Deck 16: Breasts and Axillae

Question 1

In assessing the breast of a male patient, the nurse places him in which position?

A) Standing with hands over the head
B) Supine with the hand on the side being examined placed behind the head
C) Sitting with arms at the side
D) Bending forward 45 degrees at the waist

Answer 1

Sitting with arms at the side

Question 2

Based on the history, a nurse determines that the patient with which finding requires further assessment?

A) Occasional discharge from nipples
B) Supernumerary nipples along the milk line
C) Rash in the axillae associated with change in deodorant
D) Mild breast swelling that fluctuates with the menstrual cycle

Answer 2

Occasional discharge from nipples

Question 3

A nurse is performing a breast examination of a patient who complains of pain in both breasts that occurs around the time of her menstrual period. The nurse expects which findings during the breast examination?

A) Masses in the breasts that are round, soft, mobile, and well-delineated
B) Masses in the breasts that are round, firm, mobile, and well-delineated
C) Masses in the breasts that are irregular, hard, and fixed
D) Breast tissue that is red, edematous, tender, and warm to the touch

Answer 3

Masses in the breasts that are round, soft, mobile, and well-delineated

Question 4

A patient comes to the clinic complaining of a new onset of nipple discharge. After inspection of the breast and discharge, what action of the nurse has the highest priority?

A) Palpating both breasts comparing amount of discharge
B) Asking the patient about breast pain
C) Asking the patient to raise her arms and comparing the movement of the breasts
D) Obtaining a specimen of the discharge for cytology

Question 5

A patient had a left radical mastectomy last year. The nurse assesses for painless and nonpitting swelling of the arm on that side. Which complication of a mastectomy is the nurse assessing for?

A) Infection
B) Lymphedema
C) Inflammation
D) Lymphoma

Question 6

In reviewing the charts of several patients in the clinic, a nurse recognizes which patient as being at highest risk of breast cancer?

A) A woman who had her first child at age 26
B) A woman who reached menopause at age 58
C) A woman who breastfed all four of her children
D) A woman who states that she reached menarche at age 14

Question 7

A nurse performing a breast examination on a female patient places the patient in a supine position, places a pillow under the right shoulder, and asks the patient to place her right lower arm above her head. What is the reason for this position?

A) Flatten the breast tissue evenly over the chest wall.
B) Help the patient to relax and feel more comfortable.
C) Reveal lumps deep in the breast more easily.
D) Expose any drainage from the nipples.

Question 8

In assessing a patient with lymphedema after a mastectomy, the nurse expects which finding?

A) Fragile, thin, pale skin covering the area of lymphedema
B) Several brownish-red discolorations in the center of the affected arm
C) Unilateral nonpitting edema of the affected arm
D) Pitting edema of affected arm

Question 9

Which technique does a nurse use to palpate the patient's axillary lymph nodes?

A) With the patient sitting, the nurse places fingers of both hands deep into the axilla, one hand on either side, and firmly pushes the axillary tissue toward the center to feel for enlarged nodes.
B) With the patient lying supine with arms at the sides, the nurse uses the tips of the fingers of one hand to palpate the axilla moving from the posterior to the anterior aspect of the axilla to feel for enlarged nodes.
C) With the patient lying supine with the hand behind the head of the side being assessed, the nurse uses the pads of fingers of one hand to systematically palpate the axilla using small circular motions to feel for enlarged nodes.
D) With the patient sitting, the nurse places fingers of one hand deep into the axilla and firmly slides the fingers along the patient's middle, anterior, and posterior of the axilla to feel for enlarged nodes.

Question 10

Which statement by a 40-year-old man would be most indicative of possible breast cancer?

A) "I had embarrassing breast enlargement when I was a teenager."
B) "I think I felt a hard spot in my left breast, but it does not hurt."
C) "My right breast has always been a little smaller than the left."
D) "My father's breasts got larger after he was older."

Question 11

In teaching a patient about breast self-examination, why does the nurse emphasize palpation of the axillary areas?

A) Because deep muscles in that area can mask changes
B) Because some patients avoid this area because of tenderness
C) Because most lymph draining from the breast flows through this area
D) Because supporting ligaments in this area may present as tissue changes

Question 12

While giving a presentation about breast health, a nurse informs patients about which recommendation?

A) Women in their 30s should have annual clinical breast examinations.
B) Women at high risk of breast cancer should have semiannual mammograms.
C) Women who are postmenopausal require clinical breast examination every 5 years.
D) A screening mammogram is recommended for all women beginning at age 50 years.

Question 13

During a breast examination of a male patient, the nurse recognizes which finding as normal?

A) Bilateral nontender flat breasts with symmetric nipple and areolar areas
B) A fibrous layer of subcutaneous breast tissue that is thicker than in women
C) Breast tenderness on the dominant side but not on the other side
D) Bilateral symmetry of breasts with absence of hair in the areolar areas

Question 14

A patient comes to the clinic because she found a mass in her left breast that is present during and after her menstrual periods. On palpation the nurse finds a mass in the left breast that is round, rubbery, mobile, and nontender. This finding is consistent with which breast disorder?

A) Fibrocystic breast disease
B) Invasive breast cancer
C) Mastitis
D) Fibroadenoma

Question 15

What is the purpose of asking a female to lean forward during the breast examination?

A) To accentuate the Montgomery glands
B) To observe for symmetry of the suspensory ligaments
C) To compare nipple symmetry
D) To identify any breast masses in the subcutaneous tissues

Question 16

During a breast examination of a healthy female, the nurse recognizes which finding as normal?

A) Asymmetrical venous pattern
B) Unequal nipple size
C) Supernumerary nipples along the milk line
D) Pink discharge from one nipple when manipulated

Question 17

When examining the lymph nodes of an adult female patient, the nurse recognizes which finding as normal?

A) Visible superficial nodes
B) Palpable supraclavicular nodes
C) Nonpalpable lymph nodes in the axilla
D) Enlarged, fixed nodes in the neck

Question 18

What instructions does the nurse give a female patient when she is learning to perform breast self-examination?

A) Press the pads of the fingers firmly to compress breast tissue against the rib cage.
B) Lie in front of a mirror and observe for dimpling of the skin.
C) Lift the fingers from the chest wall during palpation to better define the breast tissue.
D) Apply gentle pressure while moving the fingers in a pattern across the breast.

Question 19

In a presentation on breast cancer risk factors, a nurse would be accurate in making which statement?

A) "Women who breastfeed their children are at increased risk of breast cancer."
B) "Women who are more than 30% overweight are at increased risk of breast cancer."
C) "African-American women have the highest risk of breast cancer."
D) "Women who have children before age 30 are at increased risk of breast cancer."

Question 20

What technique does a nurse use when performing a breast examination on a patient who has had a mastectomy?

A) Excludes palpation of the axillary area where there was lymph node dissection
B) Inspects and palpates both the operative and the nonoperative sides
C) Avoids palpating the scar to prevent causing the patient any discomfort
D) Palpates only the muscle tissue on the affected side

Question 21

A nurse becomes suspicious that a patient may have breast cancer based on which abnormal finding?

A) An irregularly shaped hard mass in one breast
B) Bilateral, small, nontender nodes close to the surface
C) Multiple rubbery-feeling lumps with well-defined borders
D) A mobile, firm lump located in the upper outer quadrant of the left breast

Question 22

The nurse would give immediate attention to the patient who presents with which complaint?

A) Bilateral breast swelling
B) Unilateral nipple discharge
C) A breast lump that changes during the menstrual cycle
D) Unequal breast size

Question 23

The nurse notices dimpling of the skin surrounding a palpable mass in the right breast of a female patient. What is the most appropriate action for the nurse to take next?

A) Record this as an expected finding.
B) Palpate the area of dimpling for pain.
C) Palpate the borders of the area of dimpling for irregularity.
D) Tell the patient that dimpling indicates the mass is benign.

Question 24

Which lifestyle behaviors do nurses ask about to identify patients with risk factors for breast cancer? (Select all that apply.)

A) Obesity after age 50
B) Smoking more than 1 pack of cigarettes a day
C) Never having given birth to a viable infant
D) Drinking two to five alcoholic beverages a day
E) Estrogen replacement therapy for more than 5 years
F) High blood pressure for more than 3 years