Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 650
Chapter 51: Breast Disorders
Test Bank
MULTIPLE CHOICE
1. The nurse teaching a young womens community service group about breast self-examination (BSE) will
include that
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. The evidence is not clear that BSE reduces mortality from breast cancer. BSE should be done
monthly. Annual mammograms are not routinely scheduled for women under age 40, and newer guidelines
suggest delaying them until age 50.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
2. During a well woman physical exam, a 43-year-old patient asks about her risk for breast cancer. Which
question is most pertinent for the nurse to ask?
a. Do you currently smoke tobacco?
b. Have you ever had a breast injury?
c. At what age did you start having menstrual periods?
d. Is there a family history of fibrocystic breast changes?
ANS: C
Early menarche and late menopause are risk factors for breast cancer because of the prolonged exposure to
estrogen that occurs. Cigarette smoking, breast trauma, and fibrocystic breast changes are not associated with
increased breast cancer risk.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
3. A 51-year-old patient with a small immobile breast lump is considering having a fine-needle aspiration
(FNA) biopsy. The nurse explains that an advantage to this procedure is that
,Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 651
a. FNA is done in the outpatient clinic and results are available in 1 to 2 days.
b. only a small incision is needed, resulting in minimal breast pain and scarring.
c. if the biopsy results are negative, no further diagnostic testing will be needed.
d. FNA is guided by a mammogram, ensuring that cells are taken from the lesion.
ANS: A
FNA is done in outpatient settings and results are available in 24 to 48 hours. No incision is needed. FNA may
be guided by ultrasound, but not by mammogram. Because the immobility of the breast lump suggests cancer,
further testing will be done if the FNA is negative.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
4. Which assessment finding in a 36-year-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, nontender, and fixed
c. A breast lump that increases in size before the menstrual period
d. A breast lump that is small, mobile, with a rubbery consistency
ANS: B
Painless and fixed lumps suggest breast cancer. The other findings are more suggestive of benign processes
such as fibrocystic breasts and fibroadenoma.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
5. A 53-year-old woman at 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.
,Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 652
ANS: C
Because HT has been linked to increased risk for breast cancer, the patient and provider must determine
whether or not to use HT. Breast cancer incidence is increased in women using HT, independent of other risk
factors. HT increases the risk for both nonBRCA-associated cancer and BRCA-related cancers. Alternative
therapies can be used but are not consistent in relieving menopausal symptoms.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
6. A 58-year-old woman tells the nurse, I understand that I have stage II breast cancer and I need to decide on a
surgery, but I feel overwhelmed. What do you think I should do? Which response by the nurse is best?
a. I would have a lumpectomy, but you need to decide what is best for you.
b. Tell me what you understand about the surgical options that are available.
c. It would not be appropriate for me to make a decision about your health.
d. There is no need to make a decision rapidly; you have time to think about this.
ANS: B
Inquiring about the patients understanding shows the nurses willingness to assist the patient with the decision-
making process without imposing the nurses values or opinions. Treatment decisions for breast cancer do need
to be made relatively quickly. Imposing the nurses opinions or showing an unwillingness to discuss the topic
could cut off communication.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
7. The nurse will teach a patient with metastatic breast cancer who has a new prescription for trastuzumab
(Herceptin) that
a. hot flashes may occur with the medication.
b. serum electrolyte levels will be drawn monthly.
c. the patient will need frequent eye examinations.
d. the patient should call if she notices ankle swelling.
ANS: D
Trastuzumab can lead to ventricular dysfunction, so the patient is taught to self-monitor for symptoms of heart
failure. There is no need to monitor serum electrolyte levels. Hot flashes or changes in visual acuity may occur
with tamoxifen, but not with trastuzumab.
DIF: Cognitive Level: Apply (application)
, Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 653
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
8. After a 48-year-old patient has had a modified radical mastectomy, the pathology report identifies the tumor
as an estrogen-receptor positive adenocarcinoma. The nurse will plan to teach the patient about
a. estradiol (Estrace).
b. raloxifene (Evista).
c. tamoxifen (Nolvadex).
d. trastuzumab (Herceptin).
ANS: C
Tamoxifen is used for estrogen-dependent breast tumors in premenopausal women. Raloxifene is used to
prevent breast cancer, but it is not used postmastectomy to treat breast cancer. Estradiol will increase the
growth of estrogen-dependent tumors. Trastuzumab is used to treat tumors that have the HER-2 receptor.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
9. Which nursing action should be included in the plan of care for a patient returning to the surgical unit
following a left modified radical mastectomy with dissection of axillary lymph nodes?
a. Obtain a permanent breast prosthesis before the patient is discharged from the hospital.
b. Teach the patient to use the ordered patient-controlled analgesia (PCA) every 10 minutes.
c. Post a sign at the bedside warning against venipunctures or blood pressures in the left arm.
d. Insist that the patient examine the surgical incision when the initial dressings are removed.
ANS: C
The patient is at risk for lymphedema and infection if blood pressures or venipuncture are done on the right
arm. The patient is taught to use the PCA as needed for pain control rather than at a set time. The nurse allows
the patient to examine the incision and participate in care when the patient feels ready. Permanent breast
prostheses are usually obtained about 6 weeks after surgery.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
10. The nurse provides discharge teaching for a 61-year-old patient who has had a left modified radical
mastectomy and lymph node dissection. Which statement by the patient indicates that teaching has been
successful?
a. I will need to use my right arm and to rest the left one.
Chapter 51: Breast Disorders
Test Bank
MULTIPLE CHOICE
1. The nurse teaching a young womens community service group about breast self-examination (BSE) will
include that
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. The evidence is not clear that BSE reduces mortality from breast cancer. BSE should be done
monthly. Annual mammograms are not routinely scheduled for women under age 40, and newer guidelines
suggest delaying them until age 50.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
2. During a well woman physical exam, a 43-year-old patient asks about her risk for breast cancer. Which
question is most pertinent for the nurse to ask?
a. Do you currently smoke tobacco?
b. Have you ever had a breast injury?
c. At what age did you start having menstrual periods?
d. Is there a family history of fibrocystic breast changes?
ANS: C
Early menarche and late menopause are risk factors for breast cancer because of the prolonged exposure to
estrogen that occurs. Cigarette smoking, breast trauma, and fibrocystic breast changes are not associated with
increased breast cancer risk.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
3. A 51-year-old patient with a small immobile breast lump is considering having a fine-needle aspiration
(FNA) biopsy. The nurse explains that an advantage to this procedure is that
,Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 651
a. FNA is done in the outpatient clinic and results are available in 1 to 2 days.
b. only a small incision is needed, resulting in minimal breast pain and scarring.
c. if the biopsy results are negative, no further diagnostic testing will be needed.
d. FNA is guided by a mammogram, ensuring that cells are taken from the lesion.
ANS: A
FNA is done in outpatient settings and results are available in 24 to 48 hours. No incision is needed. FNA may
be guided by ultrasound, but not by mammogram. Because the immobility of the breast lump suggests cancer,
further testing will be done if the FNA is negative.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
4. Which assessment finding in a 36-year-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, nontender, and fixed
c. A breast lump that increases in size before the menstrual period
d. A breast lump that is small, mobile, with a rubbery consistency
ANS: B
Painless and fixed lumps suggest breast cancer. The other findings are more suggestive of benign processes
such as fibrocystic breasts and fibroadenoma.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
5. A 53-year-old woman at 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.
,Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 652
ANS: C
Because HT has been linked to increased risk for breast cancer, the patient and provider must determine
whether or not to use HT. Breast cancer incidence is increased in women using HT, independent of other risk
factors. HT increases the risk for both nonBRCA-associated cancer and BRCA-related cancers. Alternative
therapies can be used but are not consistent in relieving menopausal symptoms.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
6. A 58-year-old woman tells the nurse, I understand that I have stage II breast cancer and I need to decide on a
surgery, but I feel overwhelmed. What do you think I should do? Which response by the nurse is best?
a. I would have a lumpectomy, but you need to decide what is best for you.
b. Tell me what you understand about the surgical options that are available.
c. It would not be appropriate for me to make a decision about your health.
d. There is no need to make a decision rapidly; you have time to think about this.
ANS: B
Inquiring about the patients understanding shows the nurses willingness to assist the patient with the decision-
making process without imposing the nurses values or opinions. Treatment decisions for breast cancer do need
to be made relatively quickly. Imposing the nurses opinions or showing an unwillingness to discuss the topic
could cut off communication.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
7. The nurse will teach a patient with metastatic breast cancer who has a new prescription for trastuzumab
(Herceptin) that
a. hot flashes may occur with the medication.
b. serum electrolyte levels will be drawn monthly.
c. the patient will need frequent eye examinations.
d. the patient should call if she notices ankle swelling.
ANS: D
Trastuzumab can lead to ventricular dysfunction, so the patient is taught to self-monitor for symptoms of heart
failure. There is no need to monitor serum electrolyte levels. Hot flashes or changes in visual acuity may occur
with tamoxifen, but not with trastuzumab.
DIF: Cognitive Level: Apply (application)
, Test Bank - Lewis's Medical Surgical Nursing (11th Edition by Harding) 653
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
8. After a 48-year-old patient has had a modified radical mastectomy, the pathology report identifies the tumor
as an estrogen-receptor positive adenocarcinoma. The nurse will plan to teach the patient about
a. estradiol (Estrace).
b. raloxifene (Evista).
c. tamoxifen (Nolvadex).
d. trastuzumab (Herceptin).
ANS: C
Tamoxifen is used for estrogen-dependent breast tumors in premenopausal women. Raloxifene is used to
prevent breast cancer, but it is not used postmastectomy to treat breast cancer. Estradiol will increase the
growth of estrogen-dependent tumors. Trastuzumab is used to treat tumors that have the HER-2 receptor.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
9. Which nursing action should be included in the plan of care for a patient returning to the surgical unit
following a left modified radical mastectomy with dissection of axillary lymph nodes?
a. Obtain a permanent breast prosthesis before the patient is discharged from the hospital.
b. Teach the patient to use the ordered patient-controlled analgesia (PCA) every 10 minutes.
c. Post a sign at the bedside warning against venipunctures or blood pressures in the left arm.
d. Insist that the patient examine the surgical incision when the initial dressings are removed.
ANS: C
The patient is at risk for lymphedema and infection if blood pressures or venipuncture are done on the right
arm. The patient is taught to use the PCA as needed for pain control rather than at a set time. The nurse allows
the patient to examine the incision and participate in care when the patient feels ready. Permanent breast
prostheses are usually obtained about 6 weeks after surgery.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
10. The nurse provides discharge teaching for a 61-year-old patient who has had a left modified radical
mastectomy and lymph node dissection. Which statement by the patient indicates that teaching has been
successful?
a. I will need to use my right arm and to rest the left one.
