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A nurse is examining a patient who has been diagnosed with a fibroadenoma. The nurse should recognize what implication of this patients diagnosis?
- A. The patient will be scheduled for radiation therapy.
- B. The patient might be referred for a biopsy.
- C. The patients breast mass is considered an age-related change.
- D. The patients diagnosis is likely related to her use of oral contraceptives.
Correct Answer: B
Rationale: Fibroadenomas are benign, firm, movable tumors that may require biopsy for definitive diagnosis. They are not age-related, not linked to oral contraceptives, and do not necessitate radiation therapy.
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The nurse is caring for a patient who has just had a radical mastectomy and axillary node dissection. When providing patient education regarding rehabilitation, what should the nurse recommend?
- A. Avoid exercise of the arm for next 2 months.
- B. Keep cuticles clipped neatly.
- C. Avoid lifting objects heavier than 10 pounds.
- D. Use a sling until healing is complete.
Correct Answer: C
Rationale: Post-axillary dissection, patients should avoid lifting objects heavier than 5 to 10 pounds to prevent lymphedema or injury. Arm exercises are encouraged, cuticles should not be cut to avoid infection, and slings are unnecessary.
A patient has just been diagnosed with breast cancer and the nurse is performing a patient interview. In assessing this patients ability to cope with this diagnosis, what would be an appropriate question for the nurse to ask this patient?
- A. What is your level of education?
- B. Are you feeling alright these days?
- C. Is there someone you trust to help you make treatment choices?
- D. Are you concerned about receiving this diagnosis?
Correct Answer: C
Rationale: Asking about a trusted support person assesses the patient's social resources for coping with treatment decisions. Education level is irrelevant, and vague or obvious questions about feelings or concern are less effective.
The nurse is caring for a 52-year-old woman whose aunt and mother died of breast cancer. The patient states, My doctor and I talked about Tamoxifen to help prevent breast cancer. Do you think it will work? What would be the nurses best response?
- A. Yes, its known to have a slight protective effect.
- B. Yes, but studies also show an increased risk of osteoporosis.
- C. You wont need to worry about getting cancer as long as you take Tamoxifen.
- D. Tamoxifen is known to be a highly effective protective measure.
Correct Answer: D
Rationale: Tamoxifen is a selective estrogen receptor modulator proven to significantly reduce the risk of breast cancer in high-risk women, making it a highly effective chemopreventive agent. It does not eliminate risk entirely, and it also helps prevent osteoporosis, not increase it. A slight protective effect understates its efficacy.
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.
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.