Nokea
A patient is being discharged from the ambulatory surgery center after an incision of a mass in her left breast. What are the criteria for discharging this patient? Select all that apply.
- A. Patient must understand when she can begin ambulating
- B. Patient must have someone to accompany her home
- C. Patients must understand limitations
- D. Patient must understand care of limitations
- E. Patients must understand when she can safely remove her catheter
Correct Answer: B,C,D
Rationale: Discharge criteria include having an escort home, understanding activity restrictions, and knowing biopsy site care. Ambulation is expected before discharge, and urinary catheters are not typically used in this procedure.
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A nurse has assessed that a patient is not yet willing to view her mastectomy site. How should the nurse best assist the patient in developing a positive body image?
- A. Ask the woman to describe the current appearance of her breast.
- B. Help the patient to understand that many women have gone through the same unpleasant experience.
- C. Explain to the patient that her body image does not have to depend on her physical appearance.
- D. Provide the patient with encouragement in an empathic and thoughtful manner.
Correct Answer: D
Rationale: Empathic encouragement supports the patient's gradual acceptance of her changed appearance without pressure. Asking her to describe the site may increase distress, downplaying the experience is dismissive, and negating physical appearance may not resonate.
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.
A woman aged years comes into the clinic because she has discovered a lump in her breast. After diagnostic testing, the patient receives a diagnosis of cancer. The nurse asks when patients should begin mammography. What is the nurses best advice?
- A. Age 28
- B. Age 35
- C. Age 38
- D. Age 48
Correct Answer: C
Rationale: For women with a first-degree relative diagnosed with breast cancer at age 48, screening mammography should begin 5 to 10 years earlier than the age of diagnosis, but not before age 25. Starting at age 38 aligns with this guideline, providing early detection for those at increased familial risk.
The nurse is teaching breast self-examination (BSE) to a group of women. The nurse should recommend that the patients perform BSE at what time?
- A. At the time of menses
- B. At any convenient time, regardless of cycles
- C. Weekly
- D. Between days 5 and 7 after menses
Correct Answer: D
Rationale: BSE is best performed on days 5 to 7 after menses, when breasts are least hormonal and tender, optimizing detection of abnormalities. Monthly, not weekly, performance is recommended, and timing relative to menses is important.
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.