Nokea
A 23-year-old woman comes to the free clinic stating I think I have a lump in my breast. Do I have cancer? The nurse instructs the patient that a diagnosis of breast cancer is confirmed by what?
- A. Supervised breast self-examination
- B. Mammography
- C. Fine-needle aspiration
- D. Chest x-ray
Correct Answer: C
Rationale: Fine-needle aspiration or biopsy provides histologic confirmation of breast cancer, making it the definitive diagnostic method. Breast self-examination and mammography are screening tools, not diagnostic, and chest x-rays are used for metastasis evaluation, not primary diagnosis.
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The nurse is reviewing the physicians notes from the patient who has just left the clinic. The nurse learns that the physician suspects a malignant breast tumor. On palpation, the mass most likely had what characteristic?
- A. Nontenderness
- B. A size of 5 mm
- C. Softness and a regular shape
- D. Mobility
Correct Answer: A
Rationale: Malignant breast tumors are typically nontender, hard, fixed, and irregularly shaped. Small size, softness, or mobility are more characteristic of benign lesions like cysts.
A nurse is explaining that each breast contains 12 to 20 cone-shaped lobes. The nurse should explain that each lobe consists of what elements?
- A. Modified tendons and ligaments
- B. Connective tissue and smooth muscle
- C. Lobules and ducts
- D. Endocrine glands and sebaceous glands
Correct Answer: C
Rationale: Each breast lobe consists of lobules (milk-producing glands) and ducts (milk transport), which are the functional units of the breast. Tendons, ligaments, smooth muscle, or endocrine/sebaceous glands are not primary components.
The nurse leading an educational session is describing self-examination of the breast. The nurse tells the womens group to raise their arms and inspect their breasts in a mirror. A member of the patients group asks the nurse why raising her arms is necessary. What is the nurses best response?
- A. It helps to spread out the fat that makes up your breast.
- B. It allows you to simultaneously assess for pain.
- C. It will help to observe for dimpling more closely.
- D. This is what the American Cancer Society recommends.
Correct Answer: C
Rationale: Raising the arms during breast self-examination accentuates any skin changes, such as dimpling or retraction, by tightening the skin and underlying tissues, making these signs more visible. This is the primary reason for this maneuver. Spreading adipose tissue or assessing pain are not the goals, and citing the American Cancer Society does not directly answer the question.
A patient is being discharged from the ambulatory surgery center after an incision of a mass in her left breast. What are the criteria for discharging this patient? Select all that apply.
- A. Patient must understand when she can begin ambulating
- B. Patient must have someone to accompany her home
- C. Patients must understand limitations
- D. Patient must understand care of limitations
- E. Patients must understand when she can safely remove her catheter
Correct Answer: B,C,D
Rationale: Discharge criteria include having an escort home, understanding activity restrictions, and knowing biopsy site care. Ambulation is expected before discharge, and urinary catheters are not typically used in this procedure.
A woman calls the clinic and tells the nurse she has had bloody drainage from her right nipple. The nurse makes an appointment for this patient, expecting the physician or practitioner to order what diagnostic test on this patient?
- A. Breast ultrasound
- B. Radiography
- C. Positron emission testing (PET)
- D. Galactography
Correct Answer: D
Rationale: Galactography, involving contrast injection into the ductal system followed by mammography, is used to evaluate bloody nipple discharge for ductal abnormalities. Ultrasound, radiography, and PET are not specific for this indication.