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A patient at high risk for breast cancer is scheduled for an incision biopsy in the outpatient surgery department. When the nurse is providing preoperative education, the patient asks why an incision is being done instead of just removing the mass. What would be the nurses best response?
- A. An incision is performed because its known to be less painful and more accurate than other forms of testing.
- B. An incision is performed to confirm a diagnosis and so that special studies can be done that will help determine the treatment.
- C. An incision is performed to assess the potential for recovery from a mastectomy.
- D. An incision is performed on patients who are younger than the age of 40 and who are otherwise healthy.
Correct Answer: B
Rationale: Incisional biopsy removes a portion of the mass to confirm breast cancer and allows for specialized studies to guide treatment. It is not chosen for pain, age, or mastectomy recovery assessment, and complete mass removal may not be feasible or necessary initially.
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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 is to undergo an ultrasound-guided core biopsy. The patient tells the nurse that a patient of hers had a stereotactic core needle biopsy. She wants to understand the difference between the procedures. What would be the nurses best response?
- A. An ultrasound-guided core biopsy is faster, less expensive, and does not use radiation.
- B. An ultrasound-guided core biopsy is a little more expensive, but it doesnt use radiation and it is faster.
- C. An ultrasound-guided core biopsy is a little more expensive, and it also uses radiation but it is faster.
- D. An ultrasound-guided core biopsy takes more time, and it also uses radiation, but it is less expensive.
Correct Answer: A
Rationale: Ultrasound-guided core biopsy is faster, less expensive, and radiation-free compared to stereotactic biopsy, which uses X-rays for guidance, making it a preferred option when ultrasound is suitable.
A woman calls the clinic and tells the nurse she has had bloody drainage from her right nipple. The nurse makes an appointment for this patient, expecting the physician or practitioner to order what diagnostic test on this patient?
- A. Breast ultrasound
- B. Radiography
- C. Positron emission testing (PET)
- D. Galactography
Correct Answer: D
Rationale: Galactography, involving contrast injection into the ductal system followed by mammography, is used to evaluate bloody nipple discharge for ductal abnormalities. Ultrasound, radiography, and PET are not specific for this indication.
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.
A woman scheduled for a simple mastectomy in one week is having her preoperative education provided by the clinic nurse. What educational intervention will be of primary importance to prevent hemorrhage in the postoperative period?
- A. Limit her intake of green leafy vegetables.
- B. Increase her water intake to 8 glasses per day.
- C. Stop taking aspirin.
- D. Have nothing by mouth for 6 hours before surgery.
Correct Answer: C
Rationale: Aspirin has anticoagulant properties that can increase the risk of postoperative bleeding. Instructing the patient to stop taking aspirin is critical to minimize hemorrhage risk. Limiting green leafy vegetables affects vitamin K levels but is less directly related to immediate bleeding risk. Fluid intake or NPO status does not significantly impact hemorrhage prevention.