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The nurse is caring for a client who is employed as a manual laborer. The client has recovered from a recent mastectomy and is planning to return to work. Which instruction from the nurse would be most helpful?
- A. Do not return to work until all areas are completely healed.
- B. Have others assist in tasks involving use of affected arm.
- C. Wear gloves to prevent injury.
- D. Check to see if job description can be changed.
Correct Answer: C
Rationale: It is most helpful to provide an option that allows the client to continue employment at the current job, if the client is able. Many times, the client must continue employment and cannot change jobs. Instructing the client to not return to work may not be an option throughout the healing process, which could be up to 1 year. Asking others to do tasks and changing the job description are unrealistic throughout the recovery period.
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The nurse is working at an oncologist's office specializing in breast cancer. The nurse cares for individuals of varied ages, backgrounds, and stages of breast cancer. Which criteria are considered a priority when determining adjunct treatment in addition to surgery? Select all that apply.
- A. Stage of tumor
- B. Cosmetic consequence
- C. Presence of metastasis
- D. Age
- E. Gender
- F. Sensitivity to estrogen
Correct Answer: A,C,D,F
Rationale: When working in an oncologist's office, the nurse is correct to identify that the stage of tumor and presence of metastasis help to guide treatment. Other factors include age of client and sensitivity to estrogen. Cosmetic consequence is not considered a priority when considering lifesaving treatment options. Many times, reconstruction is a possibility. Gender is not a consideration because treatment options are very similar.
The nurse is caring for a client whose physician has ordered a sentinel lymph node mapping. The physician explained the procedure and desired outcome. Which statement, made by the client, indicates a need for further instruction?
- A. The procedure allows for an understanding of the spread of cancer cells.
- B. The procedure allows for conservation of breast tissue.
- C. The procedure removes all cancer from the body.
- D. The procedure includes minimal surrounding tissue damage.
Correct Answer: C
Rationale: Sentinel lymph node mapping involves identifying the first (sentinel) lymph nodes through which the breast cancer cells would spread to regional lymph nodes in the axilla. Validating the lack of lymph node metastasis allows the surgeon to preserve more breast tissue, axillary tissue and chest muscle. Further instruction would be needed to explain that the sentinel lymph node biopsy does not remove cancer from the body.
A female client is diagnosed with breast abscess. She would like to continue to breast-feed her newborn. Which action by the nurse would be most appropriate in this situation?
- A. Encourage the client to include a client content in the diet.
- B. Instruct the client to wear a tight-fitting bra.
- C. Reduce the frequency of removing and reapplying the dressings.
- D. Assist the client to pump the breasts to remove breast milk.
Correct Answer: D
Rationale: The nurse should help the client pump the breasts and remove breast milk to prevent engorgement. Because the client has decided to continue breast-feeding, the client should wear a loose-fitting bra. Including protein content in the diet would be correlated to the client's current situation. Frequency of dressing changes does not play a role in the intervention.
The nurse is caring for a breastfeeding client who has developed a breast abscess. When instructing on the cause of abscess formation, which organism is the most common cause?
- A. Staphylococcus aureus
- B. Escherichia coli
- C. Pseudomonas aeruginosa
- D. Enterococcus faecalis
Correct Answer: A
Rationale: An abscess in the breast is most frequently a complication of mastitis. The most common cause is Staphylococcus aureus (S. aureus).
A suspicious breast lump is noted on a mammogram. The client asks the nurse which diagnostic test confirms if the lump is cancerous or benign. Which response by the nurse is most correct?
- A. An ultrasound
- B. A biopsy
- C. A magnetic resonance imaging (MRI)
- D. A clinical breast exam
Correct Answer: B
Rationale: To confirm whether a breast lump is cancerous or benign, a tissue sample must be obtained to examine the cells. Although an ultrasound, MRI, and clinical breast exam provide data on the characteristics of the lump, only examining the tissue can specifically identify if and what type of cancer is present.