Nokea
A patient has had a total mastectomy with immediate reconstruction. The patient asks the nurse when she can take a shower. What should the nurse respond?
- A. Not until the drain is removed
- B. On the second postoperative day
- C. Now, if you wash gently with soap and water
- D. Seven days after your surgery
Correct Answer: A
Rationale: Showering is typically contraindicated until surgical drains are removed to prevent infection or disruption of the reconstruction site. Immediate or early showering risks complications, and a fixed timeline like seven days is not standard.
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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 has been referred to the breast clinic after her most recent mammogram revealed the presence of a lump. The lump is found to be a small, well-defined nodule in the right breast. The oncology nurse should recognize the likelihood of what treatment?
- A. Lumpectomy and radiation
- B. Partial mastectomy and radiation
- C. Partial mastectomy and chemotherapy
- D. Total mastectomy and chemotherapy
Correct Answer: A
Rationale: A small, well-defined nodule suggests early-stage breast cancer, for which lumpectomy followed by radiation is a common treatment to preserve the breast while effectively treating the cancer. Mastectomy or chemotherapy may be considered for more advanced or aggressive disease, which is not indicated here.
During a recent visit to the clinic a woman presents with erythema of the nipple and areola on the right breast. She states this started several weeks ago and she was fearful of what would be found. The nurse should promptly refer the patient to her primary care provider because the patients signs and symptoms are suggestive of what health problem?
- A. Peau dorange
- B. Nipple inversion
- C. Pagets disease
- D. Acute mastitis
Correct Answer: C
Rationale: Erythema of the nipple and areola is a hallmark of Paget's disease, a rare form of breast cancer affecting the nipple. Peau d'orange is associated with lymphatic obstruction in advanced breast cancer, nipple inversion suggests malignancy if recent, and acute mastitis is typically linked to lactation, which is not indicated here.
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.
A 42-year-old man has come to the clinic for an annual physical. The nurse notes in the patients history that his father was treated for breast cancer. What should the nurse provide to the patient before he leaves the clinic?
- A. A referral for a mammogram
- B. Instructions about breast self-examination (BSE)
- C. A referral to a surgeon
- D. A referral to a support group
Correct Answer: B
Rationale: Men with a family history of breast cancer, like a father, have an increased risk and should be taught breast self-examination to monitor for changes. Referrals for mammograms, surgery, or support groups are not indicated without symptoms or a diagnosis.