Chapter 6 Prep U
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.
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
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."
After teaching a woman about breast self-examination, the nurse understands that the teaching was successful when the woman makes which statement?
"I'll do the check about a week after my period."
It is recommended that a 48-year-old female client with breast cancer undergo a sentinel lymph node biopsy before a lumpectomy. The client asks the nurse the reason for removing the sentinel lymph node. Which statement would the nurse make?
"It will prevent lymphedema, which is a common side effect."
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."
How should the nurse instruct a woman to perform a breast self-examination? Select all that apply.
-"You will need to visually inspect both breasts and palpate them for changes." -"Look for any changes in shape, size, contour, or symmetry between the breasts, as well as any skin discoloration." -"It doesn't matter which pattern you use to palpate the breast as long as you cover the entire 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 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
Which are modifiable risk factors for breast cancer? Select all that apply.
-obesity -smoking -alcohol consumption -duration of breastfeeding -sedentary lifestyle
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
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%
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
When preparing a teaching plan for a woman with mastitis, the nurse would include which instruction?
Apply warm compresses to the affected breast.
A young client desires to know her risk of developing breast carcinoma. She has a positive family history of breast carcinoma. The nurse would suggest that she should undergo which diagnostic test?
BRCA-1 genetic marker
The nurse is conducting a routine well-visit on a 43-year-old client who is concerned about developing breast cancer, although no family members have experienced it. What is the best advice for this client at this time?
Be aware of the normal appearance and feel of your breasts.
A client has undergone a mastectomy for breast cancer. Which instruction should the nurse include in the postoperative client teaching plan?
Elevate the affected arm on a pillow.
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 client is considering breast augmentation. What would the nurse recommend to the client to ensure that there are no malignancies?
Mammogram
A female client with metastatic breast disease is receiving trastuzumab as part of her immunotherapy. The client has nausea, fatigue, diarrhea, appears jaundice, and has a distended abdomen. What would the nurse do next?
Notify the health care provider.
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 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.
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 with thickening in one breast with nipple irritation and retraction and a pink discharge
A woman has been treated for a tumor of the left breast that has not responded to chemotherapy. The woman has just found out that she has the BRCA mutations and discusses her options with her primary care provider. Which treatment would be most difficult for this woman?
bilateral mastectomy
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
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
A nursing diagnosis of Risk for impaired tissue integrity would be most appropriate for which client?
client having reconstructive breast surgery
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
What is the most common breast mass in women?
fibroadenoma
A client with breast cancer is receiving chemotherapy. To counteract the myelosuppressive effects of chemotherapy, the nurse recognizes the client may also be prescribed which drug?
filgrastim
A nurse is educating a client on the technique for performing breast self-examination. Which instruction should the nurse include in the teaching plan with regard to the different degrees of pressure that need to be applied on the breast?
hard pressure applied down to the ribs
A 62-year-old female client arrives at a health care facility reporting skin redness in the breast area, along with skin edema. The primary care provider suspects inflammatory breast cancer. For which symptom of inflammatory breast cancer should the nurse assess?
increased warmth of the breast
The nurse is developing a presentation for a local women's health center about breast cancer. Which cancer would the nurse include as being the most common type of breast cancer?
invasive ductal carcinoma
What is the most common type of breast cancer, accounting for approximately 85% of cases?
invasive ductal carcinoma
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
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 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 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 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
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 breast tumor is most likely found in what part of the breast?
the upper outer quadrant
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