Chapter 56: Breast Problems |Harding: Lewis’s Medical-Surgical Nursing, 12th Edition

MULTIPLE CHOICE 1. Which information would the nurse include when teaching a young women‘s community service group about breast self-examination (BSE)? a. BSE will reduce the risk of dying from breast cancer. b. BSE should be done daily while taking a bath or shower. c. Annual mammograms should be scheduled in addition to BSE. d. Performing BSE after the menstrual period is more comfortable. ANS: D Performing BSE at the end of the menstrual period will reduce the breast tenderness associated with the procedure. Research has shown that BSE has no effect on reducing deaths from breast cancer. However, you still need to teach women the importance of knowing how their breasts look and feel and to report breast changes (e.g., nipple discharge, a lump) to their HCP. BSE would be done monthly. Annual mammograms are not routinely scheduled for women younger than age 40 years. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance 2. Which question is most pertinent for the nurse to ask a 43-yr-old patient about her risk for breast cancer? a. “Have you ever had a breast or chest injury?” b. “At what age did you start having menstrual periods?” c. “Is there a family history of fibrocystic breast changes?” d. “Do you often have back pain due to heavy breast tissue?” ANS: B Early menarche and late menopause are risk factors for breast cancer because of the prolonged exposure to estrogen that occurs. Breast trauma and fibrocystic breast changes are not associated with increased breast cancer risk. Breast size or back pain caused by heavy breast tissue are not associated with increased breast cancer risk. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity 3. The nurse is teaching a patient with a small immobile breast lump about options for a breast biopsy. Which type of biopsy would be scheduled in an operating room? a. Excisional biopsy b. Core needle aspiration c. Vacuum-assisted biopsy d. Fine-needle aspiration (FNA) ANS: A An excisional biopsy is done in an operating room. Core needle aspiration, vacuum-assisted biopsy, and fine-needle aspiration (FNA) are examples of minimally invasive breast biopsies. DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity 4. Which assessment finding in a 36-yr-old patient is most indicative of a need for further evaluation? a. Bilateral breast nodules that are tender with palpation b. A breast nodule that is 1 cm in size, non-tender, and non-mobile c. A breast lump that increases in size before the menstrual period d. A breast lump that is small and mobile, with a rubbery consistency ANS: B Painless and non-mobile lumps suggest breast cancer. The other findings are more suggestive of benign processes such as fibrocystic breasts and fibro adenoma. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity 5. A 53-yr-old woman who is experiencing menopause is discussing the use of hormone therapy (HT) with the nurse. Which information about the risk of breast cancer will the nurse provide? a. HT is a safe therapy for menopausal symptoms if there is no family history of BRCA genes. b. HT does not appear to increase the risk for breast cancer unless there are other risk factors. c. The patient and her health care provider must weigh the benefits of HT against the risks of breast cancer. d. Natural herbs are as effective as estrogen in relieving symptoms without increasing the risk of breast cancer.