Deck 70: Care of Patients with Breast Disorders

Question 1

After a breast examination,the nurse is documenting assessment findings that indicate possible breast cancer.Which abnormal findings need to be included as part of the client's electronic medical record? (Select all that apply.)

A) Peau d'orange
B) Dense breast tissue
C) Nipple retraction
D) Mobile mass at two o'clock
E) Nontender axillary nodes

Answer 1

Peau d'orange
Nipple retraction
Mobile mass at two o'clock

Question 2

What comfort measure can only be performed by a nurse,as opposed to an unlicensed assistive personnel (UAP),for a client who returned from a left modified radical mastectomy 4 hours ago?

A) Placing the head of bed at 30 degrees
B) Elevating the left arm on a pillow
C) Administering morphine for pain at a "4" on a 0-to-10 scale
D) Supporting the left arm while initially ambulating the client

Answer 2

Administering morphine for pain at a "4" on a 0-to-10 scale

Question 3

A client is starting hormonal therapy with tamoxifen (Nolvadex)to lower the risk for breast cancer.What information needs to be explained by the nurse regarding the action of this drug?

A) It blocks the release of luteinizing hormone.
B) It interferes with cancer cell division.
C) It selectively blocks estrogen in the breast.
D) It inhibits DNA synthesis in rapidly dividing cells.

Answer 3

It selectively blocks estrogen in the breast.

Question 4

A client is placed on a medical regimen of doxorubicin (Adriamycin),cyclophosphamide (Cytoxan),and fluorouracil (5-FU)for breast cancer.Which side effect seen in the client should the nurse report to the provider immediately?

A) Shortness of breath
B) Nausea and vomiting
C) Hair loss
D) Mucositis

Question 5

The nurse is teaching a 45-year-old woman about her fibrocystic breast condition.Which statement by the client indicates a lack of understanding?

A) "This condition will become malignant over time."
B) "I should refrain from using hormone replacement therapy."
C) "One cup of coffee in the morning should be enough for me."
D) "This condition makes it more difficult to examine my breasts."

Question 6

A woman diagnosed with breast cancer had these laboratory tests performed at an office visit:

Which test results indicate to the nurse that some further diagnostics are needed?

A) Elevated alkaline phosphatase and calcium suggests bone involvement.
B) Only alkaline phosphatase is decreased, suggesting liver metastasis.
C) Hematocrit and hemoglobin are decreased, indicating anemia.
D) The elevated hematocrit and hemoglobin indicate dehydration.

Question 7

A 68-year-old male client is embarrassed about having bilateral breast enlargement.Which statement by the nurse is the most appropriate?

A) "Breast cancer in men is quite rare."
B) "It is good that you came to be carefully evaluated."
C) "Gynecomastia usually comes from overeating."
D) "When you get older, the male breast always enlarges."

Question 8

During dressing changes,the nurse assesses a client who has had breast reconstruction.Which finding would cause the nurse to take immediate action?

A) Slightly reddened incisional area
B) Blood pressure of 128/75 mm Hg
C) Temperature of 99° F (37.2° C)
D) Dusky color of the flap

Question 9

With a history of breast cancer in the family,a 48-year-old female client is interested in learning about the modifiable risk factors for breast cancer.After the nurse explains this information,which statement made by the client indicates that more teaching is needed?

A) "I am fortunate that I breast-fed each of my three children for 12 months."
B) "It looks as though I need to start working out at the gym more often."
C) "I am glad that we can still have wine with every evening meal."
D) "When I have menopausal symptoms, I must avoid hormone replacement therapy."

Question 10

The nurse is taking a history of a 68-year-old woman.What assessment findings would indicate a high risk for the development of breast cancer? (Select all that apply.)

A) Age greater than 65 years
B) Increased breast density
C) Osteoporosis
D) Multiparity
E) Genetic factors

Question 11

A 37-year-old Nigerian woman is at high risk for breast cancer and is considering a prophylactic mastectomy and oophorectomy.What action by the nurse is most appropriate?

A) Discourage this surgery since the woman is still of childbearing age.
B) Reassure the client that reconstructive surgery is as easy as breast augmentation.
C) Inform the client that this surgery removes all mammary tissue and cancer risk.
D) Include support people, such as the male partner, in the decision making.

Question 12

A client is diagnosed with a fibrocystic breast condition while in the hospital and is experiencing breast discomfort.What comfort measure would the nurse delegate to the unlicensed assistive personnel (UAP)?

A) Aid in the draining of the cysts by needle aspiration.
B) Teach the client to wear a supportive bra to bed.
C) Administer diuretics to decrease breast swelling.
D) Obtain a cold pack to temporarily relieve the pain.

Question 13

A 35-year-old woman is diagnosed with stage III breast cancer.She seems to be extremely anxious.What action by the nurse is best?

A) Encourage the client to search the Internet for information tonight.
B) Ask the client if sexuality has been a problem with her partner.
C) Explore the idea of a referral to a breast cancer support group.
D) Assess whether there has been any mental illness in her past.

Question 14

The nurse is examining a woman's breast and notes multiple small mobile lumps.Which question would be the most appropriate for the nurse to ask?

A) "When was your last mammogram at the clinic?"
B) "How many cans of caffeinated soda do you drink in a day?"
C) "Do the small lumps seem to change with your menstrual period?"
D) "Do you have a first-degree relative who has breast cancer?"

Question 15

A client is discharged to home after a modified radical mastectomy with two drainage tubes.Which statement by the client would indicate that further teaching is needed?

A) "I am glad that these tubes will fall out at home when I finally shower."
B) "I should measure the drainage each day to make sure it is less than an ounce."
C) "I should be careful how I lie in bed so that I will not kink the tubing."
D) "If there is a foul odor from the drainage, I should contact my doctor."

Question 16

The nurse is formulating a teaching plan according to evidence-based breast cancer screening guidelines for a 50-year-old woman with low risk factors.Which diagnostic methods should be included in the plan? (Select all that apply.)

A) Annual mammogram
B) Magnetic resonance imaging (MRI)
C) Breast ultrasound
D) Breast self-awareness
E) Clinical breast examination

Question 17

Which finding in a female client by the nurse would receive the highest priority of further diagnostics?

A) Tender moveable masses throughout the breast tissue
B) A 3-cm firm, defined mobile mass in the lower quadrant of the breast
C) Nontender immobile mass in the upper outer quadrant of the breast
D) Small, painful mass under warm reddened skin

Question 18

A client has just returned from a right radical mastectomy.Which action by the unlicensed assistive personnel (UAP)would the nurse consider unsafe?

A) Checking the amount of urine in the urine catheter collection bag
B) Elevating the right arm on a pillow
C) Taking the blood pressure on the right arm
D) Encouraging the client to squeeze a rolled washcloth

Question 19

The nurse is taking the history of a client who is scheduled for breast augmentation surgery.The client reveals that she took two aspirin this morning for a headache.Which action by nurse is best?

A) Take the client's vital signs and record them in the chart.
B) Notify the surgeon about the aspirin ingestion by the client.
C) Warn the client that health insurance may not pay for the procedure.
D) Teach the client about avoiding twisting above the waist after the operation.

Question 20

A client is concerned about the risk of lymphedema after a mastectomy.Which response by the nurse is best?

A) "You do not need to worry about lymphedema since you did not have radiation therapy."
B) "A risk factor for lymphedema is infection, so wear gloves when gardening outside."
C) "Numbness, tingling, and swelling are common sensations after a mastectomy."
D) "The risk for lymphedema is a real threat and can be very self-limiting."

Question 21

A woman has been using acupuncture to treat the nausea and vomiting caused by the side effects of chemotherapy for breast cancer.Which conditions would cause the nurse to recommend against further use of acupuncture? (Select all that apply.)

A) Lymphedema
B) Bleeding tendencies
C) Low white blood cell count
D) Elevated serum calcium
E) High platelet count

Question 22

A client states that she rates her pain as a "5" on a 0-to-10 scale post-mastectomy.The provider has ordered morphine 4 mg for moderate pain every 4 hours.The morphine is supplied in a solution of 8 mg/mL.How many mL will the nurse administer? ____ mL