BSN HESI 266 Med Surg PREDICTOR Actual
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A client with early breast cancer receives the results of a breast biopsy and asks the nurse to
explain the meaning of staging and the type of receptors found on the cancer cells. Which
explanation should the nurse provide?
Lymph node involvement is not significant.
Small tumors are aggressive and indicate poor prognosis.
The tumor's estrogen receptor guides treatment options.
Stage I indicates metastasis. –
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Correct Answer :The tumor's estrogen receptor guides treatment options.
Treatment decisions and prediction of prognosis are related to the tumor's receptor status,
such as estrogen and progesterone receptor status which commonly are well-differentiated,
have a lower chance of recurrence, and are receptive to hormonal therapy. Tumor staging
designates tumor size and spread of breast cancer cells into axillary lymph nodes, which is
one of the most important prognostic factors in early-stage breast cancer.
A client has a staging procedure for cancer of the breast and ask the nurse which type of
breast cancer has the poorest prognosis. Which information should the nurse offer the client?
Stage II.
Invasive infiltrating ductal carcinoma.
T1N0M0.
Inflammatory with peau d'orange. –
Correct Answer :Inflammatory with peau d'orange.
Inflammatory breast cancer onset is very rapid and a very rare form of breast cancer and is
considered the most aggressive form of breast malignancies. It is often mistaken for a breast
infection because it has a thickened appearance like an orange peel (peau d'orange), causing
the breast to become swollen and tender.
Which nail color alteration should the nurse expect to observe in a client with chronic kidney
disease?
Horizontal white banding.
Diffuse blue discoloration.
Diffuse brown discoloration.
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Thin, dark red vertical lines. –
Correct Answer :Horizontal white banding.
Fingernails and toenails can be affected by chronic kidney disease. This condition may cause
horizontal white lines or bands (leukonychia) to appear on the nails.
Ignatavicius,(2016). Medical-surgical nursing: Patient-centered collaborative care, eight
edition., Ch. 24, p. 426.
What instruction should the nurse give a client who is diagnosed with fibrocystic changes of
the breast?
Observe cyst size fluctuations as a sign of malignancy.
Use estrogen supplements to reduce breast discomfort.
Notify the healthcare provider if whitish nipple discharge occurs.
Perform a breast self-exam (BSE) procedure monthly. –
Correct Answer :Perform a breast self-exam (BSE) procedure monthly.
Fibrocystic changes in the breast are related to excess fibrous tissue, proliferation of
mammary ducts and cyst formation that cause edema and nerve irritation. These changes
obscure typical diagnostic tests, such as mammography, due to an increased breast density.
Women with fibrocystic breasts should be instructed to carefully perform monthly BSE and
consider changes in any previous "lumpiness." Fibrocystic disease does not increase the risk
of breast cancer. Cyst size fluctuates with the menstrual cycle, and typically lessens after
menopause, and responds with a heightened sensitivity to circulating estrogen.
Which information about mammograms is most important to provide a post-menopausal
female client?
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Breast self-examinations are not needed if annual mammograms are obtained.
Radiation exposure is minimized by shielding the abdomen with a lead-lined apron.
Yearly mammograms should be done regardless of previous normal x-rays.
Women at high risk should have annual routine and ultrasound mammograms. –
Correct Answer :Yearly mammograms should be done regardless of previous normal x-rays.
There are different recommendations from different agnecies. For a client with no risk factors,
the earliest breast screening recommendation is a yearly mammogram at the age 40 and till
the age of 54. After that every two years. The American College of OB/GYN still recommend
starting mammograms starting at the age of 40 and yearly screeenings. The American Cancer
Society new guidelines recommend starting at the age of 45 and thereafter till the age of 54
years old, then every two years. The US Preventive Services Task Force Services (USPSTS)
recommends starting at the age of 50 years old and screenings every two years thereafter.
A 49-year-old female client arrives at the clinic for an annual exam and asks the nurse why she
becomes excessively diaphoretic and feels warm during nighttime. What is the nurse's best
response?
Explain the effect of the follicle-stimulating and luteinizing hormones.
Discuss perimenopause and related comfort measures.
Assess lung fields and for a cough productive of blood-tinged mucous.
Ask if a fever above 101 F (38.3 C) has occurred in the last 24 hours. –
Correct Answer :Discuss perimenopause and related comfort measures.
The perimenopausal period begins about 10 years before menopause with the cessation of
menstruation at the average ages of 52 to 54. Lower estrogen levels causes FSH and LH
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