A
The nurse is educating a patient on the risk factors for breast cancer. The nurses teaches the patient that the risk of breast cancer increases for women who start menopause after what age?
A. 50
B. 45
C. 55
D. 42
C. 55
The nurse prepares a teaching poster for placement in a women's health clinic. Which activity should the nurse identify to help prevent breast cancer? (Select all that apply.)
A. Refraining from smoking
B. Engaging in physical activity
C. Completing monthly self-breast exams
D. Limiting hormone therapy in duration and dose
E. Avoiding exposure to environmental pollution and radiation
A. Refraining from smoking
B. Engaging in physical activity
D. Limiting hormone therapy in duration and dose
E. Avoiding exposure to environmental pollution and radiation
A patient with breast cancer arrives for an assessment before her chemo treatment. The patient's breast feels hard and resembles an orange peel. The nurses known this symptom is known as?
A. Erythema
B. Fibrosis
C. Peau d'orange
D. "The peel feel"
C. Peau d'orange
A client has a mass that has been identified by a mammogram. Which test may be ordered to further differentiate the mammogram results?
A. Chest x-ray
B. HER2/neu testing
C. PET scan
D. Breast biopsy
D. Breast biopsy
The nurse would recognize which patient as being at the highest risk for breast cancer?
A. 74 year old smoker that's homebound and has impaired mobility.
B. 17 year old female that doesn't do self-breast exams.
C. 45 year old woman that does not smoke, jogs every morning, and gets annual mammograms.
D. A 33 year old woman that began menarche later than average and had a great, great aunt that had breast cancer.
A. 74 year old smoker that's homebound and has impaired mobility.
A client with breast cancer is scheduled for radiation prior to surgery. Which situation supports the use of radiation prior to surgery?
A. The cancer has already metastasized.
B. The tumor is unusually large.
C. The tumor is expressing the HER2/neu receptor.
D. Pain from the tumor is severe.
B. The tumor is unusually large.
The nurse is caring for a client who is scheduled for a biopsy of a suspicious mass in the breast. The client is crying and is tachycardic and tachypneic. Based on this assessment data, which problem is a priority?
A. Impairment of gas exchange
B. Anxiety
C. Risk for infection
D. Body image disturbance
B. Anxiety
The nurse evaluates teaching provided to a group of community members on breast cancer awareness. Which statement indictates that teaching on risk factors has been effective? (Select all that apply.)
A. "Not breastfeeding increases the risk of breast cancer."
B. "Having children after age 30 increases the risk of breast cancer."
C. "Having previous irradiation of the chest increases the risk of breast cancer."
D. "Experiencing menopause after age 50 increases the risk of breast cancer."
E. "Having a first- or second-degree relative with breast cancer increases the risk of breast cancer."
F. "Having harmful mutations in BRCA1 or BRCA2 suppression increases the risk of breast cancer."
A. "Not breastfeeding increases the risk of breast cancer."
B. "Having children after age 30 increases the risk of breast cancer."
C. "Having previous irradiation of the chest increases the risk of breast cancer."
F. "Having harmful mutations in BRCA1 or BRCA2 suppression increases the risk of breast cancer."
The nurse recognizes which of the following as methods for early detection of breast cancer? Select all that apply.
A. Mammography
B. Clinical breast exam
C. Breast biopsy
D. Self-breast exam
E. Mastectomy
A. Mammography
B. Clinical breast exam
D. Self-breast exam
A patient that has just been diagnosed with breast cancer is very nervous about beginning chemotherapy. Which statement would the nurse make to help prepare the patient?
A. "Everything will be fine, if you want to be cured you have to do it."
B. "Buy a wig before full hair loss occurs."
C. "Live life to the fullest and do what makes you happy. The chemo treatment is independent of how you choose to live."
D. "Never go out in public once beginning treatment. You will be neutropenic which means you will become infected very easily and get sepsis and die."
B. "Buy a wig before full hair loss occurs."
A client is diagnosed with adenocarcinoma of the breast. Based upon this diagnosis, where should the nurse expect the source of the cancer to be?
A. Subcutaneous fat
B. Mammary layer fatty tissue
C. Nipple epithelium
D. Terminal section of the breast ductal tissue
D. Terminal section of the breast ductal tissue
The nurse is reviewing care instructions for a client who had a radical mastectomy of the right breast. Which instruction is appropriate for the nurse to include in the teaching session? (Select all that apply.)
A. "Sleep with the right arm elevated on a pillow."
B. "You will be able to resume playing golf with your friends."
C. "You should apply hot compresses to the right arm if it is aching."
D. "Do not allow anyone to take your blood pressure in the right arm."
E. "It is okay to carry your purse on your right arm as long as it is not heavy."
A. "Sleep with the right arm elevated on a pillow."
D. "Do not allow anyone to take your blood pressure in the right arm."
A patient that has just received her biopsy results has a confirmed breast diagnosis. The patient is determined to beat the cancer and wants to understand what lies ahead. What are potential treatment options the nurse could educate the patient about? Select all that apply.
A. Chemotherapy
B. Hormonal therapy
C. Surgery
D. Radiation
E. Antibiotic therapy
A. Chemotherapy
B. Hormonal therapy
C. Surgery
D. Radiation
The nurse is caring for a patient that is recovering from a mastectomy. Which of the following would be a nursing priority?
A. Avoid touching the dressing for the first 24 hours to prevent pain or infection.
B. Assess vital signs promptly every 4 hours.
C. Evaluate the patient's self body image and self-esteem.
D. Avoid using the affected arm for measuring BP or drawing blood.
D. Avoid using the affected arm for measuring BP or drawing blood.
A premenopausal patient with a confirmed BRCA gene mutation is at an increased risk for which type of breast cancer?
A. Triple negative breast cancer
B. Inflammatory breast cancer
C. Invasive ductal carcinoma
D. Benign breast masses
A. Triple Negative Breast Cancer
A breast cancer patient that has had several chemotherapy treatments is prescribed a new drug called Epogen after her lab results come in. The patient asks what the effects of this medication are. Which of the following statements would the nurse include? Select all that apply.
A. decrease nausea and vomiting caused by the chemo
B. decrease the duration of anemia caused by the chemo
C. allow for higher doses of chemotherapy
D. help reduce the duration and severity of neutropenia
E. reduce thrombocytopenia effects of chemo treatment
F. limit hair loss caused by treatment
B. decrease the duration of anemia caused by the chemo
C. allow for higher doses of chemotherapy
D. help reduce the duration and severity of neutropenia
E. reduce thrombocytopenia effects of chemo treatment
The nurse that gets the patient checked in and ready for her chemo treatment makes a personal connection with the patient. The patient requests that this nurse give her chemotherapy treatment instead of her usual chemo nurse. How does this nurse respond?
A. "Of course I will give your treatment! I am so honored to be helping you through your journey."
B. "Only a registered nurse with certified chemo training can administer chemotherapy, so unfortunately I can't give your chemo. I am so sorry, but I will do everything else I can to help make you comfortable."
C. "I am not a chemo nurse, so I can't give you the treatment; but, I would be happy to stay in the room during the therapy and assist your chemo nurse with your treatment."
D. "I am not technically able to administer chemo because I have not completed the training, but I will talk to the charge nurse and see if she will make an exception since it would mean so much to you."
B. "Only a registered nurse with certified chemo training can administer chemotherapy, so unfortunately I can't give your chemo. I am so sorry, but I will do everything else I can to help make you comfortable."
A nurse preparing to educate a group on breast cancer opens up the session by asking people to share what they believe they already know about breast cancer. Which of the following statements would require correction? Select all that apply.
A. "Breast cancer always presents as a palpable lump in the breast or axillary region."
B. "I am at an increased risk of breast cancer because my mother and grandmother both had breast cancer, so I may require more frequent screenings."
C. "Mammograms are the best test for diagnosing breast cancer."
D. "When caught early, localized cancer that hasn't spread can be removed without resorting to breast removal."
E. "Women ages 45 to 55 should have a mammogram done every year."
F. "A self-breast exam should be done on the same day every month, at the same time of day."
A. "Breast cancer always presents as a palpable lump in the breast or axillary region."
C. "Mammograms are the best test for diagnosing breast cancer."
F. "A self-breast exam should be done on the same day every month, at the same time of day."
The nurse anticipates which of the following labs as potential orders for a patient being assessed for breast cancer?
A. Serum calcium level
B. Liver enzymes
C. BUN and Creatinine levels
D. Platelets
E. Alkaline phosphatase
A. Serum calcium level
B. Liver enzymes
E. Alkaline phosphatase
A nurse is preparing a patient for a clinical breast exam. The patient has a family history of breast cancer and is nervous for the exam. The patient asks the nurse what findings would be concerning or require further investigation. Which of the following would the nurse list to the patient? Select all that apply.
A. Lumps in the breast or axillary areas
B. Discharge from the nipples
C. Rash and/or itching
D. One breast appears larger than the other
E. Thickening or tenderness
A. Lumps in the breast or axillary areas
B. Discharge from the nipples
C. Rash and/or itching
D. One breast appears larger than the other
E. Thickening or tenderness
A nurse is reviewing a breast cancer patient's medication list and sees that the patient is being treated with hormone therapy. A patient has a long list of symptoms due to the medication and the cancer itself. The nurse would recognize which of the following as side effects of the hormone therapy? Select all that apply.
A. A deepening of their voice and facial hair growth.
B. Hypercalcemia
C. Fluid retention
D. Alopecia
E. Acne
F. Anemia
A. A deepening of their voice and facial hair growth.
B. Hypercalcemia
C. Fluid retention
E. Acne
A client with breast cancer receives diagnostic testing and scan results that indicate a tumor that is 4.2 cm in size with evidence of metastasis to movable ipsilateral axillary nodes only. According to the TNM staging system, how should this client's breast cancer be staged?
A. T1 N0 MO
B. Tis N1 M0
C. T3 N2 M1
D. T2 N1 M0
D. T2 N1 M0
A patient that has been diagnosed with invasive breast cancer presents with scaly, red irritation all around the nipple. Which form of breast cancer does the nurse suspect the patient has been diagnosed with?
A. Triple negative breast cancer
B. Paget's disease
C. Inflammatory breast cancer
D. Ductal carcinoma in situ
B. Paget's disease
The nurse knows that chemotherapy impairs cellular regulation through which of the following ways? Select all that apply.
A. Interferes with hormones or enzymes needed for cell growth
B. Interrupts cell division
C. Inhibits mitosis
D. Inhibits DNA replication
E. Causes uncontrolled reproduction of cells
A. Interferes with hormones or enzymes needed for cell growth
B. Interrupts cell division
C. Inhibits mitosis
D. Inhibits DNA replication
A 52 yr-old female tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client’s lump is cancerous?
A. Eversion of the right nipple and a mobile mass
B. Nonmobile mass with irregular edges
C. Mobile mass that is oft and easily delineated
D. Nonpalpable right axillary lymph nodes
B. Nonmobile mass with irregular edges
Rationale: Breast cancer tumors are fixed, hard, and poorly delineated with irregular edges. Nipple retraction —not eversion—may be a sign of cancer. A mobile mass that is soft and easily delineated is most often a fluid-filled benigned cyst. Axillary lymph nodes may or may not be palpable on initial detection of a cancerous mass.