoxifen has been effective?
"I will call if I have any eye problems."
The nurse provides discharge teaching for a 61-yr-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
When the nurse is working in the women's health care clinic, which action is appropriate to take?
Teach a 28-yr-old patient with a BRCA-1 mutation about magnetic resonance imaging (MRI).
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
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.
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.
The nurse notes bilateral enlargement of the breasts during examination of a 62-yr-old male patient. Which action should the nurse take first?
Question the patient about current medications
Which nursing action should be included in the plan of care for a patient returning to the surgical unit after a left modified radical mastectomy with dissection of axillary lymph nodes?
Post a sign at the bedside warning against venipuncture or blood pressures in the left arm.
The nurse is providing preoperative teaching about the transverse rectus abdomin is musculocutaneous (TRAM) procedure to a patient. Which information will the nurse include?
Recovery from the TRAM surgery takes at least 6 to 8 weeks
Which assessment finding in a 36-yr-old patient is most indicative of a need for further evaluation?
A breast nodule that is 1 cm in size, nontender, and fixed
Which information will the nurse include in patient teaching for a 36-yr-old patient who is scheduled for stereotactic core biopsy of the breast?
A local anesthetic will be given before the biopsy specimen is obtained
A 36-yr-old patient who has a diagnosis of fibrocystic breast changes calls the nurse in the clinic reporting symptoms. Which information is likely to change the treatment plan?
An area on the breast is hot, pink, and tender to the touch.
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
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
During a well-woman physical examination, a 43-yr-old patient asks about her risk for breastcancer. Which question is most pertinent for the nurse to ask?
At what age did you start having menstrual periods?"
A 33-yr-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
A 51-yr-old patient with a small immobile breast lump is considering having a fine-needleaspiration (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.
A 58-yr-old woman tells the nurse, "I understand that I have stage II breast cancer and I needto 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
A 53-yr-old woman who is experiencing 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
After a 48-yr-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
The nurse will anticipate teaching a patient who is diagnosed with lobular carcinoma in situ (LCIS) about
tamoxifen
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
The nurse is caring for a patient with breast cancer who is receiving chemotherapy with doxorubicin and cyclophosphamide. Which assessment finding is most important to communicate to the health care provider?
The patient's apical pulse is irregular
Tell me what you understand about the surgical options that are available
he patient should call if she notices ankle swelling
The nurse teaching a young women's community service group about breast self-examination (BSE) will include that
performing BSE after the menstrual period is more comfortable.
A patient diagnosed with breast cancer asks the nurse what "triple negative" means. Anaccurate response from the nurse about triple-negative breast cancer should include that
the tumor is not likely to be responsive to hormone therapy.
