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.
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A patient has presented for her annual mammogram. The patient voices concerns related to exposure to radiation. What should the nurse teach the patient about a mammogram?
- A. It does not use radiation.
- B. Radiation levels are safe as long as mammograms are performed only once per year.
- C. The negative effects of radiation do not accumulate until late in life.
- D. Radiation from a mammogram is equivalent to an hour of sunlight.
Correct Answer: D
Rationale: The radiation from a mammogram is minimal, equivalent to about an hour of sunlight exposure, making the benefits of early cancer detection outweigh the risks. Radiation is used, and effects do not specifically accumulate later in life; annual mammograms are safe.
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 patient has had a total mastectomy with immediate reconstruction. The patient asks the nurse when she can take a shower. What should the nurse respond?
- A. Not until the drain is removed
- B. On the second postoperative day
- C. Now, if you wash gently with soap and water
- D. Seven days after your surgery
Correct Answer: A
Rationale: Showering is typically contraindicated until surgical drains are removed to prevent infection or disruption of the reconstruction site. Immediate or early showering risks complications, and a fixed timeline like seven days is not standard.
The nurse is reviewing the physicians notes from the patient who has just left the clinic. The nurse learns that the physician suspects a malignant breast tumor. On palpation, the mass most likely had what characteristic?
- A. Nontenderness
- B. A size of 5 mm
- C. Softness and a regular shape
- D. Mobility
Correct Answer: A
Rationale: Malignant breast tumors are typically nontender, hard, fixed, and irregularly shaped. Small size, softness, or mobility are more characteristic of benign lesions like cysts.
A patient newly diagnosed with breast cancer states that her physician suspects regional lymph node involvement and told her that there are signs of metastatic disease. The nurse learns that the patient has been diagnosed with stage IV breast cancer. What is an implication of this diagnosis?
- A. The patient is not a surgical candidate.
- B. The patients breast cancer is considered highly treatable.
- C. There is a 10% chance that the patients cancer will self-resolve.
- D. The patient has a 15% chance of 5-year survival.
Correct Answer: D
Rationale: Stage IV breast cancer, with metastatic disease, has a 5-year survival rate of approximately 15%. Surgery may still be part of palliative or local control strategies, the disease is not highly treatable, and spontaneous resolution is not possible.
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