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differences in breast size Explanation: It is not uncommon for women to have one breast larger than the other. Common disorders that affect breast tissue generally manifest with one or more of the following symptoms: breast tenderness or pain, breast mass, nipple discharge, and change in breast appearance.
The lump is round and movable. Explanation: When assessing a breast with fibrocystic disease, the lumps typically are different from cancerous lumps. The characteristic breast mass of fibrocystic disease is soft to firm, circular, movable, and unlikely to cause nipple retraction. A cancerous mass is typically irregular in shape, firm, and nonmovable. Lumps typically do not make one breast larger than the other. Nipple retractions are suggestive of cancerous masses.
Which of the following are the two most important prognostic factors associated with breast cancer? Select all that apply.
Tumor size Axillary lymph node involvement Explanation: The two most important prognostic factors associated with breast cancer are tumor size and axillary lymph node involvement. Age, comorbidities, and current activity level are not the most important prognostic indicators.
The nurse is providing health education regarding disorders that affect breast tissue. Which symptom is least suggestive of a breast disorder?
differences in breast size Explanation: It is not uncommon for women to have one breast larger than the other. Common disorders that affect breast tissue generally manifest with one or more of the following symptoms: breast tenderness or pain, breast mass, nipple discharge, and change in breast appearance.
A client has been diagnosed with breast cancer and is awaiting cytology results of a biopsy. During client education, the nurse discusses the possible types of breast malignancies. Which is the most common type?
ductal Explanation: The most common malignancy is ductal carcinoma (80%); followed by infiltrating lobular carcinoma (10%); medullary carcinoma, mucinous carcinoma, and tubular ductal carcinoma; and inflammatory breast cancer, the rarest but most aggressive form of breast cancer.
A client is concerned with lumps that have developed in her breasts and is fearful of cancer. The client reports variability in the size of the lumps. What would the physician indicate is the client's condition?
fibrocystic breast disease Explanation: Fibrocystic breast disease is a benign breast condition that affects women primarily between the ages of 30 and 50 years. When fibrocystic disease develops, single or multiple breast cysts appear in one or both breasts.
Which type of biopsy would the nurse tell the client is a usual procedure for any palpable breast mass found on mammography?
Excisional Explanation: An excisional biopsy is the usual procedure for any palpable breast mass. Stereotactic biopsy uses computer location of the suspicious area found on biopsy, followed by core needle insertion and sampling of tissue for pathologic examination. Incisional biopsy is performed on a palpable mass when tissue sampling alone is required. A Tru-Cut core biopsy is used when a tumor is relatively large and close to the skin surface.
Which psychosocial nursing diagnoses are common in the client with breast cancer? Select all that apply.
Fear Body image disturbance Hopelessness Explanation: Fear, anxiety, body image disturbance, hopelessness, and powerlessness are all common psychosocial nursing diagnoses for clients with breast cance
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 Explanation: Risk factors associated with breast cancer include menarche before age 12 years, menopause after age 55 years, nulliparity, and late age at first full-term pregnancy
Which type of biopsy is used for nonpalpable lesions found on mammography?
Stereotactic Explanation: Stereotactic biopsy uses computer location of the suspicious area found on biopsy, followed by core needle insertion and sampling of tissue, for pathologic examination. An excisional biopsy is the usual procedure for any palpable breast mass. Incisional biopsy is performed on a palpable mass when tissue sampling alone is required. Tru-Cut core biopsy is used when a tumor is relatively large and close to the skin surface.
On discharge, a client who underwent left modified radical mastectomy expresses relief that "the cancer" has been treated. When discussing this issue with the client, the nurse should stress that she:
should continue to perform breast self-examination on her right breast. Explanation: Having breast cancer on her left side puts the client more at risk for cancer on the opposite side and chest wall. Therefore, the nurse should stress the importance of monthly breast self-examinations and annual mammograms. Although the tumor was found, it was large enough to require a mastectomy, and could put the patient at risk for metastasis. Follow-up appointments should be monthly for the first few months and then scheduled at the direction of her health care provider. Modified radical mastectomy shouldn't affect the menstrual cycle.
The nurse is educating a group of women at the YMCA about breast cancer. What does the nurse understand is the current trend that should be focused on rather than BSE?
Breast self-awareness Explanation: Current practice is shifting from educating about BSE to promoting breast self-awareness, which is a woman's attentiveness to the normal appearance and feel of her breasts.
In which stage of breast development does breast budding occur?
2 Explanation: Breast budding occurs in stage 2 of breast development. Stage 1 describes a prepubertal breast. Stage 3 involves further enlargement of breast tissue and the areola. Stage 4 occurs when the nipple and areola form a secondary mound on top of the breast tissue.
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 Explanation: Besides reducing the risk of breast cancer, tamoxifen preserves bone mineral density, thus preventing osteoporosis. It also lowers the low-density lipoprotein cholesterol levels, although it is still unknown if it decreases the incidence of myocardial infarction in women. Tamoxifen can have detrimental effects. It increases the incidences of endometrial cancer, deep vein thrombosis, pulmonary embolism, and cataracts.
A female client is receiving paclitaxel as part of her treatment regimen for a large, node-negative cancer. The nurse recognizes a possible side effect of paclitaxel when the client is diagnosed with which condition?
Joint pain Explanation: Taxanes such as paclitaxel can cause peripheral neuropathy, arthralgias, and myalgias, particularly at high doses. During taxane administration, hypersensitivity reactions may occur; therefore, the client must be premedicated. The side effects of the anthracyclines may be severe and include cardiotoxicity in addition to nausea and vomiting, bone marrow suppression, and alopecia.
When a female client demonstrates thickening, scaling, and erosion of the nipple and areola, the nurse recognizes that the client is exhibiting signs of which disease process?
Paget disease Explanation: Paget disease is a malignancy of mammary ducts with early signs of erythema of nipple and areola. Acute mastitis is demonstrated by nipple cracks or abrasions along with reddened and warm breast skin and tenderness. Fibroadenoma is characterized as the occurrence of a single, nontender mass that is firm, mobile, and not fixed to breast tissue or chest wall. Peau d'orange is associated with the breast and demonstrates an orange peel appearance of breast skin with enlargement of skin pores.
A patient has had a total mastectomy 12 hours ago and the nurse is assessing the surgical wound. The nurse observes ecchymosis, swelling, and tightness around the wound, and the patient states that it is painful. What does the nurse suspect has occurred?
The patient has developed a hematoma. Explanation: p1737 Hematoma formation (collection of blood inside a cavity) may occur after either mastectomy or breast conservation and usually develops within the first 12 hours after surgery. The nurse assesses for signs and symptoms of hematoma at the surgical site, which may include swelling, tightness, pain, and bruising of the skin.
The nurse advises a patient scheduled for external beam radiation that side effects are minimal and usually well tolerated. The most common and annoying side effect is:
fatigue.
