A 40-year-old woman has just been diagnosed with stage 2 breast cancer. Which of the following are common reactions? Select all that apply.

Correct Answer: A

Rationale: The correct answer is A. Anxiety is common due to the impact on family, body image, disability, and pain. Concern about treatment disruptions is valid but not as common as anxiety. Fear of death is a general fear but may not be as prominent as anxiety. Decisional conflict can occur but is more specific to treatment options rather than a common reaction.

Correct Answer: B

Rationale: Correct Answer: B Rationale: 1. Breast reconstruction is not always done immediately to allow for healing post-mastectomy. 2. Immediate reconstruction may not be suitable for all patients due to various factors. 3. Delayed reconstruction is also a valid option and can be performed at a later time. 4. Therefore, the statement that breast reconstruction is always done immediately along with the mastectomy is not true. Summary: A: True - Breast reconstruction aims to promote symmetry and preserve body image. C: True - Breast reconstruction does not affect survival rates or interfere with treatments. D: True - Breast reconstruction generally has low morbidity and high patient satisfaction.

Correct Answer: B

Rationale: The correct answer is B: Those who have multiple tumors in the breast in several quadrants. Mastectomy is usually recommended for patients with multiple tumors in several quadrants to ensure complete removal of all cancerous tissue. This choice is correct because it addresses the need for more extensive surgery to effectively treat the cancer. A: Those who have not had radiation to the breast - Incorrect, as radiation history is not the sole determinant for recommending mastectomy. C: Those with no extensive DCIS - Incorrect, as the presence of DCIS alone may not warrant a mastectomy. D: Those with a small tumor compared to breast volume - Incorrect, as tumor size relative to breast volume is not the primary factor in determining the need for mastectomy in cases of multiple tumors in several quadrants.

Correct Answer: B

Rationale: The correct answer is B. Vaginal dryness is a common side effect of hormonal therapy. Using vaginal moisturizers like Replens or vitamin E suppositories can help alleviate this symptom by providing moisture and lubrication. This intervention can improve the woman's comfort and quality of life during treatment. Choice A is incorrect because wearing layered clothing and avoiding caffeine and spicy foods are strategies typically recommended for managing hot flashes, not vaginal dryness. Choice C is incorrect as managing nausea and vomiting with a bland diet and medication is not directly related to the management of side effects of hormonal therapy like vaginal dryness. Choice D is incorrect as warm baths and nonsteroidal analgesics are more commonly used to ease musculoskeletal symptoms, not specifically for managing vaginal dryness.

Correct Answer: D

Rationale: The correct answer is D: Less interest in sex. Galactorrhea is the spontaneous flow of milk from the breast unassociated with childbirth or nursing. It is commonly caused by elevated levels of prolactin, which can suppress the production of sex hormones like estrogen and testosterone, leading to symptoms like decreased libido and less interest in sex. The other choices, A, B, and C, are incorrect because milky white discharge from nipples (A) is a symptom of galactorrhea, absence of menstrual periods (B) is more indicative of conditions like amenorrhea, and temperature intolerance (C) is not typically associated with galactorrhea.