Nokea
The nurse is working at an oncologist's office specializing in breast cancer. The nurse cares for individuals of varied ages, backgrounds, and stages of breast cancer. Which criteria are considered a priority when determining adjunct treatment in addition to surgery? Select all that apply.
- A. Stage of tumor
- B. Cosmetic consequence
- C. Presence of metastasis
- D. Age
- E. Gender
- F. Sensitivity to estrogen
Correct Answer: A,C,D,F
Rationale: When working in an oncologist's office, the nurse is correct to identify that the stage of tumor and presence of metastasis help to guide treatment. Other factors include age of client and sensitivity to estrogen. Cosmetic consequence is not considered a priority when considering lifesaving treatment options. Many times, reconstruction is a possibility. Gender is not a consideration because treatment options are very similar.
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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.
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 providing dietary instruction for the client with fibrocystic breast disease. Which of the client's favorite food(s) does the nurse discourage? Select all that apply.
- A. Lasagna
- B. Chocolate pudding
- C. Organ meat
- D. Cola products
- E. Popcorn
Correct Answer: B,D
Rationale: When instructing the client on appropriate food choices, the nurse instructs the client to avoid caffeine. Caffeine is in products such as chocolate and cola drinks. Lasagna, organ meats, and popcorn do not contain caffeine.
The nurse is caring for a client experiencing metastatic cancer-related pain. Which drug of choice does the nurse anticipate being ordered?
- A. Ibuprofen (Motrin)
- B. Alprazolam (Xanax)
- C. Morphine (MS Contin)
- D. Propofol (Diprivan)
Correct Answer: C
Rationale: In treating clients with metastatic cancer-related pain, the opioid analgesics morphine (MS Contin) and fentanyl are the drugs most often used for pain relief. Morphine (MS Contin) can be given orally, rectally, subcutaneously, intravenously, intramuscularly, or by epidural catheter. Ibuprofen (Motrin) is given for mild to moderate pain. Alprazolam (Xanax) is provided to relieve anxiety. Propofol (Diprivan) is an anesthetic given, frequently for short procedures.
The nurse is caring for a client with breast cancer and removal of axillary lymph nodes. Which assessment finding is documented and brought to the physician's attention as potential lymphedema?
- A. A reddened area around the breast
- B. Fluid accumulation under in the axilla
- C. Enlargement of the arm
- D. Pain in the chest wall
Correct Answer: C
Rationale: Enlargement of the arm is a key sign of lymphedema, which can occur after axillary lymph node removal due to impaired lymphatic drainage. A reddened area around the breast may indicate infection or inflammation, not lymphedema. Fluid accumulation under the axilla could be a seroma, not lymphedema. Pain in the chest wall is not specific to lymphedema.