Deck 40: Management of Clients with Breast Disorders

Question 1

When a client with stage I breast cancer asks the nurse about the usual treatment for her problem, the nurse would base an answer on the fact that

A) breast-conserving surgery is appropriate at this stage.
B) mastectomy is done as soon as possible.
C) radiation and chemotherapy are used instead of surgery.
D) radiation therapy is given before surgery.

Answer 1

breast-conserving surgery is appropriate at this stage.

Question 2

The nursing intervention that would receive the highest priority before discharge of a client following mastectomy is

A) arrange for Reach for Recovery volunteer to visit.
B) describe the plan for follow-up treatment and surveillance.
C) discuss methods of improving self-image.
D) share information about mastectomy support groups.

Answer 2

describe the plan for follow-up treatment and surveillance.

Question 3

In a client receiving chemotherapy for breast cancer, the nurse would assess for

A) back pain.
B) confusion.
C) infection.
D) weight gain.

Answer 3

infection.

Question 4

When a 25-year-old client asks the nurse how she can lower her risk of breast cancer, the nurse would suggest that the client

A) have a mammogram every 2 years.
B) increase her intake of leafy green vegetables.
C) increase her intake of vitamin C.
D) minimize intake of alcohol.

Question 5

The nursing intervention that would best meet a client's mobility needs for the first 24 hours after modified radical mastectomy is

A) encourage the client to touch the fingers to shoulders, extending arm fully.
B) encourage the client to use the operative arm to brush her hair.
C) maintain complete immobility of the operative arm for the first 24 hours.
D) perform passive range-of-motion exercises with the operative arm.

Question 6

When the client scheduled for a modified radical mastectomy asks the nurse what tissue the surgeon will remove, the nurse would answer

A) breast, skin, and axillary nodes.
B) breast, skin, and muscle.
C) breast, skin, muscle, and axillary nodes.
D) breast, skin, muscle, axillary nodes, and internal mammary nodes.

Question 7

A nurse is teaching women about health promotion measures related to breast cancer. The woman the nurse would advise is at higher risk and should be sure to engage in breast cancer screening activities is the woman who

A) began menstruation at an early age.
B) experienced menopause at an early age.
C) had five children.
D) needed surgical removal of her ovaries at age 32.

Question 8

The nurse explains that a breast tumor that is estrogen receptor positive (ER+) is associated with

A) faster tumor growth rates.
B) longer survival.
C) more aggressive behavior.
D) poor response to hormonal manipulation.

Question 9

The statement made by a client with fibrocystic disease that would indicate to the nurse a correct understanding of the disease is

A) "If I give up coffee, it may get better."
B) "It may get worse after menopause."
C) "Pregnancy usually worsens the symptoms."
D) "This can be treated with daily diuretics."

Question 10

When the client asks the nurse when she can purchase a permanent breast prosthesis, the nurse explains that a prosthesis can be obtained when

A) a year has passed.
B) all the sutures and drains are removed.
C) the client is discharged.
D) the wound has healed completely.

Question 11

A client diagnosed with early-stage breast cancer is to undergo radiation therapy along with a lumpectomy rather than mastectomy. In helping the client make her decision, the nurse would explain to the client that

A) distant recurrence is seen more often with lumpectomy.
B) effects are comparable between the two remedies.
C) radiation therapy is not needed with mastectomy.
D) radiation may cause a significant incidence of secondary malignancies.

Question 12

To help a client cope with the body image change caused by chemotherapy with doxorubicin, the nurse suggests that the client

A) begin an exercise routine.
B) get fitted for a good prosthesis.
C) obtain a wig before hair is lost.
D) purchase some new clothes.

Question 13

For a client receiving cyclophosphamide (Cytoxan) as part of chemotherapy for her breast cancer, the nurse would include the instruction to

A) drink eight glasses of water daily.
B) eat iron-rich foods.
C) practice good skin care.
D) take high-fiber laxatives.

Question 14

After a modified radical mastectomy, the action by the client that would indicate to the nurse that the client is developing a positive body image is

A) asking about a prosthesis.
B) looking at the incision.
C) talking about her feelings.
D) wearing make-up and her own nightgown.

Question 15

The nurse explains that the most frequent breast mass is

A) carcinoma.
B) fibroadenoma.
C) fibrocystic disease.
D) mastitis.

Question 16

Teaching a client who will soon begin radiation therapy for treatment of breast cancer, the nurse would tell the client that she should expect

A) a low-residue diet to decrease diarrhea.
B) dry, itchy skin changes to develop.
C) pain in the long bones, especially the legs.
D) permanent pigment changes to the breast.

Question 17

The nursing care plan for a client receiving tamoxifen for the treatment of breast cancer would include

A) assisting the client in coping with hot flashes.
B) decreasing sodium intake.
C) encouraging milk products to increase calcium intake.
D) increasing fluid intake.

Question 18

A client is receiving chemotherapy with paclitaxel for breast cancer. A priority nursing intervention is to

A) encourage the client to get adequate rest.
B) monitor the client's safety.
C) teach the client about the drug regimen.
D) watch for drug side effects.

Question 19

The nurse explains to a client following mastectomy with lymph node dissection that care of the operative arm should include

A) avoiding heavy lifting and trauma to the arm.
B) having blood pressure taken on the operative arm.
C) limiting all movement until the incision is healed.
D) wearing an Ace bandage wrap for 2 years.

Question 20

The client discovered a stone-hard lump during breast self-examination (BSE) that has been determined to be confined to the lobular unit without permeating the basement membrane. Reinforcing the physician's explanation, the nurse would clarify that this type of tumor is

A) intraductal carcinoma.
B) infiltrating ductal carcinoma.
C) lobular carcinoma in situ.
D) tubular carcinoma.

Question 21

In caring for a client with post-mastectomy breast reconstruction using a subpectoral implant, the nurse would stress that the client can prevent capsule formation by

A) using daily heat applications.
B) keeping the implant very soft.
C) not wearing a bra until the implant drops.
D) wearing a bra at all times.

Question 22

A male client has been diagnosed with metastatic breast cancer. The nurse would understand that this client most likely may have feelings of sexual inadequacy because

A) breast cancer is a "female" disease.
B) decreased libido is common in male breast cancer clients.
C) radiation therapy produces unwanted skin side effects.
D) treatment includes medical orchiectomy.

Question 23

A client complains of premenstrual mastalgia. Self-care measures the nurse could suggest to help decrease the client's manifestations might include having the client

A) apply ice to her breasts.
B) decrease caffeine intake.
C) perform breast massage.
D) use warm, moist soaks.

Question 24

In the discharge teaching plan for a client with breast augmentation, the nurse would explain that the client should

A) avoid touching the breasts.
B) perform full range-of-motion arm exercises a week after surgery.
C) sleep on her back in a head-elevated position for a week.
D) take aspirin for pain relief and to decrease inflammation.

Question 25

A young client has a breast lump that presents as a fluid-filled cyst and increases slightly in size premenstrually. The nurse would suspect the breast disorder of

A) a cyst.
B) a papilloma.
C) carcinoma.
D) ductal hyperplasia.