OB: Chapter 6 Disorders of the Breasts

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

40

The nurse determines that a woman has implemented prescribed therapy for her fibrocystic breast disease when the client reports that she has eliminated what from her diet? A) Caffeine B) Cigarettes C) Dairy products D) Sweets

A) Caffeine

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. The nurse identifies: A) Garlic B) Soybeans C) Milk D) Leeks E) flax seeds

A) Garlic B) Soybeans D) Leeks E) Flax seeds

As part of discharge planning, the nurse refers a woman to Reach to Recovery. This groups primary purpose is to: 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

A woman diagnosed with breast cancer is to receive trastuzumab. Which of the following 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.

A nurse is preparing a presentation about risk reduction for breast cancer incorporating the recommendations from the American Institute for Cancer Research (AICR). Which recommendations would the nurse most likely include? Select all that apply. A) Limit the intake of processed foods. B) Limit the use of salt. C) Restrict red meat intake to approximately 4 ounces daily. D) Limit the intake of complex carbohydrates. E) Consume at least five servings of fruits and vegetables daily.

A) Limit the intake of processed foods. B) Limit the use of salt. E) Consume at least five servings of fruits and vegetables daily.

During a clinical breast examination, the nurse palpates a well-defined, firm, mobile lump in a 60-year-old womans left breast. The nurse notifies the physician. Which of the following would the nurse anticipate the physician to order next? A) Mammogram B) Hormone receptor status C) Fine-needle aspiration D) Genetic testing for BRCA

A) Mammogram

A 45-year-old female client tells the nurse she has a dimpling of the right breast that has occurred in the past 2 weeks. What action will the nurse take next? A) Perform an examination of both of the client's breasts. B) Determine if the client has a family history of breast cancer. C) Notify the health care provider. D) Prepare the client for a right breast ultrasound.

A) Perform an examination of both of the client's breasts.

After teaching a group of nursing students about the different types of chemotherapeutics agents used to treat breast cancer, the instructor determines that the teaching was sUccessful when the students identify which of the following as an example of a selective estrogen receptor modulator (SERM)? (Select all that apply.) A) Tamoxifen B) Letozole C) Raloxifene D) Exemestane E) Anastrozole

A) Tamoxifen C) Raloxifene

In which client would the nurse suspect cancer? A) a 45-year-old with thickening in one breast with nipple irritation and retraction and a pink discharge B) a 40-year-old with nipple retraction and a watery discharge C) a 30-year-old with a mobile, rubbery, firm, well-circumscribed, nontender lump D) a 25-year-old with multiple small, round, and smooth lesions on both breasts that are painful during menstruation

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

A nurse is working at a cancer treatment center and is developing programs for specific ethnic groups related to breast cancer. The nurse would target which ethnic group because it has the highest breast cancer mortality rate in the United States? A) black client B) Hispanic client C) white client D) Native American/First Nations client

A) black client

A nurse is educating a client on the technique for performing breast self-examination. Which instruction should the nurse include in the teaching plan with regard to the different degrees of pressure that need to be applied on the breast? A) hard pressure applied down to the ribs B) light pressure midway into the tissue C) medium pressure on the skin throughout D) medium pressure around the areolar area

A) hard pressure applied down to the ribs

A female client is scheduled to have a mammogram. When teaching the client about this test, the nurse will include which statement? A) "You may not be a candidate for a mammogram since you have breast implants." B) "Do not use perfume that day because it may interfere with the image." C) "This is a simple test that uses ultrasound imaging to visualize inside your breasts." D) "We will schedule the procedure just before your menses is to occur."

B) "Do not use perfume that day because it may interfere with the image."

After teaching a woman about breast self-examination, the nurse understands that the teaching was successful when the woman makes which statement? A) "I will check my breasts every other week." B) "I'll do the check about a week after my period." C) "I don't have to check under my arm if I don't feel any breast lumps." D) "I'll feel my breasts using my thumb and index finger."

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

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? A) "We call this drug a chemotherapy agent." B) "Tamoxifen reduces the incidence." C) "Tamoxifen prevents osteoporosis." D) "I would recommend raloxifene."

B) "Tamoxifen reduces the incidence."

A client asks the nurse, "I've heard that eating too much red meat can increase my risk for breast cancer. So how much red meat can I eat each day?" The nurse responds, saying that the client should limit the intake of red meat to how many ounces per day? A) 5 B) 3 C) 2 D) 4

B) 3

When describing programs for breast cancer screening, the nurse include breast self- examination (BSE). Which of the following 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

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? A) Notify the health care provider. B) Assess the client's breasts. C) Let the client know this sounds like a benign neoplasm. D) Ask the client when the mass was felt.

B) Assess the client's breasts.

Mammography is recommended for a client diagnosed with intraductal papilloma. Which factor should the nurse ensure when preparing the client for a mammography? A) Client is just going to start her menses. B) Client has not applied deodorant on the day of testing. C) Client has not consumed fluids 1 hour before testing. D) Client has taken an aspirin before the testing.

B) Client has not applied deodorant on the day of testing.

A 42-year-old woman is scheduled for a mammogram. Which of the following 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 small needle will be inserted to get a sample for evaluation.

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

After teaching a woman how to perform breast self-examination, which statement would indicate that the nurses 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 dont need to check under my arm on that side if my breast feels fine. D) I need to work from the center of breast outward toward my shoulder.

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

During a wellness visit to the clinic, a woman asks the nurse if there is anything she can do to reduce her risk for developing breast cancer. Which of the following would the nurse most likely include? (Select all that apply.) A) Eating three servings of fruit daily B) Keeping weight gain under 11 pounds after age 18 C) Eating at least seven portions of complex carbohydrates daily D) Limiting the intake of refined sugar products E) Using salt liberally when cooking

B) Keeping weight gain under 11 pounds after age 18 C) Eating at least seven portions of complex carbohydrates daily D) Limiting the intake of refined sugar products

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 of the following? 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

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 clients riqht arm. Which action by the nurse would be most appropriate? A) Assist in holding the clients arm still. B) Suggest a finger stick be done on one of the clients left fingers. C) Tell the technician to obtain the blood sample from the clients left arm. D) Call the surgeon to perform a femoral puncture.

B) Suggest a finger stick be done on one of the clients left fingers.

A client with advanced breast cancer, who has had both chemotherapy and radiation therapy, is to start hormonal therapy. Which agent would the nurse expect the client to receive? A) Progestin sB) Tamoxifen C) Cortisone D) Estrogen

B) Tamoxifen

A client is considering breast augmentation. What would the nurse recommend to the client to ensure that there are no malignancies? A) ultrasound B) mammogram C) breast biopsy D) mastopexy

B) mammogram

When preparing for a class on breast cancer, the nurse should explain which nonmodifiable risk factors? Select all that apply. A) high-fat dietary intake B) menarche at age 11 C) being a 52-year-old female D) BRCA1 gene E) failing to breastfeed infants

B) menarche at age 11 C) being a 52-year-old female D) BRCA1 gene

A woman is scheduled to undergo a modified radical mastectomy. Which information would the nurse include when describing this surgery to the client? A) wide excision of the tumor along with a 1-cm margin of normal tissue B) removal of breast tissue and axillary nodes C) sparing of the pectoral muscles and axillary lymph nodes D) the resulting concave appearance of the anterior chest

B) removal of breast tissue and axillary nodes

A woman comes to the clinic and asks the nurse about when she should have her first mammogram. Using the recommendations of the American Cancer Society, which would the nurse suggest? A) 30 years B) 35 years C) 40 years D) 45 years

C) 40 years

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? A) Instruct the client to wear a loose-fitting bra. B) Encourage the client to include protein content in the diet. C) Assist the client to pump the breasts to remove breast milk. D) Reduce the frequency of removing and reapplying the dressings.

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

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 clients 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

A woman comes to the clinic reporting a 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 of the following? A) Fibrocystic breast disorder B) Intraductal papilloma C) Duct ectasia D) Fibroadenoma

C) Duct ectasia

A woman who has undergone a right modified- radical mastectomy returns from surgery. Which nursing intervention would be most appropriate 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,e 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.

A group of students are reviewing information about benign and malignant breast masses. The students demonstrate understanding when they identify which of the following as indicating a benign breast mass. (Select all the apply.) A) Painless B) Unilateral location C) Firm consistency D) Absence of dimpling E) Fixed to chest wall

C) Firm consistency D) Absence of dimpling

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) 11 D) III

C) II

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? A) "I know a great support group you can join." B) "You'll beat this thing, I know it. You are very strong." C) Listen to the woman talk, and remain silent for a while D) "I'm sure you are going to be fine. You are in great hands."

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

The nurse is developing the discharge plan for a woman who has had a left-sided modified radical otmastectomy. The nurse is including instructions for ways to minimize lymphedema. Which suggestion would most likely increase the womans symptoms? A) Wear gloves when you are doing any gardening .B) Have your blood pressure taken in your right arm. C) Wear clothing with elasticized sleeves .D) Avoid driving to and from work every day.

C) Wear clothing with elasticized sleeves.

In the United States, what type of cancer accounts for one-third of cancer diagnoses and is the most common cancer in women? A) uterine cancer B) lung cancer C) breast cancer D) ovarian cancer

C) breast cancer

A nursing diagnosis of Risk for impaired tissue integrity would be most appropriate for which client? A) client taking oral contraceptives B) client with a vaginal packing in place C) client having reconstructive breast surgery D) client with endometriosis

C) client having reconstructive breast surgery

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: A) telling the client her options. B) psychiatric issues. C) education. D) treatment.

C) education.

What is the most common breast mass in women? A) intraductal papilloma B) duct ectasia C) fibroadenoma D) mastitis

C) fibroadenoma

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? A) Asian race B) 39 years of age C) history of ovarian cancer D) menarche at age 14

C) history of ovarian cancer

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? A) fibroadenoma B) breast abscess C) lymphedema D) fibrocystic breast disease

C) lymphedema

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? A) "I need to check my breast about 2 to 3 times a year." B) "My implants will feel the same as my normal breasts." C) "I need to press lightly to avoid breaking the implants." D) "I should do the exam just like I was doing before the implants."

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

A nurse is conducting a class on breast cancer prevention. Which statement would the nurse most likely include in the discussion? A) Most often a lump is felt before it is seen B) Early breast cancer usually ee 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.

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.

A woman with breast cancer is undergoing chemotherapy. Which of the following side effects would the nurse interpret as being most serious? A) Vomiting B) Hair loss C) Fatigue D) Myelosuppression

D) Myelosuppression

When assessing a client with suspected breast cancer, which of the following would the nurse expect to find? A) Painful lump B) Absence of dimpling C) Reguarly shaped mass D) Nipple retraction

D) Nipple retraction

Which breast disorder is not benign? A) duct ectasia B) fibroadenomas C) fibrocystic breasts D) Paget disease

D) Paget disease

A nurse is working with a woman who has been diagnosed with severe fibrocystic breast disease. When describing the medications that can be used as treatment, which of the following would the nurse be least likely to include? A) Tamoxifen B) Bromocriptine C) Danazol D) Penicillin

D) Penicillin