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A nurse has assessed that a patient is not yet willing to view her mastectomy site. How should the nurse best assist the patient in developing a positive body image?
- A. Ask the woman to describe the current appearance of her breast.
- B. Help the patient to understand that many women have gone through the same unpleasant experience.
- C. Explain to the patient that her body image does not have to depend on her physical appearance.
- D. Provide the patient with encouragement in an empathic and thoughtful manner.
Correct Answer: D
Rationale: Empathic encouragement supports the patient's gradual acceptance of her changed appearance without pressure. Asking her to describe the site may increase distress, downplaying the experience is dismissive, and negating physical appearance may not resonate.
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A patient who has had a lumpectomy calls the clinic to talk to the nurse. The patient tells the nurse that she has developed a tender area on her breast that is red and warm and looks like someone drew a line with a red marker. What would the nurse suspect is the womans problem?
- A. Mondor disease
- B. Deep vein thrombosis (DVT) of the breast
- C. Recurrent malignancy
- D. An area of fat necrosis
Correct Answer: A
Rationale: Mondor disease, a superficial thrombophlebitis of the breast, presents as a tender, red, linear area, often post-surgery like lumpectomy. DVT of the breast is not a recognized condition, recurrent malignancy is unlikely to present this way, and fat necrosis typically involves a firm, nontender mass.
The nurse is performing a comprehensive health history of a patient who is in her 50s. The nurse should identify what risk factor that may increase this patients risk for breast cancer?
- A. The patient breastfed each of her children.
- B. The patient gave birth to her first child at age 38.
- C. The patient experienced perimenopausal symptoms starting at age 46.
- D. The patient experienced menarche at age 13.
Correct Answer: B
Rationale: Late age at first pregnancy (after 30) is a known risk factor for breast cancer due to prolonged estrogen exposure without the protective effect of pregnancy. Breastfeeding, early perimenopause, and menarche at age 13 are not significant risk factors.
A patient who came to the clinic after finding a mass in her breast is scheduled for a diagnostic breast biopsy. During the nurses admission assessment, the nurse observes that the patient is distracted and tense. What is it important for the nurse to do?
- A. Acknowledge the fear the patient is likely experiencing.
- B. Describe the support groups that exist in the community.
- C. Assess the patients stress management skills.
- D. Document a nursing diagnosis of ineffective coping.
Correct Answer: A
Rationale: Acknowledging the patient's fear validates her emotions and opens communication, which is crucial during the diagnostic phase of a potential breast cancer diagnosis. Referring to support groups or assessing stress management is premature, and diagnosing ineffective coping assumes a problem not yet confirmed.
A 42 year-old patient tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. She says that she is afraid that she has cancer. Which assessment finding would most strongly suggest that this patients lump is cancerous?
- A. Eversion of the right nipple and mobile mass
- B. A nonmobile mass with irregular edges
- C. A mobile mass that is soft and easily delineated
- D. Nonpalpable right axillary lymph nodes
Correct Answer: B
Rationale: Breast cancer typically presents as a hard, nonmobile mass with irregular edges, as these characteristics suggest malignancy. A soft, mobile mass is more likely benign, like a cyst. Eversion of the nipple is not typical, and nonpalpable lymph nodes do not rule out cancer.
A patient in her 30 s has two young children and has just had a modified radical mastectomy with immediate reconstruction. The patient shares with the nurse that she is somewhat worried about her future, but she appears to be adjusting well to her diagnosis and surgery. What nursing intervention is most appropriate to support this patients coping?
- A. Encourage the patients spouse or partner to be supportive while she recovers.
- B. Encourage the patient to proceed with the next phase of treatment.
- C. Recommend that the patient remain optimistic for the sake of her children.
- D. Arrange a referral to a community-based support program.
Correct Answer: D
Rationale: Referring the patient to a community-based support program connects her with others who have similar experiences, supporting her coping without assuming distress. Encouraging spousal support or optimism may be inappropriate, and treatment decisions are physician-led.