Deck 10: Problems of the Breast

Question 1

A client's oncologist has just finished explaining the diagnostic workup results to her,and she still has questions.The woman states,"The physician says I have a slow-growing cancer.Very few cells are dividing.How does she know this?" What is the name of the test that gave the health care provider this information?

A) Tumor ploidy
B) S-phase index
C) Nuclear grade
D) Estrogen-receptor assay

Answer 1

S-phase index

Question 2

A nurse is providing breast care education to a client after mammography.Which information regarding fibrocystic changes in the breast is important for the nurse to share?

A) Fibrocystic breast disease is a disease of the milk ducts and glands in the breasts.
B) It is a premalignant disorder characterized by lumps found in the breast tissue.
C) Healthy women with fibrocystic breast disease find lumpiness with pain and tenderness in varying degrees in the breast tissue during menstrual cycles.
D) Lumpiness is accompanied by tenderness after menses.

Answer 2

Healthy women with fibrocystic breast disease find lumpiness with pain and tenderness in varying degrees in the breast tissue during menstrual cycles.

Question 3

The most conservative approach for early breast cancer treatment involves lumpectomy followed by which procedure?

A) Radiation
B) Adjuvant systemic therapy
C) Hormonal therapy
D) Chemotherapy

Answer 3

Radiation

Question 4

A nurse is providing education to a support group of women newly diagnosed with breast cancer.It is important for the nurse to discuss which factor related to breast cancer with the group?

A) Genetic mutations account for 50% of women who will develop breast cancer.
B) Breast cancer is the leading cause of cancer death in women.
C) In the United States, 1 in 10 women will develop breast cancer in her lifetime.
D) The exact cause of breast cancer remains unknown.

Question 5

A client has been prescribed adjuvant tamoxifen therapy.What common side effect might she experience?

A) Weight gain, hot flashes, and blood clots
B) Vomiting, weight loss, and hair loss
C) Nausea, vomiting, and diarrhea
D) Hot flashes, weight gain, and headaches

Question 6

A client is concerned because she has been experiencing some milky,sticky breast discharge.Which nonmalignant condition is exhibited with this finding?

A) Relative inflammatory lesion
B) Galactorrhea
C) Mammary duct ectasia
D) Breast infection

Question 7

A health care provider performs a clinical breast examination on a woman diagnosed with fibroadenoma.How would the nurse explain the defining characteristics of a fibroadenoma?

A) Inflammation of the milk ducts and glands behind the nipples
B) Thick, sticky discharge from the nipple of the affected breast
C) Lumpiness in both breasts that develops 1 week before menstruation
D) Single lump in one breast that can be expected to shrink as the woman ages

Question 8

Having a genetic mutation may create an 85% chance of developing breast cancer in a woman's lifetime.Which condition does not increase a client's risk for breast cancer?

A) BRCA1 or BRCA2 gene mutation
B) Li-Fraumeni syndrome
C) Paget disease
D) Cowden syndrome

Question 9

What important,immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy?

A) The blood pressure (BP) cuff should not be applied to the affected arm.
B) Venipuncture for blood work should be performed on the affected arm.
C) The affected arm should be used for intravenous (IV) therapy.
D) The affected arm should be held down close to the woman's side.

Question 10

Which client is most at risk for fibroadenoma of the breast?

A) 38-year-old woman
B) 50-year-old woman
C) 16-year-old girl
D) 27-year-old woman

Question 11

After a mastectomy,which activity should the client be instructed to avoid?

A) Emptying surgical drains twice a day and as needed
B) Lifting more than 4.5 kg (10 lb) or reaching above her head until given permission by her surgeon
C) Wearing clothing with snug sleeves to support the tissue of the arm on the operative side
D) Immediately reporting inflammation that develops at the incision site or in the affected arm

Question 12

A woman has a breast mass that is not well delineated and is nonpalpable,immobile,and nontender.Which condition is this client experiencing?

A) Fibroadenoma
B) Lipoma
C) Intraductal papilloma
D) Mammary duct ectasia

Question 13

Fibrocystic changes in the breast most often appear in women in their 20s and 30s.Although the cause is unknown,an imbalance of estrogen and progesterone may be the cause.The nurse who cares for this client should be aware that treatment modalities are conservative.Which proven modality may offer relief for this condition?

A) Diuretic administration
B) Daily inclusion of caffeine in the diet
C) Increased vitamin C supplementation
D) Application of cold packs to the breast as necessary

Question 14

A client is scheduled for surgery after a recent breast cancer diagnosis.The nurse is discussing the procedure with the client.To allay her fears,which explanation best describes a skin-sparing mastectomy?

A) Removal of the breast, nipple, and areola, leaving only the skin
B) Removal of the breast, nipple, areola, and axillary node dissection
C) Incision on the outside of the breast, leaving the nipple intact
D) Removal of both breasts in their entirety

Question 15

A healthy 60-year-old African-American woman regularly receives health care at her neighborhood clinic.She is due for a mammogram.At her first visit,her health care provider is concerned about the 3-week wait at the neighborhood clinic and made an appointment for her to have a mammogram at a teaching hospital across town.She did not keep her appointment and returned to the clinic today to have the nurse check her blood pressure.What is the most appropriate statement for the nurse to make to this client?

A) "Do you have transportation to the teaching hospital so that you can get your mammogram?"
B) "I'm concerned that you missed your appointment; let me make another one for you."
C) "It's very dangerous to skip your mammograms; your breasts need to be checked."
D) "Would you like me to make an appointment for you to have your mammogram here?"

Question 16

Breast pain occurs in many women during their perimenopausal years.Which information is a priority for the nurse to share with the client?

A) Breast pain is an early indication of cancer.
B) Pain is almost always an indication of a solid mass.
C) Distinguishing between cyclical and noncyclical pain is important.
D) Breast pain is most often treated with narcotics.

Question 17

Which diagnostic test is used to confirm a suspected diagnosis of breast cancer?

A) Mammogram
B) Ultrasound
C) Needle-localization biopsy
D) Magnetic resonance imaging (MRI)

Question 18

Which client should the nurse refer for further testing?

A) Left breast slightly smaller than right breast
B) Eversion (elevation) of both nipples
C) Faintly visible bilateral symmetry of venous network
D) Small dimple located in the upper outer quadrant of the right breast

Question 19

Macromastia,or breast hyperplasia,is a condition in which women have very large and pendulous breasts.Breast hyperplasia can be corrected with a reduction mammoplasty.Which statement regarding this procedure is the most accurate?

A) Breast reduction surgery is covered by insurance.
B) Breastfeeding might be difficult.
C) No sequelae after the procedure is known.
D) Pain in the back and shoulders may not be relieved.

Question 20

What is the correct name describing a benign breast condition that includes dilation and inflammation of the collecting ducts?

A) Mammary duct ectasia
B) Intraductal papilloma
C) Chronic cystic disease
D) Fibroadenoma

Question 21

Breast cancer is most frequently staged according to the tumor size (T), involvement of regional nodes (N), and distance and spread of the disease (M). Match the stage of breast cancer with the appropriate clinical manifestation.

Stage IV

A)Tumor 2 to 5 cm with positive node
B)Carcinoma in situ
C)Any distant metastasis
D)Tumor less than 2 cm with negative nodes
E)Tumor of any size with extension to chest wall

Question 22

Breast cancer is most frequently staged according to the tumor size (T), involvement of regional nodes (N), and distance and spread of the disease (M). Match the stage of breast cancer with the appropriate clinical manifestation.

Stage IIb

A)Tumor 2 to 5 cm with positive node
B)Carcinoma in situ
C)Any distant metastasis
D)Tumor less than 2 cm with negative nodes
E)Tumor of any size with extension to chest wall

Question 23

Breast cancer is most frequently staged according to the tumor size (T), involvement of regional nodes (N), and distance and spread of the disease (M). Match the stage of breast cancer with the appropriate clinical manifestation.

Stage IIIb

A)Tumor 2 to 5 cm with positive node
B)Carcinoma in situ
C)Any distant metastasis
D)Tumor less than 2 cm with negative nodes
E)Tumor of any size with extension to chest wall

Question 24

Breast cancer is most frequently staged according to the tumor size (T), involvement of regional nodes (N), and distance and spread of the disease (M). Match the stage of breast cancer with the appropriate clinical manifestation.

Stage 0

A)Tumor 2 to 5 cm with positive node
B)Carcinoma in situ
C)Any distant metastasis
D)Tumor less than 2 cm with negative nodes
E)Tumor of any size with extension to chest wall

Question 25

Guidelines for breast cancer screening continue to evolve as new evidence is generated.Which examination or procedure and frequency would be recommended for a 31-year-old asymptomatic client?

A) Annual mammography
B) Clinical breast examination every 3 years
C) Annual MRI
D) Breast self-examination
E) Mammography every 3 years

Question 26

Cellulitis with or without abscess formation is a fairly common condition.The nurse is providing education for a client whose presentation to the emergency department includes an infection of the breast.Which information should the nurse share with this client?

A) Nipple piercing may be the cause of a recent infection.
B) Treatment for cellulitis will include antibiotics.
C) Streptococcus aureus is the most common pathogen.
D) Obesity, smoking, and diabetes are risk factors.
E) Breast is pale in color and cool to the touch.

Question 27

Chemotherapy with multiple drug agents is used in the treatment of recurrent and advanced breast cancer with positive results.Which side effects would the nurse anticipate for the client once treatment has begun?

A) Hair loss
B) Severe constipation
C) Anemia
D) Leukopenia
E) Thrombocytopenia

Question 28

Researchers have found a number of common risk factors that increase a woman's chance of developing a breast malignancy.It is essential for the nurse who provides care to women of any age to be aware of which risk factors?

A) Family history
B) Late menarche
C) Early menopause
D) Race
E) Nulliparity or first pregnancy after age 40 years

Question 29

Breast cancer is most frequently staged according to the tumor size (T), involvement of regional nodes (N), and distance and spread of the disease (M). Match the stage of breast cancer with the appropriate clinical manifestation.

Stage I

A)Tumor 2 to 5 cm with positive node
B)Carcinoma in situ
C)Any distant metastasis
D)Tumor less than 2 cm with negative nodes
E)Tumor of any size with extension to chest wall