Chapters 64 – 69 with Solutions
Chapter 65: Concepts of Care for Patients with Breast Disorders Ignatavicius: Medical-Surgical
Nursing, 10th Edition
1. The nurse is teaching a 45-year-old woman about her fibrocystic breast changes. Which
statement by the client indicates a lack of understanding?
a. “This condition will become malignant over time.”
b. “I understand that hormone-based drugs have serious adverse effects.”
c. “One cup of coffee in the morning should be enough for me.”
d. “This condition makes it more difficult to examine my breasts.”
2. The nurse is examining a woman’s breast and notes multiple small mobile lumps. Which
question would be most appropriate for the nurse to ask?
a. “When was your last mammogram at the clinic?”
b. “How many cans of caffeinated soda do you drink in a day?”
c. “Do the small lumps seem to change with your menstrual period?”
d. “Do you have a first-degree relative who has breast cancer?”
3. The nurse is working with a male client who has gynecomastia. What action by the nurse is
most appropriate?
a. Teach the client to perform self-breast examination.
b. Review the plan for chemotherapy after surgery.
c. Educate him on the side effects of tamoxifen.
d. Assess his usual daily alcohol intake.
4. Which finding in a female client by the nurse would receive the highest priority for further
diagnostics?
a. Tender moveable masses throughout the breast tissue
b. Nipple discharge without a palpable mass
c. Nontender fixed mass in the upper outer quadrant of the breast
d. Small, painful mass under warm reddened skin and nipple discharge
5. A nurse has taught a female client about the modifiable risk factors for breast cancer. Which
statement made by the client indicates that more teaching is needed?
a. “I am fortunate that I breast-fed each of my three children for 12 months.”
b. “It looks as though I need to start working out at the gym more often.”
c. “I am glad that we can still have wine with every evening meal.”
d. “When I have menopausal symptoms, I must avoid hormone replacement therapy.”
6. A younger woman from an unfamiliar culture is at high risk for breast cancer and is
considering a prophylactic mastectomy and oophorectomy. What action by the nurse is most
appropriate?
a. Discourage this surgery since the woman is still of childbearing age.
b. Reassure the client that reconstructive surgery is as easy as breast augmentation.
,c. Inform the client that this surgery removes all mammary tissue and cancer risk.
,d. Offer to include support people, such as the male partner, in the decision making.
7. A client has just returned from a right radical mastectomy. Which action by the assistive
personnel (AP) would require the nurse consider to intervene?
a. Checking the amount of urine in the catheter collection bag
b. Elevating the right arm on a pillow
c. Taking the blood pressure on the right arm
d. Encouraging the client to squeeze a rolled washcloth
8. A client is discharged to home after a modified radical mastectomy with two drainage tubes.
Which statement by the client would indicate that further teaching is needed?
a. “I am glad that these tubes will fall out at home when I finally shower.”
b. “I should measure the drainage each day to make sure it is less than an ounce (30
mL).”
c. “I should be careful how I lie in bed so that I will not kink the tubing.”
d. “If there is a foul odor from the drainage, I will contact my primary health care
provider.”
9. During dressing changes, the nurse assesses a client who had breast reconstruction. Which
finding would cause the nurse to take immediate action?
a. Slightly reddened incisional area
b. Blood pressure of 128/75 mm Hg
c. Temperature of 99° F (37.2° C)
d. Dusky color of the breast flap
10. A client is starting hormonal therapy with tamoxifen to lower the risk for breast cancer.
What information needs to be explained by the nurse regarding the action of this drug?
a. It blocks the release of luteinizing hormone.
b. It interferes with cancer cell division.
c. It selectively blocks estrogen in the breast.
d. It inhibits DNA synthesis in rapidly dividing cells.
11. A client is placed on a medical regimen of doxorubicin (Adriamycin), cyclophosphamide, and
fluorouracil for breast cancer. Which side effect seen in the client would the nurse report to the
primary health care provider immediately?
a. Shortness of breath
b. Nausea and vomiting
c. Hair loss
d. Mucositis
12. A client is concerned about the risk of lymphedema after a mastectomy. Which response by
the nurse is best?
a. “You do not need to worry about lymphedema since you did not have radiation therapy.”
b. “Be careful not to injure that arm or get any infection in that arm.”
, c. “Numbness, tingling, and swelling are common sensations after a mastectomy.”
d. “The risk for lymphedema is a real threat and can be very self-limiting.”
13. A woman diagnosed with breast cancer had these laboratory tests performed at an office
visit:
Which test results indicate to the nurse that some further diagnostics are needed?
a. Elevated alkaline phosphatase and calcium suggests bone involvement.
b. Only alkaline phosphatase is decreased, suggesting liver metastasis.
c. Hematocrit and hemoglobin are decreased, indicating anemia.
d. The elevated hematocrit and hemoglobin indicate dehydration.
1. The nurse is taking a history of a 68-year-old woman. What assessment findings would
indicate a high risk for the development of breast cancer? (Select all that apply.)
a. Age greater than 65 years
b. Increased breast density
c. Osteoporosis
d. Multiparity
e. Genetic factors
f. Early menarche
2. The nurse is formulating a teaching plan according to evidence-based breast cancer screening
guidelines for a 50-year-old woman with low risk factors. Which diagnostic methods would be
included in the plan? (Select all that apply.)
a. Annual mammogram
b. Magnetic resonance imaging (MRI)
c. Breast ultrasound
d. Breast self-awareness
e. Clinical breast examination
f. Self-breast examination
3. After a breast examination, the nurse is documenting assessment findings that indicate
possible breast cancer. Which abnormal findings need to be included as part of the client’s
electronic medical record? (Select all that apply.)
a. Peau d’orange
b. Dense breast tissue
c. Nipple retraction
d. Mobile mass at 2 o’clock
e. Nontender axillary nodes
f. Skin ulceration
4. A woman is interested in alternative and complementary treatments for the nausea and
vomiting caused by the side effects of chemotherapy for breast cancer. Which therapies wound
the nurse suggest? (Select all that apply.)
a. Acupuncture