ATI Care of Patients with Breast Disorders, Questions and Answers with Explanations

ATI Care of Patients with Breast Disorders, Questions and Answers with Explanations, 100% Correct, Download to Score A

Test Bank

MULTIPLE CHOICE

1. A client recently had a mammogram. Which statement by the client indicates a need for clarification regarding the importance or purpose of this procedure?

a.	“Now that I have had a mammogram, my risk for getting breast cancer is reduced.”
b.	“I will still do a breast self-examination monthly even after the mammogram.”
c.	“Yearly mammograms can reduce my risk of dying from breast cancer.”
d.	“The amount of radiation exposure from a mammogram is very low.”

ANS: A

Regular or yearly mammography does not decrease the incidence of breast cancer. It only assists in early detection and diagnosis and decreases the mortality rate from breast cancer. The client should be instructed that the mammogram uses a very small amount of radiation in the test, and that consistent scheduling of a mammogram, along with a breast self-examination performed at least monthly, can reduce the client’s risk of dying from breast cancer.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Health Promotion and Maintenance (Principles of Teaching/Learning)

MSC: Integrated Process: Nursing Process (Evaluation)

2. When performing a clinical breast examination on a client, the nurse palpates a thickened area where the skin folds under the breast. Which is the nurse’s best action?

a.	Proceed with the examination.
b.	Determine whether the thickness is bilateral.
c.	Ask how long the thickness has been present.
d.	Change the client’s position and re-assess.

ANS: A

A thickened area where the skin folds under the breast is the inframammary ridge, a normal anatomic finding. Clients should be taught to identify this ridge and not confuse it with the presence of a lump or abnormal tissue thickening. Because this is a normal finding, no concern is necessary about whether it is present bilaterally or occurs in a different position, or how long the finding has been notable.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Health Promotion and Maintenance (Health Screening)

MSC: Integrated Process: Nursing Process (Assessment)

3. A client who has discovered a lump in her breast becomes tearful when scheduling a mammogram. Which is the nurse’s best response?

a.	“All lumps are considered cancerous until proven otherwise.”
b.	“Unless you have a relative with breast cancer, this lump is probably benign.”
c.	“Diagnosing cancer at this early stage is most likely to result in a cure.”
d.	“Many women have breast lumps, and most of the lumps are benign.”

ANS: D

The finding of a breast lump or mass is a frightening experience. Clients should be reassured, until they can be seen or testing is done, that 90% of all breast lumps or masses are benign. It is inaccurate for the nurse to state that all lumps are considered cancerous until proven benign, or that the lump is probably benign unless the client has a relative with breast cancer. Diagnosing cancer at an early stage results in cure more often than when the cancer is in later stages, but such a comment before diagnosis will only scare the client more.

DIF: Cognitive Level: Comprehension/Understanding REF: p. 1588

TOP: Client Needs Category: Psychosocial Integrity (Therapeutic Communication)

MSC: Integrated Process: Nursing Process (Implementation)

4. A client has just been diagnosed with fibrocystic breast disease. She asks what this means in terms of her health. Which is the nurse’s best response?

a.	“This increases your risk for breast cancer, so schedule yearly mammograms.”
b.	“This will increase as you age, especially if you have never been pregnant.”
c.	“This will diminish with menopause if you don’t take replacement hormones.”
d.	“This is genetic and you should teach your daughters about it.”

ANS: C

Although the cause of fibrocystic breast changes is unknown, the condition seems to be related to normal fluctuations in estrogen levels during the menstrual cycle. Symptoms usually resolve after menopause in the absence of estrogen supplementation. The presence of fibrocystic breast changes does not necessarily increase the client’s risk for breast cancer, will not necessarily increase with age, and does not routinely have a genetic component.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Alterations in Body Systems) MSC: Integrated Process: Teaching/Learning

5. Which client does the nurse encourage to seek genetic counseling regarding her risk for BRCA1 or BCRA2 gene mutation–related breast cancer?

a.	Woman whose father had lung cancer and mother had leukemia
b.	Woman whose sister has breast cancer and mother has ovarian cancer
c.	Woman whose fraternal twin sister has breast cancer
d.	Older woman who has bilateral benign breast disease

ANS: B

The best-defined increased genetic risk for breast cancer is related to mutations in the BRCA1 or BRCA2 gene. Families in which either of these genes is mutated have higher rates of breast and ovarian cancer in first-degree relatives. Being older is the primary risk factor for developing breast cancer but is not related to the genetic component; neither is benign breast disease. Lung cancer and leukemia are not genetically related to breast cancer. Having a twin with breast cancer does increase the genetic risk, but not as much as having two first-degree relatives with related cancers.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Health Promotion and Maintenance (Health and Wellness)

MSC: Integrated Process: Nursing Process (Assessment)

6. Which statement made by a client about breast cancer indicates correct understanding of the disease?

a.	“Breast cancer is the leading cause of cancer deaths among women in the United States.”
b.	“Breast cancer is the leading type of cancer among women in North America.”
c.	“Late onset of menses and early menopause increase the risk for breast cancer.”
d.	“Breast cancer decreases with age, and very old women have virtually no risk.”

ANS: B

Breast cancer is the second most common form of cancer diagnosed in women (after skin cancer) and is the second leading cause of cancer deaths in women in the United States (after lung cancer). The incidence of breast cancer increases with age. Early onset of menses and late menopause increase the risk for breast cancer.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Health Promotion and Maintenance (Health and Wellness)

MSC: Integrated Process: Nursing Process (Evaluation)

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