Ricci Ch 6 PrepU

A female client is diagnosed with breast abscess. Although she has been allowed to breastfeed her newborn, she decides to terminate breastfeeding. Which action would be most appropriate in this situation? Encourage the client to include protein content in the diet. Instruct the client to wear a loose-fitting bra. Reduce the frequency of removing and reapplying the dressings. Assist the client to pump the breasts to remove breast milk.

Assist the client to pump the breasts to remove breast milk.

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 ovarian cancer lung cancer uterine cancer

breast cancer

A woman in her 20s or 30s with no symptoms or family history of breast cancer should have a clinical breast examination every _____ years.

3

At what age should a woman with no risk factors begin mammography screening for breast cancer?

40

After finding a breast mass on a routine examination and undergoing diagnostic studies, a woman is diagnosed with a fibroadenoma. The treatment plan focuses on watchful waiting. When would the nurse instruct the client to return for reevaluation? 3 months 6 months 9 months 1 year

6 months

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.

Arms resting at the sides Hands placed on the hips Arms raised over the head Standing with hands on hips, leaning forward

The nurse is caring for a client who states, "I felt a round, movable mass in my left breast." Which action will the nurse take next? Notify the health care provider. Assess the client's breasts. Ask the client when the mass was felt. Let the client know this sounds like a benign neoplasm.

Assess the client's breasts.

The nurse is teaching a client with mastitis about care measures. Which client statement indicates effective teaching? "I need to wear a breast shield to keep the area moist." "I can stop the antibiotic after 5 days." "I can use warm soaks to my breast to relieve the discomfort." "I should avoid pumping my breasts until the infection is cleared."

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

The nurse is caring for a 52-year-old woman whose sisters and mother died of breast cancer. The client states, "My doctor wants me to take tamoxifen to help prevent breast cancer. What do you think?" What would be the nurse's best response? "We call this drug a chemotherapy agent." "Tamoxifen prevents osteoporosis." "I would recommend raloxifene." "Tamoxifen reduces the incidence."

"Tamoxifen reduces the incidence."

A woman diagnosed with breast cancer is to undergo a lumpectomy followed by radiation therapy. When reviewing the treatment plan with the client, the nurse determines that the woman has understood the information based on which client statement? "I'll have a portion of my breast removed, and then they'll do high-dose radiation in the operating room." "After they remove the tumor and some of the normal tissue, I'll start radiation in about 2 to 4 weeks." "The radiation will be targeted to the area near my underarm to get at the lymph nodes." "After the lumpectomy, I'll have to wait about 6 months before I can begin to receive the radiation."

"After they remove the tumor and some of the normal tissue, I'll start radiation in about 2 to 4 weeks."

At a class for new mothers, the nurse notes that the participants need more teaching when one of the mothers makes which comment? "I have to stop breastfeeding because of mastitis." "I can use warm compresses to ease the discomfort." "Breastfeeding every four hours appears to help." "I have been using a breast pump after feeding my baby."

"I have to stop breastfeeding because of mastitis."

A nurse is teaching a woman who has undergone breast augmentation about developing breast awareness through breast self examination. The nurse determines that the teaching was successful based on which client statement? "I need to check my breast about 2 to 3 times a year." "My implants will feel the same as my normal breasts." "I should do the exam just like I was doing before the implants." "I need to press lightly to avoid breaking the implants."

"I should do the exam just like I was doing before the implants."

After teaching a client with mastitis about caring for her breasts, the nurse determines that the client has understood the instructions when she makes which statement? "I need to apply cold soaks to the breast several times a day." "I will express milk with a breast pump until infection is resolved." "I should avoid wearing a bra because it would increase the pain." "Until the infection is gone, I can't take a tub bath or shower."

"I will express milk with a breast pump until infection is resolved."

A client who has had a mastectomy is to undergo breast reconstruction with augmentation. After teaching the client about the procedure, the nurse determines that the teaching was successful based on which client statement? "The implants will be placed directly under my skin." "Once implanted, the implants are good for the rest of my life." "I'll use the same technique for breast self-exam as before." "My implants will feel softer than normal breast tissue."

"I'll use the same technique for breast self-exam as before."

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 give you greater visibility." "If you feel pain you will need to inspect it." "It will help to observe for dimpling." "Everyone is different in assessing the breast."

"It will help to observe for dimpling."

The nurse is caring for a client who reports having tender and painful breasts, often feeling multiple lumps within her breast tissue. Which statement made by the client requires clarification from the nurse? "I should limit fat and caffeine consumption in my diet." "This disorder places me at increased risk for breast cancer." "The timing of symptoms is related to my menstrual cycle." "I can use a heating pad to help with any pain in my breasts."

"This disorder places me at increased risk for breast cancer."

How should the nurse counsel a postpartum client on how to prevent mastitis? "Wash your hands thoroughly, and let your breasts dry after each feeding." "If you notice that your breast is warm, hard, or red, stop feeding on that side and pump from that breast instead." "Be sure to keep your breasts covered when you are not feeding or pumping." "Sterilize your bottles and pump equipment after each use."

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

When preparing a teaching plan for a woman with mastitis, the nurse would include which instruction? Cease breastfeeding to prevent transmission to the infant. Limit fluid intake to minimize swelling. Apply warm compresses to the affected breast. Avoid the use of a supportive bra to prevent pressure on the inflamed breast.

Apply warm compresses to the affected breast.

A young client desires to know her risk of developing breast carcinoma. She has a positive family history of breast carcinoma. The nurse would suggest that she should undergo which diagnostic test? BRCA-1 genetic marker DNA ploidy status digital mammography fine-needle biopsy

BRCA-1 genetic marker

When preparing for a class on breast cancer, the nurse should explain which nonmodifiable risk factors? Select all that apply. BRCA1 gene menarche at age 11 being a 52-year-old female failing to breastfeed infants high-fat dietary intake

BRCA1 gene menarche at age 11 being a 52-year-old female

Mammography is recommended for a client diagnosed with intraductal papilloma. Which factor should the nurse ensure when preparing the client for a mammography? Client has not consumed fluids 1 hour before testing. Client has not applied deodorant on the day of testing. Client is just going to start her menses. Client has taken an aspirin before the testing.

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? Apply warm compresses to the affected breast. Continue monthly breast self-examinations. Wear a supportive bra 24 hours per day. Refrain from consuming salt in diet.

Continue monthly breast self-examinations.

A client has undergone a mastectomy for breast cancer. Which instruction should the nurse include in the postoperative client teaching plan? Breathe rapidly for an hour. Elevate the affected arm on a pillow. Avoid moving the affected arm in any way. Restrict intake of medication.

Elevate the affected arm on a pillow.

A new mother who is breastfeeding her newborn comes to the clinic reporting sore breasts. Assessment reveals mastitis. Which instruction would the nurse include when teaching the client about this disorder? Stop breastfeeding the newborn for the next several days. Massage the breasts before and during breastfeeding. Wear a supportive bra at night when in bed. Limit the amount of fluids ingested for the next week.

Massage the breasts before and during breastfeeding.

A female client with metastatic breast disease is receiving trastuzumab as part of her immunotherapy. The client has nausea, fatigue, diarrhea, appears jaundice, and has a distended abdomen. What would the nurse do next? Notify the health care provider. Decrease the trastuzumab infusion rate. Assess the client's white blood cell count. Continue to monitor the client.

Notify the health care provider.

A client reports lumpy, tender breasts, particularly during the week before menses. She reports pain that often dissipates after the onset of menses. The nurse suspects the client has fibrocystic breast changes. Which should the nurse do next? Determine if the client has had a mammography. Have the client follow up in 1 week. Perform a breast examination. Schedule the client for cryoablation.

Perform a breast examination.

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? Chlamydia trachomatis group A streptococcus Escherichia coli Staphylococcus aureus

Staphylococcus aureus

A client with breast cancer is scheduled to undergo chemotherapy with aromatase inhibitors. Which explanation 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. They block progesterone-dependent tumors from growing. They attach to endogenous protein receptors to slow the growth of cancerous cells. They stimulate the immune system to attack a protein common in many tumors.

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

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? Avoid working in the garden or yard altogether. Wear gloves and protective clothing to avoid any injuries. Increase the frequency of follow-up visits if she does work. Avoid household chores for at least 6 to 9 months.

Wear gloves and protective clothing to avoid any injuries.

In which client would the nurse suspect cancer? a 45-year-old with thickening in one breast with nipple irritation and retraction and a pink discharge a 25-year-old with multiple small, round, and smooth lesions on both breasts that are painful during menstruation a 30-year-old with a mobile, rubbery, firm, well-circumscribed, nontender lump a 40-year-old with nipple retraction and a watery discharge

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

A 27-year-old lactating client presents with the report of a solid, painless lump in her left breast. On examination, the nurse notes that the lump is mobile and slightly tender to pressure. The nurse suspects this is: a fibroadenoma. an inflamed milk duct. mastitis. malignant mass.

a fibroadenoma.

A nurse is providing education to a woman about screening for breast cancer. The woman has no symptoms and no family history of breast cancer. Which recommendation would the nurse make based on the guidelines from the American Cancer Society? biennial mammography beginning at age 50 annual mammogram beginning at age 40 clinical breast exam starting at age 30 no breast self-exam

annual mammogram beginning at age 40

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 primary care provider. Which treatment would be most difficult for this woman? more aggressive chemotherapy left mastectomy radiation therapy bilateral mastectomy

bilateral mastectomy

A nurse is working at a cancer treatment center and is developing programs for specific ethnic groups related to breast cancer. The nurse would target which ethnic group because it has the highest breast cancer mortality rate in the United States? black client Hispanic client white client Native American/First Nations client

black client white women have highest incidence of getting breast cancer but black women have higher incidence of dying from breast cancer

A client diagnosed with breast cancer is receiving chemotherapy. The nurse assesses the client for possible side effects of this therapy. Which side effect would the nurse report immediately to the health care provider? diarrhea nausea stomatitis bone marrow suppression

bone marrow suppression

During a routine assessment, a client reports to the nurse a new lump in her right breast and occasional nipple pain. The client has a family history of breast cancer. The nurse will anticipate preparing the client for which procedure first? mammogram breast examination fine-needle aspiration biopsy right breast ultrasound

breast examination

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 sign? peau d'orange skin breast symmetry nipple retraction painless mass

breast symmetry

A nursing diagnosis of Risk for impaired tissue integrity would be most appropriate for which client? client with endometriosis client taking oral contraceptives client with a vaginal packing in place client having reconstructive breast surgery

client having reconstructive breast surgery

Which action would the nurse include in the plan of care for a client diagnosed with breast cancer who has undergone a mastectomy? counseling the client to apply elastic sleeves to her arms instructing client to use arm pumps applying ace bandages to the arms encouraging the client to perform arm exercises

encouraging the client to perform arm exercises

The nurse is reviewing the history and physical exam of a woman who has come to the clinic for a routine physical. Which factor would the nurse identify as increasing the client's risk for breast cancer? 39 years of age Asian race menarche at age 14 history of ovarian cancer

history of ovarian cancer

A nurse is conducting a presentation on breast cancer for a local women's group and explaining the possible risk factors associated with its development. The nurse determines that the group has understood the information when they identify which factor as increasing a woman's risk for breast cancer? having children before the age of 30 years exposure to pelvic radiation early onset of menopause early menarche

early menarche

The health care provider has just informed the client that her breast biopsy is positive for carcinoma. One of the nurse's first responsibilities is to assist with: education. treatment. psychiatric issues. telling the client her options.

education

A nurse is assigned to educate a group of adolescent women on cancer awareness. Which risk factor(s) for breast cancer is modifiable? Select all that apply. failing to breastfeed for up to a year after pregnancy early menarche or late menopause postmenopausal use of estrogen and progestins not having children until after age 30 previous abnormal breast biopsy

failing to breastfeed for up to a year after pregnancy postmenopausal use of estrogen and progestins not having children until after age 30

What is the most common breast mass in women? fibroadenoma mastitis intraductal papilloma duct ectasia

fibroadenoma

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

invasive ductal carcinoma

What is the most common type of breast cancer, accounting for approximately 85% of cases? invasive ductal carcinoma invasive lobular carcinoma tubular carcinoma medullary carcinoma

invasive ductal carcinoma

A client has been diagnosed with in situ breast carcinoma. The nurse explains that this means: it is noninvasive and has not extended beyond the point of origin. the cancer has moved into the surrounding tissues. the cancer is located strictly in the ductal system. the cancer has spread to the lymph system.

it is noninvasive and has not extended beyond the point of origin.

A client comes to the women's health clinic for a follow-up visit. During the visit, the client says, "I've heard about all these foods that are supposed to have cancer fighting properties. Which foods are these?" The nurse would most likely include which foods in the response? Select all that apply. leeks fresh tomatoes cabbage carrots almonds

leeks cabbage carrots

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 complication? lymphedema fibrocystic breast disease fibroadenoma breast abscess

lymphedema

A nurse is preparing a presentation for a health fair about preventing breast cancer. Which suggestion would the nurse include? delaying having children until after age 30 maintaining an ideal weight opting for estrogen-only replacement therapy during menopause increasing the intake of caffeinated drinks

maintaining an ideal weight

The nurse is preparing a client for breast biopsy of a lump. The nurse explains that a needle with a cutting edge will be inserted into a lump and rotated to remove a core sample. What type of breast biopsy is this client undergoing? aspiration needle biopsy excisional biopsy incisional biopsy

needle biopsy

A woman is scheduled to undergo a modified radical mastectomy. Which information would the nurse include when describing this surgery to the client? the resulting concave appearance of the anterior chest sparing of the pectoral muscles and axillary lymph nodes wide excision of the tumor along with a 1-cm margin of normal tissue removal of breast tissue and axillary nodes

removal of breast tissue and axillary nodes

Which finding would the nurse expect when assessing the breasts of a client with fibrocystic breast disease? nipple retraction soft mass enlarged lymph nodes skin dimpling

soft mass

A breast tumor is most likely found in what part of the breast? the upper outer quadrant near the nipple at the areola the upper inner quadrant

the upper outer quadrant

A nurse is providing care to a client diagnosed with stage II breast cancer. Which finding would the nurse interpret as characteristic of this stage? tumor that is localized in the early stages tumor that is about 0.75 inch (1.9 centimeters) in diameter tumor that is about 1.5 inches (3.8 centimeters) in diameter with positive lymph nodes tumor that has metastasized to other organs

tumor that is about 1.5 inches (3.8 centimeters) in diameter with positive lymph nodes Stage II breast cancer is characterized by a tumor that is 1 to 2 inches (2.5 to 5.1 centimeters) in diameter and spreads to axillary lymph nodes. Stage I breast cancer is characterized by a localized tumor, less than 1 inch (2.5 centimeters) in diameter. Stage IV breast cancer is characterized by a tumor that has metastasized to other body organs.

As part of a presentation on breast cancer being given to a local woman's group, the nurse describes the need for early detection through screening. Applying the guidelines from the American Cancer Society, the nurse would emphasize which recommendation? yearly mammograms for women starting at age 40 clinical breast examinations every 2 years for women over age 30 breast self-examination at least yearly for women over age 20 mammograms every 3 years for women between the ages of 20 and 39 years

yearly mammograms for women starting at age 40