Chapter 51: Breast Disorders

While assessing a patient, the nurse finds that the patient has pain in the breasts and cracked nipples. What does the nurse infer about the patient's condition from the clinical manifestations presented? A. Breast cysts B. Ductal ectasia C. Fibroadenoma D. Lactational mastitis

D. Lactational mastitis

A patient reports tenderness and a lump in the breast. The primary health care provider records the size of the tumor to be 7 cm. The pathology report reveals two lymph nodes to be cancerous. Which stage of cancer is described? A. Stage 0 B. Stage 1 C. Stage 2 D. Stage 3

C. Stage 2

A nurse explains the importance of wearing a well-fitting bra to an older adult patient. What explanation should the nurse give to the patient regarding the importance of doing this? Select all that apply. A. It helps to prevent intertrigo. B. It helps to improve physical appearance. C. It promotes better blood circulation to the breast. D. It reduces pain in the back, shoulders, and neck. E. It facilitates more comfortable and effective breathing

A. It helps to prevent intertrigo. B. It helps to improve physical appearance. D. It reduces pain in the back, shoulders, and neck.

An older female patient reports having a pendulous breast. What age-related breast changes would the nurse suspect in this patient? Select all that apply. A. Loss of subcutaneous fat B. Loss of structural support C. Atrophy of mammary glands D. Proliferation of mammary ducts E. Hyperplasia of mammary ducts

A. Loss of subcutaneous fat B. Loss of structural support C. Atrophy of mammary glands

Which gene is responsible for the production of the cancer marker CA 15-3? A. MUC1 gene B. CHEK2 gene C. BRCA1 gene D. BRCA2 gene

A. MUC1 gene

What topics should the nurse include in discharge teaching for a patient who underwent an axillary lymph node dissection? Select all that apply. A. Management of drains B. Upper limb exercises C. Deep breathing exercises D. Self-monitoring of vital signs E. Self-administration of chemotherapy

A. Management of drains B. Upper limb exercises C. Deep breathing exercises

Which condition is caused by staphylococci? A. Mastitis B. Mastalgia C. Fat necrosis D. Ductal ectasia

A. Mastitis

A patient tells the nurse, "My breasts are sagging after losing so much weight." What procedure should the nurse prepare to educate the patient about? A. Mastopexy B. Lumpectomy C. Mammoplasty D. Modified radical mastectomy

A. Mastopexy

The nurse is obtaining the medical history of a male patient suffering from gynecomastia. Which responses given by this patient could be the possibilities for developing gynecomastia? Select all that apply. A. "I am smoking marijuana." B. "I am taking ranitidine for acidity." C. "I am taking spironolactone for cirrhosis." D. "I am taking ibuprofen for muscle aches." E. "I am administering gabapentin for resolution of seizure attacks."

A. "I am smoking marijuana." B. "I am taking ranitidine for acidity." C. "I am taking spironolactone for cirrhosis."

The lactation consultant is educating a lactating mother with mastitis. Which statements made by the patient indicate a need for further teaching? A. "I will avoid using a nipple shield while breastfeeding my baby." B. "I will express the breast milk by hand for feeding the baby." C. "I will avoid feeding the baby if any purulent discharge is seen from the nipple." D. "I will notify the health care provider if redness persists post-antibiotic therapy."

A. "I will avoid using a nipple shield while breastfeeding my baby."

The nurse is providing postoperative teaching for a patient after a mastectomy. Which is the priority postoperative goal? A. Adhere to the therapeutic plan. B. Comply with follow-up appointments. C. Manage side effects of drug therapy. D. Participate in decisions regarding treatment.

A. Adhere to the therapeutic plan.

A patient with mastalgia complains of burning, aching, and soreness of both the breasts. What prescription should the nurse question? A. Antibiotics B. Androgens C. Oral contraceptives D. Antiinflammatory drugs

A. Antibiotics

The nurse is assessing a patient with galactorrhea. What finding would the nurse anticipate observing? A. Milky nipple discharge B. Bloody nipple discharge C. Yellow nipple discharge D. Multicolored nipple discharge

A. Milky nipple discharge

A patient with breast cancer underwent a partial mastectomy with radiation therapy. For which symptoms should the nurse tell the patient to be observant? Select all that apply. A. Arm swelling B. Breast soreness C. Skin reactions D. Excessive hair loss E. Gastrointestinal disturbances

A. Arm swelling B. Breast soreness C. Skin reactions

A patient reports soreness of the breast and is diagnosed as having cyclic mastalgia. What instructions should the nurse give the patient? Select all that apply. A. Avoid consuming fatty food. B. Drink coffee to relieve pain. C. Wear a good support bra continuously. D. Use compresses and ice when pain occurs. E. Consume food rich in vitamins (A, B complex, E). F. Avoid taking antiinflammatory drugs.

A. Avoid consuming fatty food. C. Wear a good support bra continuously. D. Use compresses and ice when pain occurs. E. Consume food rich in vitamins (A, B complex, E).

A patient has been diagnosed with breast cancer and has been prescribed doxorubicin. Which assessments should the nurse make before administering the drug? Select all that apply. A. Check for signs and symptoms of infections. B. Check whether any recent live vaccinations have been received by the patient. C. Check whether the patient has high sugar levels. D. Check whether the patient is in contact with any person who has received live attenuated virus. E. Check the cholesterol levels of the patient.

A. Check for signs and symptoms of infections. B. Check whether any recent live vaccinations have been received by the patient. D. Check whether the patient is in contact with any person who has received live attenuated virus.

A male patient presents to the clinic with new-onset gynecomastia. The nurse reviews the patient's medication list and correctly identifies which medications as possibly causing the patient's gynecomastia? Select all that apply. A. Digitalis B. Ranitidine C. Acetaminophen D. Spironolactone E. Acetylsalicylic acid

A. Digitalis B. Ranitidine D. Spironolactone

A patient presents to the clinic reporting new-onset nipple discharge stating, "I don't know what is happening. It's been over 20 years since I breastfed my last child." During the physical exam, the nurse expresses thin, white, nonodorous fluid from both breasts. What does the nurse document that the patient is experiencing? A. Galactorrhea B. Purulent discharge C. Sanguineous drainage D. Serosanguinous secretion

A. Galactorrhea

A patient is scheduled for a breast-conserving surgery (lumpectomy) with radiation therapy. What possible complications does the nurse monitor the patient for? Select all that apply. A. Hematoma B. Lymphedema C. Breast edema D. Breast soreness E. Chest wall tightness

A. Hematoma C. Breast edema D. Breast soreness

The instructor is teaching a nursing student about the characteristics of fibroadenomas compared to cancerous growths. Which characteristics does the student correctly state fibroadenomas include? Select all that apply. A. High mobility B. Nipple discharge C. Absence of pain D. Nipple retraction E. Either softness or firmness

A. High mobility C. Absence of pain E. Either softness or firmness

An older adult patient who had a mastectomy for breast cancer six months ago wants to have breast reconstructive surgery. The nurse knows that what is the most likely motivation for this patient seeking this surgery? A. Improvement of the woman's self-image B. Being able to experience sexual arousal C. Getting a tummy tuck as well as the breast mound D. Restoring the premastectomy appearance of the breast

A. Improvement of the woman's self-image

The nurse is caring for a patient who underwent a partial mastectomy with axillary lymph node dissection. For which signs and symptoms should the nurse monitor to detect lymphedema? Select all that apply. A. Inability to move the arm B. Heaviness and pain in the arm C. Tingling sensation in the fingers D. Unbearable itching along the suture line E. Decreased strength of the arm muscles

A. Inability to move the arm B. Heaviness and pain in the arm C. Tingling sensation in the fingers

A patient who has undergone surgery for breast cancer reports muscle weakness and loss of sense of touch. Which surgery does the nurse understand the patient likely has undergone? A. Modified radical mastectomy B. Lumpectomy with radiation therapy C. Tissue expansion and breast implantation D. Breast reconstruction tissue flap procedure

A. Modified radical mastectomy

A patient's treatment plan includes a surgery that involves removal of the breast, preservation of the pectoralis muscles, sentinel lymph node dissection (SLND), and axillary lymph node dissection. The nurse expects that the surgical consent will list what procedure? A. Modified radical mastectomy B. Tissue expansion and breast implants C. Deep inferior epigastric artery perforator (DIEP) flap D. Transverse rectus abdominis musculocutaneous (TRAM) flap

A. Modified radical mastectomy

The nurse is assessing the breasts of a patient with fibrocystic complex and observes a thin green discharge from the left nipple without redness or swelling. The patient denies any unusual pain or discomfort, and vital signs are within the normal range for the patient. What does the nurse identify the green discharge as? A. Normal B. Infection C. Inflammation D. Exacerbation

A. Normal

Four patients are diagnosed with different breast disorders. Which patient's condition would be painless? A. Patient A: Fibroadenoma B. Patient B: Lactational Mastasis C. Patient C: Mastalgia D. Patient D: Ductal elastase

A. Patient A: Fibroadenoma

The nurse educates the patient about breast self-examination (BSE). How should the nurse inform the patient to tighten the pectoralis muscle? A. Placing her hands firmly on hips B. Sitting with her arms slightly raised C. Standing upright with arms slightly raised D. Lying down and placing the left arm behind the head

A. Placing her hands firmly on hips

The nurse is explaining the clinical manifestations of breast cancer to a group of young women. Which characteristics are true for breast cancer? Select all that apply. A. Presence of nipple retraction B. Presence of a lump in the breast that is highly mobile and tender C. Presence of peau d'orange in the skin of the involved breast D. Presence of a lump that is irregular in shape and poorly delineated E. Presence of a lump in the lower outer quadrant of the breast

A. Presence of nipple retraction C. Presence of peau d'orange in the skin of the involved breast D. Presence of a lump that is irregular in shape and poorly delineated

When teaching a patient about the prevention of breast cancer, what should be included as helpful in decreasing the risk of breast cancer? Select all that apply. A. Prevent smoking and alcohol intake. B. Prevent exposure to harmful radiation. C. Increase the use of oral contraceptives. D. Prevent gaining excess weight during adulthood. E. Use combined hormone therapy (progesterone and estrogen) after menopause.

A. Prevent smoking and alcohol intake. B. Prevent exposure to harmful radiation. D. Prevent gaining excess weight during adulthood.

A postmenopausal woman reports pendulous breasts. The nurse advised the patient to wear a well-fitting bra. Which outcomes could the nurse expect in this patient with this intervention? Select all that apply. A. Prevention of intertrigo B. Reduction of pain in the back C. Reduction of pain in the neck D. Reduction of pain in the breast E. Correction of sagging of breasts F. Improvement in the physical appearance

A. Prevention of intertrigo B. Reduction of pain in the back C. Reduction of pain in the neck F. Improvement in the physical appearance

The nurse is writing a plan of care for a patient with cyclic mastalgia. What actions should be included when educating the patient about the prevention or management of cyclic mastalgia? Select all that apply. A. Taking vitamin E B. Eating a chocolate bar C. Decreasing caffeine intake D. Wearing loose-fitting bras E. Reducing dietary fat intake

A. Taking vitamin E C. Decreasing caffeine intake E. Reducing dietary fat intake

Which intervention would the nurse include in the care plan for a patient who is on doxorubicin and cyclophosphamide therapy? A. Monitor for signs of stroke. B. Monitor for vaginal bleeding. C. Monitor for signs of pulmonary embolism. D. Monitor for electrocardiogram (ECG) changes.

D. Monitor for electrocardiogram (ECG) changes.

A nurse assesses a patient with a lump in the breast suspected to be a fibroadenoma. Which sign or symptom would the nurse expect to document? A. The lump is small and mobile. B. The lump enlarges during menstruation. C. The lump is accompanied by nipple discharge. D. The lump is tender to the touch.

A. The lump is small and mobile.

The primary health care provider has performed an estrogen and progesterone receptor status test for a patient with breast cancer. The result of this test has revealed that the tumor is receptor positive. Which statements appropriately convey the meaning of the test results to the patient? Select all that apply. A. The tumor cells have a higher normal DNA content than do other types. B. The tumor has a low chance of recurrence. C. The tumor cells are poorly differentiated. D. The tumor will multiply at a very fast rate. E. The tumor will respond well to hormone therapy.

A. The tumor cells have a higher normal DNA content than do other types. B. The tumor has a low chance of recurrence. E. The tumor will respond well to hormone therapy.

A patient has been diagnosed as having breast cancer stage TNM IIIC. The nurse has to convey the meaning of TNM IIIC. Which points should the nurse include in the explanation? Select all that apply. A. The tumor size is more than 5 cm. B. The tumor will respond well to hormone therapy. C. The cancer has affected the bone and spinal cord. D. The cancer has spread to more than 10 adjacent lymph nodes. E. The cancer is unresponsive to therapy.

A. The tumor size is more than 5 cm. D. The cancer has spread to more than 10 adjacent lymph nodes.

A patient has been diagnosed as having noninvasive lobular carcinoma of the breast. Which information should the nurse provide the patient? Select all that apply. A. This is not considered to be a premalignant lesion. B. No surgical treatment is indicated for this condition. C. The cancer arises from the ducts connecting the milk producing glands. D. The patient may have to undergo radiation therapy to prevent spreading of the cancer. E. She may have to take hormone therapy to reduce her risk of breast cancer.

A. This is not considered to be a premalignant lesion. B. No surgical treatment is indicated for this condition. E. She may have to take hormone therapy to reduce her risk of breast cancer.

A patient has been diagnosed as BRCA1 and BRCA2 positive. The health care provider has suggested a prophylactic bilateral oophorectomy for this patient. What information should the nurse provide before this patient decides to undergo this procedure? Select all that apply. A. This procedure will reduce the risk of acquiring breast cancer by 50%. B. This procedure can decrease the patient's susceptibility to acquiring heart disease. C. The patient will not be able to bear children naturally after this procedure. D. This procedure will increase the patient's susceptibility to developing osteoporosis. E. The patient will not have menstrual cycles after the surgery.

A. This procedure will reduce the risk of acquiring breast cancer by 50%. C. The patient will not be able to bear children naturally after this procedure. D. This procedure will increase the patient's susceptibility to developing osteoporosis. E. The patient will not have menstrual cycles after the surgery.

A patient recently underwent a radical mastectomy and wishes to have breast reconstruction surgery. What information should the nurse give the patient before she gives the consent for surgery? Select all that apply. A. This surgery will not restore lactation. B. The surgery will not restore nipple sensation or erectility. C. This surgery would be useful in preserving self-image and regaining a sense of normalcy. D. The postsurgical look of the breast will fully resemble its premastectomy appearance. E. The postsurgical treatment will require an external prosthesis to restore the contour of the breast.

A. This surgery will not restore lactation. B. The surgery will not restore nipple sensation or erectility. C. This surgery would be useful in preserving self-image and regaining a sense of normalcy.

A nurse is reviewing the record of a patient with breast cancer to determine the cancer stage according to the TNM system (tumor size, nodal involvement, presence of metastasis). Which parameters are taken into account in TNM staging of cancers? Select all that apply. A. Tumor size B. Metastasis C. Number of tumors D. Lymph node involvement E. Response to hormonal therapy

A. Tumor size B. Metastasis D. Lymph node involvement

What diagnostic option will the nurse educate the patient about that will differentiate a cystic mass from a solid mass since the breast tissues are dense? A. Ultrasound B. Mammography C. Core needle biopsy D. Vacuum-assisted biopsy

A. Ultrasound

The nurse is caring for a patient with breast cancer receiving trastuzumab therapy. What conditions could result as adverse effects of the drug that the nurse should monitor for? Select all that apply. A. Ventricular dysfunction B. Heart failure C. Deep vein thrombosis D. Gastroenteritis E. Retinopathy

A. Ventricular dysfunction B. Heart failure

A nurse is explaining the mammography procedure to a patient. Which statement best describes the procedure? A. A method of capturing ultrasonic images of the breast B. A method to visualize the breast's internal structure using x-rays C. A method that uses powerful magnetic and radio waves to create images of the breast D. A method that involves inserting a small needle into the breast tissue to obtain a tissue sample

B. A method to visualize the breast's internal structure using x-rays

A patient is progressing through menopause and still using high doses of estrogen supplements. Which condition should the nurse caution the patient that may become aggravated as a result of this? A. Ductal ectasia B. Fibroadenoma C. Fibrocystic complex D. Intraductal papilloma

C. Fibrocystic complex

Which condition does the nurse suspect in a patient who underwent the surgical removal of one breast six months ago and reports a tingling sensation, numbness in the arm, and unmanageable itching? A. Ductal ectasia B. Paget's disease C. Lactational mastitis D. Post-breast therapy pain syndrome (PBTPS)

D. Post-breast therapy pain syndrome (PBTPS)

The nurse is educating a patient with fibrocystic changes in the breast. What statement by the nurse demonstrates further education is needed? A. "Cysts may become painful just before menstruation." B. "Cysts may recur in one or both breasts during the postmenopausal period." C. "Lumps would be difficult to palpate in the case of severe fibrocystic changes." D. "Any lump responding in an acyclic manner over a two-week period should be examined."

B. "Cysts may recur in one or both breasts during the postmenopausal period."

The registered nurse is teaching the student nurse about the management of fibrocystic changes in the breast. Which statement made by the student nurse indicates the need for further teaching? A. "Excisional biopsy may be performed if a residual mass remains after fluid aspiration." B. "Excisional biopsy may be performed for the patients if the fluid is found on aspiration." C. "Excisional biopsy may be performed if the fluid that is found is hemorrhagic." D. "Surgical removal may be the best treatment option for the patient who has large and recurrent cysts."

B. "Excisional biopsy may be performed for the patients if the fluid is found on aspiration."

The nurse is instructing a patient about breast self-examination (BSE). Which statements made by the patient indicate effective learning? Select all that apply. A. "I should stand straight and place my left arm behind my head." B. "I should stand in front of the mirror by placing the hands on my hip." C. "I should examine each underarm while standing or sitting with arms raised slightly." D. "I should examine my breast by rotating the finger pads in a circular pattern over the entire breast." E. "I should use the three middle finger pads of my right hand to feel lumps on the breast."

B. "I should stand in front of the mirror by placing the hands on my hip." C. "I should examine each underarm while standing or sitting with arms raised slightly." E. "I should use the three middle finger pads of my right hand to feel lumps on the breast."

A patient is preparing to begin breast cancer treatment with tamoxifen. What point should the nurse emphasize when teaching the patient about the new drug regimen? A. "You may find that your medication causes some breast sensitivity." B. "It's important that you let your health care provider know about any changes in your vision." C. "You'll find that this drug often alleviates some of the symptoms that accompany menopause." D. "It's imperative that you abstain from drinking alcohol after you begin taking tamoxifen."

B. "It's important that you let your health care provider know about any changes in your vision."

The nurse has been asked to participate in a healthy living workshop. While teaching about women's health, which guidelines should the nurse provide to the audience? A. "Mammograms are necessary if you have a family history of breast cancer." B. "It's recommended that you get a mammogram each year after you turn 40." C. "If you are not able to perform breast self-examination (BSE), you should go for regular mammograms." D. "You should ensure that your primary health care provider performs a breast examination each time you visit."

B. "It's recommended that you get a mammogram each year after you turn 40."

A student nurse is learning about characteristics of with fibrocystic breast complex. Which statement made by the student requires correction? A. "Fibrocystic complex occurs most frequently in women 30 to 50 years old." B. "Patients with fibrocystic complex are at higher risk for developing breast cancer." C. "Pain and discomfort associated with fibrocystic complex tends to increase over time." D. "Fibrocystic complex pain usually occurs in the premenstrual phase and subsides after menstruation."

B. "Patients with fibrocystic complex are at higher risk for developing breast cancer."

The registered nurse is teaching a student nurse about the diagnostic procedures performed for definitive diagnosis of a suspicious area in the breast. Which statement made by the student nurse indicates effective learning? A. "Vacuum-assisted biopsy allows for single samples through a single needle." B. "Surgical biopsy is performed by removing the breast mass or breast lump for analysis." C. "Core needle biopsy involves insertion of a single needle to obtain sample fluid from a breast cyst." D. "Fine-needle aspiration biopsy involves removal of small samples of breast tissue using a hollow-core needle."

B. "Surgical biopsy is performed by removing the breast mass or breast lump for analysis."

A patient who has undergone breast augmentation earlier in the day will be discharged home in the early evening. What instructions should the nurse provide to minimize the patient's risk of complications in the immediate recovery period? A. Avoid wearing a bra until postoperative day three. B. Ask the patient to avoid strenuous exercise during her recovery period. C. Sleep in a semi-Fowler's position until her scheduled follow-up appointment. D. Enlist a friend or family member to perform passive range-of-motion exercises.

B. Ask the patient to avoid strenuous exercise during her recovery period.

A patient is suspected of having Paget's disease. What clinical manifestation assed by the nurse would correlate with this diagnosis? A. Sticky nipple discharge B. Bloody nipple discharge C. Palpable fluid-filled mass D. Hard mass with irregular borders

B. Bloody nipple discharge

A patient with breast cancer has been prescribed tamoxifen. What side effects should the nurse advise the patient to monitor for while taking this medication? Select all that apply. A. Chest pain B. Blurred vision C. Leg cramps D. Gastrointestinal disturbances E. Irregular vaginal bleeding

B. Blurred vision C. Leg cramps E. Irregular vaginal bleeding

A patient who underwent a radical mastectomy expresses concern that she may not look the same. What options should the nurse mention to her that may aid in improving her body image? Select all that apply. A. Self-massaging of the area can be helpful. B. Breast reconstruction surgeries can be considered. C. Estrogen pills can be used to help in developing the breasts. D. Garments such as camisoles with soft breast prosthetic inserts can be used. E. Permanent weighted prosthesis and bra can be used at around four to eight weeks postoperatively.

B. Breast reconstruction surgeries can be considered. D. Garments such as camisoles with soft breast prosthetic inserts can be used. E. Permanent weighted prosthesis and bra can be used at around four to eight weeks postoperatively.

The nurse is educating a group of women about screening and early detection of breast cancer during a breast awareness program. What should the nurse be sure to include when discussing this with the group? Select all that apply. A. Breast self-examination is preferred during the first day of menstruation. B. Breast self-examination is an option for women starting at the age of 20 years. C. Clinical breast examination is preferred every year for women who are above 40 years of age. D. Clinical breast examination is preferred at least every three years in women ages 20 to 30 years. E. Use the same level of pressure when examining the breast tissue.

B. Breast self-examination is an option for women starting at the age of 20 years. C. Clinical breast examination is preferred every year for women who are above 40 years of age. D. Clinical breast examination is preferred at least every three years in women ages 20 to 30 years.

A nurse is teaching a group of teenagers about breast cancer prevention. What topics should the nurse include in the presentation? Select all that apply. A. Yearly regular mammograms starting at age 60 B. Breast self-examinations C. Identification of an at-risk population D. Breast self-examination before the onset of menstruation monthly E. Importance of clinical breast examination yearly after age 40

B. Breast self-examinations D. Breast self-examination before the onset of menstruation monthly E. Importance of clinical breast examination yearly after age 40

A patient reports breast heaviness and pain that lasted for three days during her menstrual period. What does the nurse suspect about this patient's condition? A. Mastitis B. Cyclic mastalgia C. Intraductal papilloma D. Lactational breast abscess

B. Cyclic mastalgia

What information should the nurse give to a patient newly diagnosed with fibrocystic disease of the breast? Select all that apply. A. Cysts could turn into cancer. B. Cyst formation can be checked through regular breast self-examination. C. Cysts may recur in one or both breasts until menopause. D. Cysts may enlarge and become painful immediately after menstruation. E. Cyst formation can be checked on any new lump that does not respond in a cyclic manner over one to two weeks.

B. Cyst formation can be checked through regular breast self-examination. C. Cysts may recur in one or both breasts until menopause. E. Cyst formation can be checked on any new lump that does not respond in a cyclic manner over one to two weeks.

While performing a physical examination of the breast in a geriatric patient, the nurse is palpating the patient's breast to check for the presence of lumps. Which age-related change in this patient makes the breast easily palpable? A. Decreased calcification B. Decreased glandular mass C. Decreased subcutaneous fat D. Decreased structural support

B. Decreased glandular mass

A young adult female patient is having screening for breast cancer but has dense breast tissues. What radiological procedure should the nurse prepare the patient for? A. Ultrasound B. Digital mammography C. Fine needle aspiration D. Sterotactic core needle biopsy

B. Digital mammography

The nurse assesses that a newly admitted male patient has gynecomastia. What medications should the nurse question the patient about taking? Select all that apply. A. Aspirin B. Digitalis C. Isoniazid D. Spironolactone E. Ranitidine

B. Digitalis C. Isoniazid D. Spironolactone E. Ranitidine

The nurse is caring for a perimenopausal patient with thick, gray nipple discharge associated with breast pain. Which condition does the nurse suspect? A. Fat necrosis B. Ductal ectasia C. Fibroadenoma D. Lactational mastitis

B. Ductal ectasia

The nurse is performing a breast assessment on a patient reporting nipple discharge with burning, itching, and pain around the nipple. The nurse observes that there is swelling in the areolar area. Which breast disorder does the nurse suspect this patient is experiencing? A. Mastitis B. Ductal ectasia C. Fibroedenoma D. Intraductal papilloma

B. Ductal ectasia

Upon examination, the nurse finds that the patient has a hard, mobile, and indurated mass with irregular borders in the breast. What does the nurse infer from these findings? A. Mastitis B. Fat necrosis C. Breast cysts D. Ductal ectasia

B. Fat necrosis

A man is determined to be at risk for breast cancer during a routine health screening by the nurse. The patient does not give any history of radiation exposure or genetic inheritance. Which other factor would have led the nurse to label the patient as high risk? A. History of on and off fever B. History of allergic rashes C. History of taking hormone replacement therapy for changing sex D. History of sudden excessive hair loss resulting in alopecia

C. History of taking hormone replacement therapy for changing sex

A patient with breast cancer chooses to undergo a radical mastectomy and take hormone therapy but is concerned about the effects of this treatment on her sex life. What information should the nurse provide the patient? Select all that apply. A. Mastectomy does decrease sexual satisfaction. B. Hormone therapy may cause a decreased sexual drive. C. Vaginal dryness may be present. D. Sex should be avoided for a few months after surgery. E. Lubrication may be used during sexual intercourse.

B. Hormone therapy may cause a decreased sexual drive. C. Vaginal dryness may be present. E. Lubrication may be used during sexual intercourse.

The nurse is assessing a patient with breast cancer for the presence of any metastasis. The nurse suspects that the patient may have brain involvement. Which signs and symptoms would have led the nurse to this conclusion? Select all that apply. A. Dyspnea B. Incoordination of movements C. Unilateral sensory loss D. Progressive radiating back pain E. Nausea and vomiting which are unrelated to medication

B. Incoordination of movements C. Unilateral sensory loss E. Nausea and vomiting which are unrelated to medication

A patient experiences post-breast therapy pain syndrome (PBTPS). What should the nurse explain to the patient is the cause of this syndrome? A. Accumulation of lymph in soft tissue B. Injury to the intercostobrachial nerves C. Deposition of calcium crystals in the breast D. Increase in estrogen and progesterone levels

B. Injury to the intercostobrachial nerves

A nurse is explaining the sentinel lymph node dissection for diagnosis of cancer to a patient suspected of having breast cancer. Which statements best describe the procedure? Select all that apply. A. It involves dissecting all of the axillary lymph nodes for testing. B. It helps the surgeon identify the lymph nodes that drain first from the tumor site. C. It involves injecting the radioisotope into the affected breast and intraoperatively identifying the sentinel node. D. It confirms that axillary lymph node dissection is more accurate than sentinel lymph node dissection. E. It ensures that if sentinel lymph node dissection is negative, then no further axillary surgery is required.

B. It helps the surgeon identify the lymph nodes that drain first from the tumor site. C. It involves injecting the radioisotope into the affected breast and intraoperatively identifying the sentinel node. E. It ensures that if sentinel lymph node dissection is negative, then no further axillary surgery is required.

When caring for a patient who underwent a mastectomy, what nursing interventions should be performed to prevent shoulder joint complications and restoration of arm movements? Select all that apply. A. Place the patient in a prone position. B. Keep the affected arm elevated on a pillow. C. Keep the affected shoulder immobile after surgery to prevent pain. D. Administer analgesics 30 minutes before the initiation of shoulder exercises. E. Pour warm water on the involved shoulder.

B. Keep the affected arm elevated on a pillow. D. Administer analgesics 30 minutes before the initiation of shoulder exercises. E. Pour warm water on the involved shoulder.

The nurse is administering an aromatase inhibitor to a patient with ER positive breast cancer. Which medication will the nurse administer? A. Raloxifene B. Letrozole C. Fulvestrant D. Trastuzumab

B. Letrozole

The nurse is caring for a female patient who reports diffuse heaviness of the breast, which lasts for two to three days each month. Which disorder does the nurse suspect? A. Mastitis B. Mastalgia C. Galactorrhea D. Fibrocystic changes

B. Mastalgia

Which task could the registered nurse delegate to unlicensed assistive personnel (UAP) during the care of a patient who has had recent transverse rectus abdominis musculocutaneous (TRAM) flap surgery? A. Document the condition of the patient's incisions. B. Mobilize the patient in a slightly hunched position. C. Change the patient's abdominal and chest dressings. D. Change the parameters of the patient-controlled analgesic (PCA) pump.

B. Mobilize the patient in a slightly hunched position.

The nurse is caring for a patient with breast cancer who is receiving doxorubicin therapy. To prevent complications, which interventions should be included in the care plan? Select all that apply. A. Monitor estrogen levels. B. Monitor for signs of cardiotoxicity. C. Provide a low-protein diet to prevent food interactions. D. Recommend that the patient take aspirin to obtain pain relief. E. Instruct the patient to not receive any immunizations without the health care provider's approval.

B. Monitor for signs of cardiotoxicity. E. Instruct the patient to not receive any immunizations without the health care provider's approval.

A patient reporting pain in her left breast was prescribed danazol. During the follow-up visit, the primary health care provider finds that the patient has discontinued the drug. What could be the possible reasons for discontinuation of the drug? Select all that apply. A. Patient has itching B. Patient has edema C. Patient developed severe acne D. Patient has hair growth on the face E. Patient has yellow discharge from her left breast

B. Patient has edema C. Patient developed severe acne D. Patient has hair growth on the face

A patient who underwent a radical mastectomy is depressed and not coping well. In what ways can the nurse help the patient cope with the depression? Select all that apply. A. Administer an antidepressant drug. B. Provide a comfortable environment to let her express all her feelings. C. Promote communication between the patient and family or friends. D. Teach and encourage the patient to use various coping techniques. E. Avoid the questions being asked by the patient, because talking about such topics may simply accentuate her depression. F. Explain various ways to improve her body image, such as breast reconstruction or use of external implants.

B. Provide a comfortable environment to let her express all her feelings. C. Promote communication between the patient and family or friends. D. Teach and encourage the patient to use various coping techniques. F. Explain various ways to improve her body image, such as breast reconstruction or use of external implants.

A nurse is explaining the procedures involved in modified radical mastectomy surgery to a patient with breast cancer. Which statements best describe the procedure? Select all that apply. A. Wide excision of the tumor B. Removal of the breast C. Removal of axillary lymph nodes D. Removal of pectoralis major muscle E. Insertion of implant under the musculofascial layer of the chest wall

B. Removal of the breast C. Removal of axillary lymph nodes

A 45-year-old female presents to the clinic reporting occasional bloody nipple discharge from the right breast. There is no obvious mass upon palpation of breast tissue. What does the nurse suspect? A. Ductal ectasia B. Atypical hyperplasia C. Intraductal papilloma D. Idiopathic galactorrhea

C. Intraductal papilloma

The nurse is caring for a patient who recently underwent a radical mastectomy. What nursing interventions are appropriate for this patient to manage post-breast therapy pain syndrome (PBTPS)? Select all that apply. A. Explain that the pain occurs due to injury to the motor nerves that supply shoulder and arm muscles. B. Suggest shoulder exercises that would be helpful in preventing frozen shoulder. C. Confirm that the symptoms would persist for not more than two weeks after surgery. D. Administer nonsteroidal antiinflammatory drugs and antidepressants to relieve pain. E. Check whether the patient has chest and upper arm pain, tingling down the arm, numbness, and unbearable itching.

B. Suggest shoulder exercises that would be helpful in preventing frozen shoulder. D. Administer nonsteroidal antiinflammatory drugs and antidepressants to relieve pain. E. Check whether the patient has chest and upper arm pain, tingling down the arm, numbness, and unbearable itching.

After having a mastectomy a patient is placed on a medication to reduce the estrogen levels. What medication should the nurse educate the patient regarding? A. Paclitaxel B. Tamoxifen C. Doxorubicin D. Cyclophosphamide

B. Tamoxifen

The nurse is caring for a patient who is diagnosed with stage I breast cancer. Which assessment finding corresponds with this diagnosis? A. Metastasis is present. B. The size of the tumor is less than 2 cm. C. The axillary lymph nodes are involved. D. The internal mammary lymph nodes are affected.

B. The size of the tumor is less than 2 cm.

The nurse is providing discharge planning for a patient involved in a motor vehicle crash with a chest injury. Which risk factor should the nurse discuss with the patient? A. Inverted nipples B. Trauma to breast C. Previous lactation D. Postpartum lactation

B. Trauma to breast

The nurse is educating a group of women about breast cancer. Where should the nurse inform the group that most breast cancers occur? A. Nipple area B. Upper outer quadrant of the breast C. Upper medial area D. Lower outer quadrant

B. Upper outer quadrant of the breast

The nurse is teaching a female patient who has undergone lymph node excision about measures to reduce lymphedema in the arm. Which action of the patient indicates the need for further teaching? A. Pushing against the wall B. Wearing clothing with loose fitting sleeves C. Placing hands under the head while sleeping D. Applying antibiotic ointment to the injury on the arm

B. Wearing clothing with loose fitting sleeves

Which women are at an increased risk of acquiring fibrocystic changes in the breast? Select all that apply. A. Women who are breastfeeding B. Women who are nulliparous C. Women with late menopause D. Women using oral contraceptives E. Women with spontaneous abortions

B. Women who are nulliparous C. Women with late menopause E. Women with spontaneous abortions

The nurse is educating a patient about the risks of breast cancer. Which information will the nurse include in this teaching? A. Breast self-exams should be done monthly. B. Breast cancer is rare in men and is not of any concern to them. C. Breast cancer is the leading cause of cancer deaths in women. D. Hyperplasia increases the cancer risk and leads to breast cancer.

D. Hyperplasia increases the cancer risk and leads to breast cancer.

A female patient with fibrocystic breast complex receives instructions on performing monthly self-breast examinations (SBE). The patient asks, "Will these cysts turn into cancer?" What is the nurse's best response? A. "Yes, it is likely one or more of your cysts will become cancerous over time." B. "No, there is no risk of breast cancer at all. Usually, the cysts come and go." C. "Cysts do not turn into cancer. Call your health care provider if you develop new cysts that do not respond in a cyclic manner as usual." D. "Call your health care provider if you find that any of the cysts are sore around the time of menstruation, as this can mean you have breast cancer."

C. "Cysts do not turn into cancer. Call your health care provider if you develop new cysts that do not respond in a cyclic manner as usual."

The nurse provides preprocedure education to a patient scheduled for a mammogram. Which statement made by the patient indicates understanding of the information? A. "I won't take a shower before the test." B. "I won't eat or drink anything after midnight." C. "I won't use deodorant or body powder in the morning." D. "I won't take any medications on the morning of the test."

C. "I won't use deodorant or body powder in the morning."

The nurse is educating a patient about mastalgia. What patient statement demonstrates understanding that cyclic mastalgia is tenderness or heaviness in the breast and occurs during what time? A. "It occurs with early menopause." B. "It occurs during the circadian rhythm." C. "It will occur during my menstrual cycle." D. "It will occur during the natural aging process."

C. "It will occur during my menstrual cycle."

The nurse is preparing a plan of care for a patient to reduce postoperative edema after a mastectomy. Which nursing interventions are recommended? Select all that apply. A. "Elevate the affected arm at night." B. "Apply topical antibiotics and a sterile dressing." C. "Perform isometric exercises to the affected arm." D. "Take analgesics 30 minutes before your exercises." E. "Massage therapy of the lymph areas may be helpful." F. "Wear intermittent compression sleeves during the day."

C. "Perform isometric exercises to the affected arm." D. "Take analgesics 30 minutes before your exercises." E. "Massage therapy of the lymph areas may be helpful." F. "Wear intermittent compression sleeves during the day."

The nurse is providing preoperative teaching for a patient prior to a simple mastectomy. Which nursing statement is correct? A. "Only the breast mass will be removed." B. "The mammary glands will be removed." C. "The breast tissue and mammary glands will be removed." D. "The lymph nodes and mammary glands will be removed."

C. "The breast tissue and mammary glands will be removed."

A patient is suspected to have distant metastasis of breast cancer to the spinal cord. What clinical manifestation does the nurse anticipate assessing? A. Muscular weakness B. Swelling in the abdomen C. Change in bowel function D. Loss of sensation on one side

C. Change in bowel function

The nurse is educating a patient about oral contraceptives for the treatment of a breast disorder. Which breast disorder does the nurse determine should be discussed? A. Mastitis B. Fat necrosis C. Cyclic mastalgia D. Lactational breast abscess

C. Cyclic mastalgia

A primiparous patient has a three-week-old infant whom she is breastfeeding. The woman has sought care because of recent breast tenderness, redness, and fever. Which teaching point should the nurse prioritize when following up her care? A. Encourage patient to continue breastfeeding her infant. B. Refer patient for a mammogram as quickly as possible. C. Ensure patient adheres to her prescribed antibiotic regimen. D. Teach patient to use warm compresses and educate her about the self-limiting nature of illness.

C. Ensure patient adheres to her prescribed antibiotic regimen.

Which disorder occurs due to increased estrogen sensitivity in a localized area of the breast? A. Mastitis B. Mastalgia C. Fibroadenoma D. Intraductal papilloma

C. Fibroadenoma

A patient who underwent a radical mastectomy has developed lymphedema. What measures should the nurse take to reduce lymphedema in this patient? Select all that apply. A. Regular blood pressure readings should be taken from the affected arm. B. Intravenous injections should be given on the affected arm. C. Isometric exercises of the affected side should be performed. D. The affected arm should not be placed in the dependent position for a long period of time. E. The affected side should be washed with soap and water if trauma occurs.

C. Isometric exercises of the affected side should be performed. D. The affected arm should not be placed in the dependent position for a long period of time. E. The affected side should be washed with soap and water if trauma occurs.

A nurse is educating a patient with breast cancer who is hesitant to undergo radiation therapy. Which statements best explain the advantages of radiation therapy to reassure the patient? Select all that apply. A. It helps to prevent the development of lymphedema. B. It ensures that there are no rashes or other skin changes associated with this surgery. C. It helps to relieve pain caused by local or distant recurrence. D. It helps to prevent local and nodal recurrences after mastectomy. E. It helps to prevent local breast cancer recurrences after a breast-conserving surgery.

C. It helps to relieve pain caused by local or distant recurrence. D. It helps to prevent local and nodal recurrences after mastectomy. E. It helps to prevent local breast cancer recurrences after a breast-conserving surgery.

A nurse is providing care for a patient who underwent a left modified radical mastectomy and is now in the immediate postoperative phase. To help prevent the development of lymphedema, what intervention should the nurse perform? A. Range-of-motion exercises on the patient's left arm B. Placing the left arm in an extended and dependent position C. Keeping the left arm elevated on pillows higher than the axilla D. Encouraging the patient to perform isometric exercises with the left arm

C. Keeping the left arm elevated on pillows higher than the axilla

The nurse is assessing a postpartum patient and observes a localized area of redness around the left breast nipple. The patient states, "My breast is very sore, especially when the baby is nursing." What does the nurse suspect is occurring? A. Fibromyalgia B. Breast cancer C. Lactational mastitis D. Noncyclic mastalgia

C. Lactational mastitis

A patient with breast cancer reports shortness of breath, weakness, and light-headedness. The laboratory reports reveal a count of 2.2 million red blood cells/μL and a hemoglobin value of 8.4 g/dL. Which condition does the primary health care provider suspect? A. Metastasis to the brain B. Metastasis to the spinal cord C. Metastasis to the bone marrow D. Metastasis to the skeletal muscle

C. Metastasis to the bone marrow

Which nursing intervention is most appropriate for a patient who has undergone breast reconstruction surgery? A. Positioning the patient on the affected side B. Maintaining even pressure on the patient's wound C. Preventing the patient from having chills and shivering D. Raising the patient's arm over her head four times a day

C. Preventing the patient from having chills and shivering

A patient is suspected of having a fibroadenoma in the left breast. Which diagnostic techniques does the nurse prepare the patient for that would give a definitive diagnosis of this disorder? Select all that apply. A. Ultrasound B. Mammography C. Surgical biopsy D. Core needle biopsy E. Fine needle biopsy

C. Surgical biopsy D. Core needle biopsy E. Fine needle biopsy

A patient in the postpartum period is diagnosed with lactational breast abscess. What would be the appropriate treatment option? A. Mastopexy B. Cryoablation C. Ultrasound-guided drainage D. Antiinflammatory drug therapy

C. Ultrasound-guided drainage

A nurse is teaching a health promotion workshop to a group of women in their 40s and 50s. What information about nipple discharge should the nurse teach to participants? A. Inappropriate lactation necessitates breast biopsy. B. Nipple discharge of any type is considered a precursor to cancer. C. Unexpected nipple discharge of any type warrants medical follow-up. D. Galactorrhea is a normal age-related change and a frequent perimenopausal symptom.

C. Unexpected nipple discharge of any type warrants medical follow-up.

The nurse is providing education to the patient that has a breast abscess related to ductal ectasia. What therapeutic management prescribed by the health care provider does the nurse discuss with the patient? A. Antibiotic therapy alone B. Antiinflammatory therapy alone C. Warm compresses and antibiotic therapy D. Ice compresses and antiinflammatory therapy

C. Warm compresses and antibiotic therapy

A patient reports fever, localized pain in the right breast, and difficulty breastfeeding for the past 10 days. On examination, the nurse notices a tender, palpable mass in the right breast and that the skin overlying it has become red and edematous. Which condition should the nurse suspect? A. Ductal ectasia B. Cyclic mastalgia C. Fibroadenoma D. Lactational breast abscess

D. Lactational breast abscess

The registered nurse is teaching a student nurse about the management of lactational breast abscess. Which statements made by the student nurse indicate effective teaching? A. "Surgical incisions are not preferable." B. "Culture sensitivity tests are not required." C. "Antibiotic therapy alone would be sufficient." D. "Ultrasound-guided drainage of the abscess would be preferred."

D. "Ultrasound-guided drainage of the abscess would be preferred."

The patient with breast cancer has a left mastectomy with axillary node dissection. Ten lymph nodes are resected, with three positive for malignant cells. The patient has stage IIB breast cancer. What is the best nursing intervention to use in planning care? A. Evaluate left arm lymphatic accumulation. B. Maintain joint flexibility and left arm function. C. Teach the patient about chemotherapy and radiation therapy. D. Assess the patient's response to the diagnosis of breast cancer.

D. Assess the patient's response to the diagnosis of breast cancer.

A patient has been diagnosed with a noninvasive form of breast cancer. What type of cancer should the nurse educate the patient about? A. Tubular carcinoma B. Mucinous carcinoma C. Medullary carcinoma D. Ductal carcinoma in situ

D. Ductal carcinoma in situ

A patient is newly diagnosed with gynecomastia. What reason for development of gynecomastia should the nurse explain to the patient? A. Gynecomastia causes excessive secretion of prolactin. B. Gynecomastia causes abnormal functioning of the thyroid gland. C. Gynecomastia is caused by a disturbance in the normal ratio of testosterone to progesterone. D. Gynecomastia is caused by a disturbance in the normal ratio of active androgen to estrogen.

D. Gynecomastia is caused by a disturbance in the normal ratio of active androgen to estrogen.

A patient has benign fibrocystic breast changes and is concerned about the development of breast cancer. What should the nurse explain to the patient are the causes of the changes that occur? A. Proliferation of breast cells B. Mutations of BRCA1 and BRCA2 genes C. Interruption of blood flow to the breasts D. Heightened responsiveness to estrogen and progesterone

D. Heightened responsiveness to estrogen and progesterone

A patient recently has had a unilateral, right total mastectomy and axillary node dissection for the treatment of breast cancer. What nursing intervention should the nurse include in the patient's care? A. Immobilize the patient's right arm until postoperative day three. B. Maintain the patient's right arm in a dependent position when at rest. C. Administer diuretics prophylactically for the prevention of lymphedema. D. Promote gradually increasing mobility as soon as possible following surgery.

D. Promote gradually increasing mobility as soon as possible following surgery.

A nurse is reviewing medication orders for several patients. Which prescription should the nurse question? A. Pt A - Mastalgia and Danazol B. Pt B - Tuberculosis and Isoniazid C. Pt C - Hyperacidity and Ranitidine D. Pt D - Breast Cancer and Spironolactone

D. Pt D - Breast Cancer and Spironolactone

An older adult male patient presents to the clinic reporting enlarged breasts. After reviewing the patient's medical record and performing an assessment, what does the nurse suspect is the reason for the patient's gynecomastia? A. A recent exposure to poison ivy B. Long-time daily ingestion of vitamin C C. Avoidance of drugs containing androgens and estrogens D. Recent computerized tomography (CT) scan showing a pituitary adenoma

D. Recent computerized tomography (CT) scan showing a pituitary adenoma

A postpartum patient who is breastfeeding has developed a lactational breast abscess. For what treatment does the nurse anticipate preparing the patient? A. Radiation therapy B. Only antibiotic therapy C. Affected breast mastectomy D. Surgical incision and drainage

D. Surgical incision and drainage