Nokea
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.
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A patient in her 30 s has two young children and has just had a modified radical mastectomy with immediate reconstruction. The patient shares with the nurse that she is somewhat worried about her future, but she appears to be adjusting well to her diagnosis and surgery. What nursing intervention is most appropriate to support this patients coping?
- A. Encourage the patients spouse or partner to be supportive while she recovers.
- B. Encourage the patient to proceed with the next phase of treatment.
- C. Recommend that the patient remain optimistic for the sake of her children.
- D. Arrange a referral to a community-based support program.
Correct Answer: D
Rationale: Referring the patient to a community-based support program connects her with others who have similar experiences, supporting her coping without assuming distress. Encouraging spousal support or optimism may be inappropriate, and treatment decisions are physician-led.
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.
The nurse is caring for a patient who has just had a radical mastectomy and axillary node dissection. When providing patient education regarding rehabilitation, what should the nurse recommend?
- A. Avoid exercise of the arm for next 2 months.
- B. Keep cuticles clipped neatly.
- C. Avoid lifting objects heavier than 10 pounds.
- D. Use a sling until healing is complete.
Correct Answer: C
Rationale: Post-axillary dissection, patients should avoid lifting objects heavier than 5 to 10 pounds to prevent lymphedema or injury. Arm exercises are encouraged, cuticles should not be cut to avoid infection, and slings are unnecessary.
A 60-year-old man presents at the patient complaining that his breasts are tender and enlarging. Patients are subsequently diagnosed with gynecomastia. The patient should be assessed for what causative factor?
- A. Age-related symptoms
- B. Medication adverse effects
- C. Poor nutrition
- D. Fluid overload
Correct Answer: B
Rationale: Gynecomastia in older men is often caused by medications, such as diuretics or antipsychotics, which can disrupt hormonal balance. It is not an age-related change, nor is it linked to nutrition or fluid overload.
A patient has been referred to the breast clinic after her most recent mammogram revealed the presence of a lump. The lump is found to be a small, well-defined nodule in the right breast. The oncology nurse should recognize the likelihood of what treatment?
- A. Lumpectomy and radiation
- B. Partial mastectomy and radiation
- C. Partial mastectomy and chemotherapy
- D. Total mastectomy and chemotherapy
Correct Answer: A
Rationale: A small, well-defined nodule suggests early-stage breast cancer, for which lumpectomy followed by radiation is a common treatment to preserve the breast while effectively treating the cancer. Mastectomy or chemotherapy may be considered for more advanced or aggressive disease, which is not indicated here.