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The nurse is caring for a patient who has had a right mastectomy and the patient asks the nurse how long the biannual mammography will have to continue. Which of the following time frames should the nurse inform the patient is recommended for mammography postmastectomy?
- A. Every 6 months for a year
- B. Every 6 months for 2 years
- C. Every 6 months for 3 years
- D. Every 6 months for life
Correct Answer: B
Rationale: The patient should undergo appropriate breast imaging at regular intervals (usually 6 months to 1 year) for two consecutive years.
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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.
When the nurse is working in the women's health care clinic, which of the following actions is appropriate to take?
- A. Educate a healthy 36-year-old about the need for an annual mammogram
- B. Discuss the need for an annual mammography with a 52-year-old.
- C. Talk about magnetic resonance imaging (MRI) with a 26-year-old with a $BRCA-1$ mutation.
- D. Teach an active 70-year-old that mammography frequency should be individualized based upon her history.
Correct Answer: C
Rationale: MRI (in addition to mammography) is recommended for women who are at high risk for breast cancer. A 52-year-old patient should have a mammography every 2 years. Mammography screening is recommended for women starting at age 40 if they are considered high risk for the development of breast cancer. For healthy older women, an individualized plan of care should be discussed with her health care provider.
To determine the risk for breast cancer in a patient who has found a small lump in the left breast, which of the following questions is most pertinent for the nurse to ask?
- A. Do you currently smoke cigarettes?
- B. Have you ever had any breast injuries?
- C. At what age did you start having menstrual periods?
- D. Is there any family history of fibroccystic breast changes?
Correct Answer: C
Rationale: Early menarche and late menopause are risk factors for breast cancer because of the prolonged exposure to estrogen that occurs. Cigarette smoking, breast trauma, and fibroccystic breast changes are not associated with increased breast cancer risk.
A patient who has a diagnosis of fibrocystic breast changes calls the nurse in the clinic with these symptoms. Which of the following findings is most important to report to the health care provider?
- A. There is yellow-green discharge from one of the patient's nipples.
- B. There is an area on the breast that is hot, red, and tender to touch.
- C. The lumps are firm feeling and most are in the upper outer breast quadrants.
- D. The lumps are larger and more painful before the patient's menstrual period.
Correct Answer: B
Rationale: An area that is hot or red suggests an infectious process such as mastitis, which would require further assessment and treatment. The other information will also be reported, but these findings are typical in fibrocystic breasts.
The nurse is assessing a patient at the clinic who has metastatic breast cancer and has a new prescription for trastuzumab. Which of the following findings is a reason for the administration of this medication?
- A. Allergic to iodine
- B. HER-2 positive
- C. Immune to tamoxifen
- D. Severely dehydrated
Correct Answer: B
Rationale: For patients who are HER-2 positive, trastuzumab is a monoclonal antibody to HER-2. After the antibody attaches to the antigen, it is taken into the cancer cells and eventually kills them.