Question 1

While conducting a physical examination on a female adolescent client, you note that glandular tissue has developed under the areola of her breast and that the nipple and breast project as a single mound. At which Tanner phase is this client?

Accepted Answer

The description matches Tanner stage 2 of breast development, where there is the appearance of breast buds with small areas of glandular tissue forming under the areola.

Question 2

Tamara is a 7-year-old client who is already showing signs of breast development and growth of pubic hair. Which condition does Tamara most likely have?

Accepted Answer

Tamara is showing signs of early puberty, such as breast development and the growth of pubic hair, at the age of 7, which is indicative of precocious puberty. This condition is characterized by the early onset of puberty, typically before the age of 8 in girls and 9 in boys.

Question 3

Denisa is a 48-year-old client who complains of spontaneous discharge of milk from both breasts. She says she is taking valsartan for her blood pressure and bupropion Hcl for depression. A pregnancy test comes back negative, and her prolactin level is 14 ng/mL. What condition does Denisa most likely have?

Accepted Answer

Galactorrhea is the most likely condition Denisa has, characterized by spontaneous discharge of milk from the breast, unrelated to childbirth or nursing. Her normal prolactin level and the absence of a prolactinoma or other conditions suggest this diagnosis.

Question 4

You are teaching about breast care to Maria, a client who just gave birth and who plans to breastfeed her child. Which instruction should you give her to help prevent nipple fissures?

Accepted Answer

Applying lanolin to the nipples can help keep them moisturized, reducing the risk of developing fissures. Lanolin is safe for both the mother and the baby, and it helps in soothing and protecting sore, dry, or cracked nipples, which is common during breastfeeding.

Question 5

You have just completed a clinical breast exam on Casey, a healthy 23-year-old client with no personal or family history of breast cancer. You should advise Casey to have a clinical breast exam how often?

Accepted Answer

For women in their 20s and 30s who are at average risk for breast cancer, it is recommended to have a clinical breast exam approximately every 3 years as part of their health exam by a health professional.

Question 6

Margaret is a client who has a documented breast cancer (BRCA) 1 mutation and is at a high risk for breast cancer. Which diagnostic procedure is recommended by the American Cancer Society to screen Margaret for breast cancer?

Accepted Answer

The American Cancer Society recommends that women with a BRCA1 mutation undergo annual screening with Magnetic Resonance Imaging (MRI) in addition to mammograms, as MRI is more sensitive in detecting breast cancer in high-risk women.

Question 7

Tiffany is a client who has a large cyst in her breast. Which intervention would be most appropriate for resolving the cyst and obtaining a fluid sample to send to the laboratory for cytology studies?

Accepted Answer

Fine needle aspiration biopsy is the most appropriate intervention for resolving a cyst in the breast and obtaining a fluid sample for cytology studies. This minimally invasive procedure involves using a thin, hollow needle to extract fluid or cells from the cyst for examination.

Question 8

Miranda is a 25-year-old client who is concerned about her risk for developing breast cancer. Which of the following should you point out to Miranda as risk factors for breast cancer? (Select all that apply.)

Accepted Answer

B) Having a mutation in the BRCA1 gene significantly increases the risk of developing breast cancer. C) Alcohol consumption is associated with an increased risk of breast cancer, and drinking three beers daily elevates that risk. E) A high body mass index (BMI) is linked to an increased risk of breast cancer, especially in postmenopausal women.

Question 9

Katherine is a 30-year-old client who recently learned that she has the BRCA 1 gene mutation and is terrified that she might develop breast cancer. She lost her mother to breast cancer a few years ago and is prepared to take drastic measures to reduce her risk. She has a body mass index of 24, and drinks a glass of wine daily. Which of the following interventions would most effectively lower Katherine's risk for developing breast cancer?

Accepted Answer

Undergoing surgical prophylaxis, such as a mastectomy, is the most effective intervention for significantly reducing the risk of breast cancer in individuals with a BRCA 1 gene mutation.

Question 10

Marcy has been diagnosed with breast cancer. Her tumor is about 3 cm in diameter. What is the T stage of Marcy's tumor?

Accepted Answer

T2 stage in breast cancer is defined for tumors that are more than 2 cm but not more than 5 cm in greatest dimension. Marcy's tumor, being 3 cm, falls into this category.

Question 11

Kelly is a client who was recently diagnosed with breast cancer. She has a tumor 6 cm in diameter and several positive nodes outside the axillary nodes, with no distant metastasis. What stage is Kelly's cancer?

Accepted Answer

Kelly's cancer is classified as Stage 3 due to the size of the tumor (greater than 5 cm) and the involvement of lymph nodes outside the axillary area, indicating significant local spread but no distant metastasis, which would be required for Stage 4.

Question 12

Eva recently underwent a lumpectomy for treatment of her 7-cm tumor. What additional treatment should Eva most expect to undergo in conjunction with the lumpectomy?

Accepted Answer

Radiation therapy is commonly recommended after a lumpectomy to eliminate any remaining cancer cells and reduce the risk of recurrence.

Question 13

Harriet has been diagnosed with HER2-positive breast cancer. Which treatment would allow targeting of the cancer cells more specifically and thus would likely produce fewer side effects?

Accepted Answer

Biological therapy, also known as targeted therapy, specifically targets cancer cells with fewer effects on normal cells. In the case of HER2-positive breast cancer, drugs like trastuzumab (Herceptin) target the HER2 protein, making this approach more specific and potentially causing fewer side effects compared to more generalized treatments like chemotherapy or radiation.

Question 14

Pamela is a client who is preparing to undergo chemotherapy to treat her breast cancer. What instructions should you give her to help reduce the risk of acquiring infections? (Select all that apply.)

Accepted Answer

Chemotherapy can weaken the immune system, making it important to avoid infections. Avoiding dental work (A) can prevent exposure to bacteria. Staying out of large crowds (B) reduces the risk of catching infections. Washing hands frequently (D) is a key practice to prevent the spread of germs. Getting plenty of rest (E) helps maintain a strong immune system. A low-calorie diet (C) is not recommended as it may not provide sufficient nutrients needed during treatment.

Question 15

Women who are diagnosed with early breast cancer are thought to have what chance of survival?

Accepted Answer

Women diagnosed with early breast cancer have a high chance of survival, with current estimates suggesting a survival rate of approximately 90%. This high survival rate is attributed to advances in detection, diagnosis, and treatment.

Quiz 24: Breast Health Considerations