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While the nurse is providing education for a client with a family history of breast cancer, the client asks, 'What is the most common type of breast cancer?' What is the correct response from the nurse?
- A. Inflammatory breast cancer
- B. Ductal carcinoma
- C. Lobular carcinoma
- D. Medullary carcinoma
Correct Answer: B
Rationale: Ductal carcinoma makes up 70% to 80% of cases of breast malignancy. Inflammatory breast cancer is 1% to 5%, lobular carcinoma is 5% to 10%, and medullary carcinoma is the rarest among those listed.
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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.
The nurse is caring for a client who is employed as a manual laborer. The client has recovered from a recent mastectomy and is planning to return to work. Which instruction from the nurse would be most helpful?
- A. Do not return to work until all areas are completely healed.
- B. Have others assist in tasks involving use of affected arm.
- C. Wear gloves to prevent injury.
- D. Check to see if job description can be changed.
Correct Answer: C
Rationale: It is most helpful to provide an option that allows the client to continue employment at the current job, if the client is able. Many times, the client must continue employment and cannot change jobs. Instructing the client to not return to work may not be an option throughout the healing process, which could be up to 1 year. Asking others to do tasks and changing the job description are unrealistic throughout the recovery period.
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.
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 four clients in an oncology unit. Following report, which client would the nurse identify as having the most life-threatening diagnosis?
- A. A client with stage IV cancer receiving palliative care
- B. A client diagnosed with a stage one tumor with no lymph node involvement
- C. A client receiving chemotherapy and radiation with a low blood count
- D. A client with an estrogen receptor-positive tumor receiving oral chemotherapy
Correct Answer: A
Rationale: The client with stage IV cancer, indicating metastasis, and receiving palliative care, which includes comfort measures, is in highest life-threatening condition. A client with a stage I tumor and no lymph node involvement has a good prognosis as the cancer has been caught at an early stage. A low blood count is common when the client is receiving chemotherapy. It is common to have chemotherapy and radiation as a treatment regimen. Clients have experienced good prognosis with estrogen receptor positive tumor treatment of oral chemotherapy.