Nursing Breast Cancer

The nurse provides education to a patient with breast cancer about how to prevent side effects associated with tamoxifen. What should the nurse include in the teaching?

Eat flaxseeds regularly (for omega 3 to reduce menopausal s/s)

The nurse is instructing a patient with breast cancer who will be undergoing chemotherapy about the side effects of doxorubicin. Which side effect does the nurse instruct the patient to report to the health care provider?

Edema

The nurse is caring for a patient to be discharged the same day after a modified radical mastectomy. What does the nurse teach the patient?

Elevate the affected arm on a pillow.

What postoperative care is most appropriate for a patient who has undergone modified radical mastectomy in the right breast?

Elevating the head of the bed at least 30 degrees

What type of self-care is required from the patient after breast cancer surgery?

Emptying the drain twice daily

The nurse is teaching a patient breast self-examination (BSE). Which instructions does the nurse include in teaching? Select all that apply.

"Apply pressure when palpating." "Perform palpation when lying down or while showering." "Stand in front of the mirror and inspect for any abnormalities."

The nurse is teaching postmastectomy exercises to a patient. Which statement made by the patient indicates that teaching has been effective?

"For the pulley exercise, I'll drape a 6-foot-long rope over a shower curtain rod or over the top of a door."

The nurse is discussing treatment options with a patient newly diagnosed with breast cancer. Which statement by the patient indicates a need for further teaching?

"Radiation will remove the cancer, so I might not need surgery."

A patient who has just been notified that the breast biopsy indicates a malignancy tells the nurse, "I just don't know how this could have happened to me." Which response by the nurse is best?

"Tell me what you mean when you say you don't know how this could have happened to you."

A 20-year-old woman with no family history of cancer asks the nurse when she should begin having a clinical breast exam (CBE). Which is the best response by the nurse?

"You need a CBE now and one at least every 3 years until you are 40."

A 32-year-old female patient tells a nurse that she thinks that she has a small lump in her left breast, and although her mother had breast cancer, she hesitates to seek medical care because she is probably too young to have breast cancer. What does the nurse tell the patient is true about breast cancer in younger women? Select all that apply.

"Younger women often present with more aggressive forms of the disease." "Genetic predisposition to breast cancer is a strong risk factor for younger women." "The number of cases of advanced breast cancer in younger women is increasing."

The nurse is providing post-procedure exercise education to a patient following a mastectomy. Arrange the steps in the order the nurse should teach the patient to perform exercises.

1. Have someone put a nail or hook at the top of the door 2. Drape a 6-ft-long rope over the top of a door 3. Grab the ends of the rope, one in each hand 4. Extend arms out to the sides until they are straight 5. Keep the arms straight 6. Pull down the left arm to raise the right arm as high as possible and vice versa

A 30-year-old woman presents to the clinic for an annual routine exam. Which patient characteristic indicates to the nurse that the patient has a moderate risk for developing breast cancer?

A mother and sister with breast cancer

The nurse is assessing a patient for the risk of breast cancer. What factor puts the patient at a high to moderate risk for breast cancer?

A mother with breast cancer

The nurse is instructing a patient on how to perform breast self-examination (BSE). Which techniques does the nurse include in teaching the patient about BSE? Select all that apply.

Ask the patient to demonstrate her own method of BSE Ensure that the setting in which BSE is demonstrated is private and comfortable

A patient is struggling with body image after breast cancer surgery. Which behavior indicates to the nurse that the patient is maladaptive?

Avoiding eye contact with staff

A patient has been prescribed an aromatase inhibitor to treat breast cancer. Which common side effect is most likely to occur?

Bone density loss

The patient is suspected to have breast cancer. The nurse anticipates preparing the patient for which procedure that is diagnostic for breast cancer?

Breast biopsy

When providing health education to a group of young African American women, which topic is most appropriate for the nurse to highlight?

Breast cancer

A patient is receiving trastuzumab, a type of targeted therapy, and doxorubicin, a type of chemotherapy, for breast cancer. What is the side effect of this combination therapy?

Cardiotoxicity

A patient is transferred to the surgical unit following a mastectomy. The nurse checks the patient's vital signs, neurological condition, and notes the number of drainage tubes and intravenous lines. The nurse finds that the area around the surgical incision is edematous. To determine the reason for the edema, which action should the nurse perform?

Check the drainage tubes for kinking or blockage

Which statement about ductal carcinoma in situ (DCIS) is accurate?

DCIS is an early noninvasive form of breast cancer.

A patient takes several medications as part of a treatment plan for breast cancer. The medication list includes trastuzumab. The patient presents to the emergency department with cardiotoxic effects, including excessive fatigue, shortness of breath, chronic cough, and edema. The nurse recognizes which drug, when taken with trastuzumab (Herceptin), is likely to cause the cardiotoxic effects?

Doxorubicin Trastuzumab, when taken with an anthracyclin such as doxorubicin, will cause cardiotoxic effects resulting in symptoms such as excessive fatigue, shortness of breath, chronic cough, and edema

Which complementary and alternative medicines may be effective for treating hot flashes in the patient undergoing radiation therapy for breast cancer? Select all that apply.

Flax seed Acupuncture Black cohosh

A patient is receiving chemotherapy treatment for breast cancer and asks for additional support for managing the associated nausea and vomiting. The patient is already receiving an IV antiemetic. Which complementary therapy does the nurse suggest?

Ginger

The patient undergoing breast cancer treatment reports mild nausea and tells the nurse she has heard of a supplement that may lessen the nausea. The nurse knows the patient is most likely talking about which supplement?

Ginger

Which clinical manifestation is associated with a diagnosis of breast cancer in a male patient? Select all that apply.

Gynecomastia Rash around the nipple Blood-stained nipple discharge Hard, painless subareolar mass

The nurse is assessing a patient at a well-woman exam. Which characteristic puts this patient at the highest risk factor?

High breast density

The patient was recently diagnosed with infiltrating ductal carcinoma. The nurse knows which statements about infiltrating ductal carcinoma are correct? Select all that apply.

It causes skin dimpling in advanced stages. It causes edematous thickening and pitting of breast skin. It involves replacing normal cells with connective tissue and collagen.

A patient is scheduled for a breast mammography. What is the purpose of this diagnostic test?

It reveals masses too small to be palpated by hand

A patient is receiving an aromatase inhibitor, a type of hormonal therapy, for breast cancer. Which drug does the nurse recognize as an aromatase inhibitor?

Letrozole Goserelin and leuprolide are luteinizing hormone-releasing hormone agonists Tamoxifen is a selective estrogen receptor modulator

A premenopausal patient diagnosed with breast cancer will be receiving hormonal therapy. The nurse anticipates that the health care provider will prescribe which medication for this patient?

Leuprolide luteinizing hormone-releasing hormone (LH-RH) agonists that inhibit estrogen synthesis

Which action of a patient who is recovering from breast cancer surgery would alert the nurse that the patient may need help coping?

Looking in the mirror excessively

Which option for prevention and early detection of breast cancer is the option of choice for a patient with a high genetic risk?

Magnetic resonance imaging (MRI) and mammography every year beginning at age 30

Which statement about the early detection of breast masses is correct?

Mammography as a baseline screening is recommended by the American Cancer Society at 30 years of age

The nurse working in a breast cancer clinic knows that which statement about breast reconstruction surgery is correct?

Many women want breast reconstruction using their own tissue immediately after mastectomy

A charge nurse observes a new graduate nurse caring for a patient one day after the patient underwent a modified radical mastectomy of the left breast. Which action, if performed by the new graduate, would prompt the charge nurse to intervene immediately?

Measuring the patient's blood pressure on the left arm

A patient has undergone an elective oophorectomy because of her high risk of breast cancer. The nurse is aware this patient will likely experience which side effect of the treatment?

Menopause

A patient who had a modified radical mastectomy for cancer 8 hours ago has a Jackson-Pratt drainage tube in place. What is the priority for care of the patient at this time?

Monitor the amount and color of drainage

The nurse is planning care for a patient who underwent a modified radical mastectomy. Which interventions should the nurse include in the patient's nursing care plan? Select all that apply.

Monitor the volume and amount of drainage. Observe the wound for signs of swelling or infection. Avoid using the affected arm for measuring blood pressure

Which action can the same-day surgery charge nurse delegate to an experienced unlicensed assistive personnel (UAP) who is helping with the care of a patient who is having a breast biopsy?

Monitor vital signs after surgery

The nurse observes that a female patient defers to her husband for all decisions regarding her treatment for recently diagnosed breast cancer, as that is traditional in their culture. To which group does the patient most likely belong?

Nigerian

Which patient has the highest risk for breast cancer?

Older adult woman with high breast density

A patient has undergone breast reconstruction surgery. What information is important for the patient to know in the postoperative period?

Optimal appearance occurs after 3 to 6 months

Which patient being cared for on the medical-surgical unit will be best to assign to a nurse who has floated from the intensive care unit (ICU)?

Patient with a Jackson-Pratt drain who just arrived from the postanesthesia care unit (PACU) after a partial mastectomy

The nurse is teaching a patient how to correctly perform a breast self-examination (BSE). Which information should the nurse include in the teaching?

Perform palpation when lying down

The nurse is caring for a patient who had a lymph node dissection. What does the nurse teach the patient?

Perform reaching and stretching exercise only until the point of pain

Women belonging to which groups have the highest risk for developing triple negative breast cancer? Select all that apply.

Puerto Rican American Indian African American

A patient who recently had a mastectomy requests a volunteer to visit her home to discuss what to do next. Which community resource does the nurse recommend?

Reach to Recovery

A patient who has undergone breast surgery is struggling with issues concerning sexual intercourse. What is the best way for the nurse to address the patient's concerns?

Suggest that the patient wear a bra or camisole during intercourse

A postmenopausal patient is undergoing treatment for breast cancer. To decrease the patient's risk of osteoporosis, which drug should the nurse anticipate will be prescribed?

Tamoxifen

While caring for a patient who is recovering from breast cancer surgery, the nurse observes the patient's reaction to the surgical incision for assessment of what purpose?

The patient's coping skills

The nurse is performing a clinical breast examination (CBE) for a patient. What finding does the nurse report to the health care provider?

There is a discharge from the nipple

What cultural statistics of breast cancer must the nurse know in order to provide culturally-sensitive care?

Triple-negative breast cancer occurs more often in African-American women

What factors are considered low risk factors for breast cancer? Select all that apply.

Use of oral contraceptives Hormone replacement therapy

A community health nurse is teaching a group of young women about breast self-examination (BSE). Which instruction should be included in the teaching plan?

Women should conduct a BSE one week after their menstrual period