NU143- Chapter 6: Disorders of the Breasts

A female client is diagnosed with breast abscess. Although she has been allowed to breastfeed her newborn, she decides to terminate breastfeeding. Which action would be most appropriate in this situation?

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

A client reports lumpy, tender breasts, particularly during the week before menses. She reports pain that often dissipates after the onset of menses. The nurse suspects the client has fibrocystic breast changes. Which should the nurse do next?

Perform a breast examination.

In the United States, what type of cancer accounts for one-third of cancer diagnoses and is the most common cancer in women?

breast cancer

In which woman would the nurse most likely expect to find fibrocystic breast changes?

35-year-old

At what age should a woman with no risk factors begin mammography screening for breast cancer?

40

The nurse is teaching a client with mastitis about care measures. Which client statement indicates effective teaching?

"I can use warm soaks to my breast to relieve the discomfort."

The nurse is caring for a client who states, "I felt a round, movable mass in my left breast." Which action will the nurse take next?

Assess the client's breasts.

The nurse is caring for a 52-year-old woman whose sisters and mother died of breast cancer. The client states, "My doctor wants me to take tamoxifen to help prevent breast cancer. What do you think?" What would be the nurse's best response?

"Tamoxifen reduces the incidence."

The nurse is teaching a 48-year-old client who is scheduled for her first mammogram. Which statement by the client indicates additional teaching is needed?

"I can be prescribed a narcotic to take prior to the procedure to prevent pain."

At a class for new mothers, the nurse notes that the participants need more teaching when one of the mothers makes which comment?

"I have to stop breastfeeding because of mastitis."

A nurse is teaching a woman who has undergone breast augmentation about developing breast awareness through breast self examination. The nurse determines that the teaching was successful based on which client statement?

"I should do the exam just like I was doing before the implants."

After teaching a client with mastitis about caring for her breasts, the nurse determines that the client has understood the instructions when she makes which statement?

"I will express milk with a breast pump until infection is resolved."

After teaching a woman about breast self-examination, the nurse understands that the teaching was successful when the woman makes which statement?

"I'll do the check about a week after my period."

While performing a clinical breast examination, the nurse notes a firm and rubbery nodule that is well circumscribed and moves freely. How should the nurse counsel the client?

"It's most likely a fibroadenoma, but we may need to do a biopsy."

How should the nurse counsel a postpartum client on how to prevent mastitis?

"Wash your hands thoroughly, and let your breasts dry after each feeding."

A young client desires to know her risk of developing breast carcinoma. She has a positive family history of breast carcinoma. The nurse would suggest that she should undergo which diagnostic test?

BRCA-1 genetic marker

A nurse is teaching a group of young adult women about the different benign breast disorders. When describing fibrocystic breast changes, which characteristics would the nurse include? Select all that apply.

Clear nipple discharge may or may not be present. The pain is cyclic and usually decreases after the onset of menses. These changes are most common between the ages of 20 and 50. The lesions move freely when the breast is palpated

Mammography is recommended for a client diagnosed with intraductal papilloma. Which factor should the nurse ensure when preparing the client for a mammography?

Client has not applied deodorant on the day of testing.

A client has undergone a mastectomy for breast cancer. Which instruction should the nurse include in the postoperative client teaching plan?

Elevate the affected arm on a pillow.

A woman is crying because she just recently received the results of her biopsies, and they confirm that she has invasive breast cancer. Which response by the nurse is the most appropriate?

Listen to the woman talk, and remain silent for a while

A female client with metastatic breast disease is receiving trastuzumab as part of her immunotherapy. The client has nausea, fatigue, diarrhea, appears jaundice, and has a distended abdomen. What would the nurse do next?

Notify the health care provider.

A nurse is counseling a woman diagnosed with fibrocystic breast changes about self-care measures. Which instructions would the nurse include when teaching this client? Select all that apply.

Wear a supportive bra. Limit salt intake. Avoid caffeinated beverages.

During a follow-up visit, a female client who underwent a mastectomy asks the nurse if she can work in her backyard or at least do some household work. Which suggestion would be most appropriate?

Wear gloves and protective clothing to avoid any injuries.

In which client would the nurse suspect cancer?

a 45-year-old with thickening in one breast with nipple irritation and retraction and a pink discharge

A nurse practitioner is performing a clinical breast exam and notes a mass. Which findings would lead the nurse practitioner to suspect that the mass is benign? Select all that apply.

absence of nipple retraction firmness on palpation clearly delineated margins

While performing a clinical breast examination on a client, the nurse inspects the breasts with the client in various positions. Place the positions in their proper sequence from first to last. All options must be used.

arms resting at the sides hands placed on the hips arms raised over the head hands on hips while standing

A woman has been treated for a tumor of the left breast that has not responded to chemotherapy. The woman has just found out that she has the BRCA mutations and discusses her options with her primary care provider. Which treatment would be most difficult for this woman?

bilateral mastectomy

A client diagnosed with breast cancer is receiving chemotherapy. The nurse assesses the client for possible side effects of this therapy. Which side effect would the nurse report immediately to the health care provider?

bone marrow suppression

During a routine assessment, a client reports to the nurse a new lump in her right breast and occasional nipple pain. The client has a family history of breast cancer. The nurse will anticipate preparing the client for which procedure first?

breast examination

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 sign?

breast symmetry

A nursing diagnosis of Risk for impaired tissue integrity would be most appropriate for which client?

client having reconstructive breast surgery

A nurse is conducting a presentation on breast cancer for a local women's group and explaining the possible risk factors associated with its development. The nurse determines that the group has understood the information when they identify which factor as increasing a woman's risk for breast cancer?

early menarche

The health care provider has just informed the client that her breast biopsy is positive for carcinoma. One of the nurse's first responsibilities is to assist with:

education.

What is the most common breast mass in women?

fibroadenoma

Edema and enlargement in the ducts and glands of the breast that occur as effects of hormones are called:

fibrocystic breast changes.

The nurse is reviewing the history and physical exam of a woman who has come to the clinic for a routine physical. Which factor would the nurse identify as increasing the client's risk for breast cancer?

history of ovarian cancer

A 62-year-old female client arrives at a health care facility reporting skin redness in the breast area, along with skin edema. The primary care provider suspects inflammatory breast cancer. For which symptom of inflammatory breast cancer should the nurse assess?

increased warmth of the breast

The nurse is developing a presentation for a local women's health center about breast cancer. Which cancer would the nurse include as being the most common type of breast cancer?

invasive ductal carcinoma

What is the most common type of breast cancer, accounting for approximately 85% of cases?

invasive ductal carcinoma

A client is considering breast augmentation. What would the nurse recommend to the client to ensure that there are no malignancies?

mammogram

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 complication?

lymphedema

A woman is scheduled to undergo a modified radical mastectomy. Which information would the nurse include when describing this surgery to the client?

removal of breast tissue and axillary nodes

Which finding would the nurse expect when assessing the breasts of a client with fibrocystic breast disease?

soft mass

A breast tumor is most likely found in what part of the breast?

the upper outer quadrant

As part of a presentation on breast cancer being given to a local woman's group, the nurse describes the need for early detection through screening. Applying the guidelines from the American Cancer Society, the nurse would emphasize which recommendation?

yearly mammograms for women starting at age 40