1 . The nurse is preparing to conduct a women’s wellness seminar. What information should
the nurse plan to include about risk factors for development of breast cancer? Select all that
apply.
A. The risk increases for women who have fibrocystic breast disease.
B. The risk increases if the onset of menarche occurs at a young age.
C. Women who have breastfed their infants are at an increased risk.
D. Risk is increased in postmenopausal women with a BMI below 20.
E. Women whose sisters have had breast cancer are at increased risk.
ANSWER: B. E
A. Fibrocystic breast disease is not related to breast cancer development, but fibrocystic changes
can make it more difficult to feel early cancerous lumps during breast examination.
B. Early menarche and/or late menopause increase the risk of developing breast cancer.
C. Childless women, not those who have breastfed, are at increased risk. It is thought that
pregnancy and lactation interrupt ovulation and alter the her-monal environment, reducing
breast cancer risk.
D. Postmenopausal women who are obese, not those with a lower BMI, are at increased risk.
E. Women with first-degree relatives, such as a mother or sister, who had breast cancer are at risk.
2. The nurse overheats the client talking with her husband about her new diagnosis of stage
1 breast cancer. Which statement by the client indicates that she does not fully understood
the diagnosis?
A. “I won’t be here to see our daughter graduate this spring.”
B. “I understand that I will need some type of chemotherapy.”
C. “I will be starting radiation therapy on my breast soon.”
D. “The cancer was in an early stage, and it was contained.”
ANSWER: A
A. Ninety percent of women with localized tumors (stage 1 and 2) can be expected to achieve long-
term disease-free survival. This statement indicates she did not understand the diagnosis of
stage 1 breast cancer.
B. Both chemotherapy and radiation are recommended for stage 1 and 2 breast cancer.
C. Both chemotherapy and radiation are recommended for stage I and 2 breast cancer.
D. Stage 1 cancer means that it was contained in the area where the first abnormal cells began to
develop.
3. The client with newly diagnosed breast cancer asks the nurse to explain the advantages of
a sentinel lymph node biopsy (SLNB). Which explanation should the nurse state to the client?
A. “This biopsy will improve the chances that all of the tumor will be removed.”
B. “This biopsy can reduce the number of lymph nodes that must be removed.”
C. “This biopsy makes breast reconstruction easier to perform.”
, D. “This biopsy, if performed, will make hormonal therapy unnecessary.”
ANSWER: B
A. The SLNB will not improve the ability of the surgeon to remove all of the tumor.
B. An SLNB uses a radioactive substance or dye to help to identify axillary lymph node involvement
before axillary dissection has occurred. If the sentinel node is identified and is found to be
negative for tumor cells. then further axillary lymph node dissection is unnecessary. Thus the
lymph drainage of the involved arm can be preserved.
C. The SLNB will not make breast reconstruction easier to perform.
D. The use of hormonal therapy for breast cancer treatment is detennined by the receptor status
of the tumor, not by the SLNB results.
4. The HCP recommends tamoxifen for the female client because she is at high risk for
developing breast cancer. The client asks the nurse to explain how this drug will help avoid
developing breast cancer. Which information about tamoxifen should be the basis for the
nurse’s response?
A. Tamoxifen is an anti-inflammatory drug that reduces the body’s response to the tumor.
B. Tamoxifen is a chemotherapy agent that has minimal side effects if taken prophylactically.
C. Tamoxifen will protect against the development of other cancers such as endometrial cancer.
D. Tamoxifen will block estrogen receptors on tumor cells and thus cause the tumor to regress.
ANSWER: D
A. Tamoxifen does not have anti-inflammatory properties.
B. Tamoxifen is a hormonal rather than a chemotherapeutic agent.
C. A major side effect of tamoxifen is that it increases the risk of developing endometrial cancer.
D. Tamoxifen (Soltamox) blocks estrogen receptors on tumor cells, and thus the cell growth
declines and the tumor regresses.
5. The nurse is planning care for the client who had a TRAM (transrectus abdominis
myocutaneous) flap breast reconstruction. Which actions should the nurse include?
A. Initiate passive ROM to the affected side immediately after surgery and q4h.
B. Assess capillary refill, color, and temperature of the flap hourly for 24 hours.
C. Maintain a pressure dressing on the reconstructed breast for the first 48 hours.
D. Keep the affected arm below the level of the reconstructed breast for 48 hours-
ANSWER: B
A. Upper-extremity exercise and ROM are restricted to reduce strain on the incision site.
B. To monitor for viability and adequacy of blood supply to the TRAM flap, the flap must be
assessed hourly for the first 24 hours.
C. Pressure over the flap is avoided until healing is complete.
D. The affected arm should be elevated to promote venous return.
, 6. The client tells the nurse that she has been having breast pain and has had several
diagnostic procedures that all have been negative. Which suggestions should the nurse
include when the client asks for advice on controling this breast pain? Select al that apply.
A. Place a towel wet with primrose oil on the breasts.
B. Go without a bra for at least 4 hours every day.
C. Reduce the amount of caffeine in the diet.
D. Supplement the diet with B complex vitamins.
E. Apply hot packs to the breasts for 20 minutes.
ANSWER: C, D, E
A. There is no evidence that placing a towel wet with primrose oil over the breasts will reduce pain.
Taking evening primrose oil orally may help, but its use is controversial.
B. The women should be taught to wear a support bra, not to go Without a bra.
C. Reducing caffeine has been shown by some to reduce breast pain.
D. B complex vitamins have been shown by some to reduce breast pain.
E. Applying hot packs to the breasts for 20 minutes has been shown by some to reduce breast
pain.
7. A 21-year-old client starts crying during a clinic visit and says to the nurse, “I found a lump
in my breast last night; I’m scared I might have cancer!” Which fact should the nurse
consider when formulating a response to the client?
A. Young women at this age are at increased risk of breast cancer development.
B. A nondiscrete possible mass or thickening has a high index of suspicion for breast cancer.
C. Benign fibroadenomas are the most frequent cause of breast masses in women under 25 years.
D. Close personal contact required in dormitory living can cause infectious breast disorders-
ANSWER: C
A. Breast cancer is diagnosed most commonly in women older than 50 years.
B. A nondiscrete possible mass or thickening has a lower (not higher) index of suspicion for breast
cancer.
C. Fibroadenomas are the most common benign breast neoplasm and most often occur in women
younger than 25 years.
D. Mastitis is a bacterial infection of the breast tissue and is not contagious, and therefore it would
not be spread by dormitory living.
8. The client tells the nurse that she is considering breast reduction but wants to know if she
could breastfeed in the future after this procedure. Which response by the nurse is correct?
A. “Breast reduction will not affect whether or not you choose to breastfeed.”
B. “Breastfeeding is possible if the nipples are left connected to breast tissue.”
C. “The amount of breast tissue removed will make breastfeeding impossible.”
D. “Changes in the nipple structure from surgery will prevent milk production.”
the nurse plan to include about risk factors for development of breast cancer? Select all that
apply.
A. The risk increases for women who have fibrocystic breast disease.
B. The risk increases if the onset of menarche occurs at a young age.
C. Women who have breastfed their infants are at an increased risk.
D. Risk is increased in postmenopausal women with a BMI below 20.
E. Women whose sisters have had breast cancer are at increased risk.
ANSWER: B. E
A. Fibrocystic breast disease is not related to breast cancer development, but fibrocystic changes
can make it more difficult to feel early cancerous lumps during breast examination.
B. Early menarche and/or late menopause increase the risk of developing breast cancer.
C. Childless women, not those who have breastfed, are at increased risk. It is thought that
pregnancy and lactation interrupt ovulation and alter the her-monal environment, reducing
breast cancer risk.
D. Postmenopausal women who are obese, not those with a lower BMI, are at increased risk.
E. Women with first-degree relatives, such as a mother or sister, who had breast cancer are at risk.
2. The nurse overheats the client talking with her husband about her new diagnosis of stage
1 breast cancer. Which statement by the client indicates that she does not fully understood
the diagnosis?
A. “I won’t be here to see our daughter graduate this spring.”
B. “I understand that I will need some type of chemotherapy.”
C. “I will be starting radiation therapy on my breast soon.”
D. “The cancer was in an early stage, and it was contained.”
ANSWER: A
A. Ninety percent of women with localized tumors (stage 1 and 2) can be expected to achieve long-
term disease-free survival. This statement indicates she did not understand the diagnosis of
stage 1 breast cancer.
B. Both chemotherapy and radiation are recommended for stage 1 and 2 breast cancer.
C. Both chemotherapy and radiation are recommended for stage I and 2 breast cancer.
D. Stage 1 cancer means that it was contained in the area where the first abnormal cells began to
develop.
3. The client with newly diagnosed breast cancer asks the nurse to explain the advantages of
a sentinel lymph node biopsy (SLNB). Which explanation should the nurse state to the client?
A. “This biopsy will improve the chances that all of the tumor will be removed.”
B. “This biopsy can reduce the number of lymph nodes that must be removed.”
C. “This biopsy makes breast reconstruction easier to perform.”
, D. “This biopsy, if performed, will make hormonal therapy unnecessary.”
ANSWER: B
A. The SLNB will not improve the ability of the surgeon to remove all of the tumor.
B. An SLNB uses a radioactive substance or dye to help to identify axillary lymph node involvement
before axillary dissection has occurred. If the sentinel node is identified and is found to be
negative for tumor cells. then further axillary lymph node dissection is unnecessary. Thus the
lymph drainage of the involved arm can be preserved.
C. The SLNB will not make breast reconstruction easier to perform.
D. The use of hormonal therapy for breast cancer treatment is detennined by the receptor status
of the tumor, not by the SLNB results.
4. The HCP recommends tamoxifen for the female client because she is at high risk for
developing breast cancer. The client asks the nurse to explain how this drug will help avoid
developing breast cancer. Which information about tamoxifen should be the basis for the
nurse’s response?
A. Tamoxifen is an anti-inflammatory drug that reduces the body’s response to the tumor.
B. Tamoxifen is a chemotherapy agent that has minimal side effects if taken prophylactically.
C. Tamoxifen will protect against the development of other cancers such as endometrial cancer.
D. Tamoxifen will block estrogen receptors on tumor cells and thus cause the tumor to regress.
ANSWER: D
A. Tamoxifen does not have anti-inflammatory properties.
B. Tamoxifen is a hormonal rather than a chemotherapeutic agent.
C. A major side effect of tamoxifen is that it increases the risk of developing endometrial cancer.
D. Tamoxifen (Soltamox) blocks estrogen receptors on tumor cells, and thus the cell growth
declines and the tumor regresses.
5. The nurse is planning care for the client who had a TRAM (transrectus abdominis
myocutaneous) flap breast reconstruction. Which actions should the nurse include?
A. Initiate passive ROM to the affected side immediately after surgery and q4h.
B. Assess capillary refill, color, and temperature of the flap hourly for 24 hours.
C. Maintain a pressure dressing on the reconstructed breast for the first 48 hours.
D. Keep the affected arm below the level of the reconstructed breast for 48 hours-
ANSWER: B
A. Upper-extremity exercise and ROM are restricted to reduce strain on the incision site.
B. To monitor for viability and adequacy of blood supply to the TRAM flap, the flap must be
assessed hourly for the first 24 hours.
C. Pressure over the flap is avoided until healing is complete.
D. The affected arm should be elevated to promote venous return.
, 6. The client tells the nurse that she has been having breast pain and has had several
diagnostic procedures that all have been negative. Which suggestions should the nurse
include when the client asks for advice on controling this breast pain? Select al that apply.
A. Place a towel wet with primrose oil on the breasts.
B. Go without a bra for at least 4 hours every day.
C. Reduce the amount of caffeine in the diet.
D. Supplement the diet with B complex vitamins.
E. Apply hot packs to the breasts for 20 minutes.
ANSWER: C, D, E
A. There is no evidence that placing a towel wet with primrose oil over the breasts will reduce pain.
Taking evening primrose oil orally may help, but its use is controversial.
B. The women should be taught to wear a support bra, not to go Without a bra.
C. Reducing caffeine has been shown by some to reduce breast pain.
D. B complex vitamins have been shown by some to reduce breast pain.
E. Applying hot packs to the breasts for 20 minutes has been shown by some to reduce breast
pain.
7. A 21-year-old client starts crying during a clinic visit and says to the nurse, “I found a lump
in my breast last night; I’m scared I might have cancer!” Which fact should the nurse
consider when formulating a response to the client?
A. Young women at this age are at increased risk of breast cancer development.
B. A nondiscrete possible mass or thickening has a high index of suspicion for breast cancer.
C. Benign fibroadenomas are the most frequent cause of breast masses in women under 25 years.
D. Close personal contact required in dormitory living can cause infectious breast disorders-
ANSWER: C
A. Breast cancer is diagnosed most commonly in women older than 50 years.
B. A nondiscrete possible mass or thickening has a lower (not higher) index of suspicion for breast
cancer.
C. Fibroadenomas are the most common benign breast neoplasm and most often occur in women
younger than 25 years.
D. Mastitis is a bacterial infection of the breast tissue and is not contagious, and therefore it would
not be spread by dormitory living.
8. The client tells the nurse that she is considering breast reduction but wants to know if she
could breastfeed in the future after this procedure. Which response by the nurse is correct?
A. “Breast reduction will not affect whether or not you choose to breastfeed.”
B. “Breastfeeding is possible if the nipples are left connected to breast tissue.”
C. “The amount of breast tissue removed will make breastfeeding impossible.”
D. “Changes in the nipple structure from surgery will prevent milk production.”
