Chapter 6: Disorders of the Breasts

2. The nurse determines that a woman has implemented prescribed therapy for her fibrocystic breast disease when the client reports that she has eliminated which from her lifestyle? A. caffeine B. cigarettes C. dairy products D. sweets

A. caffeine

29. A client is diagnosed with fibrocystic breast disease. After teaching the client about this condition, the nurse determines that the teaching was successful based on which client statement? A. "I need to cut out drinking coffee like I'm used to doing." B. "It's important that I stop smoking or my condition will get worse." C. "I guess I'll have to find a replacement for milk and cheese." D. "No more cookies and baked goods for me."

A. "I need to cut out drinking coffee like I'm used to doing."

16. A woman diagnosed with breast cancer is to receive trastuzumab. What information would the nurse incorporate into the explanation about how this drug works? A. It blocks the effect of the HER-2/neu protein inhibiting the growth of cancer cells. B. The drug blocks the conversion of androgens to estrogens. C. It interferes with hormone receptors that allow estrogen to enter a cell. D. The drug ultimately attacks areas where micrometastasis has occurred.

A. It blocks the effect of the HER-2/neu protein inhibiting the growth of cancer cells.

30. A laboratory technician arrives to draw blood for a complete blood count (CBC) for a client who had a left-sided mastectomy 8 hours ago. The client has an intravenous line with fluid infusing in her right antecubital space. The nurse enters the room and sees the technician beginning to place a tourniquet on the client's right arm. Which response by the nurse would be most appropriate? A. Stop the technician immediately. B. Have the technician come back later on. C. Notify the surgeon to obtain the specimen via a cut-down procedure. D. Tell the technician to obtain the specimen from the client's left arm.

A. Stop the technician immediately.

20. A woman comes to the clinic and tells the nurse that she has read an article about certain foods that have anticancer properties and help boost the immune system. During the discussion, the nurse would expect the client to identify which foods? Select all that apply. A. garlic B. soybeans C. milk D. leeks E. flax seed

A. garlic B. soybeans D. leeks E. flax seed

8. As part of discharge planning, the nurse refers a woman to Reach to Recovery. The nurse initiates this referral to facilitate which goal? A. help support women who have undergone mastectomies B. raise funds to support early breast cancer detection programs C. provide all supplies needed after breast surgery for no cost D. collect statistics for research for the American Cancer Society

A. help support women who have undergone mastectomies

6. During a clinical breast examination, the nurse palpates a well-defined, firm, mobile lump in a 60-year-old woman's left breast. The nurse notifies the primary care provider. What would the nurse anticipate the care provider to prescribe next? A. mammogram B. hormone receptor status C. fine-needle aspiration D. genetic testing for BRCA

A. mammogram

28. A woman who has undergone a right modified-radical mastectomy returns from surgery. The nurse would focus immediate interventions on which area as the priority? A. respiratory function B. body image C. lymphedema prevention D. incisional care

A. respiratory function

27. A client with advanced breast cancer, who has had both chemotherapy and radiation therapy, is to start hormonal therapy using a selective estrogen receptor modulator (SERM). Which agent would the nurse expect the client to receive? A. tamoxifen B. letrozole C. exemastine D. cortisone

A. tamoxifen

3. A nurse has completed the assessment of a client. The nurse suspects that the client may have a malignant breast mass based on which finding? A. painful lump B. absence of dimpling C. regularly shaped mass D. nipple retraction

D. nipple retraction

14. A laboratory technician arrives to draw blood for a complete blood count (CBC) for a client who had a right-sided mastectomy 8 hours ago. The client has an intravenous line with fluid infusing in her left antecubital space. To obtain the blood specimen, the technician places a tourniquet on the client's right arm. Which action by the nurse would be most appropriate? A. Assist in holding the client's arm still. B. Suggest a finger stick be done on one of the client's left fingers. C. Tell the technician to obtain the blood sample from the client's left arm. D. Call the surgeon to perform a femoral puncture.

B. Suggest a finger stick be done on one of the client's left fingers.

5. A 42-year-old woman is scheduled for a mammogram. Which statement would the nurse include when teaching the woman about the procedure? A. "The room will be darkened throughout the procedure." B. "Each breast will be firmly compressed between two plates." C. "Make sure to refrain from eating or drinking after midnight." D. "A dye will be injected to highlight the breast tissue and its ducts."

B. "Each breast will be firmly compressed between two plates."

31. A client is being discharged after having a right-sided modified radical mastectomy. After teaching the client about ways to minimize lymphedema, the nurse determines that the teaching was successful based on which client statement? A. "I should use lotion on my hands after working in my garden." B. "I need to avoid wearing tops that have elastic in the sleeves." C. "I should have my blood pressure taken in my right arm." D. "I need to limit my driving to once a week."

B. "I need to avoid wearing tops that have elastic in the sleeves."

After teaching a woman how to perform breast self-examination, which statement would indicate that the nurse's instructions were successful? A. "I should lie down with my arms at my side when looking at my breasts." B. "I should use the fingerpads of my three middle fingers to apply pressure to my breast." C. "I don't need to check under my arm on that side if my breast feels fine." D. "I need to work from left to right down my breast towards my ribs."

B. "I should use the fingerpads of my three middle fingers to apply pressure to my breast."

22. A nurse is conducting a refresher program for a group of nurses about chemotherapy used for breast cancer. After teaching the group about the different types of chemotherapeutic agents used to treat breast cancer, the nurse determines that the teaching was successful when the group identifies which agent as an example of an aromatase inhibitor? Select all that apply. A. tamoxifen B. letozole C. raloxifene D. exemestane E. anastrozole

B. letozole D. exemestane E. anastrozole

21. During a wellness visit to the clinic, a 30-year-old woman asks the nurse if there is anything she can do to reduce her risk for developing breast cancer. Which suggestions would be appropriate? Select all that apply. A. "Eat three servings of fruit daily." B. "Keep your weight gain under 11 pounds (5 kilograms)." C. "Eat at least seven portions of complex carbohydrates daily." D. "Limit your intake of refined sugar products." E. "Use salt liberally when cooking"

B. "Keep your weight gain under 11 pounds (5 kilograms)." C. "Eat at least seven portions of complex carbohydrates daily." D. "Limit your intake of refined sugar products."

17. When describing programs for breast cancer screening, the nurse includes breast self- examination (BSE). Which statement most accurately reflects the current thinking about breast self-examination? A. BSE is essential for early breast cancer detection. B. A woman performing BSE has breast awareness. C. BSE plays a minimal role in detecting breast cancer. D. A clinical breast exam has replaced BSE.

B. A woman performing BSE has breast awareness.

15. The nurse is developing a plan of care for a woman with breast cancer who is scheduled to undergo breast-conserving surgery. The nurse interprets this as which procedure? A. removal of nipple and areolar area B. lump removal followed by radiation C. entire breast removal without lymph nodes D. axillary lymph node removal

B. lump removal followed by radiation

7. A client with advanced breast cancer, who has had both chemotherapy and radiation therapy, is to start endocrine therapy. Which agent would the nurse expect the client to receive? A. trastuzumab B. tamoxifen C. cortisone D. estrogen

B. tamoxifen

1. The nurse is developing the discharge plan for a woman who has had a left-sided radical mastectomy. The nurse is including instructions for ways to minimize lymphedema. Which statement by the client indicates the need for additional instruction? A. "I need to wear gloves when doing any gardening." B. "Any blood pressures need to be taken in my right arm." C. "I should wear clothing with elasticized sleeves." D. "I need to avoid driving to and from work every day."

C. "I should wear clothing with elasticized sleeves."

23. A woman comes to the clinic and asks the nurse about when she should have her first mammogram. The woman is at low risk and has no family history of breast cancer. Using the recommendations of the American Cancer Society, the nurse would suggest the woman have her first mammogram at which age? A. 30 years B. 35 years C. 40 years D. 45 years

C. 40 years

4. A woman who has undergone a right-sided modified-radical mastectomy returns from surgery. Which nursing intervention would be most appropriate for the nurse to include in the client's plan of care at this time? A. Ask the client how she feels about having her breast removed. B. Attach a sign above her bed to have BP, IV lines, and lab work in her right arm. C. Encourage her to turn, cough, and deep breathe at frequent intervals. D. Position her right arm below heart level.

C. Encourage her to turn, cough, and deep breathe at frequent intervals.

13. Evaluation of a woman with breast cancer reveals that her mass is approximately 1.25 inches in diameter. Three adjacent lymph nodes are positive. The nurse interprets this as indicating that the woman has which stage of breast cancer? A. 0 B. I C. II D. III

C. II

18. A breast biopsy indicates the presence of malignant cells, and the client is scheduled for a mastectomy. Which nursing diagnosis would the nurse most likely include in the client's preoperative plan of care as the priority? A. risk for deficient fluid volume B. activity intolerance C. disturbed body image D. impaired urinary elimination

C. disturbed body image

10. A woman comes to the clinic reporting a greenish-colored nipple discharge On examination, the area below the areola is red and slightly swollen, with tortuous tubular swelling. The nurse interprets these findings as suggestive of which disorder? A. fibrocystic breast disorder B. intraductal papilloma C. duct ectasia D. fibroadenoma

C. duct ectasia

24. A nurse is preparing a presentation for a group of community nurses about benign and malignant breast masses. The nurses demonstrate understanding when they identify which as an indication of a benign breast mass? Select all that apply. A. absence of pain B. unilateral location C. firm consistency D. absence of dimpling E. fixed to the chest wall

C. firm consistency D. absence of dimpling

19. A nurse is conducting a class on breast cancer prevention. Which statement would the nurse include in the discussion? A. "Most often a lump is felt before it is seen." B. "Early breast cancer usually has some symptoms." C. "If the mass is not painful, it is usually benign." D. "If lump is palpable, it has been there for some time."

D. "If lump is palpable, it has been there for some time."

11. When performing a clinical breast examination, which would the nurse do first? A. Palpate the axillary area. B. Compress the nipple for a discharge. C. Palpate the breasts. D. Inspect the breasts.

D. Inspect the breasts.

26. A woman comes to the clinic. Assessment reveals a firm, rubbery, movable mass in the upper outer quadrant of the left breast. The edges of the mass are clearly delineated. The nurse interprets these findings as suggestive of which disorder? A. fibrocystic breast disorder B. duct ectasia C. intraductal papilloma D. fibroadenoma

D. fibroadenoma

9. A woman with breast cancer is undergoing chemotherapy. Which side effect would the nurse interpret as being most serious? A. vomiting B. hair loss C. fatigue D. myelosuppression

D. myelosuppression

25. A nurse is working with a woman who has been diagnosed with severe fibrocystic breast disease. After describing the medications that can be used as treatment, the nurse determines that additional teaching is needed when the client identifies which drug as being used? A. tamoxifen B. bromocriptine C. danazol D. penicillin

D. penicillin