NR 325 - FINAL EXAM STUDY GUIDE WITH
ALL CORRECT & VERIFIED ANSWERS
BREAST CANCER SCREENING GUIDELINES Correct answer-regular screening mammography starting
at age 45 years.
Women aged 45 to 54 years should be screened annually.
Women 55 years and older should transition to biennial screening or have the opportunity to
continue screening annually.
continue screening mammography as long as overall health is good and life expectancy is 10 years or
longer
THE BREAST SELF-EXAMINATION Correct answer-lie down and place one arm behind the head
use finger pads of three middle fingers of the other hand to feel for lumps
use overlapping dime-sized circular motions to feel the breast tissue
use three different levels of pressure
up-and-down vertical pattern is recommended
stand in a front a mirror; examine breasts for:
- shape
- size
- redness/scaliness
- dimpling (skin/nipple)
MASTITIS Correct answer-inflammation of the breast
occurs in up to 10% of postpartum lactating mothers 2-4 weeks after birth
MASTITIS - CLINICAL MANIFESTATIONS Correct answer-warm to touch
indurated/painful
often unilateral
most commonly caused by staphylococcus aureus
BEST TIME TO PERFORM SELF BREAST EXAM (BSE) Correct answer-Perform BSE at the end of the
menstrual period
breast tenderness is less likely to occur
RISK FACTORS FOR BREAST CANCER Correct answer-early menarche
late menopause
,Age - at or older than 50 yrs
hormone use
Family history/Genetics
History of cancer (breast, colon, endometrial, ovarian)
First full term pregnancy after age 30
nulliparity (never given birth)
benign breast disease (atypical epithelial hyperplasia)
weight gain/obesity after menopause
exposure to ionizing radiation
alcohol consumption
ADVANTAGE OF FINE-NEEDLE ASPIRATION (FNA) BIOPSY Correct answer-FNA is performed in
outpatient settings
results are available within 24-48 hours
no incision required
BREAST LUMPS - ASSESSMENT Correct answer-*painless* and *fixed* lumps suggest breast
cancer/malignancy
HORMONE THERAPY (HT) Correct answer-*HT has been linked to increased risk for breast cancer*;
patient and HCP must determine whether or not HT therapy is appropriate
*Breast cancer incidence is increased in women using HT*, independent of other risk factors
HT increases the risk for both non-BRCA-associated cancer and BRCA-related cancers
CLASSIFICATION OF BREAST CANCER Correct answer-based on tissue type
based on invasiveness
based on hormone receptor and genetic status
CLASSIFICATION OF BREAST CANCER - BASED ON ON TISSUE TYPE Correct answer-Ductal
carcinoma (milk ducts)
- Medullary
- Tubular
- Colloid (mucinous)
Lobular carcinoma (milk-producing glands)
,Other
- Inflammatory
- Paget's disease
- Phyllodes tumor
CLASSIFICATION OF BREAST CANCER - BASED ON INVASIVENESS Correct answer-Noninvasive (In
situ)
- ductal carcinoma in situ (DCIS)
- lobular carcinoma in situ (LCIS)
Invasive (spreads)
- invasive ductal carcinoma
- invasive lobular carinoma
CLASSIFICATION OF BREAST CANCER - BASEDON HORMONE RECEPTOR STATUS/GENETIC STATUS
Correct answer-*Estrogen and Progesterone Receptor Status*
- Estrogen receptor positive
- Estrogen receptor negative
- Progesterone receptor positive
- Progesterone receptor negative
*HER-2 Genetic Status*
- HER-2 positive
- HER-2 negative
TRASTUZUMAB (HERCEPTIN) - THERAPEUTIC USE Correct answer-this Rx is for the treatment of of
tumors that have the HER-2 receptor
TRASTUZUMAB (HERCEPTIN) - ADVERSE EFFECT Correct answer-this Rx can lead to ventricular
dysfunction
patient is taught to self-monitor for symptoms of heart failure
TAMOXIFEN (NOLVADEX - THERAPEUTIC USE Correct answer-this Rx is for the treatment of
estogen-dependent breast tumors in premenopausal women
ESTRADIOL - CAUTION Correct answer-this Rx will increase the growth of estrogen-dependent
tumors
RALOXIFENE - THERAPEUTIC USE Correct answer-this Rx is used to prevent breast cancer
this Rx *IS NOT USED* postmastectomy
RADICAL MASTECTOMY - POST OP NURSING CARE Correct answer-patients are at increased risk for
lymphedema and infection
therefore, *NO BLOOD PRESSURES OR VENIPUNCTURES* in the affected arm
signage should be posted at the bedside to help remind staff
, RADICAL MASTECTOMY - PATIENT TEACHING Correct answer-patients should avoid any activity
that might injure the affected arm
analgesics can be used
exercises should be continued in order restore strength/ROM
affected arm should be elevate at or above the heart to improve ROM/function
SITES OF BREAST CANCER RECURRENCE/METASTASIS Correct answer-*LOCAL RECURRENCE*
skin
chest wall
*REGIONAL RECURRENCE*
lymph nodes
*DISTAL METASTASIS*
skeletal
spinal cord
brain
pulmonary
liver
bone marrow
TNM SYSTEM OF STAGING & PROGNOSIS Correct answer-T = tumor size
N = nodal involvement
M = metastasis
TUMOR SIZE AS PROGNOSTIC INDICATOR Correct answer-the larger the tumor, the poorer the
prognosis
well differentiated the tumors = less aggressive
poorly differentiated tumors = more aggressive
RECEPTOR-POSITIVE TUMORS Correct answer-commonly show histologic evidence of being well
differentiated
frequently have a diploid (more normal) DNA content and low proliferative indices
have a lower chance for recurrence
are frequently hormone dependent and responsive to hormone therapy
RECEPTOR-NEGATIVE TUMORS Correct answer-are often poorly differentiated histologically
have a high incidence of aneuploidy (abnormally high or low DNA content) and higher proliferative
indices
ALL CORRECT & VERIFIED ANSWERS
BREAST CANCER SCREENING GUIDELINES Correct answer-regular screening mammography starting
at age 45 years.
Women aged 45 to 54 years should be screened annually.
Women 55 years and older should transition to biennial screening or have the opportunity to
continue screening annually.
continue screening mammography as long as overall health is good and life expectancy is 10 years or
longer
THE BREAST SELF-EXAMINATION Correct answer-lie down and place one arm behind the head
use finger pads of three middle fingers of the other hand to feel for lumps
use overlapping dime-sized circular motions to feel the breast tissue
use three different levels of pressure
up-and-down vertical pattern is recommended
stand in a front a mirror; examine breasts for:
- shape
- size
- redness/scaliness
- dimpling (skin/nipple)
MASTITIS Correct answer-inflammation of the breast
occurs in up to 10% of postpartum lactating mothers 2-4 weeks after birth
MASTITIS - CLINICAL MANIFESTATIONS Correct answer-warm to touch
indurated/painful
often unilateral
most commonly caused by staphylococcus aureus
BEST TIME TO PERFORM SELF BREAST EXAM (BSE) Correct answer-Perform BSE at the end of the
menstrual period
breast tenderness is less likely to occur
RISK FACTORS FOR BREAST CANCER Correct answer-early menarche
late menopause
,Age - at or older than 50 yrs
hormone use
Family history/Genetics
History of cancer (breast, colon, endometrial, ovarian)
First full term pregnancy after age 30
nulliparity (never given birth)
benign breast disease (atypical epithelial hyperplasia)
weight gain/obesity after menopause
exposure to ionizing radiation
alcohol consumption
ADVANTAGE OF FINE-NEEDLE ASPIRATION (FNA) BIOPSY Correct answer-FNA is performed in
outpatient settings
results are available within 24-48 hours
no incision required
BREAST LUMPS - ASSESSMENT Correct answer-*painless* and *fixed* lumps suggest breast
cancer/malignancy
HORMONE THERAPY (HT) Correct answer-*HT has been linked to increased risk for breast cancer*;
patient and HCP must determine whether or not HT therapy is appropriate
*Breast cancer incidence is increased in women using HT*, independent of other risk factors
HT increases the risk for both non-BRCA-associated cancer and BRCA-related cancers
CLASSIFICATION OF BREAST CANCER Correct answer-based on tissue type
based on invasiveness
based on hormone receptor and genetic status
CLASSIFICATION OF BREAST CANCER - BASED ON ON TISSUE TYPE Correct answer-Ductal
carcinoma (milk ducts)
- Medullary
- Tubular
- Colloid (mucinous)
Lobular carcinoma (milk-producing glands)
,Other
- Inflammatory
- Paget's disease
- Phyllodes tumor
CLASSIFICATION OF BREAST CANCER - BASED ON INVASIVENESS Correct answer-Noninvasive (In
situ)
- ductal carcinoma in situ (DCIS)
- lobular carcinoma in situ (LCIS)
Invasive (spreads)
- invasive ductal carcinoma
- invasive lobular carinoma
CLASSIFICATION OF BREAST CANCER - BASEDON HORMONE RECEPTOR STATUS/GENETIC STATUS
Correct answer-*Estrogen and Progesterone Receptor Status*
- Estrogen receptor positive
- Estrogen receptor negative
- Progesterone receptor positive
- Progesterone receptor negative
*HER-2 Genetic Status*
- HER-2 positive
- HER-2 negative
TRASTUZUMAB (HERCEPTIN) - THERAPEUTIC USE Correct answer-this Rx is for the treatment of of
tumors that have the HER-2 receptor
TRASTUZUMAB (HERCEPTIN) - ADVERSE EFFECT Correct answer-this Rx can lead to ventricular
dysfunction
patient is taught to self-monitor for symptoms of heart failure
TAMOXIFEN (NOLVADEX - THERAPEUTIC USE Correct answer-this Rx is for the treatment of
estogen-dependent breast tumors in premenopausal women
ESTRADIOL - CAUTION Correct answer-this Rx will increase the growth of estrogen-dependent
tumors
RALOXIFENE - THERAPEUTIC USE Correct answer-this Rx is used to prevent breast cancer
this Rx *IS NOT USED* postmastectomy
RADICAL MASTECTOMY - POST OP NURSING CARE Correct answer-patients are at increased risk for
lymphedema and infection
therefore, *NO BLOOD PRESSURES OR VENIPUNCTURES* in the affected arm
signage should be posted at the bedside to help remind staff
, RADICAL MASTECTOMY - PATIENT TEACHING Correct answer-patients should avoid any activity
that might injure the affected arm
analgesics can be used
exercises should be continued in order restore strength/ROM
affected arm should be elevate at or above the heart to improve ROM/function
SITES OF BREAST CANCER RECURRENCE/METASTASIS Correct answer-*LOCAL RECURRENCE*
skin
chest wall
*REGIONAL RECURRENCE*
lymph nodes
*DISTAL METASTASIS*
skeletal
spinal cord
brain
pulmonary
liver
bone marrow
TNM SYSTEM OF STAGING & PROGNOSIS Correct answer-T = tumor size
N = nodal involvement
M = metastasis
TUMOR SIZE AS PROGNOSTIC INDICATOR Correct answer-the larger the tumor, the poorer the
prognosis
well differentiated the tumors = less aggressive
poorly differentiated tumors = more aggressive
RECEPTOR-POSITIVE TUMORS Correct answer-commonly show histologic evidence of being well
differentiated
frequently have a diploid (more normal) DNA content and low proliferative indices
have a lower chance for recurrence
are frequently hormone dependent and responsive to hormone therapy
RECEPTOR-NEGATIVE TUMORS Correct answer-are often poorly differentiated histologically
have a high incidence of aneuploidy (abnormally high or low DNA content) and higher proliferative
indices
