Nokea
A nurse is explaining that each breast contains 12 to 20 cone-shaped lobes. The nurse should explain that each lobe consists of what elements?
- A. Modified tendons and ligaments
- B. Connective tissue and smooth muscle
- C. Lobules and ducts
- D. Endocrine glands and sebaceous glands
Correct Answer: C
Rationale: Each breast lobe consists of lobules (milk-producing glands) and ducts (milk transport), which are the functional units of the breast. Tendons, ligaments, smooth muscle, or endocrine/sebaceous glands are not primary components.
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A new mother who is breastfeeding calls the clinic to speak to a nurse. The patient is complaining of pain in her left breast and describes her breast as feeling doughy. The nurse tells her to come into the clinic and be checked. The patient is diagnosed with acute mastitis and placed on antibiotics. What comfort measure should the nurse recommend?
- A. Apply cold compresses as ordered.
- B. Avoid wearing a bra until the infection clears.
- C. Avoid washing the breasts.
- D. Perform gentle massage to stimulate neutrophil migration.
Correct Answer: A
Rationale: Cold compresses help relieve discomfort in acute mastitis by reducing inflammation. A snug bra supports the breast, hygiene is essential, and massage is not recommended as it may worsen the condition.
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.
A 35-year-old mother of three young children has been diagnosed with stage II breast cancer. After discussing treatment options with her physician, the woman goes home to talk to her husband, later calling the nurse for clarification of some points. The patient tells the nurse that the physician has recommended breast conservation surgery followed by radiation. The patients husband has done some online research and is asking why his wife does not have a modified radical mastectomy to be sure all the cancer is gone. What would be the nurses best response?
- A. Modified radical mastectomies are very hard on a patient, both physically and emotionally and they really arent necessary anymore.
- B. According to current guidelines, having a modified radical mastectomy is no longer seen as beneficial.
- C. Modified radical mastectomies have a poor survival rate because of the risk of cancer recurrence.
- D. According to current guidelines, breast conservation combined with radiation is as effective as a modified radical mastectomy.
Correct Answer: D
Rationale: For stage II breast cancer, breast conservation surgery with radiation offers survival rates equivalent to modified radical mastectomy, per current guidelines. Mastectomies remain necessary in some cases, are not inherently riskier for recurrence, and their physical/emotional impact is not the primary reason for choosing conservation.
A patient has been discharged home after a total mastectomy without reconstruction. The patient lives alone and has a home health referral. When the home care nurse performs the first scheduled visit to this patient, what should the nurse assess? Select all that apply.
- A. Adherence to the exercise plan
- B. Overall psychological functioning
- C. Integrity of surgical drains
- D. Understanding of cancer
- E. Use of the breast prosthesis
Correct Answer: A,B,C
Rationale: The home care nurse assesses incision and drain integrity, adherence to exercises to prevent lymphedema, and psychological functioning to ensure recovery. Cancer understanding is less critical at this stage, and prosthesis use is typically addressed later.
For which of the following population groups would an annual clinical breast examination be recommended?
- A. Women over age 21
- B. Women over age 25
- C. Women over age 40
- D. All post-pubescent females with a family history of breast cancer
Correct Answer: C
Rationale: Annual clinical breast examinations are recommended for women aged 40 and older as part of routine breast cancer screening. Younger women may require less frequent exams unless at high risk, such as those with a family history.