Breast and Testicular Evolve EAQ Chap 70 & 72

A nurse is preparing to discharge a patient with fibrocystic breast condition. What instructions does the nurse include for the patient to help alleviate symptoms? Select all that apply.

"Apply ice to the breasts." "Decease caffeine intake." "Wear a supportive bra to bed." Education on self-management of fibrocystic breast condition should include applying ice to the breasts for pain relief, decreasing caffeine intake and other stimulants, and wearing a supportive bra to reduce pain by decreasing tension on the ligaments. Patients may apply heat to relieve symptoms of fibrocystic breast condition. Analgesics should be used for pain relief for women with fibrocystic breast condition.

A patient with a fibroadenoma is concerned about being scheduled for a needle aspirate. How should the nurse respond to the patient?

"It is done to determine if the mass is fluid-filled or solid."

When should a female patient consider a reduction mammoplasty for large breasts? Select all that apply.

Chronic backaches occur Well-fitting bras do not help Weight is within normal limits A reduction mammoplasty may be indicated if a large-breasted patient has backaches unrelieved by well-fitting bras and is within normal body weight. Breastfeeding issues would not be corrected by reduction mammoplasty. Although it may be difficult to purchase clothing, this is not a primary reason for reduction mammoplasty.

A nurse is educating a patient diagnosed with a fibroadenoma. Which statement by the patient indicates to the nurse that teaching was effective regarding self-examination of the breasts?

Correct "I will feel a rubbery, oval, mobile lump." A patient with a fibroadenoma will feel an oval-shaped, freely mobile, rubbery mass on clinical examination. Multiple painful lumps in the breast upon palpation is characteristic of a fibrocystic breast condition. A painful, large, red lump is characteristic of a fibrocystic breast condition. An oddly shaped mass with nipple discharge is characteristic of ductal ectasia.

The nurse is educating a group of young men about testicular self-examination (TSE). Which statement by a member of the group indicates teaching has been effective?

Correct "I will look and feel for any lumps or changes to my testes." With early detection by monthly testicular self-examination (TSE) and treatment, testicular cancer can be successfully cured. In TSE, the patient should look and feel for any lumps or changes to the testes. Any lumps that are detected should be immediately reported. A testicular exam should be performed immediately following a shower. The patient should gently roll each testicle between the thumb and forefinger. All lumps should be reported to the provider, no matter the size.

A patient scheduled for breast augmentation surgery asks if dressing changes will need to be done. How should the nurse respond to this question?

Correct "It depends on the surgeon's preference." The incisions may or may not have dressings depending on the surgeon and type of surgery. Not all surgical procedures have dressings; however, it would not be correct to say that dressings are not used after with breast augmentation surgery. The nurse does not know if the patient will have a postoperative dressing, and saying that home care will be required is premature.

A patient with a fibroadenoma is concerned about being scheduled for a needle aspirate. How should the nurse respond to the patient?

Correct "It is done to determine if the mass is fluid-filled or solid." For a fibroadenoma, the health care provider may perform a needle aspiration to establish whether the lump is cystic (fluid-filled) or solid. Radiation is not used to treat a fibroadenoma. Fibroadenoma is not breast cancer. Chemotherapy is not used to treat a fibroadenoma.

A patient elects to have breast augmentation surgery to improve the symmetry of her breasts. What should the nurse include in the discharge teaching after the procedure?

Correct Abnormal findings of breast self-examination An important issue for patients who have breast augmentation surgery is breast cancer surveillance. Breast self-examinations can still be performed because the prosthesis is placed behind the woman's normal breast tissue. Stroke symptoms, liver disease signs and symptoms, and signs of increased intracranial pressure should be taught to a patient receiving hormonal drug therapy for fibrocystic breast condition.

A patient is undergoing a diagnostic workup for suspected testicular cancer. Which serum tumor marker is indicative of testicular cancer?

Correct Alpha-fetoprotein (AFP) The serum tumor marker AFP is used to confirm the diagnosis of testicular cancer. It is also used to evaluate the response to therapy and detect residual or recurring testicular cancer. Luteinizing hormone is secreted from the pituitary gland and stimulates the Leydig cells to produce testosterone. Serum alkaline phosphatase levels are increased in bone disorders or bone metastasis and are not indicative of testicular cancer. Elevated levels of serum acid phosphatase are indicative of prostate cancer rather than testicular cancer.

The nurse suspects that a female patient has developed an intraductal papilloma. What finding did the nurse use to make this clinical determination?

Correct Bloody nipple discharge An intraductal papilloma is a benign papilloma that grows in the epithelial lining of the duct. The growth of the tissue causes trauma, leading to bloody nipple discharge. A mass is rarely palpable with an intraductal papilloma. Edematous axillary nodes and green brown drainage are associated with ductal ectasia.

After a mammogram, a patient is scheduled for a breast ultrasound. For which health problem(s) are this patient being evaluated? Select all that apply.

Correct Breast cancer Fibroadenoma Fibrocystic breast condition In a fibrocystic breast condition (FBC), breast ultrasound is used to confirm the presence of a cyst or fibroadenoma. Breast ultrasound in the diagnosis of breast cancer if the breast tissue is dense. Microscopic examination of nipple discharge is used to determine the presence of ductal ectasia and intraductal papilloma.

What symptoms can result from noncancerous changes to breast tissue in the patient with a benign breast disorder?

Correct Breast lumps, breast pain, nipple changes In benign breast disorders, noncancerous changes to breast tissue result in breast lumps, breast pain, and nipple changes. Lymphedema is an abnormal accumulation of protein fluid in the subcutaneous tissue of the affected limb after a mastectomy and is not a symptom of a benign breast disorder. In malignant breast cancer, fibrosis develops around the cancer and causes a shortening of the Cooper ligament, resulting in skin dimpling that is seen in with more advanced disease. Orange peel skin is a common sign of late-stage breast cancer.

A nurse teaching a group of young female patients about performing breast self-examinations describes the types of benign breast disorders common among young women. Which benign breast disorder is described as a solid mass of connective tissue that is unattached to the surrounding tissue?

Correct Fibroadenoma A fibroadenoma is defined as a solid mass of connective tissue that is unattached to the surrounding tissue. Ductal ectasia is a hard, irregular mass with nipple discharge, enlarged axillary nodes, redness, and edema. Gynecomastia is the enlargement of a man's breasts. A patient with a fibrocystic breast condition has breast pain and tender lumps that are rubbery, ill defined, and commonly found in the upper outer quadrant of the breast.

During an annual wellness check, a 21-year-old female patient states, "I experience a lot of pain in my breasts right before my menstrual cycle begins. When my cycle is over, the pain goes away, but then it returns during the next cycle." Which benign breast disorder is the patient most likely experiencing?

Correct Fibrocystic breast condition The patient is most likely experiencing fibrocystic breast condition because the breast pain is noticeable before the menstrual period and subsides after menstruation. Ductal ectasia symptoms include a hard, irregular mass or masses and nipple discharge. Fibroadenoma is a solid mass of connective tissues that is unattached to the surrounding tissue. Intraductal papilloma results in nipple discharge, and a mass is usually not palpable.

The nurse notes the presence of skin excoriation under the breasts of an obese female patient. What does the nurse suspect is causing this skin breakdown?

Correct Fungal infection Large-breasted women may develop fungal infections under the breasts, especially in hot weather, because it is difficult to keep this area dry and exposed to air. An ill-fitting bra is not identified as causing skin excoriations. Poor personal hygiene would cause additional skin changes and not just under the breasts. Inadequate protein intake would impact wound healing; however, it is not enough information to determine if this patient's protein intake is inadequate.

The nurse is obtaining the health history of a patient suspected of having testicular cancer. What risk factors are associated with testicular cancer? Select all that apply.

Correct History of cryptorchidism Infection with human immune deficiency virus (HIV) Family history of testicular cancer in a close male relative The risk factors associated with testicular cancer are the presence of cryptorchidism and HIV infection. Testicular cancer also runs in families; close male relatives, brothers, or identical twins of a patient are more at risk of developing testicular cancer. Frequent chlamydial infections may cause epididymitis, not testicular cancer. The presence of mutation in the GST P1 gene is a risk factor for prostate cancer, not testicular cancer.

What postoperative complications are associated with pain and fever in a patient recovering from breast augmentation surgery? Select all that apply.

Correct Implant leakage Wound infection The postoperative complications of pain and fever after breast augmentation surgery are caused by infection and implant leakage. Breast edema, nipple discharge, and swollen axillary nodes are not postoperative complications after breast augmentation surgery.

The patient scheduled for a mammogram reveals she has had breast augmentation surgery. Which diagnostic test for breast cancer should be used instead?

Correct Mammogram with displacement views For the patient with breast augmentation additional breast x-rays during mammography may be used to examine the breast tissue more completely. Breast ultrasound and CT scans of the chest are not used to diagnose breast cancer in a patient with breast augmentation. MRI is not indicated in this patient.

Which approach is used to treat a patient with a fibrocystic breast condition (FBC)?

Correct Manage symptoms Management of a fibrocystic breast condition (FBC) focuses on the symptoms of the condition. Management is not focused on eliminating the cysts. There is no reason to improve circulation. FBC does not affect functioning.

What teaching should a patient with breast augmentation receive about breast self-examination (BSE)?

Correct Perform BSE as usual After breast augmentation surgery, breast self-examination (BSE) can still be performed because the prosthesis is placed behind the woman's normal breast tissue pushing it forward. BSE does not need to be avoided. There is no reason for BSE to be performed in a standing position. BSE should be performed monthly and not just a few times a year.

Which type of malignancy grows slowly?

Correct Prostate cancer Prostate cancer grows very slowly and metastasizes in a predictable pattern. Lung cancer, kidney cancer, and pancreas cancer grow at a faster rate.

Which glycoprotein is produced by the prostate gland?

Correct Prostate-specific antigen glycoprotein Prostate-specific antigen is a glycoprotein produced by the prostate gland. Biliary glycoprotein is a cell adhesion glycoprotein expressed in the colon, liver, and hematopoietic tissues. The lungs produce airway glycoprotein. Erythropoietin, also known as EPO, is a glycoprotein hormone that controls erythropoiesis, or red blood cell production, and is produced in the kidneys.

Which body system should be assessed in a male patient who has developed excessive breast tissue?

Correct Reproductive Excess breast tissue or gynecomastia in males can be a result of a primary cancer such as testicular cancer. The patient's reproductive system should be assessed. Gynecomastia is not associated with the cardiovascular, gastrointestinal, or musculoskeletal systems.

A patient with prostate cancer is being evaluated for metastasis. Which laboratory test indicates possible bone metastasis?

Correct Serum alkaline phosphatase Serum alkaline phosphatase levels are increased in bone disorders and are indicative of possible bone metastasis in prostate cancer. PSA, serum acid phosphatase, and EPCA-2 levels are increased in prostate cancer and are also used to monitor the progression of this cancer.

The issue that is often foremost in the minds of men who have been diagnosed with prostate cancer and must be addressed by the nurse is the alteration of which factor?

Correct Sexual function after treatment Altered sexual function is one of the biggest concerns of men after cancer treatment. Comfort, mobility, and nutrition are important but are typically not the foremost concern in the minds of men with prostate cancer.

A patient with fibrocystic breast condition is beginning hormonal drug therapy. What risks associated with hormonal drug therapy should the nurse teach the patient to recognize? Select all that apply.

Correct Stroke Liver disease Increased intracranial pressure The nurse should teach the patient to recognize signs and symptoms of stroke, liver disease, and increased intracranial pressure. These are complications of hormonal drug therapy for fibrocystic breast condition. Diabetes mellitus and congestive heart failure are not complications associated with hormonal drug therapy for fibrocystic breast condition.

What is the major androgen found in the adult male?

Correct Testosterone Testosterone is the major androgen (male hormones) found in the adult male. Estrogen and progesterone are major female hormones. Androstenedione is a precursor to both male and female hormones.

What is the usual presenting symptom for testicular cancer?

Hard, painless mass Malignant testicular tumors are not painful and are not fluid-filled swellings, although a swelling may be present. The epididymis is not easily palpated with testicular cancer.

Which approach used to treat a patient with a fibrocystic breast condition (FBC)?

Manage symptoms Management of a fibrocystic breast condition (FBC) focuses on the symptoms of the condition. Management is not focused on eliminating the cysts. There is no reason to improve circulation. FBC does not affect functioning.

What is the second most common type of cancer found in men in the world?

Prostate cancer Prostate cancer is the second most common type of cancer found in men in the world. Kidney cancer is the fifth most common type of cancer found in men in the world, lung cancer is the first most common type of cancer, and pancreatic cancer is the third most common type of cancer found in men in the world.