Chapter 6: Disorders of the Breasts
A female client is diagnosed with breast abscess. Although she has been allowed to breastfeed her newborn, she decides to terminate breastfeeding. Which action would be most appropriate in this situation?
Assist the client to pump the breasts to remove breast milk.
At what age should a woman with no risk factors begin mammography screening for breast cancer?
40
After finding a breast mass on a routine examination and undergoing diagnostic studies, a woman is diagnosed with a fibroadenoma. The treatment plan focuses on watchful waiting. When would the nurse instruct the client to return for reevaluation?
6 months
The nurse is caring for a 52-year-old woman whose sisters and mother died of breast cancer. The client states, "My doctor wants me to take tamoxifen to help prevent breast cancer. What do you think?" What would be the nurse's best response?
"Tamoxifen reduces the incidence."
A woman diagnosed with breast cancer is to undergo a lumpectomy followed by radiation therapy. When reviewing the treatment plan with the client, the nurse determines that the woman has understood the information based on which client statement?
"After they remove the tumor and some of the normal tissue, I'll start radiation in about 2 to 4 weeks."
At a class for new mothers, the nurse notes that the participants need more teaching when one of the mothers makes which comment?
"I have to stop breastfeeding because of mastitis."
A nurse is teaching a woman who has undergone breast augmentation about developing breast awareness through breast self examination. The nurse determines that the teaching was successful based on which client statement?
"I should do the exam just like I was doing before the implants."
After teaching a client with mastitis about caring for her breasts, the nurse determines that the client has understood the instructions when she makes which statement?
"I will express milk with a breast pump until infection is resolved."
A client who has had a mastectomy is to undergo breast reconstruction with augmentation. After teaching the client about the procedure, the nurse determines that the teaching was successful based on which client statement?
"I'll use the same technique for breast self-exam as before."
The nurse is giving an educational event for a local women's group on self-examination of the breast. The nurse tells the women's group to raise their arms and inspect their breasts in a mirror. A member of the women's group asks the nurse why she needs to do this. What is the nurse's best response?
"It will help to observe for dimpling."
How should the nurse counsel a postpartum client on how to prevent mastitis?
"Wash your hands thoroughly, and let your breasts dry after each feeding."
A client presents to the office and is upset after finding a small lump in her breast. The nurse tries to reassure her that the lump does not automatically indicate cancer based on the understanding that what percentage of breast lumps discovered are caused by benign breast disorders?
80%
What does the American Cancer Society (ACS) say about breast self-examination (BSE)?
A monthly BSE is optional.
When preparing a teaching plan for a woman with mastitis, the nurse would include which instruction?
Apply warm compresses to the affected breast.
When preparing for a class on breast cancer, the nurse should explain which nonmodifiable risk factors? Select all that apply.
BRCA1 gene menarche at age 11 being a 52-year-old female
A client reports lumpy, tender breasts, particularly during the week before menses. She reports pain that often dissipates after the onset of menses. The nurse suspects the client has fibrocystic breast changes. Which should the nurse do next?
Perform a breast examination.
A 52-year-old female client with an estrogen receptors positive (ER+) breast cancer is undergoing hormonal therapy. While taking a selective estrogen receptor modulator (SERM), the client begins to experience hot flashes. What should the nurse do next?
Document the hot flash in the client's chart.
A woman is crying because she just recently received the results of her biopsies, and they confirm that she has invasive breast cancer. Which response by the nurse is the most appropriate?
Listen to the woman talk, and remain silent for a while
A 45-year-old female client tells the nurse she has a dimpling of the right breast that has occurred in the past 2 weeks. What action will the nurse take next?
Perform an examination of both of the client's breasts.
A small amount of breast milk is obtained for culture and sensitivity testing from a client with mastitis. The nurse would expect the results to identify which organism as the most likely cause?
Staphylococcus aureus
client with breast cancer is scheduled to undergo chemotherapy with aromatase inhibitors. Which explanation best reflects the rationale for using this group of drugs?
They lower the level of estrogen in the body, blocking the tumor's ability to use it.
A nurse is counseling a woman diagnosed with fibrocystic breast changes about self-care measures. Which instructions would the nurse include when teaching this client? Select all that apply.
Wear a supportive bra. Limit salt intake. Avoid caffeinated beverages.
During a follow-up visit, a female client who underwent a mastectomy asks the nurse if she can work in her backyard or at least do some household work. Which suggestion would be most appropriate?
Wear gloves and protective clothing to avoid any injuries.
In which client would the nurse suspect cancer?
a 45-year-old client with thickening in one breast with nipple irritation and retraction and a pink discharge
A 27-year-old lactating client presents with the report of a solid, painless lump in her left breast. On examination, the nurse notes that the lump is mobile and slightly tender to pressure. The nurse suspects this is:
a fibroadenoma.
A nurse is providing education to a woman about screening for breast cancer. The woman has no symptoms and no family history of breast cancer. Which recommendation would the nurse make based on the guidelines from the American Cancer Society?
annual mammogram beginning at age 40
A nurse is working at a cancer treatment center and is developing programs for specific ethnic groups related to breast cancer. The nurse would target which ethnic group because it has the highest breast cancer mortality rate in the United States?
black client
A client diagnosed with breast cancer is receiving chemotherapy. The nurse assesses the client for possible side effects of this therapy. Which side effect would the nurse report immediately to the health care provider?
bone marrow suppression
To help detect potential disease processes in the breasts, the nurse develops educational programs focusing on:
breast awareness.
In the United States, what type of cancer accounts for one-third of cancer diagnoses and is the most common cancer in women?
breast cancer
During a routine assessment, a client reports to the nurse a new lump in her right breast and occasional nipple pain. The client has a family history of breast cancer. The nurse will anticipate preparing the client for which procedure first?
breast examination
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 sign?
breast symmetry
A nursing diagnosis of Risk for impaired tissue integrity would be most appropriate for which client?
client having reconstructive breast surgery
While interviewing a client before their yearly examination, the nurse learns that the client stopped breastfeeding more than 1 year ago but occasionally has pain on one side behind the left nipple not related to their menstrual period. Upon examination, the nurse does not palpate any lumps but finds the left nipple retracted with a greenish discharge. What would the nurse first suspect?
duct ectasia
A nurse is conducting a presentation on breast cancer for a local women's group and explaining the possible risk factors associated with its development. The nurse determines that the group has understood the information when they identify which factor as increasing a woman's risk for breast cancer?
early menarche
The health care provider has just informed the client that her breast biopsy is positive for carcinoma. One of the nurse's first responsibilities is to assist with:
education.
A nurse is assigned to educate a group of adolescent women on cancer awareness. Which risk factor(s) for breast cancer is modifiable? Select all that apply.
failing to breastfeed for up to a year after pregnancy postmenopausal use of estrogen and progestins not having children until after age 30
A client is receiving chemotherapy as part of her treatment plan for breast cancer. The nurse assesses the client and determines that the client may be experiencing myelosuppression based on which finding?
fever
What is the most common breast mass in women?
fibroadenoma
The nurse is reviewing the history and physical exam of a woman who has come to the clinic for a routine physical. Which factor would the nurse identify as increasing the client's risk for breast cancer?
history of ovarian cancer
What is the most common type of breast cancer, accounting for approximately 85% of cases?
invasive ductal carcinoma
A client has been diagnosed with in situ breast carcinoma. The nurse explains that this means:
it is noninvasive and has not extended beyond the point of origin.
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 complication?
lymphedema
A nurse is preparing a presentation for a health fair about preventing breast cancer. Which suggestion would the nurse include?
maintaining an ideal weight
A client is considering breast augmentation. What would the nurse recommend to the client to ensure that there are no malignancies?
mammogram
The nurse is preparing a client for breast biopsy of a lump. The nurse explains that a needle with a cutting edge will be inserted into a lump and rotated to remove a core sample. What type of breast biopsy is this client undergoing?
needle biopsy
A nurse is screening women for risk factors for breast cancer. Which factors are considered a risk for this disorder? Select all that apply.
previous cancer using female hormone therapy cystic breast disorders
A woman is scheduled to undergo a modified radical mastectomy. Which information would the nurse include when describing this surgery to the client?
removal of breast tissue and axillary nodes
A nurse is performing an assessment on a 25-year-old white female client who is obese and is trying to conceive. The client presents to the clinic concerned about a newly found lump in their breast. The nurse explains to the client the difference between benign nodules and breast cancer. Complete the following sentence(s) by choosing from the lists of options. The nurse determines client understanding of the difference between a lump that is a benign nodule and a lump that is breast cancer when the client states ___________ is a sign of a benign nodule and _________
soft and movable hard and fixed
A nurse is providing care to a client diagnosed with stage II breast cancer. Which finding would the nurse interpret as characteristic of this stage?
tumor that is about 1.5 inches (3.8 centimeters) in diameter with positive lymph nodes
As part of a presentation on breast cancer being given to a local woman's group, the nurse describes the need for early detection through screening. Applying the guidelines from the American Cancer Society, the nurse would emphasize which recommendation?
yearly mammograms for women starting at age 40