HESI Case Study - Breast Cancer
Exam/29 questions and Answers
At the community education program, the client learns that breast self-exam
(BSE) is best performed 2-3 days after the start of the menstrual flow when
the breasts are least engorged and tender. Since the client had a
hysterectomy 5 years ago, she does not have periods. She asks the nurse if
she still needs to perform BSE, and if so, when. - -Which nursing explanation
best promotes effective communication?
Select a day that is easy to remember to perform BSE consistently every
month.
-The client demonstrates BSE technique for the nurse using a practice
model. She uses her fingerpads and states that when lying down, her arm
should be relaxed at her side. What instructions should the nurse provide? -
-Demonstrate how arm should be positioned behind or over the head.
-Another client in the class said she had heard that there is a genetic test
that would diagnose breast cancer. What is the best response by the nurse? -
-A positive test for the BRCA1 mutation identifies an increased risk for breast
cancer.
-Diagnostic Testing
While performing a BSE, the client discovers a lump.After seeing her
healthcare provider (HCP), the client is scheduled for a mammogram. She
brings a family member with her to the Women's Health Center to learn
about mammograms. The client's family member tells the nurse that she
does not need a mammogram annually because she has no risk factors for
breast cancer, except that her father's sister had breast cancer.
Which nursing intervention best promotes effective communication? - -
Teach the client's family that even women with no identified risk factors are
at risk.
-The client's family member states that she will schedule a mammogram
and she asks the nurse if it will be painful. How should the nurse respond? - -
Show the client's family what most women say causes the discomfort during
a mammogram.
-Therapeutic Communication
, A mass is seen on the client's mammogram, and a follow-up stereotactic
core needle biopsy is performed. The tumor specimen is found to be
cancerous. The client learns that she has a cancerous tumor requiring
surgery. She tells the nurse that this is a mistake. She is insistent her
specimen was mixed up with someone else's.
Which nursing intervention best promotes effective communication? - -Tell
the client feelings of disbelief are understandable.
-The client goes on to say that she can control this with exercising and a
change in her eating habits. Which nursing intervention best promotes
effective communication in reply to the client's solution? - -Confirm with the
client her hesitation to discuss the need for surgery.
-Ethical-Legal Issues in Preoperative Care
The client decides to have surgery and is scheduled for a modified radical
mastectomy with immediate abdominal myocutaneous flap reconstruction. A
modified radical mastectomy involves removal of breast tissue and lymph
nodes, but it conserves the pectoralis major muscle. The reconstruction
involves the use of a flap of skin and muscle from the abdomen to create a
breast mound.The client arrives at the surgery center 2 hours before her
scheduled surgery. The nurse confirms the client's NPO status. The client
states she had a cracker this morning just before coming to the surgery
center. She informs the nurse that she is so nervous about the surgery and
may back out if she is unable to have it today. The client asks the nurse not
to tell anyone about the cracker.
What action is most important for the nurse to take? - -Tell the client that to
ensure her safety, the surgeon will need to be notified about the cracker.
-Which ethical principle has the greatest weight in the nurse's decision to
inform the client's surgeon about the snack? - -Nonmaleficence.
-The nurse confirms that the client has signed the informed consent for
surgery but learns that the client does not understand the procedure for
breast reconstruction that is to be performed. What action should the nurse
implement? - -Notify the surgeon that further explanation of the procedure
is necessary.
-Post-Mastectomy Nursing Management
After surgery, the client is admitted to the Post Anesthesia Care Unit (PACU)
for immediate postoperative management.
Exam/29 questions and Answers
At the community education program, the client learns that breast self-exam
(BSE) is best performed 2-3 days after the start of the menstrual flow when
the breasts are least engorged and tender. Since the client had a
hysterectomy 5 years ago, she does not have periods. She asks the nurse if
she still needs to perform BSE, and if so, when. - -Which nursing explanation
best promotes effective communication?
Select a day that is easy to remember to perform BSE consistently every
month.
-The client demonstrates BSE technique for the nurse using a practice
model. She uses her fingerpads and states that when lying down, her arm
should be relaxed at her side. What instructions should the nurse provide? -
-Demonstrate how arm should be positioned behind or over the head.
-Another client in the class said she had heard that there is a genetic test
that would diagnose breast cancer. What is the best response by the nurse? -
-A positive test for the BRCA1 mutation identifies an increased risk for breast
cancer.
-Diagnostic Testing
While performing a BSE, the client discovers a lump.After seeing her
healthcare provider (HCP), the client is scheduled for a mammogram. She
brings a family member with her to the Women's Health Center to learn
about mammograms. The client's family member tells the nurse that she
does not need a mammogram annually because she has no risk factors for
breast cancer, except that her father's sister had breast cancer.
Which nursing intervention best promotes effective communication? - -
Teach the client's family that even women with no identified risk factors are
at risk.
-The client's family member states that she will schedule a mammogram
and she asks the nurse if it will be painful. How should the nurse respond? - -
Show the client's family what most women say causes the discomfort during
a mammogram.
-Therapeutic Communication
, A mass is seen on the client's mammogram, and a follow-up stereotactic
core needle biopsy is performed. The tumor specimen is found to be
cancerous. The client learns that she has a cancerous tumor requiring
surgery. She tells the nurse that this is a mistake. She is insistent her
specimen was mixed up with someone else's.
Which nursing intervention best promotes effective communication? - -Tell
the client feelings of disbelief are understandable.
-The client goes on to say that she can control this with exercising and a
change in her eating habits. Which nursing intervention best promotes
effective communication in reply to the client's solution? - -Confirm with the
client her hesitation to discuss the need for surgery.
-Ethical-Legal Issues in Preoperative Care
The client decides to have surgery and is scheduled for a modified radical
mastectomy with immediate abdominal myocutaneous flap reconstruction. A
modified radical mastectomy involves removal of breast tissue and lymph
nodes, but it conserves the pectoralis major muscle. The reconstruction
involves the use of a flap of skin and muscle from the abdomen to create a
breast mound.The client arrives at the surgery center 2 hours before her
scheduled surgery. The nurse confirms the client's NPO status. The client
states she had a cracker this morning just before coming to the surgery
center. She informs the nurse that she is so nervous about the surgery and
may back out if she is unable to have it today. The client asks the nurse not
to tell anyone about the cracker.
What action is most important for the nurse to take? - -Tell the client that to
ensure her safety, the surgeon will need to be notified about the cracker.
-Which ethical principle has the greatest weight in the nurse's decision to
inform the client's surgeon about the snack? - -Nonmaleficence.
-The nurse confirms that the client has signed the informed consent for
surgery but learns that the client does not understand the procedure for
breast reconstruction that is to be performed. What action should the nurse
implement? - -Notify the surgeon that further explanation of the procedure
is necessary.
-Post-Mastectomy Nursing Management
After surgery, the client is admitted to the Post Anesthesia Care Unit (PACU)
for immediate postoperative management.
