Deck 44: Caring for the Patient With Breast Disorders

Question 1

Which statement would the nurse evaluate as indicating the patient needs further education about mastitis and breastfeeding?

A) "If I wear a plastic-backed breast pad, I can continue to breastfeed."
B) "If I develop discharge from the mastitis, I should avoid feeding the baby on that side."
C) "My breast milk will help protect the baby from infection from my mastitis."
D) "If the baby is not emptying my breast, I should use a breast pump after feeding."

Answer 1

"If I wear a plastic-backed breast pad, I can continue to breastfeed."

Question 2

A patient presents to the clinic with complaints of breast pain that is continuous. Which assessment is most pertinent?

A) "Are you taking any vitamins?"
B) "Have you had back pain recently?"
C) "Has anyone in your family had breast cancer?"
D) "How old were you when your periods started?"

Answer 2

"Has anyone in your family had breast cancer?"

Question 3

Biopsy reveals that a patient has a single papilloma in her right breast. The lesion was completely removed during the biopsy procedure. What information would the nurse reinforce regarding this patient's future breast cancer risk?

A) The patient has breast cancer at present.
B) The patient is at no greater risk for breast cancer in the future.
C) The patient is at some increased risk for breast cancer, generally about 1.5 to 2 times the normal risk.
D) The patient's risk for future breast cancer is very high, generally 10 to 20 times the normal risk.

Answer 3

The patient is at some increased risk for breast cancer, generally about 1.5 to 2 times the normal risk.

Question 4

The nurse is discussing breast self-examination with a 20-year-old patient. Which statement by the patient indicates the need for further education?

A) "Lying down will help me to feel all of my breast tissue."
B) "A firm ridge in the lower curve of my breast is normal."
C) "I should examine my breasts on the first day of my menstrual period."
D) "The fact that I have breast implants does not negate my need to perform a monthly breast self-examination."

Question 5

A patient with breast cancer is being treated with docetaxel (Taxotere). Which nursing diagnoses (NDX) would the nurse include in the plan of care to address common side effects?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Risk for Injury: Falls
B) Risk for Infection
C) Ineffective Airway Clearance
D) Impaired Tissue Perfusion: Cardiovascular
E) Ineffective Individual Coping

Question 6

A female patient is scheduled for a stereotactic needle biopsy of a left breast lesion. What information should the nurse provide about this test?

A) This is a three-dimensional mammogram in which a fine-needle aspirate of the mass is taken.
B) This is the gold standard for diagnosis in which a small cut is made in the breast under intravenous sedation.
C) A needle will be inserted into the lesion, guided by ultrasound, and the contents aspirated.
D) The entire lesion is removed along with some of the surrounding tissue.

Question 7

A patient has experienced galactorrhea. Cytology is negative. Which nursing statement is indicated?

A) "It is good that your breast mass is not malignant."
B) "At least you don't have cancer."
C) "Even though this is a good report, more tests will be necessary."
D) "This result means your discharge is probably from a malignant change in your breast."

Question 8

A patient who has breast cancer is being treated with tamoxifen. Which statement indicates that the patient has understood the nurse's instruction regarding this medication?

A) "I should avoid over-the-counter pain relievers while taking tamoxifen."
B) "I will report any swelling in my legs or shortness of breath."
C) "I will avoid eating green, leafy vegetables while taking tamoxifen."
D) "I will sleep with my head on two pillows while taking tamoxifen."

Question 9

During a routine physical examination, a 22-year-old patient asks if she is at risk of developing breast cancer. Which reported factors would the nurse confirm as increasing this patient's risk?

A) Hispanic heritage
B) Onset of menarche at age 11
C) Breastfed her two children for 6 months
D) Use of the female condom

Question 10

A woman who has never been pregnant is being treated for mastitis. Which information should the nurse provide?

A) "Because you have never been pregnant, having mastitis increases your risk of breast cancer."
B) "Mastitis is rare in women who are not breastfeeding."
C) "We must differentiate between mastitis and a phyllodes tumor before we can predict whether your condition is malignant."
D) "We should run a pregnancy test because some patients develop mastitis as an initial sign of pregnancy."

Question 11

A patient is recovering from breast cancer surgery that included axillary node dissection. The nurse realizes that this patient will need education regarding which potential complication of axillary node dissection?

A) Lymphedema
B) Metastasis
C) Bleeding from the incision site
D) Altered neck movement

Question 12

A new mother reports that her infant son's breasts are enlarged and tender. How can the nurse best respond?

A) "Bring him to the clinic immediately; we need to examine him more closely."
B) "This sometimes happens in babies whose gender is not clear."
C) "Occasionally a baby is born with a cyst or tumor, but they generally disappear by the time the baby is a month old."
D) "Babies of both genders often have breast enlargement, which will go away in a month or so."

Question 13

A patient has been diagnosed with mastalgia. Mammogram results are negative. Which instructions should the nurse provide?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Wear a properly fitting bra."
B) "Increase the amount of polyunsaturated fats in your diet."
C) "Some women find that taking evening primrose oil helps reduce the symptoms of mastalgia."
D) "Smoking cessation may help to reduce your symptoms."
E) "Some women report that drinking hot tea or flavored coffee helps reduce their symptoms."

Question 14

The nurse is discussing the use of illegal substances with a group of teenage boys and wishes to approach the topic from a unique perspective. The nurse would tell this group that which drugs are implicated in the development of larger breasts in men?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Marijuana
B) Alcohol
C) Heroin
D) Cocaine
E) Amphetamines

Question 15

A patient is undergoing diagnostic testing for a breast mass. Initial reports suggest that the mass is benign, but definitive results are not yet available. Which nursing diagnoses would the nurse consider when planning this patient's care?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Fear
B) Decisional Conflicts
C) Altered Tissue Perfusion: Peripheral
D) Disturbed Body Image
E) Deficient Knowledge

Question 16

Which information should the nurse include in medication teaching for the patient prescribed clindamycin for mastitis?

A) "Let the prescriber know if you develop diarrhea."
B) "This medication may cause insomnia."
C) "You may experience dizziness while taking clindamycin."
D) "You may notice that your urine is a greenish-yellow color while taking this drug."

Question 17

A patient presents to the clinic after discovering a lump in her breast. Which finding would alert the nurse to a probable malignancy?

A) The patient reports tenderness with palpation.
B) The skin over the mass is smooth.
C) The mass is readily moved beneath the skin.
D) The borders of the mass are uneven.

Question 18

A patient has the nursing diagnosis Disturbed Body Image related to surgical excision of a benign breast mass. Which patient statement would the nurse evaluate as indicating that the goal of acceptance of body image has been achieved?

A) "The scar is not as red as I thought it would be."
B) "I hope I can still wear a bikini top."
C) "I haven't shown the scar to my husband yet."
D) "I think my shirts fit differently since my surgery."

Question 19

A patient has been prescribed danazol for treatment of mastalgia. Which patient statements indicate that the patient understands the nurse's instructions about this drug?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "I must avoid becoming pregnant while taking danazol."
B) "I may stop having periods while on this medication."
C) "This is the most effective drug for this condition."
D) "I will apply this gel to my breasts twice a day."
E) "I should watch for easy bruising and tarry stools while taking danazol."

Question 20

A patient who has just been diagnosed with a fibroadenoma in her left breast begins to cry. What information should the nurse provide?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Fibroadenomas are a nonproliferative type of tumor.
B) The next treatment step will be biopsy.
C) This tumor is caused by normal hormonal fluctuations.
D) The patient will need regular mammograms and other breast screening exams.
E) Fibroadenomas are fluid-filled cysts that may rupture.

Question 21

A patient's genetic studies reveal she is positive for both BRCA1 and BRCA2 mutations. The nurse prepares to care for a patient whose lifetime risk of developing breast cancer is _______%.

Question 22

A patient who had breast augmentation surgery last year presents to the clinic and says, "My right breast is so hard all over." The nurse would assess for development of which likely condition?

A) Infection
B) Hemorrhage into the implant
C) Capsule contracture
D) Breast cancer

Question 23

The nurse has provided education to a woman who wishes to use exercise as a way to reduce her breast cancer risk. The nurse would evaluate that teaching has been effective when the woman says, "I am going to start walking for ________ minutes every day."

Question 24

A patient diagnosed with breast cancer wishes to have reconstruction surgery as soon as possible. Which information should the nurse reinforce?

A) "Breast reconstruction works better if it is done as a separate surgery after you have recovered from mastectomy."
B) "Breast reconstruction has to wait until after chemotherapy is completed."
C) "The timing of reconstruction is your personal choice."
D) "You should wait until we are certain your cancer does not recur."

Question 25

The surgeon tells a family that the goal for their mother's surgery is a clean lumpectomy. How would the nurse interpret this statement for the family?

A) It is hoped that their mother will have a short anesthesia time and a quick surgery.
B) The goal is that only one lump is found in the breast.
C) It is hoped that the lump can be removed intact with noncancerous margins.
D) The goal is that the patient will lose a minimal amount of blood.

Question 26

A 21-year-old woman comes to the clinic seeking information about breast reduction surgery. What information should the nurse provide?

A) The scars from reduction surgery are minimal and difficult to see.
B) This surgery may make it impossible to breastfeed children.
C) Most women are not satisfied with the results of the procedure.
D) The surgery can be done only under very specific circumstances.

Question 27

A patient had a mastectomy with axillary node dissection and was told she has stage IV breast cancer. The nurse would expect surveillance of which body systems as the most likely areas for metastasis?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Bone
B) Liver
C) Brain
D) Lung
E) Uterus

Question 28

During a community information session about breast cancer a participant says, "You hear about so many women with breast cancer now. Why is it so much more common?" Which nursing statement is indicated?

A) "We believe that the hormone additives in milk and meat have made breast cancer more common."
B) "Since we revised the recommendations for the use of hormones during menopause, the rates of breast cancer have actually decreased."
C) "Our surveillance, detection, and treatment options are better now, so deaths due to breast cancer are fewer."
D) "So many more women smoke cigarettes now that breast cancer rates are going up."
E) "In the United States we have a higher percentage of Hispanic women, who are at highest risk of developing breast cancer."

Question 29

A breastfeeding mother reports that one of her nipples is cracked and sore. She is concerned about developing infection in her breast. Which instruction should the nurse provide?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Express breast milk and rub it into your nipples after feeding is completed."
B) "Purchase some evening primrose oil and treat your nipples with it twice each day."
C) "Avoid feeding on that breast until the nipple heals."
D) "You can use water-soluble lanolin on your nipple to sooth and heal it."
E) "Coat your nipples with petroleum jelly prior to feedings."

Question 30

A woman has undergone fine needle biopsy of a breast lump. Which statement would the nurse evaluate as indicating that the patient understands discharge teaching?

A) "Even if this lump was cancer, it is all gone now."
B) "I will massage my breast twice daily for the next week."
C) "I can go back to work today if I wish."
D) "There is no risk of infection with this procedure."

Question 31

A patient is admitted for Paget's disease of the breast. The nurse completing admission assessment would expect which finding?

A) A mass in the upper outer quadrant of the patient's breast
B) A thickened area of tissue in the axilla
C) Redness of the entire breast
D) A chronic rash on the nipple that is crusty in appearance

Question 32

A woman presents to the clinic with a breast mass. The nurse reviewing this patient's history identifies which finding as indicating the highest risk of the mass being malignant?

A) The patient's father died of breast cancer.
B) The woman is Native American.
27.
C) The woman's children were born when she was 22 and
D) The woman is vegetarian.

Question 33

A male patient has been diagnosed with breast cancer. The patient says, "How did this happen? I though breast cancer only occurred in women." The nurse would consider which assessment findings as risk factors for this man's condition?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The man is 5 ft. 10 inches tall and weighs 245 pounds.
B) The patient has periodic exacerbations of severe hepatitis C
C) The patient drinks three or four beers each day after work.
D) The patient works as an over-the-road trucker and is away from home for several days each week.
E) The patient had his spleen removed secondary to an automobile accident when he was a teenager.