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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.
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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.
The nurse is caring for a 52-year-old woman whose aunt and mother died of breast cancer. The patient states, My doctor and I talked about Tamoxifen to help prevent breast cancer. Do you think it will work? What would be the nurses best response?
- A. Yes, its known to have a slight protective effect.
- B. Yes, but studies also show an increased risk of osteoporosis.
- C. You wont need to worry about getting cancer as long as you take Tamoxifen.
- D. Tamoxifen is known to be a highly effective protective measure.
Correct Answer: D
Rationale: Tamoxifen is a selective estrogen receptor modulator proven to significantly reduce the risk of breast cancer in high-risk women, making it a highly effective chemopreventive agent. It does not eliminate risk entirely, and it also helps prevent osteoporosis, not increase it. A slight protective effect understates its efficacy.
A patient has been discharged home after a total mastectomy without reconstruction. The patient lives alone and has a home health referral. When the home care nurse performs the first scheduled visit to this patient, what should the nurse assess? Select all that apply.
- A. Adherence to the exercise plan
- B. Overall psychological functioning
- C. Integrity of surgical drains
- D. Understanding of cancer
- E. Use of the breast prosthesis
Correct Answer: A,B,C
Rationale: The home care nurse assesses incision and drain integrity, adherence to exercises to prevent lymphedema, and psychological functioning to ensure recovery. Cancer understanding is less critical at this stage, and prosthesis use is typically addressed later.
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 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.