Nokea
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.
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The nurse is assessing a patient with Paget's disease. Which of the following findings should the nurse anticipate that the patient may experience? (Select all that apply.)
- A. Greenish coloured nipple discharge
- B. Itchiness of the breast
- C. Increased temperature
- D. Nipple ulceration
- E. A burning sensation in the breast
Correct Answer: B,D,E
Rationale: A patient with Paget's disease may experience itching, burning sensation, bloody nipple discharge with superficial erosion, and ulceration may be present. A patient with Paget's disease generally does not have a temperature. The discharge is bloody from the nipple, not a greenish colour.
The nurse is caring for a patient who is scheduled for stereotactic core biopsy of the breast. Which of the following information should the nurse include in patient education?
- A. A local anaesthetic will be given before the biopsy specimen is obtained.
- B. You will need to lie flat on your back and lie very still during the biopsy.
- C. A thin needle will be inserted into the lump and aspirated to remove tissue.
- D. You should not have anything to eat or drink for 6 hours before the procedure.
Correct Answer: A
Rationale: A local anaesthetic is given before stereotactic biopsy. NPO status is not needed because no sedative drugs are given. The patient is placed in the prone position. A biopsy gun is used to obtain the specimens.
The nurse is caring for a patient with breast cancer who is receiving chemotherapy and tamoxifen. Which of the following findings is most important to communicate to the health care provider?
- A. The patient has symptoms of numbness and tingling in the right arm and leg.
- B. The patient has complaints of fatigue.
- C. The patient eats only $5$ of food on meal tray.
- D. The patient's white blood cell (WBC) count is $5 \times 10^9/L$.
Correct Answer: A
Rationale: One-sided tingling and numbness may indicate a stroke and should be reported to the health care provider. Tamoxifen increases the risk of blood clots, cataracts, stroke, and endometrial cancer in postmenopausal women. Anorexia, fatigue, and a low-normal WBC count are expected effects of chemotherapy.
A patient has a saline breast implant inserted in outpatient surgery. Which of the following instructions should the nurse include in the discharge teaching?
- A. Take Aspirin every 4 hours to reduce inflammation.
- B. Check wound drains for excessive blood or any foul odour.
- C. Wear a loose-fitting bra to decrease irritation of the sutures.
- D. Resume normal activities 2 to 3 days after the mammoplasty.
Correct Answer: B
Rationale: The patient should be taught drain care because the drains will be in place for 2 or 3 days after surgery. Normal activities can be resumed after 2 to 3 weeks. A bra that provides good support is typically ordered. Aspirin will decrease coagulation and is typically not given after surgery.
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.