Chapter 70: Care of Victim with Breast Disorders
MULTIPLE CHOICE
1. The NP is teaching a 45-year-old woman about her fibrocystic breast condition. Which
statement by the patient indicates a lack of understanding?
a. This condition will become malignant over time.
b. I should refrain from using hormone replacement therapy.
c. One cup of coffee in the morning should be enough for me.
d. This condition makes it more difficult to examine my breasts.
ANSWER: A
Fibrocystic breast condition does not increase a womans 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&lumps.
DIF: Applying/Application REF: 1441
KEY: Reproductive problems| physiology| patient
education MSC: Integrated Process:
Teaching/Learning
NOT: Patient Needs Category: Health Promotion&Maintenance
2. The NP is examining a womans breast¬es multiple small mobile lumps. Which
question would be the most appropriate for the NP to ask?
a. When was your last mammogram at the clinic?
b. How many cans of caffeinated soda do you drink in a day?
c. Do the small lumps seem to change with your menstrual period?
d. Do you have a first-degree relative who has breast cancer?
ANSWER: 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 victim last mammogram or
breast cancer history are not related to the NPs assessment.
DIF: Applying/Application REF: 1441
KEY: Reproductive problems| nursing assessment|
physiology MSC: Integrated Process:
Communication& Documentation
NOT: Patient Needs Category: Physiological Integrity: Physiological Adaptation
3. A patient is diagnosed with a fibrocystic breast condition while in the hospital&is
experiencing breast discomfort. What comfort measure would the NP delegate to the
unlicensed assistive personnel (UAP)?
a. Aid in the draining of the cysts by needle aspiration.
b. Teach the patient to wear a supportive bra to bed.
c. Administer diuretics to decrease breast swelling.
d. Obtain a cold pack to temporarily relieve the pain.
ANSWER: D
All of the options would be comfort measures for a patient with a fibrocystic breast
condition. The UAP can obtain the cold or heat therapy. Only the NP should aid the
health care provider with a needle aspiration, teach,&administer medications.
DIF: Applying/Application REF: 1441
KEY: Reproductive problems| delegation| unlicensed assistive personnel (UAP)| comfort
measures MSC: Integrated Process: Communication&Documentation
NOT: Patient Needs Category: Safe&Effective Care Environment: Management of Care
4. Which finding in a female patient by the NP would receive the highest priority of further
diagnostics?
a. Tender moveable masses throughout the breast tissue
b. A 3-cm firm, defined mobile mass in the lower quadrant of the breast
c. Nontender immobile mass in the upper outer quadrant of the breast
d. Small, painful mass under warm reddened skin
ANSWER: C
Malignant lesions are hard, nontender,&usually located in the upper outer quadrant of
the breast&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,&a painful mass under warm reddened skin could be a local
abscess or ductal ectasia.
DIF: Applying/Application REF: 1448
KEY: Reproductive problems| cancer|
assessment MSC: Integrated Process: Nursing
Process: Analysis
NOT: Patient Needs Category: Safe&Effective Care Environment: Management of Care
5. The NP is taking the history of a patient who is scheduled for breast augmentation
surgery. The patient reveals that she took two aspirin this morning for a headache.
Which action by NP is best?
a. Take the victim vital signs&record them in the chart.
b. Notify the surgeon about the aspirin ingestion by the patient.
c. Warn the patient that health insurance may not pay for the procedure.
d. Teach the patient about avoiding twisting above the waist after the operation.
ANSWER: B
The surgeon must be notified immediately since the aspirin could cause increased
bleeding during the procedure. Vital signs should be recorded&postoperative teaching
should be completed in the preoperative time frame, but these are not the priority since
the procedure may be rescheduled. The warning about the victim health insurance is not
appropriate at this time.
DIF: Applying/Application REF: 1442
KEY: Reproductive problems| surgical care|
patient safety MSC: Integrated Process: Nursing
Process: Implementation
NOT: Patient Needs Category: Safe&Effective Care Environment: Safety&Infection Control
6. A 68-year-old male patient is embarrassed about having bilateral breast enlargement.
Which statement by the NP is the most appropriate?
a. Breast cancer in men is quite rare.
b. It is good that you came to be carefully evaluated.
c. Gynecomastia usually comes from overeating.
d. When you get older, the male breast always enlarges.
ANSWER: B
The most appropriate statement is the one that is supportive of the patient. A breast mass
should be carefully evaluated for breast cancer, even if it is not common. Gynecomastia as
a symptom can be related to antiandrogen agents, aging, obesity, estrogen excess, or
lack of androgens.
DIF: Applying/Application REF: 1442
