Breast Cancer
A 25-year-old male develops a tumor of the breast glandular tissue. What type of tumor will be documented on the chart? A. Carcinoma B. Adenocarcinoma C. Sarcoma D. Lymphoma
B
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? A. FNA is done in the outpatient clinic, and results are available in 1 to 2 days. B. Only a small incision is needed, resulting in minimal breast pain and scarring. C. If the biopsy results are negative, no further diagnostic testing will be needed. D. FNA is guided by a mammogram, ensuring that cells are taken from the lesion.
A
A female patient complains of a "scab that just won't heal" under her left breast. During your conversation, she also mentions chronic fatigue, loss of appetite, and slight cough, attributed to allergies. What is the nurse's best action? A. Continue to conduct a symptom analysis to better understand the patient's symptoms and concerns. B. End the appointment and tell the patient to use skin protection during sun exposure. C. Suggest further testing with a cancer specialist and provide the appropriate literature. D. Tell her to put a bandage on the scab and set a follow-up appointment in 1 week.
A
A patient being evaluated for breast cancer is not certain whether she and her family should participate in a genetic screening plan since no one can guarantee the results. What is the nurse's best response? A. "If you have a family history of breast cancer, the chances for you to have this type of cancer increases." B. "The decision is up to you in the final analysis." C. "If there is no family history, then there is no need to go through the process." D. "If your insurance will pay for the screening, then there is no associated risk."
A
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? A. "Tell me what you think is important to know about the surgery." B. "It is essential that you know enough to provide informed consent." C. "Many patients do better after surgery if they have more information." D. "You can wait until after surgery for teaching about pain management."
A
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? A. The tumor is not likely to be responsive to hormone therapy. B. Treatment with chemotherapy is not likely to be recommended. C. HER-2 receptor testing was repeated for a total of three samples. D. Estrogen receptor testing identified three hormones causing the cancer.
A A patient whose breast cancer tests negative for all three receptors (estrogen, progesterone, and HER-2) has triple-negative breast cancer. These cancers do not usually respond to hormone therapy or therapy for the human epidermal growth factor receptor 2 (HER-2). Chemotherapy appears to have the most success in treating triple-negative breast cancer.
Which assessment finding in a 36-yr-old patient is most indicative of a need for further evaluation? A. Bilateral breast nodules that are tender with palpation. B. A breast nodule that is 1 cm in size, nontender, and fixed. C. A breast lump that increases in size before the menstrual period. D. A breast lump that is small and mobile, with a rubbery consistency.
B
The nurse notes bilateral enlargement of the breasts during examination of a 62-yr-old male patient. Which action should the nurse take first? A. Refer the patient for mammography. B. Question the patient about current medications. C. Explain that this is temporary due to hormonal changes. D. Teach the patient how to palpate the breast tissue for lumps.
B
The outpatient clinic receives telephone messages from four patients. Which patient should the nurse call back first? A. A 40-yr-old patient who has left side chest and arm pain 2 months after a left modified radical mastectomy B. A 50-yr-old patient with stage 2 breast cancer who is receiving doxorubicin and has ankle swelling and fatigue C. A 21-yr-old patient with a family history of breast cancer who wants to discuss genetic testing for the BRCA gene D. A 57-yr-old patient with ductal ectasia who has sticky multicolored nipple discharge and severe nipple itching
B
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? A. HT is a safe therapy for menopausal symptoms if there is no family history of BRCA genes. B. HT does not appear to increase the risk for breast cancer unless there are other risk factors. C. The patient and her health care provider must weigh the benefits of HT against the risks of breast cancer. D. Natural herbs are as effective as estrogen in relieving symptoms without increasing the risk of breast cancer.
C
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? A. "I would have a lumpectomy, but you need to decide what is best for you." B. "It would not be appropriate for me to make a decision about your health." C. "Tell me what you understand about the surgical options that are available." D. "There is no need to make a decision rapidly; you have time to think about this."
C
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? A. "There are several options that I can consider for treating the cancer." B. "I will probably need radiation to the breast after having the surgery." C. "Mastectomy is the best choice to decrease the chance of cancer recurrence." D. "I can probably have reconstructive surgery at the same time as a mastectomy."
C
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? A. The patient reports fatigue. B. The patient eats only 25% of meals. C. The patient's apical pulse is irregular. D. The patient's white blood cell count is 5000/μL.
C
The nurse teaches a postmenopausal patient with stage III breast cancer about the expected outcomes of cancer treatment. Which patient statement indicates that the teaching has been effective? A. "After cancer has not recurred for 5 years, it is considered cured." B. "The cancer will be cured if the entire tumor is surgically removed." C. "I will need follow-up examinations for many years after treatment before I can be considered cured." "Cancer is never cured, but the tumor can be controlled with surgery, chemotherapy, and radiation."
C
Which question is most pertinent for the nurse to ask a 43-yr-old patient about her risk for breast cancer? A. "Do you currently smoke tobacco?" B. "Have you ever had a breast injury?" C. "At what age did you start having menstrual periods?" D. "Is there a family history of fibrocystic breast changes?"
C Early menarche and late menopause are risk factors for breast cancer because of the prolonged exposure to estrogen that occurs. Cigarette smoking, breast trauma, and fibrocystic breast changes are not associated with increased breast cancer risk.
What information should the nurse include when teaching a young women's community service group about breast self-examination (BSE)? A. BSE will reduce the risk of dying from breast cancer. B. BSE should be done daily while taking a bath or shower. C. Annual mammograms should be scheduled in addition to BSE. D. Performing BSE after the menstrual period is more comfortable.
D
What will the nurse teach a patient with metastatic breast cancer who has a new prescription for trastuzumab (Herceptin)? A. Hot flashes may occur with the medication. B. Serum electrolyte levels will be drawn monthly. C. The patient will need frequent eye examinations. D. The patient should call if she notices ankle swelling.
D
