Adult Health chapter 58 Breast

Which statement demonstrates that a client has understood instructions about breast self-examination?

"I need to use the pads of three fingers to apply pressure when checking each breast."

Atypical hyperplasia increases a woman's risk for breast cancer about how many times compared with that of the general population?

4

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."

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 to 7 days

A group of students are reviewing material in preparation for a test on the male and female breasts. The students demonstrate understanding of the material when they identify which of the following?

A primary function of the female breast is to produce milk.

Which is part of the education for a client undergoing a stereotactic core biopsy?

A small titanium clip is placed at the biopsy site.

A client returns to the recovery room following a mastectomy. An initial postoperative assessment is performed by the nurse. What is the nurse's priority assessment?

Assessing the vital signs and oxygen saturation levels.

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.

A nurse is describing the advantages and disadvantages associated with tamoxifen therapy as a means of breast cancer prevention. The nurse would identify that the drug has a beneficial effect on which of the following?

Bone mineral density

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

Which primary prevention modality aims to prevent the disease before it starts?

Chemoprevention

Which nursing intervention(s) are related to a client with breast cancer? Select all that apply.

Client education and preparation for treatment Promotion of positive body image Relieving fear Management of complications

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 client has just been diagnosed with breast cancer and has been seen by the physician who has described the various options available to the client. The client tells the nurse, "I just don't know what to do. I'm so frightened. I don't know if surgery is the best thing. But I've heard such horror stories about chemotherapy, too." When developing this client's plan of care which nursing diagnosis would be most appropriate?

Decisional conflict related to the choice of treatment options

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

Develop screening and educational programs.

A client has undergone a transverse rectus abdominis myocutaneous (TRAM) flap procedure for breast reconstruction immediately following a mastectomy. Which of the following would be most appropriate to include in the client's postoperative plan of care?

Encouraging coughing and deep breathing exercises

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

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

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

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.

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

A client is demonstrating breast self-examination while the nurse is observing the woman's technique. The nurse stops the client and provides reinstruction when the nurse observes the client palpating in which manner?

In a horizontal pattern across each quadrant of the breast from the inner edge outward

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

When a female client demonstrates a wart-like growth near the nipple, causing bloody nipple discharge, the client is exhibiting signs of which disease process?

Intraductal papilloma

The nurse is assessing an older adult female who has not seen her physician in 2 years. The nurse is assisting the patient into a gown and notices that the patient has edema and pitting of the skin on the right breast. What does the nurse understand is the significance of this finding?

It may result from a neoplasm blocking lymphatic drainage, giving the skin an orange-peel appearance, a classic sign of advanced breast 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 of the following?

Lymphedema

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

Mammogram

Which term is used to describe removal of breast tissue and axillary lymph node dissection leaving muscular structure intact as surgical treatment of breast cancer?

Modified radical mastectomy

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

Mother affected by cancer before 60 years of age

Which is inconsistent as a risk factor for breast cancer?

Multiparity

Which is an early sign of Paget disease?

Nipple erythema

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

A 49-year-old woman reports that her last known menstrual cycle occurred over 1 year ago. Her records indicate gravida 0, para 0. Upon further review of the chart, the nurse notes that the client has a positive maternal history of hypertension. Moreover, the client has a positive paternal history of diabetes. With no additional significant history noted, which of the nurse's findings is consistent as a risk factor for breast cancer for this client?

Nulliparity

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

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

Erythropoietin growth factor increases production of which of the following?

Red blood cells

A nurse is caring for a client who has just had a modified radical mastectomy with immediate reconstruction. She's in her 30s and has two young children. Although she's worried about her future, she seems to be adjusting well to her diagnosis. What should the nurse do to support her coping?

Refer the client to the American Cancer Society's Reach for Recovery program or another support program.

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.

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 patient is having a fine-needle biopsy (FNB) for a mass in the left breast. When the needle is inserted and the mass is no longer palpable, what does the nurse know has most likely occurred?

The mass may be cystic and was ruptured when the needle was inserted.

The nurse is providing preoperative instruction for a patient who will be having an excisional breast biopsy. The patient asks the nurse what type of bra should be used after the procedure. What should the nurse inform the patient?

The patient should wear a supportive bra after the procedure.

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.

During a teaching demonstration on breast self-examination (BSE), the nurse should always explain that the majority of breast cancers are found in the:

Upper, outer quadrant.

A client with breast cancer is scheduled to undergo chemotherapy with aromatase inhibitors. Which of the following best reflects the rationale for using this group of drugs?

They lower the level of estrogen in the body blocking the tumor's ability to use it.

The nurse is caring for a client who will be having artificial implants for breast reconstruction. The client is arriving at the physician's office for which procedure to be completed before the surgery can be done?

Tissue expansion

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 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.

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.

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 nurse is teaching a client who suspects that she has a lump in her breast. The nurse instructs the client that a diagnosis of breast cancer is confirmed by:

fine needle aspiration.

A nurse is instructing a premenopausal woman about breast self-examination. The nurse should tell the client to do her self-examination:

immediately after her menses.

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 will be having surgery to remove a mass in the left breast. The client is told that the procedure will include removing the tumor and some breast tissue as well as some of the surrounding lymph nodes. Which surgical procedure has been chosen for this client?

segmental mastectomy

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

yearly starting at age 45.