Nokea
A 42-year-old man has come to the clinic for an annual physical. The nurse notes in the patients history that his father was treated for breast cancer. What should the nurse provide to the patient before he leaves the clinic?
- A. A referral for a mammogram
- B. Instructions about breast self-examination (BSE)
- C. A referral to a surgeon
- D. A referral to a support group
Correct Answer: B
Rationale: Men with a family history of breast cancer, like a father, have an increased risk and should be taught breast self-examination to monitor for changes. Referrals for mammograms, surgery, or support groups are not indicated without symptoms or a diagnosis.
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A 60-year-old man presents at the patient complaining that his breasts are tender and enlarging. Patients are subsequently diagnosed with gynecomastia. The patient should be assessed for what causative factor?
- A. Age-related symptoms
- B. Medication adverse effects
- C. Poor nutrition
- D. Fluid overload
Correct Answer: B
Rationale: Gynecomastia in older men is often caused by medications, such as diuretics or antipsychotics, which can disrupt hormonal balance. It is not an age-related change, nor is it linked to nutrition or fluid overload.
A patient has been referred to the breast clinic after her most recent mammogram revealed the presence of a lump. The lump is found to be a small, well-defined nodule in the right breast. The oncology nurse should recognize the likelihood of what treatment?
- A. Lumpectomy and radiation
- B. Partial mastectomy and radiation
- C. Partial mastectomy and chemotherapy
- D. Total mastectomy and chemotherapy
Correct Answer: A
Rationale: A small, well-defined nodule suggests early-stage breast cancer, for which lumpectomy followed by radiation is a common treatment to preserve the breast while effectively treating the cancer. Mastectomy or chemotherapy may be considered for more advanced or aggressive disease, which is not indicated here.
A patient is to undergo an ultrasound-guided core biopsy. The patient tells the nurse that a patient of hers had a stereotactic core needle biopsy. She wants to understand the difference between the procedures. What would be the nurses best response?
- A. An ultrasound-guided core biopsy is faster, less expensive, and does not use radiation.
- B. An ultrasound-guided core biopsy is a little more expensive, but it doesnt use radiation and it is faster.
- C. An ultrasound-guided core biopsy is a little more expensive, and it also uses radiation but it is faster.
- D. An ultrasound-guided core biopsy takes more time, and it also uses radiation, but it is less expensive.
Correct Answer: A
Rationale: Ultrasound-guided core biopsy is faster, less expensive, and radiation-free compared to stereotactic biopsy, which uses X-rays for guidance, making it a preferred option when ultrasound is suitable.
During a recent visit to the clinic a woman presents with erythema of the nipple and areola on the right breast. She states this started several weeks ago and she was fearful of what would be found. The nurse should promptly refer the patient to her primary care provider because the patients signs and symptoms are suggestive of what health problem?
- A. Peau dorange
- B. Nipple inversion
- C. Pagets disease
- D. Acute mastitis
Correct Answer: C
Rationale: Erythema of the nipple and areola is a hallmark of Paget's disease, a rare form of breast cancer affecting the nipple. Peau d'orange is associated with lymphatic obstruction in advanced breast cancer, nipple inversion suggests malignancy if recent, and acute mastitis is typically linked to lactation, which is not indicated here.
A 45-year-old woman comes into the health clinic for her annual check-up. She mentions to the nurse that she has noticed dimpling of the right breast that has occurred in a few months. What assessment would be most appropriate for the nurse to make?
- A. Evaluate the patients milk production.
- B. Palpate the area for a breast mass.
- C. Assess the patients knowledge of breast cancer.
- D. Assure the patient that this is likely an age-related change.
Correct Answer: B
Rationale: Dimpling of the breast is a concerning sign that may indicate an underlying breast mass or malignancy, such as breast cancer, due to possible lymphatic obstruction or tumor fixation. Palpating the area to assess for a mass is the most appropriate action to identify potential pathology and determine the need for referral. Evaluating milk production is irrelevant as there is no indication of lactation. Assessing knowledge is secondary to physical examination, and dimpling is not an age-related change.