Nokea
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.
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A suspicious breast lump is noted on a mammogram. The client asks the nurse which diagnostic test confirms if the lump is cancerous or benign. Which response by the nurse is most correct?
- A. An ultrasound
- B. A biopsy
- C. A magnetic resonance imaging (MRI)
- D. A clinical breast exam
Correct Answer: B
Rationale: To confirm whether a breast lump is cancerous or benign, a tissue sample must be obtained to examine the cells. Although an ultrasound, MRI, and clinical breast exam provide data on the characteristics of the lump, only examining the tissue can specifically identify if and what type of cancer is present.
A client with a painless, firm, notender lump in the breast is being scheduled for diagnostic testing. Which test would the nurse expect the physician to order?
- A. Standard mammogram
- B. Ultrasound
- C. Excisional biopsy
- D. Culture of discharge
Correct Answer: B
Rationale: Ultrasound can reveal physical characteristics unique to a fibroadenom a versus malignant mass with a higher degree of accuracy than standard mammography. In the case of very young women - an atypical age for breast cancer - an excisional biopsy is performed only if the mass changes or becomes larger. If the mass is detected in a woman with a higher risk for developing breast cancer, such as one with a family history or of an older age, a biopsy is performed to confirm that the tissue is indeed benign. There is no discharge to culture.
The nurse is caring for a client who has been diagnosed with a breast lump. The physician states that studies indicate a cancerous tumor in situ. The client is anxious and wants to know what may come next. The nurse is most correct to support physician instruction of which of the following?
- A. Since your tumor appears localized, removal of the tumor is indicated.
- B. A mastectomy is recommended for all clients in this situation.
- C. The next step is just as the physician described. We can have the physician talk to you again.
- D. Chemotherapy and radiation are typical treatments prescribed by the oncologist.
Correct Answer: A
Rationale: The nurse is correct to restate the information that the physician has just discussed. Many times, anxious clients have a difficult time understanding information. The nurse realizes that a tumor that is in situ has developed in a localized area without invading the surrounding tissue. This criterion would allow the removal of tissue from only that area, not an entire mastectomy. When the client asks for the next step, chemotherapy and radiation, as indicated, would be initiated after removal of the tumor.
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.
A female client is diagnosed with breast abscess. She would like to continue to breast-feed her newborn. Which action by the nurse would be most appropriate in this situation?
- A. Encourage the client to include a client content in the diet.
- B. Instruct the client to wear a tight-fitting bra.
- C. Reduce the frequency of removing and reapplying the dressings.
- D. Assist the client to pump the breasts to remove breast milk.
Correct Answer: D
Rationale: The nurse should help the client pump the breasts and remove breast milk to prevent engorgement. Because the client has decided to continue breast-feeding, the client should wear a loose-fitting bra. Including protein content in the diet would be correlated to the client's current situation. Frequency of dressing changes does not play a role in the intervention.