Question 1

The nurse is developing the discharge plan for a woman who has had a left-sided modified radical mastectomy. The nurse is including instructions for ways to minimize lymphedema. Which suggestion would most likely increase the woman's symptoms?

Accepted Answer

Wearing clothing with elasticized sleeves can constrict the flow of lymphatic fluid, potentially increasing the risk of lymphedema in the affected arm.

Question 2

A laboratory technician arrives to draw blood for a complete blood count (CBC. for a client who had a right-sided mastectomy 8 hours ago. The client has an intravenous line with fluid infusing in her left antecubital space. To obtain the blood specimen, the technician places a tourniquet on the client's right arm. Which action by the nurse would be most appropriate?

Accepted Answer

Drawing blood from the arm on the side of a recent mastectomy can increase the risk of lymphedema, and using the arm with an IV line can contaminate the sample or cause complications. A finger stick is a safer alternative in this scenario.

Question 3

The nurse determines that a woman has implemented prescribed therapy for her fibrocystic breast disease when the client reports that she has eliminated what from her diet?

Accepted Answer

Caffeine is often recommended to be eliminated or reduced in the diet of individuals with fibrocystic breast disease as it may help alleviate symptoms.

Question 4

When assessing a client with suspected breast cancer, which of the following would the nurse expect to find?

Accepted Answer

Nipple retraction can be a sign of breast cancer due to the tumor pulling the tissue inward. Other options like painful lump, absence of dimpling, and regularly shaped mass are less commonly associated with breast cancer, as cancerous lumps are often painless, may cause dimpling, and are irregularly shaped.

Question 5

A woman who has undergone a right modified-radical mastectomy returns from surgery. Which nursing intervention would be most appropriate at this time?

Accepted Answer

Encouraging the patient to turn, cough, and deep breathe at frequent intervals is crucial for preventing postoperative complications such as pneumonia. This intervention promotes lung expansion and secretion clearance.

Question 6

A breast biopsy indicates the presence of malignant cells, and the client is scheduled for a mastectomy. Which nursing diagnosis would the nurse most likely include in the client's preoperative plan of care as the priority?

Accepted Answer

Disturbed body image is the most likely nursing diagnosis to be prioritized in the preoperative plan of care for a client scheduled for a mastectomy due to the presence of malignant cells. This diagnosis addresses the emotional and psychological impact of losing a part of the body that is often closely tied to personal identity and femininity.

Question 7

A 42-year-old woman is scheduled for a mammogram. Which of the following would the nurse include when teaching the woman about the procedure?

Accepted Answer

Mammography involves compressing each breast between two plates to spread out the breast tissue for clear imaging. This is a key aspect of the procedure that patients should be prepared for. The other options are not accurate descriptions of a mammogram.

Question 8

During a clinical breast examination, the nurse palpates a well-defined, firm, mobile lump in a 60-year-old woman's left breast. The nurse notifies the physician. Which of the following would the nurse anticipate the physician to order next?

Accepted Answer

A mammogram is typically the next step after a lump is found during a clinical breast examination to assess the nature of the lump and determine if further testing is needed.

Question 9

A client with advanced breast cancer, who has had both chemotherapy and radiation therapy, is to start hormonal therapy. Which agent would the nurse expect the client to receive?

Accepted Answer

Tamoxifen is a common hormonal therapy used for the treatment of breast cancer, especially in cases that have progressed despite chemotherapy and radiation. It works by blocking estrogen receptors on breast cancer cells, which can slow or stop the growth of hormone receptor-positive tumors.

Question 10

As part of discharge planning, the nurse refers a woman to Reach to Recovery. This group's primary purpose is to:

Accepted Answer

Reach to Recovery is primarily designed to support women who have undergone mastectomies, offering emotional support, information, and comfort from volunteers who have had similar experiences.

Question 11

A woman with breast cancer is undergoing chemotherapy. Which of the following side effects would the nurse interpret as being most serious?

Accepted Answer

Myelosuppression is the most serious side effect listed as it involves the suppression of the bone marrow's ability to produce blood cells, leading to increased risk of infection, anemia, and bleeding complications, which can be life-threatening.

Question 12

A woman comes to the clinic reporting a nipple discharge. On examination, the area below the areola is red and slightly swollen, with tortuous tubular swelling. The nurse interprets these findings as suggestive of which of the following?

Accepted Answer

Duct ectasia is characterized by the inflammation and dilation of the ducts beneath the areola, often presenting with nipple discharge and redness or swelling in the affected area, matching the symptoms described.

Question 13

When performing a clinical breast examination, which would the nurse do first?

Accepted Answer

The first step in performing a clinical breast examination is to inspect the breasts for size, shape, symmetry, skin texture, and any visible abnormalities. This non-invasive observation provides initial important information before proceeding to more direct physical examination techniques.

Question 14

Evaluation of a woman with breast cancer reveals that her mass is approximately 1.25 inches in diameter. Three adjacent lymph nodes are positive. The nurse interprets this as indicating that the woman has which stage of breast cancer?

Accepted Answer

Stage II breast cancer is characterized by a tumor size of 2 cm to 5 cm (approximately 0.8 to 2 inches) and/or spread to nearby lymph nodes.

Question 15

A nurse is working with a woman who has been diagnosed with severe fibrocystic breast disease. When describing the medications that can be used as treatment, which of the following would the nurse be least likely to include?

Accepted Answer

Penicillin is an antibiotic and is not used to treat fibrocystic breast disease, which is a condition characterized by noncancerous changes in the breast tissue. Tamoxifen, Bromocriptine, and Danazol are medications that can be used to manage symptoms or aspects of fibrocystic breast disease.

Question 16

A group of students are reviewing information about benign and malignant breast masses. The students demonstrate understanding when they identify which of the following as indicating a benign breast mass. (Select all the apply.)

Accepted Answer

Benign breast masses often have a firm consistency and do not cause dimpling of the skin.

Question 17

The nurse is developing a plan of care for a woman with breast cancer who is scheduled to undergo breast-conserving surgery. The nurse interprets this as which of the following?

Accepted Answer

Breast-conserving surgery, often referred to as a lumpectomy, involves the removal of the lump (tumor) and a small margin of surrounding tissue while leaving the rest of the breast intact. It is typically followed by radiation therapy to destroy any remaining cancer cells. This approach allows for the preservation of the breast and is a common treatment option for early-stage breast cancer.

Question 18

After teaching a group of nursing students about the different types of chemotherapeutic agents used to treat breast cancer, the instructor determines that the teaching was successful when the students identify which of the following as an example of a selective estrogen receptor modulator (SERM)? (Select all that apply.)

Accepted Answer

Tamoxifen and Raloxifene are examples of selective estrogen receptor modulators (SERMs), which work by binding to estrogen receptors and either activating or blocking them depending on the tissue type. This makes them effective in treating and preventing certain types of breast cancer.

Question 19

A woman diagnosed with breast cancer is to receive trastuzumab. Which of the following would the nurse incorporate into the explanation about how this drug works?

Accepted Answer

Trastuzumab works by targeting the HER-2/neu protein, which is overexpressed in some types of breast cancer cells. By binding to the HER-2/neu protein, trastuzumab can inhibit the proliferation of cancer cells that overexpress this protein, thereby helping to treat breast cancer. Choices B and C describe mechanisms of action for other types of breast cancer therapies that target hormonal pathways, and choice D describes a more general approach to targeting metastatic cancer, not specific to the mechanism of action of trastuzumab.

Question 20

A nurse is conducting a class on breast cancer prevention. Which statement would the nurse most likely include in the discussion?

Accepted Answer

The answer of A nurse is conducting a class on...

Quiz 6: Disorders of the Breasts