Nokea
A nurse is teaching a group of women about the potential benefits of breast self-examination (BSE). The nurse should teach the patients that effective BSE is dependent on what factor?
- A. Womens knowledge of how their breasts normally look and feel
- B. The rapport that exists between the woman and her primary care provider
- C. Synchronizing womens routines around BSE with the performance of mammograms
- D. Womens knowledge of the pathophysiology of breast cancer
Correct Answer: A
Rationale: Effective BSE relies on the patient's familiarity with her breasts' normal appearance and feel, enabling detection of changes. Rapport with providers, mammogram synchronization, or pathophysiology knowledge are not essential for BSE efficacy.
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A patient has just returned to the postsurgical unit from post-anesthetic recovery after breast surgery for removal of a malignancy. What is the most likely major nursing diagnosis to include in this patients immediate plan of care?
- A. Acute pain related to tissue manipulation and incision
- B. Ineffective coping related to surgery
- C. Risk for trauma related to post-surgical injury
- D. Chronic sorrow related to change in body image
Correct Answer: A
Rationale: Acute pain is a common immediate postoperative issue due to tissue manipulation and incision, making it a priority nursing diagnosis. Coping, sorrow, or trauma risks may emerge later but are not immediate concerns.
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.
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.
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 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.