Chapter 44 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

Chapter 44 Medical Surgical Nursing 2nd Edition By Osborn Wraa Watson

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

A patient is recovering from breast cancer surgery that included axillary node dissection. The nurse realizes that this patient will need education regarding which potential complication of axillary node dissection?

1. Lymphedema
2. Metastasis
3. Bleeding from the incision site
4. Altered neck movement

Correct Answer: 1

Rationale 1: Lymphedema is a common complication of axillary node dissection.

Rationale 2: The lymph nodes are removed to reduce the risk of metastasis.

Rationale 3: There is no greater risk of bleeding from the incision site than there would be from any other surgery.

Rationale 4: Removal of the axillary lymph nodes should not adversely affect neck movement.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 44-4

 

Question 2

Type: MCSA

During a routine physical examination, a 22-year-old patient asks if she is at risk of developing breast cancer. Which reported factors would the nurse confirm as increasing this patient’s risk?

1. Hispanic heritage
2. Onset of menarche at age 11
3. Breastfed her two children for 6 months
4. Use of the female condom

Correct Answer: 2

Rationale 1: Asian, Hispanic, and Native American women have a lower risk of developing and dying from breast cancer.

Rationale 2: The early onset of menarche contributes to the risk for breast cancer because the woman is exposed to higher levels of estrogen and progestin for a longer period.

Rationale 3: Some studies suggest that breastfeeding reduces the risk of breast cancer.

Rationale 4: The female condom does not have hormonal ingredients and does not impact breast cancer risk.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 44-2

 

Question 3

Type: MCSA

A patient presents to the clinic after discovering a lump in her breast. Which finding would alert the nurse to a probable malignancy?

1. The patient reports tenderness with palpation.
2. The skin over the mass is smooth.
3. The mass is readily moved beneath the skin.
4. The borders of the mass are uneven.

Correct Answer: 4

Rationale 1: Tenderness on palpation is a finding associated with benign masses.

Rationale 2: The skin overlying malignant masses is often irregular or has the appearance of peau d’orange.

Rationale 3: Malignant masses are often fixed to underlying tissue.

Rationale 4: Irregular borders are characteristic of malignancy.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 44-2

 

Question 4

Type: MCSA

A female patient is scheduled for a stereotactic needle biopsy of a left breast lesion. What information should the nurse provide about this test?

1. This is a three-dimensional mammogram in which a fine-needle aspirate of the mass is taken.
2. This is the gold standard for diagnosis in which a small cut is made in the breast under intravenous sedation.
3. A needle will be inserted into the lesion, guided by ultrasound, and the contents aspirated.
4. The entire lesion is removed along with some of the surrounding tissue.

Correct Answer: 1

Rationale 1: A stereotactic needle biopsy is a three-dimensional mammogram in which the patient lies on the stomach and a fine needle is used to aspirate the mass.

Rationale 2: The gold standard for breast biopsy is the surgical incisional biopsy, in which a less-than-2-inch incision is made in the breast under local anesthesia or intravenous sedation.

Rationale 3: In a fine-needle aspiration, a fine needle is inserted into the lesion, guided by ultrasound, and the contents are removed.

Rationale 4: An excisional biopsy involves complete removal of the abnormality and some surrounding tissue.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 44-2