QUIZ: Breast Disorders
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.
A patient diagnosed with breast cancer asks the nurse what "triple negative" means. What should an accurate response from the nurse about triple-negative breast cancer include?
The tumor is not likely to be responsive to hormone therapy.
What information should the nurse include when teaching a young women's community service group about breast self-examination (BSE)?
Performing BSE after the menstrual period is more comfortable.
When the nurse is working in the women's health care clinic, which action is appropriate to take?
Teach a 34-yr-old patient with a BRCA-1 mutation about magnetic resonance imaging (MRI).
The nurse is providing preoperative teaching about the transverse rectus abdominis musculocutaneous (TRAM) procedure to a patient. Which information will the nurse include?
Recovery from the TRAM surgery takes at least 6 to 8 weeks.
The nurse is teaching a patient about breast self-examination. Which area on the accompanying illustration should the nurse identify as the area that most breast cancers are located? a. 1 b. 2 c. 3 d. 4 e. 5
A. 1 The upper outer quadrant is the location of most of the glandular tissue of the breast.
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 venipunctures or blood pressures in the left arm.
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.
After a 48-yr-old patient has had a modified radical mastectomy, the pathology report identifies the tumor as an estrogen-receptor positive adenocarcinoma. What topic should the nurse plan to teach the patient?
Tamoxifen
What topic should the nurse anticipate teaching a patient who is diagnosed with lobular carcinoma in situ (LCIS)?
Tamoxifen
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 needed.
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.
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.
A 51-yr-old patient with a small immobile breast lump is considering having a fine-needle aspiration (FNA) biopsy. What should the nurse explain as an advantage to this procedure?
FNA is done in the outpatient clinic, and results are available in 1 to 2 days.
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/VN)?
Giving an analgesic 30 minutes before scheduled arm exercises
Which question is most pertinent for the nurse to ask a 43-yr-old patient about her risk for breast cancer?
"At what age did you start having menstrual periods?"
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."
Which patient statement indicates that the nurse's teaching about tamoxifen has been effective?
"I will call if I have any eye problems."
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."
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."
A 58-yr-old woman tells the nurse, "I understand that I have stage 2 breast cancer and I need to 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."
The outpatient clinic receives telephone messages from four patients. Which patient should the nurse call back first?
A 50-yr-old patient with stage 2 breast cancer who is receiving doxorubicin and has ankle swelling and fatigue
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 when teaching a patient who is scheduled for stereotactic core biopsy of the breast?
A local anesthetic will be given before the biopsy specimen is obtained.
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.
What will the nurse teach a patient with metastatic breast cancer who has a new prescription for trastuzumab (Herceptin)?
The patient should call if she notices ankle swelling.
