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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.
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A patient has just returned to the postsurgical unit from post-anesthetic recovery after breast surgery for removal of a malignancy. What is the most likely major nursing diagnosis to include in this patients immediate plan of care?
- A. Acute pain related to tissue manipulation and incision
- B. Ineffective coping related to surgery
- C. Risk for trauma related to post-surgical injury
- D. Chronic sorrow related to change in body image
Correct Answer: A
Rationale: Acute pain is a common immediate postoperative issue due to tissue manipulation and incision, making it a priority nursing diagnosis. Coping, sorrow, or trauma risks may emerge later but are not immediate concerns.
A 23-year-old woman comes to the free clinic stating I think I have a lump in my breast. Do I have cancer? The nurse instructs the patient that a diagnosis of breast cancer is confirmed by what?
- A. Supervised breast self-examination
- B. Mammography
- C. Fine-needle aspiration
- D. Chest x-ray
Correct Answer: C
Rationale: Fine-needle aspiration or biopsy provides histologic confirmation of breast cancer, making it the definitive diagnostic method. Breast self-examination and mammography are screening tools, not diagnostic, and chest x-rays are used for metastasis evaluation, not primary diagnosis.
A 42-year-old man has come to the clinic for an annual physical. The nurse notes in the patients history that his father was treated for breast cancer. What should the nurse provide to the patient before he leaves the clinic?
- A. A referral for a mammogram
- B. Instructions about breast self-examination (BSE)
- C. A referral to a surgeon
- D. A referral to a support group
Correct Answer: B
Rationale: Men with a family history of breast cancer, like a father, have an increased risk and should be taught breast self-examination to monitor for changes. Referrals for mammograms, surgery, or support groups are not indicated without symptoms or a diagnosis.
A 52-year-old woman has just been told she has breast cancer and is scheduled for a modified mastectomy the following week. The nurse caring for this patient knows that she is anxious and fearful about the upcoming procedure and the newly diagnosed malignancy. How can the nurse most likely alleviate this patients fears?
- A. Provide written material on the procedure that has been scheduled for the patient.
- B. Provide the patient with relevant information about expected recovery.
- C. Give the patient current information on breast cancer survival rates.
- D. Offer the patient alternative treatment options.
Correct Answer: B
Rationale: Providing realistic information about recovery helps reduce anxiety by setting clear expectations. Written materials alone may not suffice, survival rates may not address procedural fears, and offering alternatives is outside the nurse's scope.
A patient who came to the clinic after finding a mass in her breast is scheduled for a diagnostic breast biopsy. During the nurses admission assessment, the nurse observes that the patient is distracted and tense. What is it important for the nurse to do?
- A. Acknowledge the fear the patient is likely experiencing.
- B. Describe the support groups that exist in the community.
- C. Assess the patients stress management skills.
- D. Document a nursing diagnosis of ineffective coping.
Correct Answer: A
Rationale: Acknowledging the patient's fear validates her emotions and opens communication, which is crucial during the diagnostic phase of a potential breast cancer diagnosis. Referring to support groups or assessing stress management is premature, and diagnosing ineffective coping assumes a problem not yet confirmed.