Chapter 17: Breasts and Axillae
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Montgomery tubercles are most prominent in the breasts of:
a. adult males.
b. patients with lung disease.
c. pregnant women.
d. pubertal females.
ANS: C
Montgomery tubercles undergo hypertrophy and become more prominent in the breasts of
pregnant and lactating women.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
2. Most women with breast cancer:
a. possess the BRCA1 or BRCA2 gene.
b. risk increases with aging.
c. have a mother who had breast cancer.
d. continue to menstruate after age 52.
ANS: B
Of all breast cancers, 77% occur in women older than 50 years. Most women with breast cancer
do not possess the BRCA1 or BRCA2 gene. Only 5% to 10% of women with breast cancer are
known to have either gene. Most women with breast cancer do not have a mother who had breast
cancer. Familial breast cancers occur in 10% to 20% of breast cancer populations. Most women
with breast cancer do not continue to menstruate after age 52. Having a later start of menopause
does not overshadow the 77% of all breast cancers that occur in women older than 50 years.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. A 50-year-old woman presents as a new patient. Which finding in her personal and social
history would increase her risk profile for
developing breast cancer?
a. Drinking three glasses of wine per week
b. Early menopause
c. Nulliparity
d. Late menarche
ANS: C
Nulliparity, or late age at the birth of the first child (after 30 years old), is a risk factor for breast
cancer. Other risk factors include late menopause, early menarche, and drinking more than one
alcoholic drink daily.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
4. If your patient has nipple discharge, you will most likely need a:
, a. Vacutainer tube.
b. glass slide and fixative.
c. specimen jar with formaldehyde.
d. tape strip to test pH.
ANS: B
A glass slide and fixative are used for microscopic examination of the discharge to identify its
cellular makeup.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
5. While examining a 30-year-old woman, you note that one breast is slightly larger than the
other. In response to this finding, you should:
a. note the finding in the patient’s record.
b. ask the patient if she has ever had breast cancer.
c. tell the patient to get a mammogram as soon as possible.
d. tell the patient to get a mammary sonogram as soon as possible.
ANS: A
Often one breast is slightly larger than the other. This is a normal variation and no further
intervention is required.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
6. A 23-year-old white woman has come to the clinic because she has missed two menstrual
periods. She states that her breasts have enlarged and that her nipples have turned a darker color.
Your response to this finding is to:
a. instruct her that this is a side effect of birth control injection therapy.
b. suggest pregnancy testing.
c. question her use of tanning beds.
d. schedule an appointment with a surgeon.
ANS: B
In light-skinned women, pregnancy produces enlarged breasts with a darker areola. Neither
hormonal injections nor the use of tanning beds will change the color of the areola as does
pregnancy. Surgical consultation is not necessary.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
7. In patients with breast cancer, peau d’orange skin is often first evident:
a. in the axilla.
b. in the upper inner quadrant.
c. on or around the nipple.
d. at the inframammary ridge.
ANS: C
The areola is the most common initial site for visualization of peau d’orange skin.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
8. A firm, transverse ridge of compressed tissue is felt bilaterally along the lower edge of a 40-
year-old patient’s breast. You should:
a. ask the patient if she has a history of breast cancer.
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Montgomery tubercles are most prominent in the breasts of:
a. adult males.
b. patients with lung disease.
c. pregnant women.
d. pubertal females.
ANS: C
Montgomery tubercles undergo hypertrophy and become more prominent in the breasts of
pregnant and lactating women.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
2. Most women with breast cancer:
a. possess the BRCA1 or BRCA2 gene.
b. risk increases with aging.
c. have a mother who had breast cancer.
d. continue to menstruate after age 52.
ANS: B
Of all breast cancers, 77% occur in women older than 50 years. Most women with breast cancer
do not possess the BRCA1 or BRCA2 gene. Only 5% to 10% of women with breast cancer are
known to have either gene. Most women with breast cancer do not have a mother who had breast
cancer. Familial breast cancers occur in 10% to 20% of breast cancer populations. Most women
with breast cancer do not continue to menstruate after age 52. Having a later start of menopause
does not overshadow the 77% of all breast cancers that occur in women older than 50 years.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. A 50-year-old woman presents as a new patient. Which finding in her personal and social
history would increase her risk profile for
developing breast cancer?
a. Drinking three glasses of wine per week
b. Early menopause
c. Nulliparity
d. Late menarche
ANS: C
Nulliparity, or late age at the birth of the first child (after 30 years old), is a risk factor for breast
cancer. Other risk factors include late menopause, early menarche, and drinking more than one
alcoholic drink daily.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
4. If your patient has nipple discharge, you will most likely need a:
, a. Vacutainer tube.
b. glass slide and fixative.
c. specimen jar with formaldehyde.
d. tape strip to test pH.
ANS: B
A glass slide and fixative are used for microscopic examination of the discharge to identify its
cellular makeup.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
5. While examining a 30-year-old woman, you note that one breast is slightly larger than the
other. In response to this finding, you should:
a. note the finding in the patient’s record.
b. ask the patient if she has ever had breast cancer.
c. tell the patient to get a mammogram as soon as possible.
d. tell the patient to get a mammary sonogram as soon as possible.
ANS: A
Often one breast is slightly larger than the other. This is a normal variation and no further
intervention is required.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
6. A 23-year-old white woman has come to the clinic because she has missed two menstrual
periods. She states that her breasts have enlarged and that her nipples have turned a darker color.
Your response to this finding is to:
a. instruct her that this is a side effect of birth control injection therapy.
b. suggest pregnancy testing.
c. question her use of tanning beds.
d. schedule an appointment with a surgeon.
ANS: B
In light-skinned women, pregnancy produces enlarged breasts with a darker areola. Neither
hormonal injections nor the use of tanning beds will change the color of the areola as does
pregnancy. Surgical consultation is not necessary.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
7. In patients with breast cancer, peau d’orange skin is often first evident:
a. in the axilla.
b. in the upper inner quadrant.
c. on or around the nipple.
d. at the inframammary ridge.
ANS: C
The areola is the most common initial site for visualization of peau d’orange skin.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Reduction of Risk Potential
8. A firm, transverse ridge of compressed tissue is felt bilaterally along the lower edge of a 40-
year-old patient’s breast. You should:
a. ask the patient if she has a history of breast cancer.
