Deck 16: Breasts and Axillae

Question 1

The nurse is performing a breast examination and is palpating into the tail of Spence.The nurse understands that this is necessary for which of the following reasons?
1)It does not contain any lymph nodes.
2)It can show the difference between fibrocystic disease and fibroadenomas.
3)Breast cancer occurs more frequently in this area.
4)Peau d'orange may occur in this area of the breast.

Answer 1

3

Question 2

The nurse is conducting a breast health workshop for a group of women.Which of the following would the nurse include in this workshop when outlining risk factors for breast cancer?
1)Caucasian race
2)Positive family history
3)Low socioeconomic status
4)Hormone replacement therapy
5)Female age 35 to 40

Answer 2

1,2,3,4

Question 3

The nurse is using inspection to assess the breasts of a female client.Which of the following findings might the nurse obtain using this assessment technique?
1)Symmetry
2)Hard nodules
3)Tenderness
4)Skin consistency

Answer 3

1

Question 4

The nurse is asking a client questions regarding lifestyle patterns.Which of the following statements by the client would alert the nurse to possible risk for breast cancer?
1)"I work in a chemical factory."
2)"I drink two glasses of wine each night."
3)"I have smoked two packs of cigarettes daily for four years."
4)"I occasionally have unprotected sexual contact with unknown partners."

Question 5

The nurse is teaching a client with benign breast disease about symptom relief.Which of the following topics would the nurse include in this session?
1)Avoiding all fat in the diet
2)Wearing a firm bra
3)Limiting salt intake
4)Drinking tea instead of coffee

Question 6

The nurse is teaching a group of high school males about self-breast examination.The nurse knows the teaching has been effective when one of the males makes which of the following comments regarding breast cancer in males?
1)"I need to be concerned only if I have pain in my chest."
2)"I know that I need to do monthly self-breast exams."
3)"I'll be able to know about problems if I see changes in my chest."
4)"Breast cancer is not something I have to worry about."

Question 7

The nurse is compiling statistics for a breast cancer awareness presentation for a group of women.The nurse would correctly use which of the following facts about breast cancer?
1)Breast cancer is one of the most common cancers in females.
2)Rates are on the decline.
3)Associated mortality has declined.
4)Diagnostics have improved.
5)25% of females in Western countries are genetically predisposed.

Question 8

A pregnant client expresses concern about performing breast self-examination during pregnancy since her breasts are tender.Which of the following would be the best response by the nurse in this situation?
1)"All you need to do is just concentrate on having a healthy baby for now."
2)"You can wait until your breasts are no longer tender,and then resume your self-exams."
3)"It's very important for you to be familiar with the changes in your breasts."
4)"Breast cancer during pregnancy is rare,so don't worry about it."

Question 9

A female client is hospitalized with injury and tissue destruction of the left pectoralis major and serratus anterior muscles due to a motor vehicle accident.The nurse would include which of the following information during the discharge teaching?
1)Prosthestic devices
2)Support bras
3)Plastic surgery
4)Physical therapy

Question 10

The nurse is assessing a client and confirms the presence of galactorrhea.The nurse understands that this finding is:
1)suggestive of endocrine disorders.
2)may indicate a malignancy.
3)probably an infection.
4)usually indicative of lactation.

Question 11

The nurse is preparing a poster on self-breast examination and is labeling the anatomical structures of the breast.Identify the area that the nurse should label as the tail of Spence.

Question 12

During the breast examination on a client,the nurse palpates a small,subclavicular node on the right side of the client's chest.The priority action at this time is for the nurse is to do which of the following?
1)Call the primary care provider.
2)Ask the client if they have a family history of breast cancer.
3)Continue with the exam.
4)Schedule a mammogram for the next available appointment.

Question 13

The nurse is examining a client with a history of benign breast disease (sometimes referred to as fibrocystic breast disease).The nurse would expect which of the following findings during this assessment?
1)Straw-colored discharge from the nipples
2)Freely movable masses
3)Hard,fixed nodules
4)Thickened breast tissue
5)Masses with well defined boundaries

Question 14

The nurse is interviewing a 37-year-old client for breast cancer risks.The nurse understands that the client knows the risks associated with breast cancer when which of the following comments is made?
1)"I know my risk for breast cancer increases with age."
2)"A mammogram every three years is my goal."
3)"I will see my healthcare provider every two years for a breast examination."
4)"My family history is negative so I do not need to worry."

Question 15

The nurse is performing an assessment on a newborn and notes a thin,milky discharge from the infant's nipple.The nurse knows this is a:
1)congenital anomaly.
2)highly irregular finding.
3)reason to call in a specialist.
4)common finding in newborns.

Question 16

The nurse is teaching an older adult client about breast self-examination (BSE).Which of the following should the nurse provide during this instruction?
1)Additional lighting
2)Increased time
3)Opportunity for questions
4)Large-print handouts
5)A quiz at the end of the instruction

Question 17

The nurse is educating a prenatal class about lactation when one of the clients asks how milk is produced.The nurse would correctly identify which of the following structures as responsible for milk production?
1)Montgomery's glands
2)Areola
3)Acini cells
4)Mammary ridge

Question 18

The nurse is planning to perform a breast examination of a female client.In preparing the client,the nurse will inform the client to expect which of the following techniques?
1)Inspection
2)Palpation
3)Percussion
4)Auscultation
5)Client interview

Question 19

The nurse is teaching self-breast examination to a client and demonstrates inspecting the breasts with arms over the head.The client asks the nurse why this is necessary.The nurse would respond with which of the following?
1)"It allows any masses to bulge forward to be seen."
2)"This is the only position to detect Paget's disease."
3)"This is the best position to look for skin dimpling."
4)"It is the only way to look for nipple retraction."

Question 20

A menopausal woman comes to the clinic with complaints of thin,watery nipple discharge with blood present.The nurse would suspect which of the following disorders in this client?
1)Mammary duct ectasia
2)Fibrocystic disease
3)Breast malignancy
4)Intraductal papillomas

Question 21

The mother of a 9-year-old girl voices concern to the nurse regarding her daughter's breast development and breast tenderness.The nurse's best response to the mother is:
1)"I understand your concern.9 years old is very young for your daughter's breasts to be developing.Children this age are not equipped to deal with these changes."
2)"I will let her primary care provider know that an exam is necessary due to your daughter's symptoms."
3)"I wouldn't worry about it unless the tenderness continues or worsens."
4)"Breast enlargement and tenderness is common between the ages of 9 to 13,but I will inform her primary care provider of your concerns."

Question 22

During a health assessment,a male client voices concern that he is at risk for breast cancer.The nurse is aware that further evaluation of the client's history should focus on predisposing factors that increase the chance for breast cancer in males.The interview should include questions related to which of the following factors?
1)Previous history of taking testosterone
2)The client's mother having a history of breast cancer
3)History of cirrhosis of the liver
4)History of kidney disease
5)History of radiation treatment for lung cancer

Question 23

While the nurse is performing an assessment of a male client,gynecomastia is noted.The nurse is aware that this condition is most frequently associated with:
1)cancer of the breast in male clients.
2)infants following birth.
3)the onset of puberty.
4)older males that have undergone hormonal treatment.
5)infection of breast tissue.

Question 24

A female client asks the nurse when the best time is to perform self-breast examination (SBE).The nurse's best response is:
1)"If you are still menstruating the best time is about 5 days after your period begins each month."
2)"If you are postmenopausal the best time is at the beginning of each month."
3)"It doesn't really matter as long as you keep a record of when you perform the exam."
4)"Your primary care provider can tell you when the best time is for you."

Question 25

The nurse working in a predominately Hispanic community outlines a breast health screening.The nurse is aware that:
1)Breast cancer is the leading cause of cancer death in Hispanic women.
2)This cultural group is strict about performing monthly self breast exams.
3)Hispanic women have a higher incidence of breast cancer after age 40.
4)Hispanic women have an open attitude about private issues.

Question 26

While the nurse is counseling a client about fibrocystic breast disease,the client asks if having this disorder will lead to cancer.The nurse's best response is:
1)"There is no direct link between this disease and breast cancer."
2)"You will need to ask the primary healthcare provider that question."
3)"This disease is a form of cancer."
4)"Why are you so worried about this?"

Question 27

During the focused assessment of a female client,she reports breast tenderness,swelling,and lymph node enlargement around the time of her period.The nurse's best response to this finding is:
1)"This sounds like a condition known as nodularity.It is a benign disorder so you will need to monitor your breasts monthly."
2)"Fluctuating hormone levels around the time of your period frequently causes these symptoms.I will note this in your chart and notify your primary care provider."
3)"As long as you have not detected any lumps you have nothing to worry about."
4)"Do you have a history of fibrocystic breast disease? These symptoms are usually seen with this disease."

Question 28

The nurse is performing a breast assessment of an Asian adult female.Which of the following should the nurse do first?
1)Ask the client if she has ever had any breast disease such as cancer of the breast,fibrocystic disease,or fibroadenoma.
2)Ask the client to disrobe from the waist up and place a gown on with the opening to the front.
3)Ask the client if she has noticed any changes in her breasts such as lumps,thickening,or discharge from the nipples.
4)Ask the client how she feels about her breasts.

Question 29

The nurse is teaching a childbirth education class.The nurse would be correct in stating that which of the following commonly leaks from the nipples during the last month of pregnancy?
1)Blood
2)Milk
3)Serum
4)Colostrum

Question 30

The nurse is aware that the client with breast cancer is most at risk for metastasis of the disease through the lymphatic system.Identify which lymph nodes are most responsible for the spread of breast cancer via the lymphatic system: