Nokea
A student nurse prepares a list of teaching topics for a patient with a new diagnosis of breast cancer. Which of the following topics indicate that the student needs more education about breast cancer diagnostic testing?
- A. A firm, moveable mass is most often breast cancer
- B. HER-2 receptor testing
- C. Estrogen receptor testing
- D. Oncotype DX assay testing
Correct Answer: A
Rationale: A firm, moveable mass is characteristic of fibroadenoma, not breast cancer. The other tests are likely to be used for additional diagnostic testing in a patient with breast cancer.
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After a patient is diagnosed with lobular carcinoma in situ (LCIS), the nurse will anticipate that patient teaching may be needed about which of the following topics?
- A. Lumpectomy
- B. Lymphatic mapping
- C. Prilocaine
- D. Tamoxifen
Correct Answer: D
Rationale: Tamoxifen is used as a chemopreventive therapy in some patients with LCIS. The other diagnostic tests and therapies are not needed because LCIS does not usually require treatment.
A patient who has a diagnosis of fibrocystic breast changes calls the nurse in the clinic with these symptoms. Which of the following findings is most important to report to the health care provider?
- A. There is yellow-green discharge from one of the patient's nipples.
- B. There is an area on the breast that is hot, red, and tender to touch.
- C. The lumps are firm feeling and most are in the upper outer breast quadrants.
- D. The lumps are larger and more painful before the patient's menstrual period.
Correct Answer: B
Rationale: An area that is hot or red suggests an infectious process such as mastitis, which would require further assessment and treatment. The other information will also be reported, but these findings are typical in fibrocystic breasts.
Which of the following information should the nurse include when teaching a patient about the transverse rectus abdominis musculocutaneous (TRAM) procedure?
- A. Saline-filled implants are placed under the pectoral muscles.
- B. Recovery from the TRAM surgery takes at least 6 to 8 weeks.
- C. Muscle tissue is removed from the back and used to form a breast.
- D. TRAM flap procedures may be done in outpatient surgery centres.
Correct Answer: B
Rationale: Patients take at least 6 to 8 weeks to recover from the TRAM surgery. Tissue from the abdomen is used to reconstruct the breast. The TRAM procedure can take up to 8 hours and requires postoperative hospitalization. Saline implants are used in mammoplasty.
The nurse is caring for a patient who has had a right mastectomy and the patient asks the nurse how long the biannual mammography will have to continue. Which of the following time frames should the nurse inform the patient is recommended for mammography postmastectomy?
- A. Every 6 months for a year
- B. Every 6 months for 2 years
- C. Every 6 months for 3 years
- D. Every 6 months for life
Correct Answer: B
Rationale: The patient should undergo appropriate breast imaging at regular intervals (usually 6 months to 1 year) for two consecutive years.
Which of the following statements by a patient newly diagnosed with stage I breast cancer indicates to the nurse that patient teaching may be needed?
- A. There are several options available for treating the cancer.
- B. I will probably need radiation to the breast after having the surgery.
- C. I can probably have reconstructive surgery at the same time as a mastectomy.
- D. Mastectomy will be the best choice to decrease the chance of cancer recurrence.
Correct Answer: D
Rationale: The survival rates with lumpectomy and radiation or modified radical mastectomy are comparable. The other patient statements indicate a good understanding of stage I breast cancer treatment.