Deck 14: Breasts And Regional Nodes

Question 1

Patients having physical examination of their breasts often experience feelings of embarrassment,anxiety,and loss of control.Which of the following is least likely to assist the patient in dealing with these feelings?

A) ensuring privacy, providing adequate draping material, and a warm environment
B) listening carefully, examining her feelings in the context of her culture, validating concerns
C) telling her not to worry and that everything will be fine
D) providing her with information about the examination before starting, and answering questions about her body and sexuality

Answer 1

telling her not to worry and that everything will be fine

Question 2

According to Tanner's sexual maturity rating for female breast development,the normal breast development in an adolescent female occurring after 10 years of age is characterized initially by a(n)

A) small mound of breast tissue with widening of the areola.
B) enlarged breast.
C) small, elevated nipple.
D) areola flush with the breast contour with a protruding nipple.

Answer 2

small mound of breast tissue with widening of the areola.

Question 3

Which associated manifestation in a female with a chief complaint of a lump in the breast and discharge is most likely to be linked with breast cancer?

A) multiple soft, well-defined masses, and tenderness upon palpation
B) fever and breast swelling
C) bruising of the breast tissue and chest wall
D) dimpling of the skin

Answer 3

dimpling of the skin

Question 4

To lessen patient discomfort during the breast examination,the nurse would instruct the patient to do which of the following?

A) Schedule the appointment during the next menstrual period.
B) Avoid shaving her underarms 24 to 48 hours before the scheduled examination.
C) Apply lotion or powder to her breasts and underarms before the appointment to minimize friction to the skin during the examination.
D) Restrict fluid intake for 24 hours before the appointment.

Question 5

Which finding is most likely indicative of a fibroadenoma in the breast?

A) round, movable lump
B) firm nodule tender to touch
C) erythema
D) retraction and dimpling

Question 6

Breast masses are most frequently found

A) around the nipple.
B) in the lower outer quadrant.
C) in the upper outer quadrant.
D) in the supraclavicular lymph nodes.

Question 7

When inspecting the breast,in which positions should the patient be placed?

A) arms at sides, arms overhead, hands pressed on hips, leaning forward
B) arms at side, arms overhead, leaning forward, hands on knees
C) arms at side, arms overhead, hands pressed on hips, leaning backward
D) arms at sides, arms overhead, hands pressed on shoulders, leaning forward

Question 8

When inspecting the breasts and axillae for color and vascularity in a nonpregnant female,it is normal to find

A) moles.
B) striae.
C) reddened areas
D) unilateral superficial vascular patterns.

Question 9

With the patient in a sitting position and using the palmar surfaces of the fingers of the dominant hand,you should palpate the breast tissue

A) against the chest wall in a large-breasted patient.
B) in an upward manner while supporting the breast with the nondominant hand.
C) initially in the outer quadrants, moving to the sternal border of each breast.
D) in a circular pattern, moving from the nipple toward the outer aspects.

Question 10

Which finding is normal in the breast of a pregnant woman?

A) localized erythema
B) small, nontender nodule
C) dermatitis of the areola
D) spontaneous discharge of a yellow fluid

Question 11

An abnormal finding related to the size and symmetry of the breasts is which of the following?

A) enlargement of the breast on the side of the dominant arm
B) nipples pointing upward and laterally
C) significant unilateral reduction of breast tissue
D) supernumerary nipples

Question 12

Thickening or edema of the breast tissue called peau d'orange is most likely

A) indicative of renal disease.
B) caused by plugged skin pores.
C) indicative of a tumor that is obstructing lymphatic drainage.
D) related to obesity or pregnancy.

Question 13

The function of Cooper's ligaments is to

A) serve as a reservoir for milk during lactation.
B) provide support for the breast tissue.
C) lubricate the nipple.
D) excrete colostrum.

Question 14

Palpation of the supraclavicular lymph nodes is most effectively performed

A) using a light rotary motion of the finger pads of all five fingers.
B) using a firm rotary motion of the palmar surfaces of the fingers.
C) by probing with the index and middle fingers of both hands, using a back-and-forth motion.
D) by rolling the tissue against the clavicles.

Question 15

Which finding obtained from the health history of a 40-year-old female is most likely linked to an increased risk for breast cancer?

A) patient treated surgically for a pituitary tumor
B) brother diagnosed with gynecomastia
C) grandmother diagnosed with breast cancer
D) menarche at age 16

Question 16

To palpate the supraclavicular lymph nodes,you should place your fingers over the patient's clavicles

A) lateral to the tendinous portion of the sternocleidomastoid muscle.
B) lateral to the tendinous portion of the trapezius muscle.
C) anterior to the tendinous portion of the sternocleidomastoid muscles.
D) superior to the tendinous portion of the scalene muscles.

Question 17

Preparation of the patient for palpation of the supraclavicular and infraclavicular lymph nodes should include instructing the patient to do which of the following?

A) Lean slightly forward with her head in a neutral position.
B) Relax the muscles of her head and neck by flexing the neck.
C) Turn her head first to one side and then to the other to relax the sternocleidomastoid muscle.
D) Lift the upper arm and elbow away from her body and then repeat with the other arm.

Question 18

The current guidelines for screening by mammogram recommend which of the following?

A) baseline screening mammogram for women age 30
B) mammogram every 2 years for women ages 30-45
C) baseline mammography and annual screening starting at age 40
D) annual mammogram for women after age 45

Question 19

Abnormal changes in the contour of the breasts such as dimpling,retractions,or flattening may be due to a cancerous growth resulting in which of the following?

A) fibrotic shortening of Cooper's ligaments
B) necrosis of epidermal tissue
C) inflammation of the mammary duct
D) pectoral muscle atrophy

Question 20

According to Tanner's sexual maturity rating for female breast development,in an adolescent female between the ages of 14 and 17,the presence of a secondary mound of tissue over the breast formed by the areola and nipple normally coincides with

A) the peak of the height spurt.
B) the onset of menarche.
C) the end of the height spurt.
D) hormonal fluctuations occurring at the beginning of the menstrual cycle.

Question 21

Findings upon palpation of lymph nodes that are indicative of a systemic infection include which of the following?

A) fixed firm, immobile, irregular nodes
B) enlarged nodes less than 1 cm in diameter
C) enlarged, nontender, firm nodes
D) enlarged, tender, or painful nodes that are matted together

Question 22

The diagnostic procedure in which a breast mass is examined by means of x-rays is called

A) ultrasonography.
B) mammography.
C) thermography.
D) biopsy.

Question 23

Palpation of the axillary lymph nodes should include the central axillary group (midaxillary),which is located

A) at the anterior edge of the latissimus dorsi muscle.
B) at the thoracic wall of the axilla.
C) behind the lateral edge of the pectoralis major muscle.
D) on the inner aspect of the upper part of the humerus close to the axillary vein.

Question 24

Normal findings upon examining the breasts of a patient who has undergone breast augmentation are

A) breast tenderness.
B) firm tissue remaining erect when the patient is supine.
C) decreased nipple and skin sensation.
D) incision sites on the anterior and lateral aspects of the breasts.

Question 25

When examining a patient who has undergone a left simple mastectomy,the nurse should do which of the following?

A) examine the right breast first
B) omit palpating the lymph nodes on the left side because they were removed
C) turn her to her right side before palpation
D) omit palpating the left nipple because it was removed

Question 26

A nurse preceptor asks a new graduate nurse to identify the different types of mastectomy surgeries.Which response by the new graduate would indicate that further clarification is needed? Select all that apply.

A) Simple
B) Radical
C) Modified Simple
D) Modified radical
E) Cross-sectional
F) Subcutaneous

Question 27

The nurse is teaching a class on breast self-examination.Which of the following should the nurse include in the class?

A) Include both inspection and palpation of the breast in the exam.
B) Use only deep pressure when palpating the breast.
C) Use the fingertips to palpate the breast.
D) Perform a breast palpation exam in front of a mirror.

Question 28

Which regional nodes are easily accessible to palpation? Select all that apply.

A) Central axillary nodes
B) Pectoral nodes
C) Subscapular nodes
D) Internal mammary nodes
E) Lateral nodes
F) Rotter's nodes

Question 29

Instructions to males regarding breast examination should include recommending

A) monthly breast self-exams and clinical examination every 1-3 years.
B) annual breast self-exam and clinical examination every 5 years.
C) annual clinical examination of the breasts and mammogram every 3 years.
D) breast self-exam every 6 months and clinical examination every 2 years.

Question 30

When examining a patient who has undergone a mastectomy,the nurse should do which of the following? Select all that apply.

A) Always begin the examination on the unaffected breast.
B) Inspect the scar(s) for swelling, lumps, thickening, redness, rash, or irritation.
C) Use two finger pads to palpate the surgical scar.
D) Perform large, circular motions when palpating the area.
E) Examine the area for swelling, lumps, thickening, or tenderness.
F) Instruct the patient to perform annual breast self-examinations to determine if masses have returned to the excised area.

Question 31

Examination of the breasts by palpation with the patient supine includes

A) peripheral breast tissue, lactiferous ducts, areola, and nipple.
B) Cooper's ligaments, tail of Spence, and muscles and lymph nodes of the chest.
C) areola, axillary nodes, Cooper's ligaments, and compression of the nipple for discharge.
D) peripheral breast tissue, tail of Spence, areola, and compression of the nipple for discharge.

Question 32

The nurse should teach a patient that one of the steps of a complete breast self-examination is to examine her breasts while standing in front of a mirror

A) with both arms raised and then with her hands pressed into her hips.
B) with her hands at her sides and then with hands behind her head.
C) with both arms raised and leaning forward.
D) with her hands at her sides, with arms raised, and with hands pressed into her hips.

Question 33

The procedure for palpation of the axillary lymph nodes is to first stand at the patient's right side,facing the patient,and next

A) ask her to flex her head to enhance relaxation of the shoulders and arms.
B) abduct her left arm, using your left hand to relax the axillary muscles.
C) adduct her right arm, using your left hand so that it is close to the chest wall.
D) support her flexed left arm on your left forearm.

Question 34

Which of the following can cause nipple discharge? Select all that apply.

A) Medications
B) Mammary duct ectasia
C) Infection
D) Cysts
E) Pituitary tumors
F) Manual stimulation

Question 35

Which of the following findings on a female breast exam should the nurse report as suspicious of breast cancer?

A) multiple, bilateral, round, lumpy tissue that is tender
B) soft, mobile, single lobular nodule that is nontender
C) single soft lump that is well defined and tender
D) poorly defined, firm lump that is nontender and fixed to the skin

Question 36

The procedure for examining the male breasts is essentially the same as that for the female breasts.The only modification is that the patient

A) is examined only in the supine position unless gynecomastia is present.
B) is not examined for nipple discharge.
C) does not need to lean forward unless gynecomastia is present.
D) is examined only for the presence of nodules or masses.

Question 37

Which of the following women is at the highest risk for breast cancer?

A) 50-year-old woman who is obese and has Down syndrome
B) 25-year-old woman with a malignant melanoma of the face
C) 40-year-old woman who had thoracic radiation therapy 10 years ago for Hodgkin's disease
D) 72-year-old woman who smokes and has a BMI of 21

Question 38

It is recommended that mastectomy patients perform routine breast examination,including

A) monthly breast self-exams, annual clinical evaluation, and mammography every 2 years.
B) weekly breast self-exams, clinical evaluation every 6 months, and mammography annually.
C) weekly breast self-exams, annual clinical evaluation, and mammography every 6 months.
D) monthly breast self-exams and clinical evaluation and mammography annually.

Question 39

A breast cancer that results in fibrotic shortening and disablement of the Cooper's ligaments can be manifested in which clinical finding?

A) nipple discharge
B) breast edema
C) eczematous dermatitis
D) dimpling

Question 40

Instructions on breast self-examination should include encouraging the woman to perform the exam

A) once a month, 1 week before menses.
B) twice a month, 1 week before and following menses.
C) once a month, 8 days following menses.
D) once a week, except during menses.

Question 41

A nursing student is caring for a patient scheduled for a mastectomy.When the nursing instructor asks the student to name the muscles supporting the breast,which response/s by the student would suggest that further study is needed? Select all that apply.

A) Vastus lateralis
B) Serratus anterior
C) Latissimus dorsi
D) Rectus abdominus
E) Axillary tail of Spence
F) Pectoralis major and minor

Question 42

_______________________ are openings through which milk and colostrum are excreted.

Question 43

The pigmented area surrounding the nipple is called the ____________________.