Ch. 6 - Disorders of the breasts

11.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

13. 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

10.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

21.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

3. 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

8. 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

25.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 A) Garlic B) Soybeans C) Milk D) Leeks E) Flax seeds

a, b, d, e

20.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

15.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

18.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

2. 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

23.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

7. 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

9. 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

24.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

1. 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

12.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

14.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

19.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

5. 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

6. 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

17.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

16.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

22.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

4. 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