Chapter 52: Assessment and Management of Patients with Breast Disorders

The nurse working on a cancer treatment floor assesses her assigned clients. It is most important for the nurse to report which assessment finding?

Coolness and mottling of a newly constructed breast site

A 28-year-old woman is learning about breast self-examination. The nurse teaches the woman that the best time of each month to examine her breasts is during the:

First week after menstruation.

Students are reviewing information about the use of adjuvant hormonal therapy for breast cancer. They demonstrate understanding of this information when they identify which of the following as an example of a selective estrogen receptor modulator (SERM)?

Tamoxifen

A nurse who works in an oncology practice prepares patients for the side effects of adjuvant hormonal therapy to treat breast cancer. Which of the following is the hormonal agent that has an increased risk of pulmonary embolism and deep vein thrombosis?

Tamoxifen

A client has been diagnosed with breast cancer and is awaiting cytology results of a biopsy. During client education, the nurse discusses the possible types of breast malignancies. Which is the most common type?

ductal

Which psychosocial nursing diagnoses are common in the client with breast cancer? Select all that apply.

-Fear -Body image disturbance -Hopelessness

A nurse is providing breast cancer education at a community facility. The American Cancer Society recommends that women of average risk for breast cancer get mammograms:

yearly starting no later than age 45.

The nurse is obtaining a history from a client who states recurrent breast tenderness. The client inquires if there is something wrong with her breasts. Which question by the nurse is a priority?

"Does the tenderness occur around the same time each month?"

A client has had a right modified radical mastectomy and axillary lymph node dissection. The nurse is teaching the client about measures to reduce the risk of complications. The client demonstrates understanding of the instructions when she states which of the following?

"I need to use an electric shaver when shaving my right armpit."

A client diagnosed with breast cancer has developed neutropenia secondary to chemotherapy. Which of the following would the nurse anticipate as being ordered to address the neutropenia? Select all that apply.

-Filgrastim -Pegfilgrastim

The nurse is educating a patient about the best time to perform breast self-examination (BSE). When does the nurse inform her is the best time after menses to perform BSE?

5-7 days

During a breast examination, which finding most strongly suggests that a client has breast cancer?

A fixed nodular mass with dimpling of the overlying skin

A 33-year-old female client is recovering from a modified radical mastectomy with immediate reconstruction. This is the client's fourth day postoperatively. Her vital signs are temperature 99°F, pulse 82, respirations 18, and blood pressure 152/90. She continues to complain of considerable pain, with a pain rating of 9 on a scale of 1 to 10, with 10 being the worst possible pain. The client was discharged home with a prescription for oxycodone and acetaminophen and has been taking the drugs as prescribed. Which assessment finding would cause the nurse to phone the physician?

A well-defined oval area near the incision site

A nurse is reviewing a female client's history, which includes the following information:Age at menarche: 14 yearsCesarean delivery: 2 pregnanciesAge at first pregnancy: 35 yearsAlcohol use: approximately 1 to 2 glasses of wine/monthThe nurse identifies which as a possible risk factor for the client to develop breast cancer?

Age at first pregnancy

A female client is diagnosed with breast abscess. She would like to continue to breast-feed her newborn. Which of the following would be most appropriate in this situation?

Assist the client to pump the breasts to remove breast milk.

After teaching a group of students about the signs and symptoms of breast cancer, the instructor determines that additional teaching is needed when the group identifies which of the following?

Breast symmetry

The nurse has identified the following nursing diagnosis on the plan of care for a client who has undergone breast cancer surgery: Disturbed sensory perception related to nerve irritation in the affected breast area. Which of the following indicates that the outcome has been achieved?

Client states that feeling in her breast area will gradually subside with time.

How can breast cancer prevention programs best serve at-risk women from lower socioeconomic backgrounds?

Develop screening and educational programs.

A patient is having a biopsy that will remove the entire mass, plus a margin of surrounding tissue. What type of biopsy will be documented on the operative permit?

Excisional biopsy

Which is a characteristic of a breast cancer mass?

Firm, hard, embedded in surrounding tissue

A nurse is reviewing a client's history for possible risk factors associated with breast cancer. Which of the following would the nurse identify as increasing the client's risk?

First full-term pregnancy at age 34 years

Hematoma and seroma formation are complications of breast surgery. Which of the following is the indicator that should be reported to the surgeon?

Gross swelling

The nurse is assessing the breast of a female patient and observes a prominent venous pattern on the left breast. What does the nurse understand that this can be indicative of?

Increased blood supply required by a tumor

A female patient comes to the clinic with the complaint that she is having a greenish-colored discharge from the nipple and the breast feels warm to touch. What does the nurse suspect these symptoms may indicate?

Infection

A patient is told that she has a common form of breast cancer where the tumor arises from the duct system and invades the surrounding tissues, often forming a solid irregular mass. What type of cancer does the nurse prepare to discuss with the patient?

Infiltrating ductal carcinoma

Several days before admission, a client reports finding a small lump in the left breast near the nipple. What should the nurse tell the client to do?

Inform the physician immediately.

The nurse is providing care to a client who has had surgery as treatment for breast cancer. The nurse would be alert for the development of which of the following?

Lymphedema

A nurse is preparing a presentation for a health fair about preventing breast cancer. Which of the following would the nurse include?

Maintaining an ideal weight

Which term refers to breast pain?

Mastalgia

The nurse recognizes which statement as accurately reflecting a risk factor for breast cancer?

Mother affected by cancer before 60 years of age

A client is receiving adjuvant chemotherapy for breast cancer. Which is most likely her node status and tumor size?

Node negative, tumor size 1.2 cm

The nurse teaches a premenopausal female client to perform breast self-examination (BSE) at which interval?

On day 5 to day 7, counting the first day of menses as day 1

The nurse is completing the admission history for a client who is admitted for a reduction mammoplasty. Which of the following client statements is uncommon when explaining the rationale for the procedure?

Others disapprove

A client is considering use of chemoprevention because she is at high risk for developing breast cancer. What can the nurse do to assist the patient with her decision?

Provide the patient with information regarding the benefits, risks, and possible side effects.

At a follow-up visit, the client is informed that her breast cancer has recurred. The nurse knows that which situation places the client at risk for developing bone metastases?

Recurrence within 2 years of the original diagnosis

A nurse is caring for a group of breast cancer survivors after mastectomy. Which teaching point should the nurse reinforce about activities 6 weeks after surgery?

Resume light household work.

Which is one of the most important prognostic factors in breast cancer?

Status of lymph nodes

A client comes to the clinic for a routine evaluation. During the physical examination, the nurse palpates the client's breast and finds a small lump. Which of the following would lead the nurse to suspect possible breast cancer?

The lump is irregularly shaped.

The client arrives at a public health clinic worried that she has breast cancer since finding a lump in her breast. When assessing the breast, which assessment finding is characteristic of fibrocystic disease?

The lump is round and movable.

The nurse is caring for a client who is ordered a sentinel lymph node biopsy. The physician explained the procedure and desired outcome. Which statement, made by the client, indicates a need for further instruction?

The procedure removes all cancer from the body.

A group of students are reviewing the anatomy and physiology of the breasts. The students demonstrate understanding of breast structure when they identify the tail of Spence as an extension of which quadrant?

Upper outer

During a follow-up visit, a female client who underwent a mastectomy presents with an infection that requires an antibiotic. She admits she has been doing some gardening. What further instruction and reinforcement of teaching is needed?

Wear gloves and protective clothing to avoid any injuries.

An older client underwent a lumpectomy for a breast lesion that was determined to be malignant. Which factors in the client's history may have increased the risk of breast cancer?

all options are correct

A client is concerned about the lumps that have developed in her breasts and is fearful of cancer. The client reports variability in the size of the lumps. What could be causing this condition?

cyclical hormonal changes

A client is very concerned about possibly having breast cancer, especially after caring for a close family member who recently died from the disease. The nurse informs the client that the primary and most common sign of breast cancer is a

painless mass in the breast, most often in the upper outer quadrant.

A client is very concerned about possibly having breast cancer, especially after caring for a close family member who recently died from the disease. The nurse informs the client that the primary and most common sign of breast cancer is a:

painless mass in the breast, most often in the upper outer quadrant.