27/11/2024 11:35AM
HESI Case Study - Breast Cancer All
Solutions
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. - Answers✓✓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? - Answers✓✓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? - Answers✓✓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.
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27/11/2024 11:35AM
Which nursing intervention best promotes effective communication? - Answers✓✓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? - Answers✓✓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? - Answers✓✓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? - Answers✓✓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