Nokea
The nurse is formulating a teaching plan according to evidence-based breast cancer screening guidelines for a 50-year-old woman with low risk factors. Which diagnostic methods should be included in the plan? (Select all that apply.)
- A. Magnetic resonance imaging (MRI)
- B. Breast ultrasound
- C. Breast self-awareness
- D. Clinical breast examination
- E. Mammogram
Correct Answer: C,D,E
Rationale: Guidelines recommend annual mammograms for women aged 40 and older, breast self-awareness, and clinical breast examinations for low-risk women. MRI is recommended for high-risk cases, and breast ultrasound is used for follow-up if abnormalities or dense breast tissue are found.
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A client is placed on a medical regimen of doxorubicin (Adriamycin), cyclophosphamide (Cytoxan), and another agent for breast cancer. What effect seen in the client should the nurse report to the provider immediately?
- A. Shortness of breath
- B. Hair loss
- C. Mucositis
- D. Vomiting
Correct Answer: A
Rationale: Doxorubicin (Adriamycin) can cause cardiac problems, with symptoms like shortness of breath indicating potential cardiotoxicity, which requires immediate reporting. Hair loss, mucositis, and vomiting are common chemotherapy side effects but are not immediately life-threatening.
The nurse is teaching a 45-year-old woman about her fibrocystic breast condition. Which statement by the client indicates a lack of understanding?
- A. This condition will become malignant over time.
- B. I should refrain from using hormone replacement therapy.
- C. One cup of coffee in the morning should be enough for time.
- D. This condition makes it more difficult to examine my breasts.
Correct Answer: A
Rationale: Fibrocystic breast condition does not increase a woman's chance of developing breast cancer. Hormone replacement therapy is not indicated since the additional estrogen may aggravate the condition. Limiting caffeine intake may give relief to tender breasts. The fibrocystic changes to the breasts make it more difficult to examine the breasts because of fibrotic changes and lumps.
A client states that she rates her pain as a 5 on a 0-10 scale post-mastectomy. The provider has ordered morphine 4 mg IV for moderate pain every 4 hours. The morphine is supplied as a solution of 8 mg/mL. How many mL will the nurse administer?
- A. 0.25 mL
- B. 0.5 mL
- C. 1 mL
- D. 2 mL
Correct Answer: B
Rationale: To calculate the dose: 4 mg (ordered) ÷ 8 mg/mL (concentration) = 0.5 mL. Thus, the nurse will administer 0.5 mL of morphine.
A client is discharged to home after a modified radical mastectomy with two drainage tubes. Which statement by the client would indicate that further teaching is needed?
- A. I can empty the drainage tubes daily and record the output.
- B. I should avoid lifting heavy objects with the affected arm.
- C. I can resume normal activities like swimming immediately.
- D. I will report any signs of infection, such as redness or swelling, to my provider.
Correct Answer: C
Rationale: The client should avoid strenuous activities like swimming until cleared by the provider to prevent complications such as lymphedema or infection. Emptying drainage tubes, avoiding heavy lifting, and reporting signs of infection are appropriate actions, indicating understanding.
A client is starting hormonal therapy with tamoxifen (Nolvadex) to lower the risk for breast cancer. What information needs to be explained by the nurse regarding the action of this drug?
- A. It blocks the release of luteinizing hormone.
- B. It interferes with cancer cell division.
- C. It blocks estrogen in the breast.
- D. It inhibits DNA synthesis in rapidly dividing cells.
Correct Answer: C
Rationale: Tamoxifen (Nolvadex) reduces the estrogen available to breast tumors to stop or prevent growth. It does not block luteinizing hormone (leuprolide does this), interfere with cell division (chemotherapy agents like cyclophosphamide do this), or inhibit DNA synthesis (doxorubicin does this).