NR 325 - FINAL EXAM STUDY GUIDE Questions with Correct
Answers (Grade A+)
Question 1: BREAST CAN- CER SCREENING GUIDELINES
Answer: regular screening mammography starting at age 45 years. Women aged 45 to 54 years should be
screened annually. Women 55 years and older should transition to biennial screening or have the
opportunity to continue screening annually. continue screening mammography as long as overall health is
good and life expectancy is 10 years or longer
Question 2: THE BREAST SELF-EXAMINA- TION
Answer: lie down and place one arm behind the head use finger pads of three middle fingers of the other
hand to feel for lumps use overlapping dime-sized circular motions to feel the breast tissue use three
different levels of pressure up-and-down vertical pattern is recommended stand in a front a mirror; examine
breasts for: - shape - size - redness/scaliness - dimpling (skin/nipple)
Question 3: MASTITIS
Answer: inflammation of the breast occurs in up to 10% of postpartum lactating mothers 2-4 weeks after
birth
Question 4: MASTITIS - CLIN- ICAL MANIFESTA- TIONS
Answer: warm to touch indurated/painful often unilateral most commonly caused by staphylococcus aureus
Question 5: BEST TIME TO PERFORM SELF BREAST EXAM (BSE)
Answer: Perform BSE at the end of the menstrual period breast tenderness is less likely to occur
Question 6: RISK FACTORS FOR BREAST CANCER
Answer: early menarche late menopause Age - at or older than 50 yrs hormone use Family history/Genetics
History of cancer (breast, colon, endometrial, ovarian) First full term pregnancy after age 30 nulliparity
(never given birth) benign breast disease (atypical epithelial hyperplasia) weight gain/obesity after
menopause exposure to ionizing radiation alcohol consumption
Question 7: ADVANTAGE OF FINE-NEEDLE AS- PIRATION (FNA) BIOPSY
Answer: FNA is performed in outpatient settings results are available within 24-48 hours no incision
required
Question 8: BREAST LUMPS - ASSESSMENT
Answer: *painless* and *fixed* lumps suggest breast cancer/malignancy
Page 1
,Question 9: HORMONE THERAPY (HT)
Answer: *HT has been linked to increased risk for breast cancer*; patient and HCP must determine whether
or not HT therapy is appropriate *Breast cancer incidence is increased in women using HT*, independent of
other risk factors HT increases the risk for both non-BRCA-associated cancer and BRCA-related cancers
Question 10: CLASSIFICATION OF BREAST CANCER
Answer: based on tissue type based on invasiveness based on hormone receptor and genetic status
Question 11: CLASSIFICATION OF BREAST CANCER - BASED ON ON TISSUE TYPE
Answer: Ductal carcinoma (milk ducts) - Medullary - Tubular - Colloid (mucinous) Lobular carcinoma
(milk-producing glands) Other - Inflammatory - Paget's disease - Phyllodes tumor
Question 12: CLASSIFICATION OF BREAST CANCER - BASED ON INVASIVENESS
Answer: Noninvasive (In situ) - ductal carcinoma in situ (DCIS) - lobular carcinoma in situ (LCIS) Invasive
(spreads) - invasive ductal carcinoma - invasive lobular carinoma
Question 13: CLASSIFICATION OF BREAST CANCER - BASEDON HORMONE RECEPTOR
STATUS/GENET- IC STATUS
Answer: *Estrogen and Progesterone Receptor Status* - Estrogen receptor positive - Estrogen receptor
negative - Progesterone receptor positive - Progesterone receptor negative *HER-2 Genetic Status* - HER-2
positive - HER-2 negative
Question 14: TRASTUZUMAB (HERCEPTIN) - THERAPEUTIC USE
Answer: this Rx is for the treatment of of tumors that have the HER-2 receptor
Question 15: TRASTUZUMAB (HERCEPTIN) - ADVERSE EFFECT
Answer: this Rx can lead to ventricular dysfunction patient is taught to self-monitor for symptoms of heart
failure
Question 16: TAMOXIFEN (NOLVADEX - THERAPEUTIC USE
Answer: this Rx is for the treatment of estogen-dependent breast tumors in premenopausal women
Question 17: ESTRADIOL - CAUTION
Answer: this Rx will increase the growth of estrogen-dependent tumors
Page 2
,Question 18: RALOXIFENE - THERAPEUTIC USE
Answer: this Rx is used to prevent breast cancer this Rx *IS NOT USED* postmastectomy
Question 19: RADICAL MAS- TECTOMY - POST OP NURSING CARE
Answer: patients are at increased risk for lymphedema and infection therefore, *NO BLOOD PRESSURES
OR VENIPUNCTURES* in the affected arm signage should be posted at the bedside to help remind staff
Question 20: RADICAL MAS- TECTOMY - PA- TIENT TEACHING
Answer: patients should avoid any activity that might injure the affected arm analgesics can be used
exercises should be continued in order restore strength/ROM affected arm should be elevate at or above the
heart to improve ROM/function
Question 21: SITES OF BREAST CANCER RECUR- RENCE/METASTA- SIS
Answer: *LOCAL RECURRENCE* skin chest wall *REGIONAL RECURRENCE* lymph nodes
*DISTAL METASTASIS* skeletal spinal cord brain pulmonary liver bone marrow
Question 22: TNM SYSTEM OF STAGING & PROGNOSIS
Answer: T = tumor size N = nodal involvement M = metastasis
Question 23: TUMOR SIZE AS PROGNOSTIC IN- DICATOR
Answer: the larger the tumor, the poorer the prognosis well differentiated the tumors = less aggressive
poorly differentiated tumors = more aggressive
Question 24: RECEPTOR-POSI- TIVE TUMORS
Answer: commonly show histologic evidence of being well differentiated frequently have a diploid (more
normal) DNA content and low proliferative indices have a lower chance for recurrence are frequently
hormone dependent and responsive to hormone therapy
Question 25: RECEPTOR-NEG- ATIVE TUMORS
Answer: are often poorly differentiated histologically have a high incidence of aneuploidy (abnormally high
or low DNA content) and higher proliferative indices frequently recur are usually unresponsive to hormone
therapy
Question 26: TRIPLE-NEGA- TIVE BREAST CANCER
Answer: a patient who tests negative for all three receptors (estogen, progesterone, and HER-2)
Page 3
, Question 27: TUMOR MARK- ERS FOR BREAST CANCER
Answer: CA 15-3 CA 27-29 CEA (carcinoembryonic antigen) these tumor markers are used to help monitor
metastatic breast cancer
Question 28: BREAST CANCER - STAGE 0
Answer: tumor in situ (TIS) no lymph node involvement no metastasis
Question 29: BREAST CANCER - STAGE I
Answer: tumor < 2 cm no lymph node involvement no metastasis
Question 30: BREAST CANCER - STAGE II
Answer: tumor(s) are 2-5 cm lymph node involvement may or may not be present 1-3 axillary nodes and/or
internal mammary nodes (if lymph nodes involved) no metastasis
Question 31: BREAST CANCER - STAGE III
Answer: tumors can be any size lymph node involvement *IIIA/IIIB* 4-9 axillary nodes and/or internal
mammary nodes *IIIC* e10 axillary nodes, internal mammary nodes, or infraclavicular nodes no metastasis
Question 32: BREAST CANCER - STAGE IV
Answer: tumors can be any size any type of nodal involvement active metastasis
Question 33: BREAST-CON- SERVING SURGERY (LUMPECTOMY) WITH RADIATION
THERAPY
Answer: Wide excision of tumor, sentinel lymph node biopsy (SLNB) and/or axillary lymph node
dissection (ALND) Radiation therapy
Question 34: BREAST-CON- SERVING SURGERY (LUMPECTOMY) WITH RADIATION
THERAPY - SIDE EFFECTS
Answer: breast soreness breast edema skin reactions arm swelling sensory changes
Question 35: BREAST-CON- SERVING SURGERY (LUMPECTOMY) WITH RADIATION
THERAPY - COMPLICATIONS
Answer: *Short-term* Moist desquamation (skin peeling) hematoma seroma infection *Long-term *
Fibrosis lymphedema myositis pneumonitis rib fractures
Page 4
Answers (Grade A+)
Question 1: BREAST CAN- CER SCREENING GUIDELINES
Answer: regular screening mammography starting at age 45 years. Women aged 45 to 54 years should be
screened annually. Women 55 years and older should transition to biennial screening or have the
opportunity to continue screening annually. continue screening mammography as long as overall health is
good and life expectancy is 10 years or longer
Question 2: THE BREAST SELF-EXAMINA- TION
Answer: lie down and place one arm behind the head use finger pads of three middle fingers of the other
hand to feel for lumps use overlapping dime-sized circular motions to feel the breast tissue use three
different levels of pressure up-and-down vertical pattern is recommended stand in a front a mirror; examine
breasts for: - shape - size - redness/scaliness - dimpling (skin/nipple)
Question 3: MASTITIS
Answer: inflammation of the breast occurs in up to 10% of postpartum lactating mothers 2-4 weeks after
birth
Question 4: MASTITIS - CLIN- ICAL MANIFESTA- TIONS
Answer: warm to touch indurated/painful often unilateral most commonly caused by staphylococcus aureus
Question 5: BEST TIME TO PERFORM SELF BREAST EXAM (BSE)
Answer: Perform BSE at the end of the menstrual period breast tenderness is less likely to occur
Question 6: RISK FACTORS FOR BREAST CANCER
Answer: early menarche late menopause Age - at or older than 50 yrs hormone use Family history/Genetics
History of cancer (breast, colon, endometrial, ovarian) First full term pregnancy after age 30 nulliparity
(never given birth) benign breast disease (atypical epithelial hyperplasia) weight gain/obesity after
menopause exposure to ionizing radiation alcohol consumption
Question 7: ADVANTAGE OF FINE-NEEDLE AS- PIRATION (FNA) BIOPSY
Answer: FNA is performed in outpatient settings results are available within 24-48 hours no incision
required
Question 8: BREAST LUMPS - ASSESSMENT
Answer: *painless* and *fixed* lumps suggest breast cancer/malignancy
Page 1
,Question 9: HORMONE THERAPY (HT)
Answer: *HT has been linked to increased risk for breast cancer*; patient and HCP must determine whether
or not HT therapy is appropriate *Breast cancer incidence is increased in women using HT*, independent of
other risk factors HT increases the risk for both non-BRCA-associated cancer and BRCA-related cancers
Question 10: CLASSIFICATION OF BREAST CANCER
Answer: based on tissue type based on invasiveness based on hormone receptor and genetic status
Question 11: CLASSIFICATION OF BREAST CANCER - BASED ON ON TISSUE TYPE
Answer: Ductal carcinoma (milk ducts) - Medullary - Tubular - Colloid (mucinous) Lobular carcinoma
(milk-producing glands) Other - Inflammatory - Paget's disease - Phyllodes tumor
Question 12: CLASSIFICATION OF BREAST CANCER - BASED ON INVASIVENESS
Answer: Noninvasive (In situ) - ductal carcinoma in situ (DCIS) - lobular carcinoma in situ (LCIS) Invasive
(spreads) - invasive ductal carcinoma - invasive lobular carinoma
Question 13: CLASSIFICATION OF BREAST CANCER - BASEDON HORMONE RECEPTOR
STATUS/GENET- IC STATUS
Answer: *Estrogen and Progesterone Receptor Status* - Estrogen receptor positive - Estrogen receptor
negative - Progesterone receptor positive - Progesterone receptor negative *HER-2 Genetic Status* - HER-2
positive - HER-2 negative
Question 14: TRASTUZUMAB (HERCEPTIN) - THERAPEUTIC USE
Answer: this Rx is for the treatment of of tumors that have the HER-2 receptor
Question 15: TRASTUZUMAB (HERCEPTIN) - ADVERSE EFFECT
Answer: this Rx can lead to ventricular dysfunction patient is taught to self-monitor for symptoms of heart
failure
Question 16: TAMOXIFEN (NOLVADEX - THERAPEUTIC USE
Answer: this Rx is for the treatment of estogen-dependent breast tumors in premenopausal women
Question 17: ESTRADIOL - CAUTION
Answer: this Rx will increase the growth of estrogen-dependent tumors
Page 2
,Question 18: RALOXIFENE - THERAPEUTIC USE
Answer: this Rx is used to prevent breast cancer this Rx *IS NOT USED* postmastectomy
Question 19: RADICAL MAS- TECTOMY - POST OP NURSING CARE
Answer: patients are at increased risk for lymphedema and infection therefore, *NO BLOOD PRESSURES
OR VENIPUNCTURES* in the affected arm signage should be posted at the bedside to help remind staff
Question 20: RADICAL MAS- TECTOMY - PA- TIENT TEACHING
Answer: patients should avoid any activity that might injure the affected arm analgesics can be used
exercises should be continued in order restore strength/ROM affected arm should be elevate at or above the
heart to improve ROM/function
Question 21: SITES OF BREAST CANCER RECUR- RENCE/METASTA- SIS
Answer: *LOCAL RECURRENCE* skin chest wall *REGIONAL RECURRENCE* lymph nodes
*DISTAL METASTASIS* skeletal spinal cord brain pulmonary liver bone marrow
Question 22: TNM SYSTEM OF STAGING & PROGNOSIS
Answer: T = tumor size N = nodal involvement M = metastasis
Question 23: TUMOR SIZE AS PROGNOSTIC IN- DICATOR
Answer: the larger the tumor, the poorer the prognosis well differentiated the tumors = less aggressive
poorly differentiated tumors = more aggressive
Question 24: RECEPTOR-POSI- TIVE TUMORS
Answer: commonly show histologic evidence of being well differentiated frequently have a diploid (more
normal) DNA content and low proliferative indices have a lower chance for recurrence are frequently
hormone dependent and responsive to hormone therapy
Question 25: RECEPTOR-NEG- ATIVE TUMORS
Answer: are often poorly differentiated histologically have a high incidence of aneuploidy (abnormally high
or low DNA content) and higher proliferative indices frequently recur are usually unresponsive to hormone
therapy
Question 26: TRIPLE-NEGA- TIVE BREAST CANCER
Answer: a patient who tests negative for all three receptors (estogen, progesterone, and HER-2)
Page 3
, Question 27: TUMOR MARK- ERS FOR BREAST CANCER
Answer: CA 15-3 CA 27-29 CEA (carcinoembryonic antigen) these tumor markers are used to help monitor
metastatic breast cancer
Question 28: BREAST CANCER - STAGE 0
Answer: tumor in situ (TIS) no lymph node involvement no metastasis
Question 29: BREAST CANCER - STAGE I
Answer: tumor < 2 cm no lymph node involvement no metastasis
Question 30: BREAST CANCER - STAGE II
Answer: tumor(s) are 2-5 cm lymph node involvement may or may not be present 1-3 axillary nodes and/or
internal mammary nodes (if lymph nodes involved) no metastasis
Question 31: BREAST CANCER - STAGE III
Answer: tumors can be any size lymph node involvement *IIIA/IIIB* 4-9 axillary nodes and/or internal
mammary nodes *IIIC* e10 axillary nodes, internal mammary nodes, or infraclavicular nodes no metastasis
Question 32: BREAST CANCER - STAGE IV
Answer: tumors can be any size any type of nodal involvement active metastasis
Question 33: BREAST-CON- SERVING SURGERY (LUMPECTOMY) WITH RADIATION
THERAPY
Answer: Wide excision of tumor, sentinel lymph node biopsy (SLNB) and/or axillary lymph node
dissection (ALND) Radiation therapy
Question 34: BREAST-CON- SERVING SURGERY (LUMPECTOMY) WITH RADIATION
THERAPY - SIDE EFFECTS
Answer: breast soreness breast edema skin reactions arm swelling sensory changes
Question 35: BREAST-CON- SERVING SURGERY (LUMPECTOMY) WITH RADIATION
THERAPY - COMPLICATIONS
Answer: *Short-term* Moist desquamation (skin peeling) hematoma seroma infection *Long-term *
Fibrosis lymphedema myositis pneumonitis rib fractures
Page 4
