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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.
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A patient who has had a lumpectomy calls the clinic to talk to the nurse. The patient tells the nurse that she has developed a tender area on her breast that is red and warm and looks like someone drew a line with a red marker. What would the nurse suspect is the womans problem?
- A. Mondor disease
- B. Deep vein thrombosis (DVT) of the breast
- C. Recurrent malignancy
- D. An area of fat necrosis
Correct Answer: A
Rationale: Mondor disease, a superficial thrombophlebitis of the breast, presents as a tender, red, linear area, often post-surgery like lumpectomy. DVT of the breast is not a recognized condition, recurrent malignancy is unlikely to present this way, and fat necrosis typically involves a firm, nontender mass.
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.
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 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.
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.