A client complains of having tender and painful breasts, often feeling multiple jumps within the breast tissue. The nurse would need to gather additional information about which of the following?
- A. Alcohol and caffeine consumption
- B. Client's workplace in relation to the surroundings
- C. Timing of symptoms in relation to the menstrual cycle
- D. Bathing frequency and living surroundings
Correct Answer: C
Rationale: Considering that the client has tender and painful breasts and often feels lumps within her breast tissue, it is most likely that she suffers from fibrocystic breast disease. To confirm these findings, the nurse should ask relevant questions about the characteristics and timing of symptoms in relation to the menstrual cycle. Symptoms of fibrocystic breast disease are noticeable before menstruation and usually state during menstruation. The size of one cyst becomes larger before menstruation and often changes with the menstrual cycle. The nurse should further ask the client about her habits of smoking and consuming coffee, chocolate, and caffeinated soft drinks, not alcohol, because they aggravate the condition. Workplace surroundings or cleanliness habits do not matter because fibrocystic breast disease is not infectious.
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A suspicious breast lump is noted on a mammogram. The client asks the nurse which diagnostic test confirms if the lump is cancerous or benign. Which response by the nurse is most correct?
- A. An ultrasound
- B. A biopsy
- C. A magnetic resonance imaging (MRI)
- D. A clinical breast exam
Correct Answer: B
Rationale: To confirm whether a breast lump is cancerous or benign, a tissue sample must be obtained to examine the cells. Although an ultrasound, MRI, and clinical breast exam provide data on the characteristics of the lump, only examining the tissue can specifically identify if and what type of cancer is present.
The nurse is obtaining a history from a client who states recurrent breast tenderness. The client inquiries if there is something wrong with her breasts. Which question by the nurse is a priority?
- A. Do you have a history of breast disorders and cancer in the family?
- B. Does the tenderness occur around the same time each month?
- C. Have you pulled a muscle or had any injury to the breast?
- D. When did you first recognize the symptoms?
Correct Answer: B
Rationale: The breasts are part of the female reproductive system, and they respond to the hormonal cycle associated with ovulation, menstruation, and pregnancy. Because the hormonal cycle is monthly, it is best to ask the client if the tenderness occurs at the same time each month. The other options are also important questions to ask.
The nurse is working at an oncologist's office specializing in breast cancer. The nurse cares for individuals of varied ages, backgrounds, and stages of breast cancer. Which criteria are considered a priority when determining adjunct treatment in addition to surgery? Select all that apply.
- A. Stage of tumor
- B. Cosmetic consequence
- C. Presence of metastasis
- D. Age
- E. Gender
- F. Sensitivity to estrogen
Correct Answer: A,C,D,F
Rationale: When working in an oncologist's office, the nurse is correct to identify that the stage of tumor and presence of metastasis help to guide treatment. Other factors include age of client and sensitivity to estrogen. Cosmetic consequence is not considered a priority when considering lifesaving treatment options. Many times, reconstruction is a possibility. Gender is not a consideration because treatment options are very similar.
The lactation nurse is caring for a mother who is 2 weeks postpartum and has mastitis. Which statement, made by the client, requires instruction and is the probable cause of the mastitis?
- A. I feed the baby every 2 hours.
- B. I break the baby's such before pulling the baby off of the breast.
- C. I nurse the baby on one breast each feeding.
- D. I use a lanolin ointment on my dry nipples.
Correct Answer: C
Rationale: Because the client has mastitis, emptying each breast with alternate feedings is important. The baby's such is strongest at the beginning of the feeding, thus, the mother should alternate the breast that the baby starts nursing from. If not, one breast would not be drained of the milk.
The nurse is caring for four clients in an oncology unit. Following report, which client would the nurse identify as having the most life-threatening diagnosis?
- A. A client with stage IV cancer receiving palliative care
- B. A client diagnosed with a stage one tumor with no lymph node involvement
- C. A client receiving chemotherapy and radiation with a low blood count
- D. A client with an estrogen receptor-positive tumor receiving oral chemotherapy
Correct Answer: A
Rationale: The client with stage IV cancer, indicating metastasis, and receiving palliative care, which includes comfort measures, is in highest life-threatening condition. A client with a stage I tumor and no lymph node involvement has a good prognosis as the cancer has been caught at an early stage. A low blood count is common when the client is receiving chemotherapy. It is common to have chemotherapy and radiation as a treatment regimen. Clients have experienced good prognosis with estrogen receptor positive tumor treatment of oral chemotherapy.
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