Question 1

The nurse is discussing mammography with a postmenopausal 64-year-old woman.How often does the nurse recommend that the patient have a mammography exam?

Accepted Answer

Women aged 50-69 years should have a mammogram every 2 to 3 years.

Question 2

While examining a 75-year-old woman,the nurse notes that the skin over her right breast is thickened and the hair follicles appear exaggerated.This condition is known as:

Accepted Answer

Lymphatic obstruction produces edema,which thickens the skin and exaggerates the appearance of hair follicles.The skin has a pigskin or orange-peel look,and this condition is indicative of cancer.

Question 3

During physical examination,the nurse notes that a female patient has an inverted left nipple.Which of the following statements about inverted nipples is most accurate?

Accepted Answer

Distinguish a recent nipple inversion from one that has existed for many years or since puberty.Normal nipple inversion may be unilateral or bilateral,and usually the inverted nipple can be pulled out (i.e. ,it is not fixed).Recent nipple inversion signifies acquired disease.

Question 4

While examining a patient's breasts,the nurse finds the left breast slightly larger than the right and the presence of Montgomery's glands bilaterally.The nurse would:

Accepted Answer

Normal findings of the breast include one breast (most often the left)slightly larger than the other and the presence of Montgomery's glands across the areola.

Question 5

During breast examination,which of the following is the correct procedure to screen for nipple or skin retraction?

Accepted Answer

Direct the woman to change position while checking the breasts for signs of skin retraction.First,ask her to lift her arms slowly over her head.Both breasts should move up symmetrically.Retraction signs are seen in the presence of fibrosis in the breast tissue,which is usually caused by growing neoplasms.Note any lag in the movement of a breast.

Question 6

The nurse is conducting a class about breast health.Which of the following statements is true?

Accepted Answer

The best time to conduct BSE is right after the menstrual period,or the fourth through seventh day of the menstrual cycle,when the breasts are the smallest and least congested.

Question 7

Which of the following clinical situations would the nurse consider as being outside normal limits?

Accepted Answer

After palpating over the four breast quadrants,palpate the nipple.Note any induration or subareolar mass.Use your thumb and forefinger to apply gentle pressure or a stripping action to the nipple.If any discharge appears,note its colour and consistency.Except in pregnancy and lactation,discharge is abnormal.

Question 8

During breast examination,the nurse notes that the woman's nipple is flat,broad,and fixed.The patient states that this "started happening a few months ago." This finding suggests:

Accepted Answer

The retracted nipple looks flatter and broader,like an underlying crater.Recent retraction suggests cancer,which causes fibrosis of the entire duct system and pulls in the nipple.Retraction also may occur with benign lesions such as ectasia of the ducts.Do not confuse retraction with the normal longstanding type of nipple inversion,in which broadening is not seen and the nipple is not fixed.

Question 9

Which assessment finding regarding the shape of a breast lump would indicate that the woman may have breast cancer?

Accepted Answer

The shape of a breast lump often associated with breast cancer is irregular and star-shaped.

Question 10

A patient states during the assessment that she noticed a new lump in her left breast near her axilla while in the shower a few days ago.The nurse should plan to:

Accepted Answer

If the woman mentions a breast lump she has discovered herself,examine the unaffected breast first to establish a baseline of normal consistency for this individual.

Question 11

A 54-year-old man comes to the clinic with a "horrible problem." He tells the nurse that he has just discovered a lump in his breast and is fearful of cancer.Which statement about breast cancer in men is true?

Accepted Answer

Fewer than 1% of all breast cancers occur in men.Breast masses are noticeable early because of minimal breast tissue.

Question 12

Which of the following statements reflects the best approach to teaching a woman about BSE?

Accepted Answer

BSEs are no longer routinely recommended to women between the ages of 40 and 74 with a low to average risk for the development of breast cancer.

Question 13

A 43-year-old woman is at the clinic for a routine examination.She reports that she has had a lump in her right breast for years.Recently,it has begun to change in consistency and is becoming harder.She reports that 5 years ago her physician evaluated the lump and had determined that it "was nothing to worry about." The examination validates the presence of a mass in the right upper outer quadrant at 1 o'clock,approximately 5 cm from the nipple.It is firm,mobile,and nontender,with borders that are not well defined.The nurse's recommendation to her is:

Accepted Answer

A lump that has been present for years and is not exhibiting changes may not be serious but still should be explored.Any recent change or new lump should be further investigated.

Question 14

Which of the following is an abnormal finding during the inspection phase of breast examination?

Accepted Answer

Nipples should be symmetrical on the same plane on the two breasts.If there is deviation in pointing,it suggests an underlying cancer that causes fibrosis in the mammary ducts,pulling the nipple angle toward it.

Question 15

A 55-year-old postmenopausal woman is being seen in the clinic for her annual physical examination.She is concerned about the changes she has noticed in her breasts in the past 5 years.She states that her breasts have decreased in size and that the elasticity has decreased so much that her breasts seem "flat and flabby." The nurse's best reply would be:

Accepted Answer

Ovarian secretion of estrogen and progesterone decreases after menopause.This causes the breast glandular tissue to atrophy.

Question 16

During breast palpation,which of the following positions is most likely to clearly delineate significant lumps?

Accepted Answer

Help the woman to a supine position.Tuck a small pad under the breast to be palpated,and raise her arm over her head.These manoeuvres will flatten the breast tissue and displace it medially.Any significant lumps will then be felt more distinctly.

Question 17

While palpating,the nurse has found a lump in a female patient's right breast.The nurse documents this as a small,round,firm,distinct lump located at the 2:00 position,2 cm from the nipple.It is nontender and fixed.There is no associated retraction of skin or nipple,no erythema,and no axillary lymphadenopathy.This entry is missing information about:

Accepted Answer

If you do feel a lump or mass,note these characteristics: (1)location,(2)size-measure in centimetres in three dimensions: width ´ length ´ thickness,(3)shape,(4)consistency,(5)motility,(6)distinctness,(7)nipple,(8)the skin over the lump,(9)tenderness,and (10)lymphadenopathy.

Question 18

During examination,the nurse notes a supernumerary nipple just under the patient's left breast.The patient tells the nurse that she always thought it was a mole.Which of the following statements about this finding is correct?

Accepted Answer

A supernumerary nipple looks like a mole,but close examination reveals a tiny nipple and areola.It is,however,not a significant finding.

Question 19

A breastfeeding mother is diagnosed with a breast abscess.Which of the following instructions from the nurse is correct? The mother needs to:

Accepted Answer

With a breast abscess,the patient must temporarily discontinue nursing on the affected breast,manually express the milk,and discard it.

Question 20

A new mother,who has been breastfeeding for 1 month,calls the clinic to report that an area of her left breast is red,swollen,tender,very hot,and hard.She has a fever of 38.3°C.She has also had symptoms of flu,such as chills,sweating,and tiredness.From this description,what condition does the nurse suspect?

Accepted Answer

The symptoms indicate mastitis,which stems from infection or stasis caused by a plugged duct.With a plugged duct,infection is not present.

Quiz 18: Breasts and Regional Lymphatic System