Chapter 70: Care of Patients with Breast Disorders

Chapter 70: Care of Patients with Breast Disorders

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The nurse is teaching a 45-year-old woman about her fibrocystic breast condition. Which statement by the client indicates a lack of understanding?
   1. “This condition will become malignant over time.”
   2. “I should refrain from using hormone replacement therapy.”
   3. “One cup of coffee in the morning should be enough for me.”
   4. “This condition makes it more difficult to examine my breasts.”

ANS:   A

Fibrocystic breast condition does not increase a woman’s chance of developing breast cancer. Hormone replacement therapy is not indicated since the additional estrogen may aggravate the condition. Limiting caffeine intake may give relief for tender breasts. The fibrocystic changes to the breasts make it more difficult to examine the breasts because of fibrotic changes and lumps.

DIF:     Applying/Application                         REF: 1462                   KEY: Reproductive problems| physiology| patient education                         MSC: Integrated Process: Teaching/Learning          NOT:   Client Needs Category: Health Promotion and Maintenance

2. The nurse is examining a woman’s breast and notes multiple small mobile lumps. Which question would be the most appropriate for the nurse to ask?
   1. “When was your last mammogram at the clinic?”
   2. “How many cans of caffeinated soda do you drink in a day?”
   3. “Do the small lumps seem to change with your menstrual period?”
   4. “Do you have a first-degree relative who has breast cancer?”

ANS:   C

The most appropriate question would be one that relates to benign lesions that usually change in response to hormonal changes within a menstrual cycle. Reduction of caffeine in the diet has been shown to give relief in fibrocystic breast conditions, but research has not found that it has a significant impact. Questions related to the client’s last mammogram or breast cancer history are not related to the nurse’s assessment.

DIF:     Applying/Application                         REF: 1462                   KEY: Reproductive problems| nursing assessment| physiology  MSC:         Integrated Process: Communication and Documentation  NOT:   Client Needs Category: Physiological Integrity: Physiological Adaptation

3. A client is diagnosed with a fibrocystic breast condition while in the hospital and is experiencing breast discomfort. What comfort measure would the nurse delegate to the unlicensed assistive personnel (UAP)?
   1. Aid in the draining of the cysts by needle aspiration.
   2. Teach the client to wear a supportive bra to bed.
   3. Administer diuretics to decrease breast swelling.
   4. Obtain a cold pack to temporarily relieve the pain.

ANS:           D

All of the options would be comfort measures for a client with a fibrocystic breast condition. The UAP can obtain the cold or heat therapy. Only the nurse should aid the health care provider with a needle aspiration, teach, and administer medications.

DIF:            Applying/Application                         REF:    1462                 KEY: Reproductive problems| delegation| unlicensed assistive personnel (UAP)| comfort measures      MSC: Integrated Process: Communication and Documentation NOT:          Client Needs Category: Safe and Effective Care Environment: Management of Care

4. Which finding in a female client by the nurse would receive the highest priority of further diagnostics?
   1. Tender moveable masses throughout the breast tissue
   2. A 3-cm firm, defined mobile mass in the lower quadrant of the breast
   3. Nontender immobile mass in the upper outer quadrant of the breast
   4. Small, painful mass under warm reddened skin

ANS:           C

Malignant lesions are hard, nontender, and usually located in the upper outer quadrant of the breast and would be the priority for further diagnostic study. The other lesions are benign breast disorders. The tender moveable masses throughout the breast tissue could be a fibrocystic breast condition. A firm, defined mobile mass in the lower quadrant of the breast is a fibroadenoma, and a painful mass under warm reddened skin could be a local abscess or ductal ectasia.

DIF:     Applying/Application             REF:    1469     KEY: Reproductive problems| cancer| assessment   MSC:   Integrated Process: Nursing Process: Analysis           NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care