Deck 54: Nursing Management Breast Disorders

Question 1

The nurse is conducting a breast assessment on a female client. Which of the following findings is most indicative of a need for further evaluation?

A)Bilateral nodules that are tender with palpation
B)A nodule that is 1 cm in size, painless, and firm
C)A lump that increases in size before the menstrual period
D)A lump that is small, mobile, and has a rubbery consistency

Answer 1

A nodule that is 1 cm in size, painless, and firm

Question 2

The nurse is caring for a client who returns to the surgical unit following a right modified radical mastectomy with dissection of axillary lymph nodes. Which of the following nursing actions should be included in the plan of care?

A)Insist that the client examine the surgical incision when the dressings are removed.
B)Teach the client to use the ordered patient-controlled analgesia (PCA) every 10 minutes.
C)Post a sign at the bedside warning against blood pressures or venipunctures in the right arm.
D)Obtain a permanent breast prosthesis for the client before she is discharged from the hospital.

Answer 2

Post a sign at the bedside warning against blood pressures or venipunctures in the right arm.

Question 3

When the nurse is working in the women's health care clinic, which of the following actions is appropriate to take?

A)Educate a healthy 36-year-old about the need for an annual mammogram.
B)Discuss the need for an annual mammography with a 52-year-old.
C)Talk about magnetic resonance imaging (MRI) with a 26-year-old with a BRCA-1 mutation.
D)Teach an active 70-year-old that mammography frequency should be individualized based upon her history.

Answer 3

Talk about magnetic resonance imaging (MRI) with a 26-year-old with a BRCA-1 mutation.

Question 4

Which of the following information should the nurse include when teaching a client about the transverse rectus abdominis musculo-cutaneous (TRAM) procedure?

A)Saline-filled implants are placed under the pectoral muscles.
B)Recovery from the TRAM surgery takes at least 6 to 8 weeks.
C)Muscle tissue is removed from the back and used to form a breast.
D)TRAM flap procedures may be done in outpatient surgery centres.

Question 5

The nurse has completed teaching a client who has breast cancer about the newly prescribed tamoxifen. Which of the following client statements indicate that the teaching has been effective?

A)"I will expect to have leg cramps with this drug."
B)"I will call the clinic if I develop any hot flashes."
C)"I will be taking the medication for at least a year."
D)"I will call immediately if I experience cloudy and blurred vision."

Question 6

The nurse is teaching a client about breast self-examination (BSE) who has had a right-sided mastectomy. Which of the following information should the nurse include in the teaching plan?

A)Only the remaining breast requires a mammogram screening annually.
B)BSE should be done daily while taking a bath or shower.
C)Mammograms should be scheduled every two years.
D)Performing BSE monthly

Question 7

A client has a saline breast implant inserted in the outpatient surgery area. Which of the following instructions should the nurse include in the discharge teaching?

A)Take Aspirin every 4 hours to reduce inflammation.
B)Check wound drains for excessive blood or any foul odour.
C)Wear a loose-fitting bra to decrease irritation of the sutures.
D)Resume normal activities 2 to 3 days after the mammoplasty.

Question 8

After a client is diagnosed with lobular carcinoma in situ (LCIS), the nurse will anticipate that client teaching may be needed about which of the following topics?

A)Lumpectomy
B)Lymphatic mapping
C)MammaPrint testing
D)Tamoxifen

Question 9

The nurse is caring for a client who is scheduled for stereotactic core biopsy of the breast. Which of the following information should the nurse include in client education?

A)A local anaesthetic will be given before the biopsy specimen is obtained.
B)You will need to lie flat on your back and lie very still during the biopsy.
C)A thin needle will be inserted into the lump and aspirated to remove tissue.
D)You should not have anything to eat or drink for 6 hours before the procedure.

Question 10

Which of the following statements by a client newly diagnosed with stage I breast cancer indicates to the nurse that client teaching may be needed?

A)"There are several options available for treating the cancer."
B)"I will probably need radiation to the breast after having the surgery."
C)"I can probably have reconstructive surgery at the same time as a mastectomy."
D)"Mastectomy will be the best choice to decrease the chance of cancer recurrence."

Question 11

The nurse is preparing a client with a small immobile breast lump for a fine-needle aspiration (FNA) biopsy. Which of the following information about the procedure should the nurse explain to the client?

A)FNA is done in the outpatient clinic, and results are available in 1 to 2 days.
B)Only a small incision is needed, resulting in minimal breast pain and scarring.
C)If the biopsy results are negative, no further diagnostic testing will be needed.
D)FNA is guided by a mammogram, ensuring that cells are taken from the lesion.

Question 12

The nurse is caring for a client who is at menopause and considering the use of hormone replacement therapy (HRT) but is concerned about the risk of breast cancer. Which of the following information should the nurse include when discussing HRT with the client?

A)HRT does not appear to increase the risk for breast cancer unless there are other risk factors.
B)HRT is a safe therapy for menopausal symptoms if there is no family history of BRCA genes.
C)She and her health care provider must weigh the benefits of HRT against the possible risks of breast cancer.
D)Alternative therapies with herbs and natural drugs are as effective as estrogen in relieving menopausal symptoms.

Question 13

Which of the following actions should the nurse take first when caring for a client who has been admitted for lumpectomy and axillary lymph node dissection?

A)Teach the client how to deep breathe and cough.
B)Discuss options for postoperative pain management.
C)Explain the postdischarge care of the axillary drains.
D)Ask the client to describe what she knows about the surgery.

Question 14

The nurse is caring for a client following breast augmentation surgery. Which of the following information should the nurse include in client teaching?

A)A drain will be in place for 24 hours after the surgery and then removed.
B)Temperature will be monitored every 4 hours postoperatively.
C)A compression dressing will be in place for 5-7 days
D)Most women can resume normal activities 1 week postoperative.

Question 15

The nurse is assessing a client at the clinic who has metastatic breast cancer and has a new prescription for trastuzumab. Which of the following findings is a reason for the administration of this medication?

A)Allergic to iodine
B)HER-2 positive
C)Immune to tamoxifen
D)Severely dehydrated

Question 16

To determine the risk for breast cancer in a client who has found a small lump in the left breast, which of the following questions is most pertinent for the nurse to ask?

A)"Do you currently smoke cigarettes?"
B)"Have you ever had any breast injuries?"
C)"At what age did you start having menstrual periods?"
D)"Is there any family history of fibrocystic breast changes?"

Question 17

A student nurse prepares a list of teaching topics for a client with a new diagnosis of breast cancer. Which of the following topics indicate that the student needs more education about breast cancer diagnostic testing?

A)A firm, moveable mass is most often breast cancer
B)HER-2 receptor testing
C)Estrogen receptor testing
D)Oncotype DX assay testing

Question 18

The nurse is caring for a client who has had a right mastectomy and the client asks the nurse how long the biannual mammography will have to continue. Which of the following time frames should the nurse inform the client is recommended for mammography postmastectomy?

A)Every 6 months for a year
B)Every 6 months for 2 years
C)Every 6 months for 5 years
D)Every 6 months for life

Question 19

The pathology report for a client who has had a modified radical mastectomy identifies the tumour as an estrogen-receptor positive adenocarcinoma. Which of the following medications should the nurse include when teaching the client?

A)Estradiol
B)Raloxifene
C)Tamoxifen
D)Trastuzumab

Question 20

Aclient with stage II breast cancer tells the nurse, "I need to decide about what type of surgery to have, but I feel so overwhelmed that I cannot make any decisions yet! What do you think I should do?" Which of the following responses by the nurse is best?

A)"I would have a lumpectomy, but you need to decide what is best for you."
B)"Tell me what you understand about the surgical options that are available."
C)"It would not be appropriate for me to make the decision about your health."
D)"There is no need to make a decision rapidly; you have time to think about this."

Question 21

The nurse is assessing a client with Paget's disease. Which of the following findings should the nurse anticipate that the client may experience? (Select all that apply.)

A)Greenish coloured nipple discharge
B)Itchiness of the breast
C)Increased temperature
D)Nipple ulceration
E)A burning sensation in the breast

Question 22

The nurse is assessing a male client and notes bilateral enlargement of the breasts. Which of the following actions should the nurse take first?

A)Question the client about any medications being currently used.
B)Teach the client about how to palpate the breast tissue for lumps.
C)Refer the client for mammography and biopsy of the breast tissue.
D)Explain that this is a temporary condition due to hormonal changes.

Question 23

The nurse is caring for a client with left arm lymphedema. Which of the following actions should be included in the plan of care?

A)Check BP on both right and left arms.
B)Avoid isometric exercise on the left arm.
C)Assist with application of compression dressings.
D)Keep the left arm at or below the level of the heart.

Question 24

The nurse is caring for a client with breast cancer who is receiving chemotherapy and tamoxifen. Which of the following findings is most important to communicate to the health care provider?

A)The client has symptoms of numbness and tingling in the right arm and leg.
B)The client has complaints of fatigue.
C)The client eats only 15% of food on meal tray.
D)The client's white blood cell (WBC) count is 5 * 10?/L.

Question 25

A client who has a diagnosis of fibrocystic breast changes calls the nurse in the clinic with these symptoms. Which of the following findings is most important to report to the health care provider?

A)There is yellow-green discharge from one of the client's nipples.
B)There is an area on the breast that is hot, red, and tender to touch.
C)The lumps are firm feeling and most are in the upper outer breast quadrants.
D)The lumps are larger and more painful before the client's menstrual period.