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
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
