Nokea
A client is scheduled to undergo a procedure to lift breasts that have drooped because of significant weight loss. The nurse identifies this procedure as which of the following?
- A. Reduction mammoplasty
- B. Mastopexy
- C. Autogenous breast reconstruction
- D. Mastectomy
Correct Answer: B
Rationale: A mastopexy is a procedure that involves lifting a breast. This procedure is similar to a reduction mammoplasty (removal of glandular breast tissue, fat, and skin bilaterally to decrease the size of large pendulous breasts), although the incision and scar line are smaller and the recovery time is shorter. Autogenous breast reconstruction involves the harvesting of the client's tissue from the rectus abdominis muscle to create a new breast. A mastectomy is a removal of a breast.
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The client arrives at a public health clinic worried that she has breast cancer since finding a lump in her breast. When the nurse assesses the client's breast, which assessment finding is characteristic of fibrocystic disease?
- A. One breast is larger than the other.
- B. The lump is firm and immovable.
- C. The lump is round and movable.
- D. Nipple retractions are noted.
Correct Answer: C
Rationale: The lump being round and movable is characteristic of fibrocystic breast disease, which often presents with multiple, mobile, and tender lumps that may change with the menstrual cycle. One breast being larger than the other is not specific to fibrocystic disease. A firm and immovable lump is more suggestive of malignancy. Nipple retractions are associated with breast cancer, not fibrocystic disease.
The nurse is caring for a client experiencing metastatic cancer-related pain. Which drug of choice does the nurse anticipate being ordered?
- A. Ibuprofen (Motrin)
- B. Alprazolam (Xanax)
- C. Morphine (MS Contin)
- D. Propofol (Diprivan)
Correct Answer: C
Rationale: In treating clients with metastatic cancer-related pain, the opioid analgesics morphine (MS Contin) and fentanyl are the drugs most often used for pain relief. Morphine (MS Contin) can be given orally, rectally, subcutaneously, intravenously, intramuscularly, or by epidural catheter. Ibuprofen (Motrin) is given for mild to moderate pain. Alprazolam (Xanax) is provided to relieve anxiety. Propofol (Diprivan) is an anesthetic given, frequently for short procedures.
A female client is diagnosed with breast abscess. She would like to continue to breast-feed her newborn. Which action by the nurse would be most appropriate in this situation?
- A. Encourage the client to include a client content in the diet.
- B. Instruct the client to wear a tight-fitting bra.
- C. Reduce the frequency of removing and reapplying the dressings.
- D. Assist the client to pump the breasts to remove breast milk.
Correct Answer: D
Rationale: The nurse should help the client pump the breasts and remove breast milk to prevent engorgement. Because the client has decided to continue breast-feeding, the client should wear a loose-fitting bra. Including protein content in the diet would be correlated to the client's current situation. Frequency of dressing changes does not play a role in the intervention.
The nurse is completing the admission history for a client who is admitted for a reduction mammoplasty. Which of the following client statements is uncommon when explaining the rationale for the procedure?
- A. Back pain
- B. Low self-esteem
- C. Others disapprove
- D. Skin irritation
Correct Answer: C
Rationale: The rationale for a reduction mammoplasty most often comes from the client experiencing a complication due to the size of the breast. Back pain, low self-esteem, self-consciousness, and skin irritation are common rationales. The disapproval of others is not a common rationale.
A nurse is describing to a client the advantages and disadvantages associated with tamoxifen therapy as a means of breast cancer prevention. The nurse would identify that the drug has a beneficial effect on which factor?
- A. Bone mineral density
- B. High density lipoprotein levels
- C. Risk for endometrial cancer
- D. Cataract formation
Correct Answer: A
Rationale: Besides reducing the risk of breast cancer, tamoxifen preserves bone mineral density, thus preventing osteoporosis. It also lowers the low-density lipoprotein cholesterol levels, although it is still unknown if it decreases the incidence of myocardial infarction in women. Tamoxifen can have detrimental effects. It increases the incidences of endometrial cancer, deep vein thrombosis, pulmonary embolism, and cataracts.