Nokea
The nurse is performing a comprehensive health history of a patient who is in her 50s. The nurse should identify what risk factor that may increase this patients risk for breast cancer?
- A. The patient breastfed each of her children.
- B. The patient gave birth to her first child at age 38.
- C. The patient experienced perimenopausal symptoms starting at age 46.
- D. The patient experienced menarche at age 13.
Correct Answer: B
Rationale: Late age at first pregnancy (after 30) is a known risk factor for breast cancer due to prolonged estrogen exposure without the protective effect of pregnancy. Breastfeeding, early perimenopause, and menarche at age 13 are not significant risk factors.
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When planning discharge teaching with a patient who has undergone a total mastectomy with axillary dissection, the nurse knows to instruct the patient that she should report what sign or symptom to the physician immediately?
- A. Fatigue
- B. Temperature greater than 98.5 F
- C. Sudden cessation of output from the drainage device
- D. Gradual decline in output from the drain
Correct Answer: C
Rationale: Sudden cessation of drainage output may indicate an occlusion, which requires immediate medical attention to prevent complications like seroma. Gradual decline is expected, fatigue is common, and a temperature of 98.5 F is not concerning; 100.4 F or higher would suggest infection.
A new mother who is breastfeeding calls the clinic to speak to a nurse. The patient is complaining of pain in her left breast and describes her breast as feeling doughy. The nurse tells her to come into the clinic and be checked. The patient is diagnosed with acute mastitis and placed on antibiotics. What comfort measure should the nurse recommend?
- A. Apply cold compresses as ordered.
- B. Avoid wearing a bra until the infection clears.
- C. Avoid washing the breasts.
- D. Perform gentle massage to stimulate neutrophil migration.
Correct Answer: A
Rationale: Cold compresses help relieve discomfort in acute mastitis by reducing inflammation. A snug bra supports the breast, hygiene is essential, and massage is not recommended as it may worsen the condition.
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.
A 45-year-old woman comes into the health clinic for her annual check-up. She mentions to the nurse that she has noticed dimpling of the right breast that has occurred in a few months. What assessment would be most appropriate for the nurse to make?
- A. Evaluate the patients milk production.
- B. Palpate the area for a breast mass.
- C. Assess the patients knowledge of breast cancer.
- D. Assure the patient that this is likely an age-related change.
Correct Answer: B
Rationale: Dimpling of the breast is a concerning sign that may indicate an underlying breast mass or malignancy, such as breast cancer, due to possible lymphatic obstruction or tumor fixation. Palpating the area to assess for a mass is the most appropriate action to identify potential pathology and determine the need for referral. Evaluating milk production is irrelevant as there is no indication of lactation. Assessing knowledge is secondary to physical examination, and dimpling is not an age-related change.
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.