Nokea
The nurse is caring for a patient who is scheduled for stereotactic core biopsy of the breast. Which of the following information should the nurse include in patient education?
- A. A local anaesthetic will be given before the biopsy specimen is obtained.
- B. You will need to lie flat on your back and lie very still during the biopsy.
- C. A thin needle will be inserted into the lump and aspirated to remove tissue.
- D. You should not have anything to eat or drink for 6 hours before the procedure.
Correct Answer: A
Rationale: A local anaesthetic is given before stereotactic biopsy. NPO status is not needed because no sedative drugs are given. The patient is placed in the prone position. A biopsy gun is used to obtain the specimens.
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A student nurse prepares a list of teaching topics for a patient with a new diagnosis of breast cancer. Which of the following topics indicate that the student needs more education about breast cancer diagnostic testing?
- A. A firm, moveable mass is most often breast cancer
- B. HER-2 receptor testing
- C. Estrogen receptor testing
- D. Oncotype DX assay testing
Correct Answer: A
Rationale: A firm, moveable mass is characteristic of fibroadenoma, not breast cancer. The other tests are likely to be used for additional diagnostic testing in a patient with breast cancer.
Which of the following statements by a patient newly diagnosed with stage I breast cancer indicates to the nurse that patient teaching may be needed?
- A. There are several options available for treating the cancer.
- B. I will probably need radiation to the breast after having the surgery.
- C. I can probably have reconstructive surgery at the same time as a mastectomy.
- D. Mastectomy will be the best choice to decrease the chance of cancer recurrence.
Correct Answer: D
Rationale: The survival rates with lumpectomy and radiation or modified radical mastectomy are comparable. The other patient statements indicate a good understanding of stage I breast cancer treatment.
The nurse is caring for a patient with breast cancer who is receiving chemotherapy and tamoxifen. Which of the following findings is most important to communicate to the health care provider?
- A. The patient has symptoms of numbness and tingling in the right arm and leg.
- B. The patient has complaints of fatigue.
- C. The patient eats only $5$ of food on meal tray.
- D. The patient's white blood cell (WBC) count is $5 \times 10^9/L$.
Correct Answer: A
Rationale: One-sided tingling and numbness may indicate a stroke and should be reported to the health care provider. Tamoxifen increases the risk of blood clots, cataracts, stroke, and endometrial cancer in postmenopausal women. Anorexia, fatigue, and a low-normal WBC count are expected effects of chemotherapy.
The nurse is caring for a patient with left arm lymphedema. Which of the following actions should be included in the plan of care?
- A. Check BP on both right and left arms.
- B. Avoid isometric exercise on the left arm.
- C. Assist with application of compression dressings.
- D. Keep the left arm at or below the level of the heart.
Correct Answer: C
Rationale: Compression of the arm assists in improving lymphatic flow toward the heart. Isometric exercises may be prescribed for lymphedema. BPs should only be done on the patient's right arm. The arm should not be placed in a dependent position.
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.