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The nurse is teaching a patient about breast self-examination (BSE) who has had a right-sided mastectomy. Which of the following information should the nurse include in the teaching plan?
- A. Only the remaining breast requires a mammogram screening annually.
- B. BSE should be done daily while taking a bath or shower.
- C. Mammograms should be scheduled every two years.
- D. Performing BSE monthly.
Correct Answer: D
Rationale: It is recommended, postmasectomy, that the patient perform monthly BSE on the remaining breast and the surgical site. The most common site of local recurrence of breast cancer is at the surgical site. The woman should undergo appropriate breast imaging at regular intervals (usually 6 months to 1 year), as determined by her risk of recurrence and breast cancer history.
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A patient who has a diagnosis of fibrocystic breast changes calls the nurse in the clinic with these symptoms. Which of the following findings is most important to report to the health care provider?
- A. There is yellow-green discharge from one of the patient's nipples.
- B. There is an area on the breast that is hot, red, and tender to touch.
- C. The lumps are firm feeling and most are in the upper outer breast quadrants.
- D. The lumps are larger and more painful before the patient's menstrual period.
Correct Answer: B
Rationale: An area that is hot or red suggests an infectious process such as mastitis, which would require further assessment and treatment. The other information will also be reported, but these findings are typical in fibrocystic breasts.
A student nurse prepares a list of teaching topics for a patient with a new diagnosis of breast cancer. Which of the following topics indicate that the student needs more education about breast cancer diagnostic testing?
- A. A firm, moveable mass is most often breast cancer
- B. HER-2 receptor testing
- C. Estrogen receptor testing
- D. Oncotype DX assay testing
Correct Answer: A
Rationale: A firm, moveable mass is characteristic of fibroadenoma, not breast cancer. The other tests are likely to be used for additional diagnostic testing in a patient with breast cancer.
To determine the risk for breast cancer in a patient who has found a small lump in the left breast, which of the following questions is most pertinent for the nurse to ask?
- A. Do you currently smoke cigarettes?
- B. Have you ever had any breast injuries?
- C. At what age did you start having menstrual periods?
- D. Is there any family history of fibroccystic breast changes?
Correct Answer: C
Rationale: Early menarche and late menopause are risk factors for breast cancer because of the prolonged exposure to estrogen that occurs. Cigarette smoking, breast trauma, and fibroccystic breast changes are not associated with increased breast cancer risk.
The nurse has completed teaching a patient who has breast cancer about the newly prescribed tamoxifen. Which of the following patient statements indicate that the teaching has been effective?
- A. I will expect to have leg cramps with this drug.
- B. I will call the clinic if I develop any hot flashes.
- C. I will be taking the medication for at least a year.
- D. I will call immediately if I experience cloudy and blurred vision.
Correct Answer: D
Rationale: Blurred and cloudy vision should be immediately reported because it is likely that the patient is developing cataracts and the tamoxifen will be discontinued or decreased. Tamoxifen treatment generally lasts 5 years. Hot flashes are an expected adverse effect of tamoxifen. Leg cramps may be a sign of deep vein thrombosis, and the patient should immediately notify the health care provider if pain occurs.
The nurse is caring for a patient who is scheduled for stereotactic core biopsy of the breast. Which of the following information should the nurse include in patient education?
- A. A local anaesthetic will be given before the biopsy specimen is obtained.
- B. You will need to lie flat on your back and lie very still during the biopsy.
- C. A thin needle will be inserted into the lump and aspirated to remove tissue.
- D. You should not have anything to eat or drink for 6 hours before the procedure.
Correct Answer: A
Rationale: A local anaesthetic is given before stereotactic biopsy. NPO status is not needed because no sedative drugs are given. The patient is placed in the prone position. A biopsy gun is used to obtain the specimens.