Chap 58-Assessment and Management of Pts. with Breast Disorders

Which of the following would be inconsistent as a risk factor for breast cancer? a) Family history of breast cancer b) Increased age c) Late menopause d) Multiparity

d) Multiparity

Hematoma and seroma formation are complications of breast surgery. Which of the following is the indicator that should be reported to the surgeon? a) Gross swelling b) Bruising of the skin c) Tightness of the skin d) Pain at the site

a) Gross swelling

Sentinel lymph node mapping is done to validate the lack of lymph node metastasis. Which of the following complications does this technique help avoid? a) Lymphedema b) Fibroadenoma c) Breast cancer d) Mastalgia

a) Lymphedema

The nurse is assessing the breast of a female patient and observes a prominent venous pattern on the left breast. What does the nurse understand that this can be indicative of? a. Increased blood supply required by a tumor b. Infection c. Ulceration of the nipple d. Thrombus formation

a. Increased blood supply required by a tumor

A client is considering breast augmentation. Which of the following would the nurse recommend to the client to ensure that there are no malignancies? a) Breast biopsy b) Mammogram c) Mastopexy d) Ultrasound

b) Mammogram

The nurse is discussing mammography with a female patient at the clinic. The patient asks at what age she should begin getting yearly mammograms. What answer should the nurse provide to the patient? a) 40 b) 35 c) 50 d) 55

a) 40

A patient is having a biopsy that will remove the entire mass, plus a margin of surrounding tissue. What type of biopsy will be documented on the operative permit? a. Excisional biopsy b. Incisional biopsy c. Core biopsy d. Ultrasound-guided core biopsy

a. Excisional biopsy

The nurse is obtaining a history from a client who states recurrent breast tenderness. The client inquires if there is something wrong with her breasts. Which question by the nurse is a priority? a) "Have you pulled a muscle or had any injury to the breast?" b) "Does the tenderness occur around the same time each month?" c) "Do you have a history of breast disorders and cancer in the family?" d) "When did you first recognize the symptoms?"

b) "Does the tenderness occur around the same time each month?"

A suspicious breast lump is noted on a mammogram. The client asks the nurse which diagnostic test confirms if the lump is cancerous or benign. Which response by the nurse is most correct? a) A clinical breast exam b) A biopsy c) An ultrasound d) A magnetic resonance imaging (MRI)

b) A biopsy

A 28-year-old woman is learning about breast self-examination. The nurse teaches the woman that the best time of each month to examine her breasts is during the: a) Week that ovulation occurs. b) First week after menstruation. c) Week before menstruation occurs. d) Week that menstruation occurs.

b) First week after menstruation.

The client arrives at a public health clinic worried that she has breast cancer since finding a lump in her breast. When assessing the breast, which assessment finding is characteristic of fibrocystic disease? a) One breast is larger than the other. b) Nipple retractions are noted. c) The lump is round and movable. d) The lump is firm and nonmovable.

c) The lump is round and movable

A client who just had a left radical mastectomy. The nurse caring for her is providing information on complications that may arise due to removing the axillary lymph nodes. Which of the following would not be included? a) Reduced range of motion b) Infection c) Tissue necrosis d) All would be included in the discussion.

d) All would be included in the discussion.

A client who has had a left total mastectomy is about to view her surgical site for the first time. Which of the following would be most appropriate for the nurse to say? a) "Do you feel like you're ready to look at your incision now?" b) "Did you have reconstructive surgery when they removed your breast?" c) "You need to look at the incision so you can heal emotionally." d) "Don't be afraid. Everybody feels the same way."

a) "Do you feel like you're ready to look at your incision now?"

A client has had a right modified radical mastectomy and axillary lymph node dissection. The nurse is teaching the client about measures to reduce the risk of complications. The client demonstrates understanding of the instructions when she states which of the following? a) "I need to use an electric shaver when shaving my right armpit." b) "I can lift with my right arm objects that weigh as much as 15 pounds." c) "I should tell my manucurist that it is okay to trim the cuticles on my right hand." d) "Anytime I need blood drawn, they should get the sample from my right arm."

a) "I need to use an electric shaver when shaving my right armpit."

A group of students are reviewing material in preparation for a test on the male and female breasts. The students demonstrate understanding of the material when they identify which of the following? a) A primary function of the female breast is to produce milk. b) The breasts contain a limited supply of blood vessels. c) Progesterone is primarily responsible for the growth of breast tissue. d) Striated muscle in the nipples contract causing them to become erect

a) A primary function of the female breast is to produce milk.

A female client is diagnosed with breast abscess. She would like to continue to breast-feed her newborn. Which of the following would be most appropriate in this situation? a) Assist the client to pump the breasts to remove breast milk. b) Encourage the client to include protein content in the diet. c) Reduce the frequency of removing and reapplying the dressings. d) Instruct the client to wear a tight-fitting bra.

a) Assist the client to pump the breasts to remove breast milk.

After teaching a group of students about the signs and symptoms of breast cancer, the instructor determines that additional teaching is needed when the group identifies which of the following? a) Breast symmetry b) Peau d'orange skin c) Painless mass d) Nipple retraction

a) Breast symmetry

On a follow-up visit, the patient is informed that her breast cancer has recurred. The nurse knows which of the following situations places the patient at risk for developing bone metastases? a) Recurrence within 2 years of the original diagnosis b) No maternal family history of breast cancer c) Aggressive treatment, including surgery, radiation, and hormonal therapy d) Previous therapeutic response to chemotherapy

a) Recurrence within 2 years of the original diagnosis

Students are reviewing information about the use of adjuvant hormonal therapy for breast cancer. They demonstrate understanding of this information when they identify which of the following as an example of a selective estrogen receptor modulator (SERM)? a) Tamoxifen b) Exemestane c) Letrozole d) Anastrozole

a) Tamoxifen

A client with breast cancer is scheduled to undergo chemotherapy with aromatase inhibitors. Which of the following best reflects the rationale for using this group of drugs? a) They lower the level of estrogen in the body blocking the tumor's ability to use it. b) They stimulate the immune system to attack a protein common in many tumors. c) They block progesterone-dependent tumors from growing. d) They attach to endogenous protein receptors to slow the growth of cancerous cells.

a) They lower the level of estrogen in the body blocking the tumor's ability to use it.

A nurse is providing breast cancer education at a community facility. The American Cancer Society recommends that women get mammograms: a) yearly starting at age 40. b) every 3 years between ages 20 and 40 and annually thereafter. c) after the first menstrual period and annually thereafter. d) after the birth of the first child and every 2 years thereafter.

a) yearly starting at age 40

A nurse is reviewing a female patient's history, which includes the following information: Age at menarche: 14 years Cesarean delivery: 2 pregnancies Age at first pregnancy: 35 years Alcohol use: approximately 1 to 2 glasses of wine/month The nurse identifies which of the following as a possible risk factor for developing breast cancer? a) Age at menarche b) Age at first pregnancy c) Cesarean deliveries d) Alcohol use

b) Age at first pregnancyb) Age at first pregnancy

The nurse working on a woman's cancer treatment floor performs nursing assessments on her assigned patients. It is most important for the nurse to report which of the following assessment findings? a) Immediate postoperative reports of throat tenderness b) Coolness and mottling of a newly constructed breast site c) Temperature of 99.2°F, pulse 72, respirations 18, blood pressure 130/80 d) Small amount of bloody drainage on surgical dressing 12 hours postoperatively

b) Coolness and mottling of a newly constructed breast site

A 30-year-old client whose mother died of breast cancer at age 44 and whose sister has ovarian cancer, is concerned about developing cancer. As a member of the oncology multidisciplinary team, the nurse should suggest that the client ask the physician about which topic? a) Mammogram b) Genetic counseling c) Pap testing d) Contacting the American Cancer Society

b) Genetic counseling

A female patient comes to the clinic with the complaint that she is having a greenish-colored discharge from the nipple and the breast feels warm to touch. What does the nurse suspect these symptoms may indicate? a) A ruptured cyst b) Infection c) Blocked lymph duct d) Cancer

b) Infection

A patient has been newly diagnosed with breast cancer. During her preoperative instructions the physician indicated that removal of the breast tissue and axillary lymph node dissection leaving the muscular structure intact was indicated as surgical treatment for her breast cancer. To which of the following procedures is the physician asking the patient to consent? a) Total mastectomy b) Radical mastectomy c) Segmental mastectomy d) Modified radical mastectomy

b) Radical mastectomy

The nurse is educating a patient about the best time to perform breast self-examination (BSE). When does the nurse inform her is the best time after menses to perform BSE? a) 5 to 7 days b) After the 10th day c) 8 to 9 days d) 3 to 4 days

c) 8 to 9 days

Which primary prevention modality aims to prevent the disease before it starts? a) Radiation therapy b) Prophylactic mastectomy c) Chemoprevention d) Long-term surveillance

c) Chemoprevention

A client is diagnosed with a palpable mass in her breast. The nurse would anticipate diagnostic testing using which of the following? a) MRI-guided core biopsy b) Ultrasound-guided core biopsy c) Core needle biopsy d) Wire needle localization biopsy

c) Core needle biopsy

The nurse is monitoring a client with metastatic breast cancer who is receiving morphine for pain control. The nurse would be alert for which of the following? a) Bone marrow depression, granulocytopenia, and anemia b) Central nervous system (CNS) depression, amenorrhea, and anemia c) Excessive sedation, confusion, and weakness d) Malaise, diarrhea, and stomatitis

c) Excessive sedation, confusion, and weakness

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? a) Menopause after age 50 b) Menarche at age 14 c) First full-term pregnancy at age 34. d) One of three living children born prematurely

c) First full-term pregnancy at age 34.

The nurse is providing care to a client who has had surgery as treatment for breast cancer. The nurse would be alert for the development of which of the following? a) Breast abscess b) Fibroadenoma c) Lymphedema d) Fibrocystic breast disease

c) Lymphedema

The nurse recognizes which of the following statements as accurately reflecting a risk factor for breast cancer? a) Onset of menses before 14 years of age b) Multiparity c) Mother affected by cancer before 60 years of age d) No alcohol consumption

c) Mother affected by cancer before 60 years of age

A client is considering use of chemoprevention because she is at high risk for developing breast cancer. What can the nurse do to assist the patient with her decision? a) Inform the patient that medication should not be used prophylactically due to the many side effects. b) Inform the patient that she should take every measure available to her to prevent this disease. c) Provide the patient with information regarding the benefits, risks, and possible side effects. d) Provide the patient with information about bilateral mastectomy for the prevention of this disease.

c) Provide the patient with information regarding the benefits, risks, and possible side effects.

The nurse is caring for a client who is ordered a sentinel lymph node biopsy. The physician explained the procedure and desired outcome. Which statement, made by the client, indicates a need for further instruction? a) The procedure allows for conservation of breast tissue. b) The procedure allows for an understanding of the spread of cancer cells. c) The procedure removes all cancer from the body. d) The procedure includes minimal surrounding tissue damage.

c) The procedure removes all cancer from the body.

A client is very concerned about possibly having breast cancer, especially after caring for a close family member who recently died from the disease. The nurse informs the client that the primary and most common sign of breast cancer is a: a) painful mass in the breast, most often in the lower quadrant near the nipple. b) painful mass in the breast, most often in the upper outer quadrant. c) painless mass in the breast, most often in the upper outer quadrant. d) painless mass in the breast, most often in the lower quadrant near the nipple.

c) painless mass in the breast, most often in the upper outer quadrant.

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: a) should schedule a follow-up appointment in 6 months. b) is lucky that the cancer was caught in time. c) should continue to perform breast self-examination on her right breast. d) will have irregular menses.

c) should continue to perform breast self-examination on her right breast.

Which statement demonstrates that a client has understood instructions about breast self-examination? a) "I don't need to check the nipple area of the breast or under my arm." b) "I should perform the exam on the first day of my menstrual period." c) "I should move the palm of my hand around the breast in a diagonal fashion." d) "I need to use the pads of three fingers to apply pressure when checking each breast."

d) "I need to use the pads of three fingers to apply pressure when checking each breast."

A nurse is meeting with a woman scheduled to have a modified radical mastectomy to remove an aggressive breast tumor. The woman tells the nurse that she agreed to have the surgery before considering alternative options. Which of the following statements is the nurse's best response? a) "If I were you, I would consider a second opinion." b) "You might want to consider a less invasive surgical procedure." c) "You have a very competent surgeon and you should move forward as planned." d) "Tell me more about your fears and concerns."

d) "Tell me more about your fears and concerns."

A nurse is preparing a presentation for a health fair about preventing breast cancer. Which of the following would the nurse include? a) Increasing the intake of caffeinated drinks b) Opting for estrogen only replacement therapy during menopause c) Delaying childbearing until after age 30 d) Maintaining an ideal weight

d) Maintaining an ideal weight

The nurse is completing the admission history for a client who is admitted for a reduction mammoplasty. Which of the following client statements is uncommon when explaining the rationale for the procedure? a) Back pain b) Skin irritation c) Low self-esteem d) Others disapprove

d) Others disapprove

A health care provider tells a breast cancer client that he is going to prescribe hormone therapy that has been found to significantly reduce mortality. Which drug would most likely be prescribed? a) Bevacizumab b) Trastuzumab c) Lapatinib d) Tamoxifen

d) Tamoxifen

A nurse who works in an oncology practice prepares patients for the side effects of adjuvant hormonal therapy to treat breast cancer. Which of the following is the hormonal agent that has an increased risk of pulmonary embolism and deep vein thrombosis? a) Anastrozole b) Exemestane c) Letrozole d) Tamoxifen

d) Tamoxifen

A patient had a sentinel node biopsy and informs the nurse that something is very wrong with her. The patient explains that she had a bowel movement and urinated and both are a blue color. What should the nurse inform the patient? a) The physician will have to discuss this with her. b) The patient must be having a reaction to the dye that was used. c) The cancer may be invasive and holding on to some of the dye that is used. d) The dye that was used during the biopsy is safe and being excreted.

d) The dye that was used during the biopsy is safe and being excreted.

A patient is having a fine-needle biopsy (FNB) for a mass in the left breast. When the needle is inserted and the mass is no longer palpable, what does the nurse know has most likely occurred? a) The mass may not have been located correctly. b) The mass has been absorbed into the tissues of the breast. c) The mass is not palpable because it is an inflammatory lesion. d) The mass may be cystic and was ruptured when the needle was inserted.

d) The mass may be cystic and was ruptured when the needle was inserted

A group of students are reviewing the anatomy and physiology of the breasts. The students demonstrate understanding of breast structure when they identify the tail of Spence as an extension of which quadrant? a) Lower inner b) Upper inner c) Lower outer d) Upper outer

d) Upper outer

During a teaching demonstration on breast self-examination (BSE), the nurse should always explain that the majority of breast cancers are found in the: a) Lower, outer quadrant. b) Lower, inner quadrant. c) Upper, inner quadrant. d) Upper, outer quadrant.

d) Upper, outer quadrant.

During a follow-up visit, a female client who underwent a mastectomy presents with an infection that requires an antibiotic. She admits she has been doing some gardening. What further instruction and reinforcement of teaching is needed? A) Avoid working in the garden or yard altogether. B) Wear gloves and protective clothing to avoid any injuries. C) Increase the frequency of follow-up visits if she does works. D) Avoid household chores for at least 6 to 9 months.

B) Wear gloves and protective clothing to avoid any injuries