Nokea
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.
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A 37-year-old Nigerian woman is at high risk for breast cancer and is considering a prophylactic mastectomy and oophorectomy. What action by the nurse is most appropriate?
- A. Discourage this surgery since the woman is still of childbearing age.
- B. Reassure the client that reconstructive surgery is as easy as breast augmentation.
- C. Inform the client that this surgery removes all mammary tissue and cancer risk.
- D. Include support people, such as the male partner, in the decision making.
Correct Answer: D
Rationale: The cultural aspects of decision making need to be considered. In Nigerian culture, the man often plays a significant role in decision-making processes, so including support people like the male partner is appropriate to ensure culturally sensitive care.
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.
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 woman has been using acupuncture to treat the nausea and vomiting caused by the side effects of chemotherapy for breast cancer. Which conditions would cause the nurse to recommend against further use of acupuncture? (Select all that apply.)
- A. Lymphedema
- B. Bleeding tendencies
- C. Low white blood cell count
- D. Elevated serum calcium
- E. High platelet count
Correct Answer: A,B,C
Rationale: Acupuncture is contraindicated in lymphedema due to poor drainage in the affected extremity, bleeding tendencies due to increased bleeding risk, and low white blood cell count due to infection risk. Elevated serum calcium and high platelet count do not contraindicate acupuncture.
A woman diagnosed with breast cancer had these laboratory tests performed at an office visit. Which test results indicate to the nurse that some further diagnoses are needed?
- A. The elevated alkaline phosphatase and calcium suggest bone involvement.
- B. Only alkaline phosphatase is decreased, suggesting liver metastasis.
- C. Hematocrit and hemoglobin are decreased, indicating anemia.
- D. The elevated hematocrit and hemoglobin indicate dehydration.
Correct Answer: A
Rationale: The alkaline phosphatase (normal 30 to 120 U/L) and total calcium (normal 9 to 10.5 mg/dL) levels are elevated (125 U/L and 12 mg/dL, respectively), suggesting bone metastasis. Hematocrit (19%) and hemoglobin (14 g/dL) are within normal limits for females, ruling out anemia or dehydration.