ATI LPN
Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017)
Chapter 58 Questions
Question 1 of 5
A 45-year-old woman comes into the health clinic for her annual check-up. She mentions to the nurse that she has noticed dimpling of the right breast that has occurred in a few months. What assessment would be most appropriate for the nurse to make?
Correct Answer: B
Rationale: Dimpling of the breast is a concerning sign that may indicate an underlying breast mass or malignancy, such as breast cancer, due to possible lymphatic obstruction or tumor fixation. Palpating the area to assess for a mass is the most appropriate action to identify potential pathology and determine the need for referral. Evaluating milk production is irrelevant as there is no indication of lactation. Assessing knowledge is secondary to physical examination, and dimpling is not an age-related change.
Question 2 of 5
The nurse leading an educational session is describing self-examination of the breast. The nurse tells the womens group to raise their arms and inspect their breasts in a mirror. A member of the patients group asks the nurse why raising her arms is necessary. What is the nurses best response?
Correct Answer: C
Rationale: Raising the arms during breast self-examination accentuates any skin changes, such as dimpling or retraction, by tightening the skin and underlying tissues, making these signs more visible. This is the primary reason for this maneuver. Spreading adipose tissue or assessing pain are not the goals, and citing the American Cancer Society does not directly answer the question.
Question 3 of 5
A woman aged years comes into the clinic because she has discovered a lump in her breast. After diagnostic testing, the patient receives a diagnosis of cancer. The nurse asks when patients should begin mammography. What is the nurses best advice?
Correct Answer: C
Rationale: For women with a first-degree relative diagnosed with breast cancer at age 48, screening mammography should begin 5 to 10 years earlier than the age of diagnosis, but not before age 25. Starting at age 38 aligns with this guideline, providing early detection for those at increased familial risk.
Question 4 of 5
A woman scheduled for a simple mastectomy in one week is having her preoperative education provided by the clinic nurse. What educational intervention will be of primary importance to prevent hemorrhage in the postoperative period?
Correct Answer: C
Rationale: Aspirin has anticoagulant properties that can increase the risk of postoperative bleeding. Instructing the patient to stop taking aspirin is critical to minimize hemorrhage risk. Limiting green leafy vegetables affects vitamin K levels but is less directly related to immediate bleeding risk. Fluid intake or NPO status does not significantly impact hemorrhage prevention.
Question 5 of 5
The nurse is caring for a 52-year-old woman whose aunt and mother died of breast cancer. The patient states, My doctor and I talked about Tamoxifen to help prevent breast cancer. Do you think it will work? What would be the nurses best response?
Correct Answer: D
Rationale: Tamoxifen is a selective estrogen receptor modulator proven to significantly reduce the risk of breast cancer in high-risk women, making it a highly effective chemopreventive agent. It does not eliminate risk entirely, and it also helps prevent osteoporosis, not increase it. A slight protective effect understates its efficacy.