1.
Nurse April is teaching a client who suspects that she has a lump in her breast. The nurse instructs the client that a diagnosis of breast cancer is confirmed by:
Correct Answer
C. Fine needle aspiration.
Explanation
Fine needle aspiration and biopsy provide cells for histologic examination to confirm a diagnosis of cancer. A breast self-examination, if done regularly, is the most reliable method for detecting breast lumps early. Mammography is used to detect tumors that are too small to palpate. Chest X-rays can be used to pinpoint rib metastasis.
2.
A female client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a fluid and electrolyte imbalance induced by chemotherapy?
Correct Answer
D. Dry oral mucous membranes and cracked lips
Explanation
Chemotherapy commonly causes nausea and vomiting, which may lead to fluid and electrolyte imbalances. Signs of fluid loss include dry oral mucous membranes, cracked lips, decreased urine output (less than 40 ml/hour), abnormally low blood pressure, and a serum potassium level below 3.5 mEq/L.
3.
Nurse April is teaching a group of women to perform breast self-examination. The nurse should explain that the purpose of performing the examination is to discover:
Correct Answer
C. Changes from previous self-examinations.
Explanation
Women are instructed to examine themselves to discover changes that have occurred in the breast. Only a physician can diagnose lumps that are cancerous, areas of thickness or fullness that signal the presence of a malignancy, or masses that are fibrocystic as opposed to malignant.
4.
Nurse Amy is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47. Following the American Cancer Society guidelines, the nurse should recommend that the women:
Correct Answer
B. Have a mammogram annually.
Explanation
The American Cancer Society guidelines state, "Women older than age 40 should have a mammogram annually and a clinical examination at least annually [not every 2 years]; all women should perform breast self-examination monthly [not annually]." The hormonal receptor assay is done on a known breast tumor to determine whether the tumor is estrogen- or progesterone-dependent.
5.
A male client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the seven warning signs of cancer. What is another warning sign of cancer?
Correct Answer
C. Indigestion
Explanation
Indigestion, or difficulty swallowing, is one of the seven warning signs of cancer. The other six are a change in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge, a thickening or lump in the breast or elsewhere, an obvious change in a wart or mole, and a nagging cough or hoarseness. Persistent nausea may signal stomach cancer but isn’t one of the seven major warning signs. Rash and chronic ache or pain seldom indicate cancer.
6.
Nurse Lucia is providing breast cancer education at a community facility. The American Cancer Society recommends that women get mammograms:
Correct Answer
A. Yearly after age 40.
Explanation
The American Cancer Society recommends a mammogram yearly for women over age 40. The other statements are incorrect. It’s recommended that women between ages 20 and 40 have a professional breast examination (not a mammogram) every 3 years.
7.
Jeovina, with advanced breast cancer is prescribed tamoxifen (Nolvadex). When teaching the client about this drug, the nurse should emphasize the importance of reporting which adverse reaction immediately?
Correct Answer
A. Vision changes
Explanation
The client must report changes in visual acuity immediately because this adverse effect may be irreversible. Tamoxifen isn’t associated with hearing loss. Although the drug may cause anorexia, headache, and hot flashes, the client need not report these adverse effects immediately because they don’t warrant a change in therapy.
8.
A 34-year-old female client is requesting information about mammograms and breast cancer. She isn’t considered at high risk for breast cancer. What should the nurse tell this client?
Correct Answer
B. She should eat a low-fat diet to further decrease her risk of breast cancer.
Explanation
A low-fat diet (one that maintains weight within 20% of recommended body weight) has been found to decrease a woman’s risk of breast cancer. A baseline mammogram should be done between ages 30 and 40. Monthly breast self-examinations should be done between days 7 and 10 of the menstrual cycle. The client should continue to perform monthly breast self-examinations even when receiving yearly mammograms.
9.
Nina, an oncology nurse educator is speaking to a women’s group about breast cancer. Questions and comments from the audience reveal a misunderstanding of some aspects of the disease. Various members of the audience have made all of the following statements. Which one is accurate?
Correct Answer
D. Men can develop breast cancer.
Explanation
Men can develop breast cancer, although they seldom do. The most reliable method for detecting breast cancer is monthly self-examination, not mammography. Lung cancer causes more deaths than breast cancer in women of all ages. A mastectomy may not be required if the tumor is small, confined, and in an early stage.
10.
Nurse Meredith is instructing a premenopausal woman about breast self-examination. The nurse should tell the client to do her self-examination:
Correct Answer
D. Immediately after her menstrual period.
Explanation
Premenopausal women should do their self-examination immediately after the menstrual period, when the breasts are least tender and least lumpy. On the 1st and last days of the cycle, the woman’s breasts are still very tender. Postmenopausal women because their bodies lack fluctuation of hormone levels, should select one particular day of the month to do breast self-examination.
11.
A 37-year-old client with uterine cancer asks the nurse, "Which is the most common type of cancer in women?" The nurse replies that it's breast cancer. Which type of cancer causes the most deaths in women?
Correct Answer
B. Lung cancer
Explanation
Lung cancer is the most deadly type of cancer in both women and men. Breast cancer ranks second in women, followed (in descending order) by colon and rectal cancer, pancreatic cancer, ovarian cancer, uterine cancer, lymphoma, leukemia, liver cancer, brain cancer, stomach cancer, and multiple myeloma.
12.
During a breast examination, which finding most strongly suggests that the Luz has breast cancer?
Correct Answer
B. A fixed nodular mass with dimpling of the overlying skin
Explanation
A fixed nodular mass with dimpling of the overlying skin is common during late stages of breast cancer. Many women have slightly asymmetrical breasts. Bloody nipple discharge is a sign of intraductal papilloma, a benign condition. Multiple firm, round, freely movable masses that change with the menstrual cycle indicate fibrocystic breasts, a benign condition.
13.
A client with breast cancer is returned to the room following a right total mastectomy. The nurse should:
Correct Answer
A. Elevate the client’s right arm on pillows
Explanation
A total mastectomy involves removal of the entire breast and some or all of the axillary lymph nodes. Following surgery, the client’s right arm should be elevated on pillows, to facilitate lymph drainage. Other options are incorrect because they would not help facilitate lymph drainage and would create increased edema in the affected extremity.
14.
Maria Sison, 40 years old, single, was admitted to the hospital with a diagnosis of Breast Cancer. She was scheduled for radical mastectomy. Nursing care during the preoperative period should consist of
Correct Answer
B. Assessing Maria’s expectations and doubts
Explanation
Assessing the client’s expectations and doubts will help lessen her fears and anxieties. The nurse needs to encourage the client to verbalize and to listen and correctly provide explanations when needed.
15.
Maria refuses to acknowledge that her breast was removed. She believes that her breast is intact under the dressing. The nurse should
Correct Answer
B. Recognize that Kathy is experiencing denial, a normal stage of the grieving process
Explanation
A person grieves to a loss of a significant object. The initial stage in the grieving process is denial, then anger, followed by bargaining, depression and last acceptance. The nurse should show acceptance of the patient’s feelings and encourage verbalization.
16.
Hormonal agents are used to treat some cancers. An example would be:
Correct Answer
C. Estrogen antagonists to treat breast cancer.
Explanation
Estrogen antagonists are used to treat estrogen hormone-dependent cancer, such as breast carcinoma. A well-known estrogen antagonist used in breast cancer therapy is tamoxifen (Nolvadex). This drug, in combination with surgery and other chemotherapeutic drugs reduces breast cancer recurrence by 30 percent. Estrogen antagonists can also be administered to prevent breast cancer in women who have a strong family history of the disease. Thyroxine is a natural thyroid hormone. It does not treat thyroid cancer. ACTH is an anterior pituitary hormone, which stimulates the adrenal glands to release glucocorticoids. It does not treat adrenal cancer. Glucagon is a pancreatic alpha cell hormone, which stimulates glycogenolysis and gluconeogenesis. It does not treat pancreatic cancer.
17.
The nurse recognizes which of the following statements as accurately reflecting a risk factor for breast cancer?
Correct Answer
A. Mother affected by cancer before 60 years of age
Explanation
Risk for breast cancer increases twofold if first-degree female relatives (sister, mother, or daughter) had breast cancer. Increased risk is associated with early menarche (i.e., menses beginning before 12 years of age). Nulliparity and later maternal age for first birth are associated with increased risk for breast cancer. Alcohol use remains controversial; however, a slightly increased risk is found in women who consume even one drink daily and doubles among women drinking three drinks daily.
18.
Which of the following terms is used to describe removal of the breast tissue and an axillary lymph node dissection leaving muscular structure intact as surgical treatment of breast cancer?
Correct Answer
A. Modified radical mastectomy
Explanation
A modified radical mastectomy leaves the pectoralis major and minor muscles intact. In a segmental mastectomy, varying amounts of breast tissue are removed, including the malignant tissue and some surrounding tissue to ensure clear margins. In a total mastectomy, breast tissue only is removed. Radical mastectomy includes removal of the pectoralis major and minor muscles in addition to breast tissue and axillary lymph node dissection.
19.
Ductal lavage is used for
Correct Answer
A. Women at higher risk for benign proliferative breast disease.
Explanation
Performed in the doctor’s office, a microcatheter is inserted through the nipple while instilling saline and retrieving the fluid for analysis. It has been shown to identify atypical cells in this population and has been found to be adept at detecting cellular changes within the breast tissue.
20.
The 2000 NIH Consensus Development Conference Statement states that what percentage of women with invasive breast cancer should consider the option of systemic chemotherapy, not just women whose tumors are greater than 1cm in size?
Correct Answer
A. 100% (all)
Explanation
The 2000 Consensus Development Conference Statement states that all women with invasive breast cancer should consider the option of systemic chemotherapy, not just women whose tumors are greater than 1 cm in size.
21.
The community health nurse implemented a new program about effective breast cancer screening technique for the female personnel of the health department of Valenzuela. Which of the following technique should the nurse consider to be of the lowest priority?
Correct Answer
B. Detailed health history to identify women at risk
Explanation
Because of the high incidence of breast cancer, all women are considered to be at risk regardless of health history.
22.
A client receiving chemotherapy for breast cancer has an order for Zofran (ondansetron) 8mg PO to be given 30 minutes before induction of the chemotherapy. The purpose of the medication is to:
Correct Answer
C. Prevent nausea
Explanation
Zofran is given before chemotherapy to prevent nausea. Answers A, B, and D are not associated with the medication; therefore, they are incorrect.
23.
A female client was diagnosed with breast cancer. It is found to be stage IV, and a modified mastectomy is performed. After the procedure, what behaviors could the nurse expects the client to display?
Correct Answer
B. Signs of grief reaction.
Explanation
It is mostly likely that grief would be expressed because of object loss.
24.
The nurse is teaching the client about breast self-examination. Which observation should the client be taught to recognize when doing the examination for detection of breast cancer?
Correct Answer
D. Dimpling of the breast tissue
Explanation
The tumor infiltrates nearby tissue, it can cause retraction of the overlying skin and create a dimpling appearance.
25.
The nurse is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47. Following the American Cancer Society (ACS) guidelines, the nurse should recommend that the women:
Correct Answer
B. Have a mammogram annually
Explanation
According to the ACS guidelines, “Women older than age 40 should perform breast selfexamination monthly (not annually).” The hormonal receptor assay is done on a known breast tumor to determine whether the tumor is estrogen- or progesterone-dependent.
26.
A 52 yr-old female tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client’s lump is cancerous?
Correct Answer
B. Nonmobile mass with irregular edges
Explanation
Breast cancer tumors are fixed, hard, and poorly delineated with irregular edges. Nipple retraction —not eversion—may be a sign of cancer. A mobile mass that is soft and easily delineated is most often a fluid-filled benigned cyst. Axillary lymph nodes may or may not be palpable on initial detection of a cancerous mass.
27.
The community health nurse implemented a new program about effective breast cancer screening technique for the female personnel of the health department of Valenzuela. Which of the following technique should the nurse consider to be of the lowest priority?
Correct Answer
B. Detailed health history to identify women at risk
Explanation
Because of the high incidence of breast cancer, all women are considered to be at risk regardless of health history.
28.
What is a symptom of Breast Cancer?
Correct Answer
B. Lump in underarm or breast area.
Explanation
A lump in the underarm or breast area is a common symptom of breast cancer. It is important to note that not all lumps are cancerous, but it is recommended to consult a healthcare professional if any unusual lump is found. Itchy throat and pain in the arm are not typically associated with breast cancer and may be caused by other factors.
29.
Breast Cancer is most likely to spread to your ____________area.
Correct Answer
C. Underarm
Explanation
Breast cancer is most likely to spread to the underarm area because the lymph nodes in the underarm region are the first ones to receive drainage from the breast. The lymphatic system plays a crucial role in the spread of cancer cells, and if breast cancer has metastasized, it often first spreads to the nearby lymph nodes in the underarm area. Therefore, monitoring and evaluating the underarm lymph nodes is an important part of breast cancer diagnosis and staging.
30.
Only women can get Breast Cancer.
Correct Answer
B. False
Explanation
Breast cancer can affect both men and women, although it is more commonly found in women. While the majority of breast cancer cases occur in women, it is important to note that men can also develop breast cancer, although it is much rarer. Therefore, the statement that only women can get breast cancer is false.
31.
What is Breast Cancer?
Correct Answer
D. All of the above
Explanation
Breast cancer is a tumor that develops in the breast area. It is a very common disease among women and can be deadly if not detected and treated early. Therefore, the correct answer is "All of the above" as all the statements are true.
32.
Breast Cancer is the most common reason for death in what ages?
Correct Answer
D. 15-54
Explanation
Breast cancer is the most common reason for death in the age group of 15-54. This age range is considered to be the prime of a person's life, where they are typically more active and productive. Breast cancer is a serious disease that can affect individuals of any age, but it is particularly prevalent in this age group. Early detection and timely treatment are crucial in improving survival rates for breast cancer patients.
33.
Breast reconstruction is done after_____________surgery.
Correct Answer
B. Mastectomy
Explanation
Breast reconstruction is performed after mastectomy surgery. Mastectomy is the surgical removal of one or both breasts, usually to treat or prevent breast cancer. After mastectomy, some women may choose to undergo breast reconstruction to restore the appearance of the breasts. This procedure can involve the use of implants or the transfer of tissue from other parts of the body to recreate a natural-looking breast shape. Lumpectomy, on the other hand, is a less invasive surgical procedure that removes only the tumor and a small margin of surrounding healthy tissue, typically leaving the breast intact.
34.
Noninvasive Breast Cancer is when..
Correct Answer
B. The cancer cells have stayed from their origin and have not spread
Explanation
Noninvasive breast cancer refers to a type of cancer where the cancer cells have remained confined to the ducts or lobules in the breast and have not spread to surrounding tissues or other parts of the body. This means that the cancer has not invaded or metastasized to other organs or distant sites. It is important to detect and treat noninvasive breast cancer early to prevent it from progressing to invasive breast cancer.
35.
1 in ____ women get Breast Cancer.
Correct Answer
C. 8
Explanation
Approximately 1 in 8 women are diagnosed with breast cancer in their lifetime. This statistic highlights the high prevalence of breast cancer among women, emphasizing the importance of regular screenings and early detection.
36.
Can family history of breast cancer increase the chances of the family members?
Correct Answer
B. Yes
Explanation
A family history of breast cancer can increase the chances of family members developing the disease. This is because certain genetic mutations that increase the risk of breast cancer can be passed down from generation to generation. While the risk is higher if a close family member such as a mother or sister has had breast cancer, it can also be increased if more distant relatives have been affected. Therefore, having a family history of breast cancer can be a significant risk factor for individuals.
37.
Can a mammography detect breast cancer before you can even see it.
Correct Answer
A. Yes
Explanation
A mammography is a type of imaging test that uses low-dose X-rays to examine the breasts for any signs of breast cancer. It can detect breast cancer before it becomes visible or causes any symptoms. This is because mammography can identify small abnormalities, such as tiny calcifications or tumors, that may not be felt during a physical examination. Early detection of breast cancer through mammography increases the chances of successful treatment and improves the overall prognosis for the patient. Therefore, the correct answer is "Yes."
38.
Is early detection of breast cancer your best chance of survival?
Correct Answer
B. Yes
Explanation
Early detection of breast cancer is indeed the best chance of survival. Breast cancer is easier to treat and has a higher chance of successful treatment when detected early. Regular screenings, such as mammograms, can help in detecting breast cancer at an early stage when it is more likely to be curable. Early detection allows for prompt medical intervention, which can increase the chances of successful treatment and improve overall survival rates.
39.
Can men get breast cancer?
Correct Answer
C. Yes, but not likely
Explanation
Men can get breast cancer, although it is not as common as in women. While the risk is lower, it is still possible for men to develop breast cancer due to factors such as genetics, hormonal imbalances, and exposure to certain environmental factors. Therefore, the correct answer is "Yes, but not likely."
40.
Which of the following are used in diagnosing breast cancer?
Correct Answer
E. All of the above
Explanation
All of the options listed - mammogram, ultrasound, MRI, and biopsy - are commonly used in diagnosing breast cancer. A mammogram is an X-ray of the breast that can detect abnormalities. Ultrasound uses sound waves to create images of the breast tissue. MRI (Magnetic Resonance Imaging) uses radio waves and magnets to produce detailed images of the breast. Biopsy involves removing a small sample of breast tissue for examination under a microscope to determine if cancer cells are present. Therefore, all of these methods are utilized in the diagnosis of breast cancer.
41.
What is the purpose of using hormonal therapy for patients with breast cancer cells?
Correct Answer
C. To block the supply of estrogen or pregesterone to the cells.
Explanation
Hormonal therapy is used for patients with breast cancer cells to block the supply of estrogen or progesterone to the cells. Breast cancer cells often rely on these hormones to grow and divide. By blocking the supply of these hormones, hormonal therapy can help slow down or stop the growth of breast cancer cells. This treatment approach is especially effective for hormone receptor-positive breast cancers, where the cancer cells have receptors for estrogen or progesterone. By blocking the supply of these hormones, hormonal therapy can help prevent the cancer from spreading and reduce the risk of recurrence.
42.
The statistics decrease for getting breast cancer as one gets older in age.
Correct Answer
B. False
Explanation
The statement is false because the statistics actually increase for getting breast cancer as one gets older in age. This is supported by research and data that consistently show a higher risk of breast cancer in older women compared to younger women. Age is considered one of the strongest risk factors for developing breast cancer, with the majority of cases occurring in women over the age of 50.
43.
What is the percentage of breast tissue that can be removed and rearranged to have the breast still looking like a breast?
Correct Answer
C. 30%
Explanation
30% is the percentage of breast tissue that can be removed and rearranged while still maintaining the appearance of a breast. This means that if up to 30% of the breast tissue is removed and rearranged, the breast will still retain its shape and form. Removing or rearranging more than 30% of the breast tissue may result in a significant change in the appearance of the breast.
44.
What does regional refer to in relation to breast cancer?
Correct Answer
B. LympH nodes
Explanation
Regional refers to the lymph nodes in relation to breast cancer. Lymph nodes are small, bean-shaped structures that play a crucial role in the body's immune system. In the case of breast cancer, regional refers to the nearby lymph nodes where cancer cells can spread. The presence or absence of cancer cells in the regional lymph nodes is an important factor in determining the stage and treatment options for breast cancer.
45.
What does local breast cancer refer to?
Correct Answer
C. The breast
Explanation
Local breast cancer refers to cancer that is confined to the breast and has not spread to other parts of the body. It specifically refers to the tumor or cancer cells that are located within the breast tissue itself, without involving the lymph nodes or other distant organs. This term is used to distinguish it from metastatic breast cancer, which is cancer that has spread to other areas of the body beyond the breast.