Ch 6: Disorders of the Breasts

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

A) Apply warm compresses to the affected breast. Warm compresses are soothing and help reduce inflammation. Breastfeeding is encouraged with mastitis to ensure continued emptying of the breast. Fluid intake is encouraged to promote milk production and resolution of infection. Wearing a supportive bra 24 hours a day is necessary to support the breasts.

A nurse is reviewing the medical records of several female clients. The nurse would identify a woman with which body mass index as being at increased risk for breast cancer? A) 21 B) 27 C) 25 D) 23

B) 27 Being overweight or obese is a risk factor for breast cancer in postmenopausal women. Research suggest that women keep a maximum body mass index of 25. Therefore a woman with a BMI of 27 would have an increased risk.

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? A) Schedule the client for cryoablation. B) Perform a breast examination. C) Have the client follow up in 1 week. D) Determine if the client has had a mammography.

B) Perform a breast examination. To determine if the client is experiencing fibrocystic breast changes, the nurse must first examine the client's breasts. It is not important to know if the client has a mammography at this time. Cryoabation is done to remove a tumor.

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? A) infiltrating ductal carcinoma B) invasive ductal carcinoma C) medullary carcinoma D) inflammatory breast cancer

B) invasive ductal carcinoma The most common malignancy is invasive ductal carcinoma (85%), followed by infiltrating ductal carcinoma (75%), tubular carcinoma, colloid carcinoma, medullary, and inflammatory breast cancer, the rarest but most aggressive form of breast cancer.

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? A) Caucasian B) Hispanic C) African American D) Native American

C) African American Although the incidence of breast cancer is highest in Caucasians, African American women have a higher breast cancer mortality rate at every age and a lower survival rate than any other racial or ethnic group.

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? A) "I know a great support group you can join." B) "I'm sure you are going to be fine. You are in great hands." C) Listen to the woman talk, and remain silent for a while D) "You'll beat this thing, I know it. You are very strong."

C) Listen to the woman talk, and remain silent for a while When a woman first receives the devastating news of the diagnosis of cancer, most often the best response is to allow the woman to express her feelings and concerns before speaking. Giving her false reassurances is not therapeutic and can break reliability and trust in a provider/patient relationship. Attempting to give her information about groups or next steps before she is in a state to take it in is also nontherapeutic.

The primary 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: A) telling the client her options. B) psychiatric issues. C) education. D) treatment.

C) education. The primary care provider will ultimately be responsible for treatment and deciding the client's options. The nurse will assist by helping the woman to prioritize the voluminous amount of information given to her so she can make informed decisions. The nurse should prepare an individual packet of information and review it with the client.

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? A) clinical breast examinations every 2 years for women over age 30 B) mammograms every 3 years for women between the ages of 20 and 39 years C) yearly mammograms for women over age 40 D) breast self-examinations at least yearly for women over age 20

C) yearly mammograms for women over age 40 The American Cancer Society recommends yearly mammograms for women over age 40. Clinical breast examinations are recommended every year starting at age 40. According to the American Cancer Society Breast Cancer Screening Guidelines, breast self-examination is optional.

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

D) Elevate the affected arm on a pillow. When providing care to the client, the nurse should instruct the client to elevate the affected arm on a pillow. As part of the respiratory care, the nurse should instruct the client to turn, cough, and breathe deeply every 2 hours; rapid breathing is not encouraged. Active range-of-motion and arm exercises are necessary. To counter any pain experienced by the client, analgesics are administered as needed; intake of medication is not restricted.

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 suspect first? A) duct ectasia B) inflammatory breast cancer C) intraductal papilloma D) mastitis

D) mastitis These symptoms most closely resemble mastitis. Mastitis usually occurs in the postpartum period while the woman is still breastfeeding. Mastitis is usually unilateral and is seen as a red, painful breast with elevated temperature and flu-like symptoms.