HESI Case Study - Breast Cancer

HESI CASE STUDY - BREAST CANCER EXAM QUESTIONS
AND ACCURATE SOLUTIONS

Atrhtherhcommunityrheducationrhprogram,rhtherhclientrhlearnsrhthatrhbreastrhself-
examrh(BSE)rhisrhbestrhperformedrh2-
3rhdaysrhafterrhtherhstartrhofrhtherhmenstrualrhflowrhwhenrhtherhbreastsrharerhleastrh
engorgedrhandrhtender.rhSincerhtherhclientrhhadrharhhysterectomyrh5rhyearsrhago,rhsh
erhdoesrhnotrhhaverhperiods.rhSherhasksrhtherhnurserhifrhsherhstillrhneedsrhtorhperfor
mrhBSE,rhandrhifrhso,rhwhen.rh-
rhanswersWhichrhnursingrhexplanationrhbestrhpromotesrheffectiverhcommunication?



SelectrharhdayrhthatrhisrheasyrhtorhrememberrhtorhperformrhBSErhconsistentlyrheveryr
hmonth.



TherhclientrhdemonstratesrhBSErhtechniquerhforrhtherhnurserhusingrharhpracticerhmode
l.rhSherhusesrhherrhfingerpadsrhandrhstatesrhthatrhwhenrhlyingrhdown,rhherrharmrhsho
uldrhberhrelaxedrhatrhherrhside.rhWhatrhinstructionsrhshouldrhtherhnurserhprovide?rh-
rhanswersDemonstraterhhowrharmrhshouldrhberhpositionedrhbehindrhorrhoverrhtherhhe
ad.



Anotherrhclientrhinrhtherhclassrhsaidrhsherhhadrhheardrhthatrhthererhisrharhgeneticrhte
strhthatrhwouldrhdiagnoserhbreastrhcancer.rhWhatrhisrhtherhbestrhresponserhbyrhtherh
nurse?rh-
rhanswersArhpositiverhtestrhforrhtherhBRCA1rhmutationrhidentifiesrhanrhincreasedrhriskr
hforrhbreastrhcancer.



DiagnosticrhTesting



WhilerhperformingrharhBSE,rhtherhclientrhdiscoversrharhlump.Afterrhseeingrhherrhhealth
carerhproviderrh(HCP),rhtherhclientrhisrhscheduledrhforrharhmammogram.rhSherhbringsr
harhfamilyrhmemberrhwithrhherrhtorhtherhWomen'srhHealthrhCenterrhtorhlearnrhabout
rhmammograms.rhTherhclient'srhfamilyrhmemberrhtellsrhtherhnurserhthatrhsherhdoesrh
notrhneedrharhmammogramrhannuallyrhbecauserhsherhhasrhnorhriskrhfactorsrhforrhbre
astrhcancer,rhexceptrhthatrhherrhfather'srhsisterrhhadrhbreastrhcancer.

, Whichrhnursingrhinterventionrhbestrhpromotesrheffectiverhcommunication?rh-
rhanswersTeachrhtherhclient'srhfamilyrhthatrhevenrhwomenrhwithrhnorhidentifiedrhriskrh
factorsrharerhatrhrisk.



Therhclient'srhfamilyrhmemberrhstatesrhthatrhsherhwillrhschedulerharhmammogramrhan
drhsherhasksrhtherhnurserhifrhitrhwillrhberhpainful.rhHowrhshouldrhtherhnurserhrespon
d?rh-
rhanswersShowrhtherhclient'srhfamilyrhwhatrhmostrhwomenrhsayrhcausesrhtherhdiscomf
ortrhduringrharhmammogram.



TherapeuticrhCommunication



Arhmassrhisrhseenrhonrhtherhclient'srhmammogram,rhandrharhfollow-
uprhstereotacticrhcorerhneedlerhbiopsyrhisrhperformed.rhTherhtumorrhspecimenrhisrhfo
undrhtorhberhcancerous.rhTherhclientrhlearnsrhthatrhsherhhasrharhcancerousrhtumorrhr
equiringrhsurgery.rhSherhtellsrhtherhnurserhthatrhthisrhisrharhmistake.rhSherhisrhinsisten
trhherrhspecimenrhwasrhmixedrhuprhwithrhsomeonerhelse's.



Whichrhnursingrhinterventionrhbestrhpromotesrheffectiverhcommunication?rh-
rhanswersTellrhtherhclientrhfeelingsrhofrhdisbeliefrharerhunderstandable.



Therhclientrhgoesrhonrhtorhsayrhthatrhsherhcanrhcontrolrhthisrhwithrhexercisingrhandrh
arhchangerhinrhherrheatingrhhabits.rhWhichrhnursingrhinterventionrhbestrhpromotesrhef
fectiverhcommunicationrhinrhreplyrhtorhtherhclient'srhsolution?rh-
rhanswersConfirmrhwithrhtherhclientrhherrhhesitationrhtorhdiscussrhtherhneedrhforrhsur
gery.



Ethical-LegalrhIssuesrhinrhPreoperativerhCare



Therhclientrhdecidesrhtorhhaverhsurgeryrhandrhisrhscheduledrhforrharhmodifiedrhradical
rhmastectomyrhwithrhimmediaterhabdominalrhmyocutaneousrhflaprhreconstruction.rhArh
modifiedrhradicalrhmastectomyrhinvolvesrhremovalrhofrhbreastrhtissuerhandrhlymphrhno
des,rhbutrhitrhconservesrhtherhpectoralisrhmajorrhmuscle.rhTherhreconstructionrhinvolve