Question 1

A patient who is scheduled for a lumpectomy and axillary lymph node dissection tells the nurse,"I would rather not know much about the surgery." Which response by the nurse is best?

Accepted Answer

This response shows sensitivity to the individual patient's need for information about the surgery.The other responses are also accurate,but the nurse should tailor patient teaching to individual patient preferences.

Question 2

The outpatient clinic receives telephone calls from four patients.Which patient should the nurse call back first?

Accepted Answer

Although all the patients have needs that the nurse should address,the patient who is receiving a cardiotoxic medication and has symptoms of heart failure should be assessed by the nurse first.BRCA testing may be appropriate for the 21-year-old,but it does not need to be done immediately.Chest and arm pain are normal up to 3 months after mastectomy.Nipple discharge and itching is a common finding with ductal ectasia.

Question 3

The nurse notes bilateral enlargement of the breasts during examination of a 62-year-old man.Which action should the nurse take first?

Accepted Answer

The first action should be further assessment.Because gynecomastia is a possible side effect of drug therapy,asking about the current drug regimen is appropriate.The other actions may be needed,depending on the data that are obtained with further assessment.

Question 4

The nurse is caring for a 52-year-old patient with breast cancer who is receiving chemotherapy with doxorubicin (Adriamycin)and cyclophosphamide (Cytoxan).Which assessment finding is most important to communicate to the health care provider?

Accepted Answer

Doxorubicin can cause cardiac toxicity.The dysrhythmia should be reported because it may indicate a need for a change in therapy.Anorexia,fatigue,and a low-normal WBC count are expected effects of chemotherapy.

Question 5

A patient has had left-sided lumpectomy (breast-conservation surgery)and an axillary lymph node dissection.Which nursing intervention is appropriate to delegate to a licensed practical/vocational nurse (LPN/LVN)?

Accepted Answer

LPN/LVN education and scope of practice include administration and evaluation of the effects of analgesics.Assessment,teaching,and evaluation of a patient's understanding of instructions are more complex tasks that are more appropriate to RN level education and scope of practice.

Question 6

A 36-year-old who has a diagnosis of fibrocystic breast changes calls the nurse in the clinic with symptoms.Which is most important to report to the health care provider?

Accepted Answer

An area that is hot or pink suggests an infectious process such as mastitis,which would require further assessment and treatment.The other information also will be reported,but these findings are typical in fibrocystic breasts.

Question 7

Which action will the nurse include in the plan of care for a patient with right arm lymphedema?

Accepted Answer

Compression of the arm assists in improving lymphatic flow toward the heart.Isometric exercises may be prescribed for lymphedema.BPs should only be done on the patient's right arm.The arm should not be placed in a dependent position.

Question 8

When using the accompanying illustration to teach a patient about breast self-examination,the nurse will include the information that most breast cancers are located in which part of the breast?

Accepted Answer

The upper outer quadrant is the location of most of the glandular tissue of the breast.

Quiz 48: Nursing Management: Breast Disorders