Chapter 10: Problems of the Breast
MULTIPLE CHOICE
1. A nurse is providing breast care education to a client after mammography. Which
information regarding fibrocystic changes in the breast is important for the nurse to share?
a. Fibrocystic breast disease is a disease of the milk ducts and glands in the breasts.
b. It is a premalignant disorder characterized by lumps found in the breast tissue.
c. Fibrocystic breast disease causes lumpiness with or without pain and tenderness in
varying degrees in the breast tissue during menstrual cycles.
d. Lumpiness is accompanied by tenderness after menses.
ANS: C
Fibrocystic changes are palpable thickenings in the breast and can be associated with or
without pain and tenderness. The symptoms fluctuate with the menstrual cycle. Fibrocystic
changes are not premalignant changes; this information is inaccurate. Tenderness most often
occurs before menses.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
2. A nurse is providing education to a support group of women newly diagnosed with breast
cancer. It is important for the nurse to discuss which factor related to breast cancer with the
group? NURSINGTB.COM
a. Genetic mutations account for 50% of women who will develop breast cancer.
b. Breast cancer is the leading cause of cancer death in women.
c. In the United States, 1 in 10 women will develop breast cancer in her lifetime.
d. The exact cause of breast cancer remains unknown.
ANS: D
The exact cause of breast cancer is unknown. 15% of these cancers are related to genetic
mutations. Breast cancer is the second leading cause of cancer death in woman ages 45 to 55
years. One in eight women in the United States will develop breast cancer in her lifetime.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
3. Which diagnostic test is used to confirm a suspected diagnosis of breast cancer?
a. Mammogram
b. Ultrasound
c. Core needle biopsy
d. Magnetic resonance imaging (MRI)
ANS: C
, When a suspicious mammogram is noted or a lump is detected, diagnosis is confirmed by
either a core-needle biopsy or a needle-localization biopsy. Mammography is a clinical
screening tool that may aid in the early detection of breast cancers. Transillumination,
thermography, and ultrasound breast imaging are being explored as methods for detecting
early breast carcinoma. An MRI is useful in women with masses that are difficult to find
(occult breast cancer).
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
4. A healthy 60-year-old African-American woman regularly receives health care at her
neighborhood clinic. She is due for a mammogram. At her first visit, her health care
provider is concerned about the 3-week wait at the neighborhood clinic and made an
appointment for her to have a mammogram at a teaching hospital across town. She did not
keep her appointment and returned to the clinic today to have the nurse check her blood
pressure. What is the most appropriate statement for the nurse to make to this client?
a. “Do you have transportation to the teaching hospital so that you can get your
mammogram?”
b. “I’m concerned that you missed your appointment; let me make another one for
you.”
c. “It’s very dangerous to skip your mammograms; your breasts need to be checked.”
d. “Would you like me to make an appointment for you to have your mammogram
here?”
ANS: D
Offering to make an appointment for the client at the neighborhood location is
nonjudgmental and gives hN er oR
ptioI
ns aG
s toBw.hC
ere M
s he may have her mammogram.
U S N
Furthermore, it is an innocuous way to investigate the reasons the client missed her previous
appointment. Mortality rates from breast cancer remain high for African-American women.
Rather than reminding this woman that she has “missed her appointment,” discussing the
evidence behind the recommendations for a mammogram might be preferable for the nurse.
The nurse can offer to reschedule should the client agree to return for the test. Telling the
client that it is dangerous to skip mammograms can be perceived as judgmental and
derogatory and may alienate and embarrass the client.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
5. A client’s oncologist has just finished explaining the diagnostic workup results to her, and
she still has questions. The woman states, “The physician says I have a slow-growing
cancer. Very few cells are dividing. How does she know this?” What is the name of the test
that gave the health care provider this information?
a. Tumor ploidy
b. S-phase index
c. Nuclear grade
d. Estrogen-receptor assay
ANS: B
, The S-phase index measures the number of cells in the synthesis phase of cell development.
If the number of cells noted is high, then the cancer is growing at a fast rate. In this client’s
case, her S-phase index is assumed to be low. Tumor ploidy is the amount of
deoxyribonucleic acid (DNA) in a tumor cell, compared with that in a normal cell. Nuclear
grade describes the degree of abnormalities present in the cancer cell tubules, the nuclei
morphologic features, and mitotic rates. Estrogen and progesterone receptors are proteins
found in the cell cytoplasm and surface of some breast cancer cells.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
6. Breast pain occurs in many women during their perimenopausal years. Which information is
a priority for the nurse to share with the client?
a. Breast pain is an early indication of cancer.
b. Pain is almost always an indication of a solid mass.
c. Distinguishing between cyclical and noncyclical pain is important.
d. Breast pain is most often treated with narcotics.
ANS: C
Breast pain is unusual in breast cancer. Solid masses are generally benign and described as
smooth, round, mobile, and painless. Distinguishing between cyclical and noncyclical pain
is important to determine whether the cause is hormonal. Idiopathic pain is most often
treated with nonsteroidal anti-inflammatory medications.
PTS: 1 DIF: Cognitive Level: Applying
TOP: Nursing Process: Assessment
MSC: Client Needs: HealtN
hUPrRoS
mI ioG
otN nTanBd.MCaO
inM
tenance
7. After a mastectomy, which activity should the client be instructed to avoid?
a. Emptying surgical drains twice a day and as needed
b. Lifting more than 4.5 kg (10 lb) or reaching above her head until given permission
by her surgeon
c. Wearing clothing with snug sleeves to support the tissue of the arm on the
operative side
d. Immediately reporting inflammation that develops at the incision site or in the
affected arm
ANS: C
The woman should not be advised to wear snug clothing. She should be advised to avoid
tight clothing, tight jewelry, and other apparel that might cause decreased circulation in the
affected arm. As part of the teaching plan, the woman should be instructed to empty the
surgical drains twice a day, to avoid lifting more than 4.5 kg (10 lb) or reaching above her
head until given permission by her surgeon, and to report immediately any inflammation
that develops at the incision site or in the affected arm.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
8. What important, immediate postoperative care practice should the nurse remember when
caring for a woman who has had a mastectomy?
MULTIPLE CHOICE
1. A nurse is providing breast care education to a client after mammography. Which
information regarding fibrocystic changes in the breast is important for the nurse to share?
a. Fibrocystic breast disease is a disease of the milk ducts and glands in the breasts.
b. It is a premalignant disorder characterized by lumps found in the breast tissue.
c. Fibrocystic breast disease causes lumpiness with or without pain and tenderness in
varying degrees in the breast tissue during menstrual cycles.
d. Lumpiness is accompanied by tenderness after menses.
ANS: C
Fibrocystic changes are palpable thickenings in the breast and can be associated with or
without pain and tenderness. The symptoms fluctuate with the menstrual cycle. Fibrocystic
changes are not premalignant changes; this information is inaccurate. Tenderness most often
occurs before menses.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
2. A nurse is providing education to a support group of women newly diagnosed with breast
cancer. It is important for the nurse to discuss which factor related to breast cancer with the
group? NURSINGTB.COM
a. Genetic mutations account for 50% of women who will develop breast cancer.
b. Breast cancer is the leading cause of cancer death in women.
c. In the United States, 1 in 10 women will develop breast cancer in her lifetime.
d. The exact cause of breast cancer remains unknown.
ANS: D
The exact cause of breast cancer is unknown. 15% of these cancers are related to genetic
mutations. Breast cancer is the second leading cause of cancer death in woman ages 45 to 55
years. One in eight women in the United States will develop breast cancer in her lifetime.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
3. Which diagnostic test is used to confirm a suspected diagnosis of breast cancer?
a. Mammogram
b. Ultrasound
c. Core needle biopsy
d. Magnetic resonance imaging (MRI)
ANS: C
, When a suspicious mammogram is noted or a lump is detected, diagnosis is confirmed by
either a core-needle biopsy or a needle-localization biopsy. Mammography is a clinical
screening tool that may aid in the early detection of breast cancers. Transillumination,
thermography, and ultrasound breast imaging are being explored as methods for detecting
early breast carcinoma. An MRI is useful in women with masses that are difficult to find
(occult breast cancer).
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
4. A healthy 60-year-old African-American woman regularly receives health care at her
neighborhood clinic. She is due for a mammogram. At her first visit, her health care
provider is concerned about the 3-week wait at the neighborhood clinic and made an
appointment for her to have a mammogram at a teaching hospital across town. She did not
keep her appointment and returned to the clinic today to have the nurse check her blood
pressure. What is the most appropriate statement for the nurse to make to this client?
a. “Do you have transportation to the teaching hospital so that you can get your
mammogram?”
b. “I’m concerned that you missed your appointment; let me make another one for
you.”
c. “It’s very dangerous to skip your mammograms; your breasts need to be checked.”
d. “Would you like me to make an appointment for you to have your mammogram
here?”
ANS: D
Offering to make an appointment for the client at the neighborhood location is
nonjudgmental and gives hN er oR
ptioI
ns aG
s toBw.hC
ere M
s he may have her mammogram.
U S N
Furthermore, it is an innocuous way to investigate the reasons the client missed her previous
appointment. Mortality rates from breast cancer remain high for African-American women.
Rather than reminding this woman that she has “missed her appointment,” discussing the
evidence behind the recommendations for a mammogram might be preferable for the nurse.
The nurse can offer to reschedule should the client agree to return for the test. Telling the
client that it is dangerous to skip mammograms can be perceived as judgmental and
derogatory and may alienate and embarrass the client.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
5. A client’s oncologist has just finished explaining the diagnostic workup results to her, and
she still has questions. The woman states, “The physician says I have a slow-growing
cancer. Very few cells are dividing. How does she know this?” What is the name of the test
that gave the health care provider this information?
a. Tumor ploidy
b. S-phase index
c. Nuclear grade
d. Estrogen-receptor assay
ANS: B
, The S-phase index measures the number of cells in the synthesis phase of cell development.
If the number of cells noted is high, then the cancer is growing at a fast rate. In this client’s
case, her S-phase index is assumed to be low. Tumor ploidy is the amount of
deoxyribonucleic acid (DNA) in a tumor cell, compared with that in a normal cell. Nuclear
grade describes the degree of abnormalities present in the cancer cell tubules, the nuclei
morphologic features, and mitotic rates. Estrogen and progesterone receptors are proteins
found in the cell cytoplasm and surface of some breast cancer cells.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
6. Breast pain occurs in many women during their perimenopausal years. Which information is
a priority for the nurse to share with the client?
a. Breast pain is an early indication of cancer.
b. Pain is almost always an indication of a solid mass.
c. Distinguishing between cyclical and noncyclical pain is important.
d. Breast pain is most often treated with narcotics.
ANS: C
Breast pain is unusual in breast cancer. Solid masses are generally benign and described as
smooth, round, mobile, and painless. Distinguishing between cyclical and noncyclical pain
is important to determine whether the cause is hormonal. Idiopathic pain is most often
treated with nonsteroidal anti-inflammatory medications.
PTS: 1 DIF: Cognitive Level: Applying
TOP: Nursing Process: Assessment
MSC: Client Needs: HealtN
hUPrRoS
mI ioG
otN nTanBd.MCaO
inM
tenance
7. After a mastectomy, which activity should the client be instructed to avoid?
a. Emptying surgical drains twice a day and as needed
b. Lifting more than 4.5 kg (10 lb) or reaching above her head until given permission
by her surgeon
c. Wearing clothing with snug sleeves to support the tissue of the arm on the
operative side
d. Immediately reporting inflammation that develops at the incision site or in the
affected arm
ANS: C
The woman should not be advised to wear snug clothing. She should be advised to avoid
tight clothing, tight jewelry, and other apparel that might cause decreased circulation in the
affected arm. As part of the teaching plan, the woman should be instructed to empty the
surgical drains twice a day, to avoid lifting more than 4.5 kg (10 lb) or reaching above her
head until given permission by her surgeon, and to report immediately any inflammation
that develops at the incision site or in the affected arm.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
8. What important, immediate postoperative care practice should the nurse remember when
caring for a woman who has had a mastectomy?
