Nokea
The nurse is obtaining a history from a client who states recurrent breast tenderness. The client inquiries if there is something wrong with her breasts. Which question by the nurse is a priority?
- A. Do you have a history of breast disorders and cancer in the family?
- B. Does the tenderness occur around the same time each month?
- C. Have you pulled a muscle or had any injury to the breast?
- D. When did you first recognize the symptoms?
Correct Answer: B
Rationale: The breasts are part of the female reproductive system, and they respond to the hormonal cycle associated with ovulation, menstruation, and pregnancy. Because the hormonal cycle is monthly, it is best to ask the client if the tenderness occurs at the same time each month. The other options are also important questions to ask.
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A client is scheduled to undergo a procedure to lift breasts that have drooped because of significant weight loss. The nurse identifies this procedure as which of the following?
- A. Reduction mammoplasty
- B. Mastopexy
- C. Autogenous breast reconstruction
- D. Mastectomy
Correct Answer: B
Rationale: A mastopexy is a procedure that involves lifting a breast. This procedure is similar to a reduction mammoplasty (removal of glandular breast tissue, fat, and skin bilaterally to decrease the size of large pendulous breasts), although the incision and scar line are smaller and the recovery time is shorter. Autogenous breast reconstruction involves the harvesting of the client's tissue from the rectus abdominis muscle to create a new breast. A mastectomy is a removal of a breast.
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).
The nurse is providing care to a client who has had surgery as treatment for breast cancer. The nurse would be alert for the development of which condition?
- A. Lymphedema
- B. Fibrocystic breast disease
- C. Fibroadenom
- D. Breast abscess
Correct Answer: A
Rationale: Lymphedema occurs in some women after breast cancer surgery. It causes disfigurement and increases the lifetime potential for infection and poor healing. Fibrocystic breast disease and fibroadenom are two benign breast conditions that occur usually in premenopausal woman. Breast abscess is the infectious and inflammatory breast condition that is common among breast-feeding mothers.
A nurse is describing to a client the advantages and disadvantages associated with tamoxifen therapy as a means of breast cancer prevention. The nurse would identify that the drug has a beneficial effect on which factor?
- A. Bone mineral density
- B. High density lipoprotein levels
- C. Risk for endometrial cancer
- D. Cataract formation
Correct Answer: A
Rationale: Besides reducing the risk of breast cancer, tamoxifen preserves bone mineral density, thus preventing osteoporosis. It also lowers the low-density lipoprotein cholesterol levels, although it is still unknown if it decreases the incidence of myocardial infarction in women. Tamoxifen can have detrimental effects. It increases the incidences of endometrial cancer, deep vein thrombosis, pulmonary embolism, and cataracts.
The nurse is caring for a client who will be having artificial implants for breast reconstruction. The client is arriving at the physician's office for which procedure to be completed before the surgery can be done?
- A. Incisional alignment
- B. Tissue expansion
- C. Fluid drainage
- D. Pain control
Correct Answer: B
Rationale: Before an implant for breast reconstruction can produce an optimum cosmetic appearance, the skin and tissue on the chest wall are expanded to provide a large enough space to fill and approximate the size of the remaining breast. The other options are not correct.