Self Breast Exam & Breast Cancer – Flashcards
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The client frequently finds lumps in her breasts, esp. around her period. Which info should the nurse teach the client re: breast self care? 1. This is a benign process that does not need follow up. 2. Eliminate chocolate and caffeine from diet. 3. Practice breast self exam monthly. 4. This is how breast cancer starts and she needs surgery.
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3. The American Cancer Soc. doesn't recommend monthly self exams for everyone, but knowing baseline is helpful.
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The client diagnosed with breast cancer is considering whether to have a lumpectomy or a more invasive procedure, a modified radical mastectomy. Which info should the nurse discuss? 1. Ask if she is afraid of general anesthesia. 2. Ask how she feels about radiation and chemotherapy. 3. Tell her that she will need reconstruction with either procedure. 4. Find out if she has BC in her family.
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2. She should understand the Tx regimen for F/U care. Rad. and chemo are reqd for lumpectomy; Regimen results are equal to MRM.
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The client has undergone a wedge resection for cancer on the left breast. Which discharge instruction should the nurse teach? 1. Don't life more than 5 lbs. with left hand until released by HCP 2. The cancer has been totally removed and no F/U therapy is required. 3. Client should empty Hemovac every 12 hours. 4. Client should arrange for an appt. with a plastic surgeon for reconstruction.
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1. Pressure on incision should be limited.
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Which recommendationt is the American Cancer Society guideline for early detection of BC? 1. Beginning at 18 y.o. have a biannual clinical breast exam with HCP. 2. Beginning at 30 y.o. perform monthly breast self exams. 3. Beginning at 40 y.o., receive a yearly mammogram. 4. Beginning at 50 y.o. have a breast sonogram every 5 yrs.
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3.
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The client has a mastectomy and asks nurse about a Tram Flap procedure. Which info should nurse provide? 1. The surgeon will insert a saline filled sac under the skin to simulate a breast. 2. The surgeon will pull the client's own tissue under the skin to create a breast. 3. The surgeon will use tissue from inside the mouth to make a nipple. 4. The surgeon can make the breast any size the client wants.
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2.
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The nurse is teaching a class on breast health to a group of ladies at the senior center. Which is the most important risk factor to emphasize to this group? 1. Find out about family Hx of BC 2. Men at this age can get breast cancer and should also be screened. 3. Monthly self exam is the key to early detection. 4. The older a woman gets, the greater the chance of developing BC.
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4. Female gender and increasing age are risk factors.
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the client who is scheduled for breast biopsy with sentinel node dissection sates, "I don't understand. What does a sentinel node biopsy do?" 1. A dye is injected into the tumor and traced to determine spread of cells. 2. The surgeon removes the nodes that drain the diseased portion of the breast. 3. The nodes that can be felt manually will be removed and sent to pathology. 4. A visual inspection of the lymph nodes will e made while the client is sleeping.
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1. Radioactive dye is injected into tumor and traced to identify which lymph nodes the tumor has shed into.
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The client is 4 months pregnant and finds a lump in her breast and the biopsy is positive for stage II BC. Which Tx should the nurse anticipate? 1. A lumpectomy to be performed after the baby is born. 2. A modified radical mastectomy. 3. Radiation therapy to chest wall only. 4. Chemo only until baby is born.
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2. Can't do rad/chemo which would also be required for lumpectomy. Tumor should be removed ASAP.
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The client who had a right modified radical mastectomy 4 years before is being admitted for a cardiac workup for chest pain. Which intervention is most important? 1. Determine when client had chemo last. 2. Ask client if she received Adriamycin, an antineoplastic agent. 3. Post a message at the head of the bed to not use the right arm. 4. Examine the chest wall for cancer sites.
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3. Risk for lymphedema.
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The client is being discharged after a left modified radical mastectomy. Which discharge instructions should the nurse include? Select all that apply: 1. Notify HCP of temperature of 100 F 2. Carry large purses and bundles with the right hand. 3. Do not go to church or anywhere with crowds. 4. Try to keep the arm as still as possible until seen by HCP. 5. Have a mammogram of the right and left breast yearly.
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1. Correct. Possible infection. 2. Correct. Risk of lymphedema. Protect arm from injury. 3. Wrong. 4.Wrong. Should be taught arm climbing exercises before DC. 5. Correct. Risk for more cancer is high in both breasts.
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The client who has had a mastectomy tells the nurse, "My husband will leave me now that I am not a whole woman anymore." Which response is therapeutic? 1. Are you afraid that your husband will not find you sexually appealing? 2. Your husband should be grateful that you will be able to live and be with him. 3. Maybe your husband would like to attend a support group for spouses. 4. You don't know that's true. Give him a chance.
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1. This is restating her feelings and is therapeutic.
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The client has been diagnosed with BC. What is the most appropriate referral for the nurse to make? 1. Hospital social worker 2. CanSurmount 3. Reach to Recovery 4. ICanCope
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3. Reach to Recovery is specific to breast cancer.
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A client asks the nurse, "Why do I need to examine my armpits when I do my monthly breast exam?" Which of the following would be an appropriate response for the nurse to make to this client? a. This is the hardest area to feel for changes. b. Who told you that you have to do that? c. I'm not sure why that is important, but it sounds like it is. d. Breast tissue extends into the axilla.
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d. Breast tissue extends into the axilla.
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During the breast exam, the nurse palpates a series of lymph nodes. Why is this a part of the breast exam? a. It's not. It's done because the chest area is exposed. b. To review the integrity of the skin. c. To assess the deep lymph nodes which drain the mammary lobules. d. To assess shoulder range of motion.
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c. To assess the deep lymph nodes which drain the mammary lobules.
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A 14-year-old female client is upset because her breast development is not equal. What can the nurse say to this client? a. Don't worry about that! b. They look equal to me. c. Maybe you should talk with your mother about breast surgery? d. Breast tissue growth is uneven but will even out as you get older.
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d. Breast tissue growth is uneven but will even out as you get older.
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An elderly female client wants to know when she can stop doing breast exams. What can the nurse say to this client? a. It's not really necessary at your age. b. Breast cancer can still develop when you get older. c. Probably in a month or two. d. You can stop five years after menopause.
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b. Breast cancer can still develop when you get older.
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A female client tells the nurse, "I know I should examine my breasts but I just don't." What should the nurse do with this information? a. Nothing. b. Talk with the client about possible fears associated with the breast exam. c. Instruct the client on how to perform the breast exam again. d. Instruct the client on getting an annual mammogram instead.
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b. Talk with the client about possible fears associated with the breast exam. Many females do not perform the breast exam even after receiving instruction. This type of behavior may be related to anxiety and fear of cancer or surgery. During the assessment, the nurse needs to encourage the client to share her fears and concerns.
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The nurse is planning a focused breast/axilla interview and wants to include a general health question. Which of the following questions would fit this criteria? a. Has your mother or sister had breast cancer? b. Have you ever had a mammogram? c. Are you still menstruating? d. Have you had any breast trauma?
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c. Are you still menstruating? General health questions for the breast/axilla focused interview include a description of the breasts, changes in the breasts with menstruation, and date of the last menstrual period.
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A pregnant client is upset and thinks she has breast disease because she has a thick white discharge coming from her left breast. What can the nurse say or do for this client? a. Nothing. This client needs a mammogram as soon as possible. b. A thick yellow discharge from the breasts during pregnancy is normal. c. Call the physician. This information is not normal. d. Help the client understand that she might not be able to breastfeed her infant.
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b. A thick yellow discharge from the breasts during pregnancy is normal.
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During the breast exam, the nurse asks the client to raise her arms over her head. Why did the nurse change the client's position? a. Skin dimpling is accented in this position. b. The nurse couldn't palpate the axillae correctly. c. The client has small breasts. d. The client has large breasts.
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a. Skin dimpling is accented in this position.
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The nurse is examining a client's breasts and follows a specific pattern. Which of the following patterns can be used for a breast exam? a. Letter H b. Back and forth technique. c. Letter S d. ABC
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b. Back and forth technique.
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The client tells the nurse, "At times I have drainage from my right breast." What should the nurse do with this information? a. Write it in the medical record and say nothing to the client. b. Phone for a mammogram for the client immediately. c. Explain that this could be benign or it could mean something else. It needs to be further investigated. d. Nothing. It doesn't mean a thing.
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c. Explain that this could be benign or it could mean something else. It needs to be further investigated
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A client with fibrocystic breast disease says she has increased breast pain and tenderness with menses. Which of the following can help this client? a. Nothing can be done to help this client. b. Discuss how this can be a precursor to breast cancer. c. Review how reducing caffeine and salt and wearing a support bra might help. d. Explain how a breast biopsy is indicated.
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c. Review how reducing caffeine and salt and wearing a support bra might help.
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The clinic is sponsoring a client education session for breast cancer awareness month. Which of the following considerations should be included to support cultural differences about breast health? a. Refer all clients to the American Cancer Society if they have questions. b. Inform all about the low-cost breast cancer screening program. c. Encourage all females to increase their intake of vitamins A and E. d. Encourage all females to complete monthly breast exams.
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c. Encourage all females to increase their intake of vitamins A and E.
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A postmenopausal client has difficulty remembering to complete a monthly breast exam. What can be done to help this client? a. Nothing. This client doesn't need to do self examinations. b. Suggest the client plan to conduct the exam the first day of every month. c. Schedule the client to come into the clinic every month for the exam. d. Schedule the client to receive a monthly phone call from the clinic as a reminder.
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c. Schedule the client to come into the clinic every month for the exam. Remind the client to use a calendar to keep a record of when she performs the breast examination. Teach clients to perform the exam at the same time each month.
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What diagnostic studies are recommended to be performed annually on all women older than age 40? (SELECT ALL THAT APPLY)
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(1) Mammography (4) Clinical breast examination
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A client in the terminal stage of cancer is being transferred to hospice care. Which information should the nurse include in the teaching plan regarding hospice care? (SELECT ALL THAT APPLY)
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(1) Care focuses on controlling symptoms and relieving pain. (2) A multidisciplinary team provides care. (5) Bereavement care is provided to the family
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After undergoing chemotherapy to treat breast cancer, a client has a white blood cell (WBC) count of 1,300/microliter. Which nursing interventions should be used with this client? (SELECT ALL THAT APPLY)
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(1) Monitor the client's temperature and vital signs; report temperature higher than 101.3° F (38.5° C). (2) Make sure no one with a viral or bacterial infection enters the client's room. (3) Administer hematopoietic growth factors as prescribed. (4) Reinforce good hand-washing techniques to anyone entering the client's room.
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A client receiving chemotherapy for breast cancer develops myelosuppression. Which instructions should the nurse include in the discharge teaching plan? (SELECT ALL THAT APPLY)
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(1) Avoid people who have recently received attenuated vaccines. (2) Avoid activities that may cause bleeding. (3) Wash hands frequently. (5) Avoid crowded places, such as shopping malls.
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A 30-year-old client whose mother died of breast cancer at age 44 and whose sister has ovarian cancer is concerned about developing cancer. A nurse who is a member of the oncology multidisciplinary team should suggest that the client ask the physician about which of the following actions?
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Obtaining genetic counseling
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A 35-year-old female client is requesting information about mammograms and breast cancer. She isn't considered at high risk for breast cancer. What should the nurse tell this client? a. She should have had a baseline mammogram before age 30. b. She should eat a low-fat diet to further decrease her risk of breast cancer. c. She should perform breast self-examination during the first 5 days of each menstrual cycle. d. When she begins having yearly mammograms, breast self-examinations will no longer be necessary.
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B. She should eat a low-fat diet to further decrease her risk of breast cancer. A low-fat diet (one that maintains weight within 20% of recommended body weight) has been found to decrease a woman's risk of breast cancer. A baseline mammogram should be done between ages 30 and 40. Monthly breast self-examinations should be done between days 7 and 10 of the menstrual cycle. The client should continue to perform monthly breast self-examinations even when receiving yearly mammograms.
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A client is receiving chemotherapy to treat breast cancer. Which data collection finding indicates a fluid and electrolyte imbalance induced by chemotherapy? a. Urine output of 400 ml in 8 hours b. Serum potassium level of 3.6 mEq/L c. Blood pressure of 120/64 to 130/72 mm Hg d. Dry oral mucous membranes and cracked lips
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D. Dry oral mucous membranes and cracked lips Chemotherapy commonly causes nausea and vomiting, which may lead to fluid and electrolyte imbalances. Signs of fluid loss include dry oral mucous membranes, cracked lips, decreased urine output (less than 40 ml/hour), abnormally low blood pressure, and a serum potassium level below 3.5 mEq/
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A client is undergoing a left modified radical mastectomy for breast cancer. Postoperatively, blood pressure should be obtained from the client's right arm, and the left arm and hand should be elevated as much as possible to prevent which condition?
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Lymphedema
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A client with a cancerous tumor must undergo a modified radical mastectomy, which includes axillary node removal and immediate breast reconstruction. The nurse explains to the client that the axillary nodes will be removed in order to:
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Provide prognostic information.
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An oncology nurse educator is speaking to a women's group about breast cancer. Questions and comments from the audience reveal a misunderstanding of some aspects of the disease. Various members of the audience have made all of the following statements. Which statement is accurate?
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Men can develop breast cancer.
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During a breast examination, which finding most strongly suggests that the client has breast cancer?
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A fixed nodular mass with dimpling of the overlying skin
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How can breast cancer prevention programs best serve women who are at risk and come from lower socioeconomic backgrounds?
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Develop screening and educational programs.
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On discharge, a client who underwent a left mastectomy expresses relief that "the cancer" has been treated. When discussing this issue with the client, the nurse should stress that she:
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Should continue to perform breast self-examination on her right breast
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Several days before admission, a client reports finding a small lump in the left breast near the nipple. What should the nurse tell the client to do?
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Inform the physician immediately.
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The nurse is instructing a premenopausal woman about breast self-examination. The nurse should tell the client to do her self-examination:
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Immediately after her menses
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The nurse is providing breast cancer education at a community facility. The American Cancer Society recommends that women get mammograms: a. yearly after age 40. b. after the birth of the first child and every 2 years thereafter. c. after the first menstrual period and annually thereafter. d. every 3 years between ages 20 and 40 and annually thereafter.
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Answer A. The American Cancer Society recommends a mammogram yearly for women over age 40. The other statements are incorrect. It's recommended that women between ages 20 and 40 have a professional breast examination (not a mammogram) every 3 years.
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The nurse is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47. Following the American Cancer Society guidelines, the nurse should recommend that the women:a. perform breast self-examination annually. b. have a mammogram annually. c. have a hormonal receptor assay annually. d. have a physician conduct a clinical examination every 2 years.
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b. have a mammogram annually. The American Cancer Society guidelines state, "Women older than age 40 should have a mammogram annually and a clinical examination at least annually [not every 2 years]; all women should perform breast self-examination monthly [not annually]." The hormonal receptor assay is done on a known breast tumor to determine whether the tumor is estrogen- or progesterone-dependent
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The nurse is teaching a client who suspects that she has a lump in her breast. The nurse instructs the client that a diagnosis of breast cancer is confirmed by: a. breast self-examination. b. mammography. c. fine needle aspiration. d. chest X-ray.
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C Fine needle aspiration and biopsy. Fine needle aspiration and biopsy provide cells for histologic examination to confirm a diagnosis of cancer. A breast self-examination, if done regularly, is the most reliable method for detecting breast lumps early. Mammography is used to detect tumors that are too small to palpate. Chest X-rays can be used to pinpoint rib metastasis
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The nurse is teaching a group of women to perform breast self-examination. The nurse should explain that the purpose of performing the examination is to discover
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Changes from previous self-examinations
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A nurse is going to teach a patient how to perform breast self-examination. Which behavioral objective does the nurse set to best measure the patient's ability to perform the examination? 1. The patient will verbalize the steps involved in breast self-examination within 1 week. 2. The nurse will explain the importance of performing breast self-examination once a month. 3. The patient will perform breast self-examination correctly on herself before the end of the teaching session. 4. The nurse will demonstrate breast self-examination on a breast model provided by American Cancer Society.
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3. The patient will perform breast self-examination correctly on herself before the end of the teaching session.
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A client, age 41, visits the gynecologist. After examining her, the physician suspects cervical cancer. The nurse reviews the client's history for risk factors for this disease. Which history finding is a risk factor for cervical cancer? a. Onset of sporadic sexual activity at age 17 b. Spontaneous abortion at age 19 c. Pregnancy complicated with eclampsia at age 27 d. Human papillomavirus infection at age 32
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Answer D. Like other viral and bacterial venereal infections, human papillomavirus is a risk factor for cervical cancer. Other risk factors for this disease include frequent sexual intercourse before age 16, multiple sex partners, and multiple pregnancies. A spontaneous abortion and pregnancy complicated by eclampsia aren't risk factors for cervical cancer.
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When teaching a 28-year-old patient about breast self-examination (BSE), the nurse will instruct the patient that a. BSE will reduce the risk of dying from breast cancer. b. BSE should be done daily while taking a bath or shower. c. annual mammograms should be scheduled in addition to BSE. d. performing BSE right after the menstrual period will improve comfort.
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ANS: D Performing BSE at the end of the menstrual period will reduce the breast tenderness associated with the procedure. The evidence is not clear that BSE reduces breast cancer mortality. BSE should be done monthly. Annual mammograms are not routinely scheduled for women under age 40.
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A patient with a small immobile breast lump is advised to have a fine needle aspiration (FNA) biopsy. The nurse explains that an advantage to this procedure is that a. FNA is done in the outpatient clinic, and results are available in 1 to 2 days. b. only a small incision is needed, resulting in minimal breast pain and scarring. c. if the biopsy results are negative, no further diagnostic testing will be needed. d. FNA is guided by a mammogram, ensuring that cells are taken from the lesion.
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ANS: A FNA is done in outpatient settings and results are available in 24 to 48 hours. No incision is needed. FNA may be guided by ultrasound, but not by mammogram. Since the immobility of the breast lump suggests cancer, further testing will be done if the FNA is negative
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When the nurse is assessing the breasts of a 31-year-old, which finding is most indicative of a need for further evaluation? a. Bilateral nodules that are tender with palpation b. A nodule that is 1 cm in size, painless, and fixed c. A lump that increases in size before the menstrual period d. A lump that is small, mobile, and has a rubbery consistency
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ANS: B Painless and fixed lumps suggest breast cancer. The other findings are more suggestive of benign processes such as fibrocystic breasts and fibroadenoma.
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A 51-year-old woman at menopause is considering the use of hormone replacement therapy (HRT) but is concerned about the risk of breast cancer. Which information will the nurse include when discussing HRT with the patient? a. HRT does not appear to increase the risk for breast cancer unless there are other risk factors. b. HRT is a safe therapy for menopausal symptoms if there is no family history of BRCA genes. c. She and her health care provider must weigh the benefits of HRT against the possible risks of breast cancer. d. Alternative therapies with herbs and natural drugs are as effective as estrogen in relieving menopausal symptoms.
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ANS: C Because HRT has been linked to increased risk for breast cancer, the patient and provider must determine whether or not to use HRT. Breast cancer incidence is increased in women using HRT, independent of other risk factors. HRT increases the risk for both non-BRCA-associated cancer and BRCA-related cancers. Alternative therapies can be used but are not consistent in relieving menopausal symptoms.
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A patient with stage II breast cancer tells the nurse, "I need to decide about what type of surgery to have, but I feel so overwhelmed that I cannot make any decisions yet! What do you think I should do?" Which response by the nurse is best? a. "I would have a lumpectomy, but you need to decide what is best for you." b. "Tell me what you understand about the surgical options that are available." c. "It would not be appropriate for me to make the decision about your health." d. "There is no need to make a decision rapidly you have time to think about this."
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ANS: B This response indicates the nurse's willingness to assist the patient with the decision-making process without imposing the nurse's values or opinions. Response B indicates that the nurse is not willing to help the patient with the decision about treatment. Because treatment decisions for breast cancer do need to be made relatively quickly, response C is not accurate. Since the nurse's values and situation are not the same as the patient's, imposing the nurse's opinions during this emotionally vulnerable time is not appropriate.
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A patient returns to the surgical unit following a right modified radical mastectomy with dissection of axillary lymph nodes. Which nursing action should be included in the plan of care? a. Insist that the patient examine the surgical incision when the dressings are removed. b. Teach the patient to use the ordered patient-controlled analgesia (PCA) every 10 minutes. c. Post a sign at the bedside warning against blood pressures or venipunctures in the right arm. d. Obtain a permanent breast prosthesis for the patient before she is discharged from the hospital.
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ANS: C The patient is at risk for lymphedema and infection if blood pressures or venipuncture are done on the right arm. The patient is taught to use the PCA as needed for pain control rather than at a set time. The nurse allows the patient to examine the incision and participate in care when the patient feels ready. Permanent breast prostheses are usually obtained about 6 weeks after surgery.
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After the nurse completes discharge teaching for a patient who has had a left modified radical mastectomy and lymph node dissection, which statement by the patient indicates that teaching has been successful? a. "I will need to use my right arm and to rest the left one." b. "I will avoid reaching over the stove with my left hand." c. "I will keep my left arm in a sling until the incision is healed." d. "I will stop the left arm exercises if moving the arm is painful."
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ANS: B The patient should avoid any activity that might injure the left arm, such as reaching over a burner. If the left arm exercises are painful, analgesics should be used and the exercises continued in order to restore strength and range of motion. The left arm should be elevated at or above heart level and should be used to improve range of motion and function.
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Which statement by a 52-year-old patient newly diagnosed with stage I breast cancer indicates to the nurse that patient teaching may be needed? a. "There are several options available for treating the cancer." b. "I will probably need radiation to the breast after having the surgery." c. "I can probably have reconstructive surgery at the same time as a mastectomy." d. "Mastectomy will be the best choice to decrease the chance of cancer recurrence."
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ANS: D The survival rates with lumpectomy and radiation or modified radical mastectomy are comparable. The other patient statements indicate a good understanding of stage I breast cancer treatment.
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When a patient is scheduled for stereotactic core biopsy of the breast, which information will the nurse include in patient education? a. A local anesthetic will be given before the biopsy specimen is obtained. b. You will need to lie flat on your back and lie very still during the biopsy. c. A thin needle will be inserted into the lump and aspirated to remove tissue. d. You should not have anything to eat or drink for 6 hours before the procedure.
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ANS: A A local anesthetic is given before stereotactic biopsy. NPO status is not needed because no sedative drugs are given. The patient is placed in the prone position. A biopsy gun is used to obtain the specimens.
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A student nurse prepares a list of teaching topics for a patient with a new diagnosis of breast cancer. Which topic indicates that the student needs more education about breast cancer diagnostic testing? a. CA 15-3 level testing b. HER-2 receptor testing c. Estrogen receptor testing d. Oncotype DX assay testing
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ANS: A Tumor markers such as CA 15-3 are used to monitor response to treatment for breast cancer, not to detect or diagnose breast cancer. The other tests are likely to be used for additional diagnostic testing in a patient with breast cancer.
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Following a lumpectomy, a patient is scheduled for external beam radiation to the right breast. Which information should the nurse include in patient teaching? a. The radiation therapy will take a week to complete. b. Careful skin care in the radiated area will be necessary. c. Visitors are restricted until the radiation therapy is completed. d. Wigs may be used until the hair regrows after radiation therapy.
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ANS: B Skin care will be needed because of the damage caused to the skin by the radiation. External beam radiation is done over a 5- to 6-week period. Hair loss does not occur with radiation therapy. Since the patient does not have radioactive implants, no visitor restrictions are necessary.
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Which action should the nurse take first when caring for a patient who has been admitted for lumpectomy and axillary lymph node dissection? a. Teach the patient how to deep breathe and cough. b. Discuss options for postoperative pain management. c. Explain the postdischarge care of the axillary drains. d. Ask the patient to describe what she knows about the surgery.
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ANS: D Before teaching, the nurse should assess the patient's current knowledge level. The other teaching also may be appropriate, depending on the assessment findings.
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When the nurse is working in the women's health care clinic, which of these actions is appropriate to take? a. Educate a healthy 36-year-old about the need for an annual mammogram. b. Discuss the need for a clinical breast examination every year with a 22-year-old. c. Talk about magnetic resonance imaging (MRI) with a 26-year-old with a BRCA-1 mutation. d. Teach an active 70-year-old that mammography frequency can be reduced to every 3 years.
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ANS: C MRI (in addition to mammography) is recommended for women who are at high risk for breast cancer. A 22-year-old patient should have a clinical breast exam every 3 years. Annual mammograms are recommended for women starting at age 40. Annual mammography is recommended for healthy older women.
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A 33-year-old who has a diagnosis of fibrocystic breast changes calls the nurse in the clinic with these symptoms. Which is most important to report to the health care provider? a. There is yellow-green discharge from one of the patient's nipples. b. There is an area on the breast that is hot, pink, and tender to touch. c. The lumps are firm feeling and most are in the upper outer breast quadrants. d. The lumps are larger and more painful before the patient's menstrual period.
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ANS: B 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.
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During examination of a 67-year-old man, the nurse notes bilateral enlargement of the breasts. Which action should the nurse take first? a. Question the patient about any medications being currently used. b. Teach the patient about how to palpate the breast tissue for lumps. c. Refer the patient for mammography and biopsy of the breast tissue. d. Explain that this is a temporary condition due to hormonal changes.
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ANS: A The first action should be further assessment. Since 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
