OB Chapter 6 Practice
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
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
During a clinical breast examination, the nurse palpates a well-defined, firm, mobile lump in a 60-year-old woman's 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
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
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 (Select all that apply): A) Garlic B) Soybeans C) Milk D) Leeks E) Flax seeds
A, B, D, E
After teaching a group of nursing students about the different types of chemotherapeutic 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, C
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) II D) III
C
The nurse is developing the discharge plan for a woman who has had a left-sided modified radical mastectomy. The nurse is including instructions for ways to minimize lymphedema. Which suggestion would most likely increase the woman's 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
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) Progestins B) Tamoxifen C) Cortisone D) Estrogen
B
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
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 don't need to check under my arm on that side if my breast feels fine. D) I need to work from the center of my breast outward toward my shoulder.
B
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
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 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 right 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 I would think the answer would be C.?
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, C, D
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
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
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
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, 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
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, D
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 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
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
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
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) Regularly shaped mass D) Nipple retraction
D
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
Breast cancer that is localized is referred to as: A) Primary B) In situ C) Metastasized D) Localized
The correct response is "B" since it defines a small lesion that has not spread from its origin. Responses "A," "C," and "D" are not terms used to describe a local cancerous lesion.
A 25-year-old woman presents with an asymptomatic breast mass. Which of the following is true concerning her diagnosis and treatment? A) All breast masses should be considered pre-malignant B) The breast mass should be surgically removed immediately C) Ultrasound is typically used to determine the diagnosis D) Since it is asymptomatic, just reassurance is needed now
The correct response is "C" Since an ultrasound can differentiate a solid mass from a cyst. In addition, the ultrasound appearance of a well-rounded, homogeneous mass may be a sufficient characteristic to diagnose fibroadenoma. Response "A" is incorrect because up to 80% of breast masses are benign, especially in young women. Response "B" is incorrect because it is not necessary to surgically remove a breast mass in women under 30 years of age. It warrants observation. Response "D" is incorrect since it is important to identify what kind of mass it is and if there is any increased risk for the development of breast cancer.
Which of the following is the strongest risk factor for breast cancer? A) Advancing age and being female B) High number of children C) Genetic mutations in BRCA1 and BRCA2 genes D) Family history of colon cancer
The correct response is A. The incidence of breast cancer increases with aging, especially over age 50. Only 1% of breast cancers occur in men. B is incorrect: bearing children interrupts the menstrual cycle and decreases a woman's risk of breast cancer. C is incorrect: only 7% of women have a genetic mutation resulting in breast cancer, whereas in the remaining 93% it is a sporadic occurrence. D is incorrect: colon cancer is not a risk factor for breast cancer.
What suggestion would be helpful for the client experiencing painful fibrocystic breast changes? A) Increase her caffeine intake. B) Take a mild analgesic when needed. C) Reduce her intake of leafy vegetables. D) Wear a bra bigger than she needs.
The correct response is B. The discomfort is usually mild and analgesics will relieve it in most cases. A is incorrect: women are advised to reduce caffeine to reduce the stimulation of breast tissue, not increase it. C is incorrect: women are advised to increase their intake of leafy vegetables, not reduce them, since this would be a part of a balanced healthy diet. D is incorrect: women are advised to wear a firm supportive bra to reduce the strain on the breast tissue, not a bra that offers no support.
A biopsy procedure that traces radioisotopes and blue dye from the tumor site through the lymphatic system into the axillary nodes is: A) Stereotactic biopsy B) Sentinel node biopsy C) Axillary dissection biopsy D) Advanced breast biopsy
The correct response is B. This describes the procedure for performing a sentinel node biopsy. A is incorrect: there is no dye used and a biopsy is taken of the breast mass, not the node. C is incorrect: this is an actual surgical removal of the axillary nodes and not just a biopsy, and no dye is used in this procedure. D is incorrect: an advanced breast biopsy does not use dye and involves taking a tissue sample of the breast mass, not the nodes in the axillary area.
Breast self-examinations involve both touching of breast tissue and: A) Palpation of cervical lymph nodes B) Firm squeezing of both breast nipples C) Visualizing both breasts for any change D) A mammogram to evaluate breast tissue
The correct response is C. Visible changes to the skin of the breast take place (dimpling, contour changes, nipple discharge) and can be seen if inspected in front of a mirror. A is incorrect: breast cancer first spreads to the axillary lymph nodes, not the cervical nodes. Palpation of the axillary lymph nodes is warranted, not the cervical ones. B is incorrect: spontaneous nipple discharge is more indicative of breast cancer than discharge produced by squeezing the nipple. D is incorrect: a mammogram is not part of a breast self-examination, which the woman does in the privacy of her home.
A postoperative mastectomy client should be referred to which of the following organizations for assistance upon discharge from the hospital? A) National Organization for Women (NOW) B) Food and Drug Administration (FDA) C) March of Dimes Foundation (MDF) D) Reach to Recovery (RTR)
The correct response is D. This volunteer organization offers support and practical advice to women with breast cancer; all the volunteers have had breast cancer themselves. A is incorrect: NOW does not focus on breast cancer per se, but all women's issues, especially ones of equality. B is incorrect: the FDA is concerned with the regulation, security, and safety of all foods and drugs in the United States, not breast cancer issues. C is incorrect: the March of Dimes focuses on prevention of preterm births and reduction of birth defects, not breast cancer.
The most serious potential adverse reaction from chemotherapy is: A) Thrombocytopenia B) Deep vein thrombosis C) Alopecia D) Myelosuppression
The correct response is D. When the bone marrow is suppressed secondary to chemotherapy, the woman experiences bleeding tendencies (low platelets), limited immunity (low white blood cells), and anemia (low red blood cells). This myelosuppression can become life-threatening. A is incorrect: a decrease in the number of platelets in the circulating blood may cause bleeding tendencies if the body is traumatized, but it is not as life-threatening as having all bone marrow cells depressed. B is incorrect: having blood clots in deep veins is typically not a frequent response to chemotherapy, whereas myelosuppression is very common. C is incorrect: losing one's hair, while emotionally and aesthetically traumatizing, it is not a life-threatening event, and the hair will grow back after therapy ends.
