Ch 70
A patient is struggling with body image after breast cancer surgery. Which behavior indicates to the nurse that the patient is maladaptive?
Avoiding eye contact with staff
A patient has undergone breast reconstruction surgery. What information is important for the patient to know in the postoperative period?
Optimal appearance occurs after 3 to 6 months.
Which diagnostic procedure is the definitive way to diagnose breast cancer?
Breast biopsy
A patient has been diagnosed with breast cancer. Which patient-chosen treatment option requires the nurse to discuss with the patient the necessity of considering additional therapy?
Complementary and alternative medicine (CAM)
The nurse is teaching postmastectomy exercises to a patient. Which statement made by the patient indicates that teaching has been effective?
"For the pulley exercise, I'll drape a 6-foot-long rope over a shower curtain rod or over the top of a door."
The nurse is discussing treatment options with a patient newly diagnosed with breast cancer. Which statement by the patient indicates a need for further teaching?
"Radiation will remove the cancer, so I might not need surgery."
A patient who has just been notified that the breast biopsy indicates a malignancy tells the nurse, "I just don't know how this could have happened to me." Which response by the nurse is best?
"Tell me what you mean when you say you don't know how this could have happened to you."
The nurse is assessing a patient for the risk of breast cancer. What factor puts the patient at a moderate risk for breast cancer?
A mother with breast cancer
Which factor puts a patient at the highest risk for breast cancer?
High breast density
A patient is receiving trastuzumab, a type of targeted therapy, and doxorubicin, a type of chemotherapy, for breast cancer. What is the side effect of this combination therapy?
Cardiotoxicity
A patient is transferred to the surgical unit following a mastectomy. The nurse checks the patient's vital signs, neurological condition, and notes the number of drainage tubes and intravenous lines. The nurse finds that the area around the surgical incision is edematous. To determine the reason for the edema, which action should the nurse perform?
Check the drainage tubes for kinking or blockage
Which drug does the nurse identify as an alkylating agent used to treat a patient with breast cancer?
Cyclophosphamide
Which statement about ductal carcinoma in situ (DCIS) is accurate?
DCIS is an early noninvasive form of breast cancer.
A patient takes several medications as part of a treatment plan for breast cancer. The medication list includes trastuzumab. The patient presents to the emergency department with cardiotoxic effects, including excessive fatigue, shortness of breath, chronic cough, and edema. The nurse recognizes that which drug, when taken with trastuzumab (Herceptin), is likely to cause the cardiotoxic effects?
Doxorubicin
The nurse provides education to a patient with breast cancer about how to prevent side effects associated with tamoxifen. What should the nurse include in the teaching?
Eat flaxseeds regularly.
The nurse is instructing a patient with breast cancer who will be undergoing chemotherapy about the side effects of doxorubicin. Which side effect does the nurse instruct the patient to report to the health care provider?
Edema
The nurse is caring for a patient to be discharged the same day after a modified radical mastectomy. What does the nurse teach the patient?
Elevate the affected arm on a pillow.
The nurse is caring for a patient who is prescribed ultrasonography of the breast after mammography. What does the nurse tell her about the purpose of the test?
It helps to differentiate a fluid-filled cyst from a solid mass.
A patient is scheduled for a breast mammography. What is the purpose of this diagnostic test?
It reveals masses too small to be palpated by hand.
Which patient being cared for on the medical-surgical unit will be best to assign to a nurse who has floated from the intensive care unit (ICU)?
Patient with a Jackson-Pratt drain who just arrived from the postanesthesia care unit (PACU) after a quadrantectomy
What information must a patient know to perform a breast self-examination (BSE) correctly?
Perform palpation when lying down.
The nurse teaches a patient who is undergoing breast cancer treatment about complementary and alternative medicine. To prevent nausea associated with the treatments, what should the nurse recommend to the patient?
Ginger
A patient who recently had a mastectomy requests a volunteer to visit her home to help with recovery. Which community resource does the nurse recommend?
Reach to Recovery
A 20-year-old woman with no family history of cancer asks the nurse when she should begin having a clinical breast exam (CBE). Which is the best response by the nurse?
"You need a CBE now and one at least every 3 years until you are 40."
Which complementary and alternative medicines may be effective for treating hot flashes in the patient undergoing radiation therapy for breast cancer?
Acupuncture Flax seed Black cohosh
What postoperative care is most appropriate for a patient who has undergone modified radical mastectomy in the right breast?
Elevating the head of the bed at least 30 degrees.
What type of self-care is required from the patient after breast cancer surgery?
Emptying the drain twice daily
The nurse is instructing a patient on how to perform breast self-examination (BSE). Which techniques does the nurse include in teaching the patient about BSE?
Ensure that the setting in which BSE is demonstrated is private and comfortable. Ask the patient to demonstrate her own method of BSE.
Which factor is a moderate increased risk factor for breast cancer?
Family Hx
A patient is receiving chemotherapy treatment for breast cancer and asks for additional support for managing the associated nausea and vomiting. Which complementary therapy does the nurse suggest?
Ginger
Which statements about infiltrating ductal carcinoma are correct?
It involves replacing normal cells with connective tissue and collagen. It causes skin dimpling in advanced stages. It causes edematous thickening and pitting of breast skin.
A patient is receiving an aromatase inhibitor, a type of hormonal therapy, for breast cancer. Which drug does the nurse recognize as an aromatase inhibitor?
Letrozole
A premenopausal patient diagnosed with breast cancer will be receiving hormonal therapy. The nurse anticipates that the health care provider will request which medication for this patient?
Leuprolide
A patient has been prescribed an aromatase inhibitor to treat breast cancer. Which common side effect is most likely to occur?
Loss of bone density
Which option for prevention and early detection of breast cancer is the option of choice for a patient with a high genetic risk?
Magnetic resonance imaging (MRI) and mammography every year beginning at age 30
Which statement about breast reconstruction surgery is correct?
Many women want breast reconstruction using their own tissue immediately after mastectomy.
A charge nurse observes a new graduate nurse caring for a patient one day after the patient underwent a modified radical mastectomy of the left breast. Which action performed by the new graduate should the charge nurse question?
Measuring the patient's blood pressure on the left arm
A patient has undergone an elective oophorectomy because of the high risk of breast cancer. What is a side effect that results from elective oophorectomy?
Menopause
A patient who had a modified radical mastectomy for cancer 8 hours ago has a Jackson-Pratt drainage tube in place. What is the priority for care of the patient at this time?
Monitor the amount and color of drainage.
Which action can the same-day surgery charge nurse delegate to an experienced unlicensed assistive personnel (UAP) who is helping with the care of a patient who is having a breast biopsy?
Monitor vital signs after surgery.
What anatomic structure is usually left intact when a patient undergoes a modified radical mastectomy?
Muscles
Which assessment finding indicates to the nurse that a patient is at high risk for a malignant breast lesion?
Nipple discharge and dimpling
Which patient has the highest risk for breast cancer?
Older adult woman with high breast density
The nurse is caring for a patient who had a lymph node dissection. What does the nurse teach the patient?
Perform reaching and stretching exercise only until the point of pain.
The nurse is caring for a patient after breast reconstruction surgery. What action does the nurse take?
Position the patient on the nonoperative side.
A patient who has just been discharged from the hospital after a modified radical mastectomy is referred to a home health agency. Which nursing action is most appropriate to delegate to an experienced home health aide?
Reinforcing the guidelines for hand and arm care
The nurse is teaching a patient breast self-examination (BSE). What does the nurse instruct the patient?
Stand in front of the mirror and inspect for any abnormalities. Apply pressure when palpating. Perform palpation when lying down or while showering.
A patient who has undergone breast surgery is struggling with issues concerning her sexuality. What is the best way for the nurse to address the patient's concerns?
Suggest that the patient wear a bra or camisole during intercourse.
A postmenopausal patient is undergoing treatment for breast cancer. To decrease the patient's risk of osteoporosis, which drug should the nurse anticipate will be prescribed?
Tamoxifen
How does the nurse help a patient to prepare for recovery from breast cancer surgery?
Teach the patient to empty the reservoir from the drain.
A community health nurse is teaching a group of young women about breast self-examination (BSE). What instruction should be included in the teaching plan?
Women should conduct a BSE one week after their menstrual period.
Which statement about the early detection of breast masses is correct?
The goal of screening for breast cancer is early detection.
The nurse is performing a clinical breast examination (CBE) for a patient. What finding does the nurse report to the health care provider?
There is a discharge from the nipple.
The nurse is examining the breasts of an older patient. What finding is a cause of concern?
There is edematous thickening and pitting of the breast skin.
What cultural statistics of breast cancer must the nurse know in order to properly care for patients?
Triple negative breast cancer occurs more often in African-American women.
Which factors are identified as carrying the highest risk for the development of breast cancer?
Two or more first-degree relatives with breast cancer (mother, sister, daughter) Age >50 years Female gender
A patient is undergoing chemotherapy for breast cancer. What complementary and alternative therapy (CAM) may help the patient to cope with the side effects of chemotherapy?
Use of flax seed for menopausal symptoms.
What factors are considered low risk factors for breast cancer?
Use of oral contraceptives Hormone replacement therapy
A patient who is undergoing treatment for breast cancer is considering acupuncture. The nurse identifies that the patient may have severe contraindications for acupuncture when which laboratory result is noted in the patient's medical record?
White blood cell count of 3000 cells/microliter
The nurse is caring for a patient who is undergoing chemotherapy for breast cancer. What does the nurse tell the patient who is looking for complementary and alternative therapies (CAM)?
Avoid acupuncture for pain relief.
The nurse is caring for a patient who underwent a modified radical mastectomy. What actions does the nurse take?
Avoid using the affected arm for measuring blood pressure. Monitor the volume and amount of drainage. Observe the wound for signs of swelling or infection.
