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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.
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A patient at high risk for breast cancer is scheduled for an incision biopsy in the outpatient surgery department. When the nurse is providing preoperative education, the patient asks why an incision is being done instead of just removing the mass. What would be the nurses best response?
- A. An incision is performed because its known to be less painful and more accurate than other forms of testing.
- B. An incision is performed to confirm a diagnosis and so that special studies can be done that will help determine the treatment.
- C. An incision is performed to assess the potential for recovery from a mastectomy.
- D. An incision is performed on patients who are younger than the age of 40 and who are otherwise healthy.
Correct Answer: B
Rationale: Incisional biopsy removes a portion of the mass to confirm breast cancer and allows for specialized studies to guide treatment. It is not chosen for pain, age, or mastectomy recovery assessment, and complete mass removal may not be feasible or necessary initially.
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 woman aged years comes into the clinic because she has discovered a lump in her breast. After diagnostic testing, the patient receives a diagnosis of cancer. The nurse asks when patients should begin mammography. What is the nurses best advice?
- A. Age 28
- B. Age 35
- C. Age 38
- D. Age 48
Correct Answer: C
Rationale: For women with a first-degree relative diagnosed with breast cancer at age 48, screening mammography should begin 5 to 10 years earlier than the age of diagnosis, but not before age 25. Starting at age 38 aligns with this guideline, providing early detection for those at increased familial risk.
A 42 year-old patient tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. She says that she is afraid that she has cancer. Which assessment finding would most strongly suggest that this patients lump is cancerous?
- A. Eversion of the right nipple and mobile mass
- B. A nonmobile mass with irregular edges
- C. A mobile mass that is soft and easily delineated
- D. Nonpalpable right axillary lymph nodes
Correct Answer: B
Rationale: Breast cancer typically presents as a hard, nonmobile mass with irregular edges, as these characteristics suggest malignancy. A soft, mobile mass is more likely benign, like a cyst. Eversion of the nipple is not typical, and nonpalpable lymph nodes do not rule out cancer.
A patient is to undergo an ultrasound-guided core biopsy. The patient tells the nurse that a patient of hers had a stereotactic core needle biopsy. She wants to understand the difference between the procedures. What would be the nurses best response?
- A. An ultrasound-guided core biopsy is faster, less expensive, and does not use radiation.
- B. An ultrasound-guided core biopsy is a little more expensive, but it doesnt use radiation and it is faster.
- C. An ultrasound-guided core biopsy is a little more expensive, and it also uses radiation but it is faster.
- D. An ultrasound-guided core biopsy takes more time, and it also uses radiation, but it is less expensive.
Correct Answer: A
Rationale: Ultrasound-guided core biopsy is faster, less expensive, and radiation-free compared to stereotactic biopsy, which uses X-rays for guidance, making it a preferred option when ultrasound is suitable.