Breast Flashcards
In performing a breast examination, the nurse knows that examining the upper outer quadrant of the breast is especially important. The reason for this is that the upper outer quadrant is:
a.
The largest quadrant of the breast.
b.
The location of most breast tumors.
c.
Where most of the suspensory ligaments attach.
d.
More prone to injury and calcifications than other locations in the breast.
ANS: B
The upper outer quadrant is the site of most breast tumors. In the upper outer quadrant, the nurse should notice the axillary tail of Spence, the cone-shaped breast tissue that projects up into the axilla, close to the pectoral group of axillary lymph nodes.
- A woman is in the family planning clinic seeking birth control information. She states that her breasts change all month long and that she is worried that this is unusual. What is the nurses best response? The nurse should tell her that:
a.
Continual changes in her breasts are unusual. The breasts of nonpregnant women usually stay pretty much the same all month long.
b.
Breast changes in response to stress are very common and that she should assess her life for stressful events.
c.
Because of the changing hormones during the monthly menstrual cycle, cyclic breast changes are common.
d.
Breast changes normally occur only during pregnancy and that a pregnancy test is needed at this time.
ANS: C
Breasts of the nonpregnant woman change with the ebb and flow of hormones during the monthly menstrual cycle. During the 3 to 4 days before menstruation, the breasts feel full, tight, heavy, and occasionally sore. The breast volume is smallest on days 4 to 7 of the menstrual cycle.
A woman has just learned that she is pregnant. What are some things the nurse should teach her about her breasts?
a.
She can expect her areolae to become larger and darker in color.
b.
Breasts may begin secreting milk after the fourth month of pregnancy.
c.
She should inspect her breasts for visible veins and immediately report these.
d.
During pregnancy, breast changes are fairly uncommon; most of the changes occur after the birth.
ANS: A
The areolae become larger and grow a darker brown as pregnancy progresses, and the tubercles become more prominent. (The brown color fades after lactation, but the areolae never return to their original color). A venous pattern is an expected finding and prominent over the skin surface and does not need to be reported. After the fourth month of pregnancy, colostrum, a thick, yellow fluid (precursor to milk), may be expressed from the breasts.
- The nurse is teaching a pregnant woman about breast milk. Which statement by the nurse is correct?
a.
Your breast milk is immediately present after the delivery of your baby.
b.
Breast milk is rich in protein and sugars (lactose) but has very little fat.
c.
The colostrum, which is present right after birth, does not contain the same nutrients as breast milk.
d.
You may notice a thick, yellow fluid expressed from your breasts as early as the fourth month of pregnancy.
ANS: D
After the fourth month, colostrum may be expressed. This thick yellow fluid is the precursor of milk, and it contains the same amount of protein and lactose but practically no fat. The breasts produce colostrum for the first few days after delivery. It is rich with antibodies that protect the newborn against infection; therefore, breastfeeding is important.
During an annual physical examination, a 43-year-old patient states that she does not perform monthly breast self-examinations (BSEs). She tells the nurse that she believes that mammograms do a much better job than I ever could to find a lump. The nurse should explain to her that:
a.
BSEs may detect lumps that appear between mammograms.
b.
BSEs are unnecessary until the age of 50 years.
c.
She is correctmammography is a good replacement for BSE.
d.
She does not need to perform BSEs as long as a physician checks her breasts annually.
ANS: A
The monthly practice of BSE, along with clinical breast examination and mammograms, are complementary screening measures. Mammography can reveal cancers too small to be detected by the woman or by the most experienced examiner. However, interval lumps may become palpable between mammograms.
- The nurse is conducting a class on BSE. Which of these statements indicates the proper BSE technique?
a.
The best time to perform BSE is in the middle of the menstrual cycle.
b.
The woman needs to perform BSE only bimonthly unless she has fibrocystic breast tissue.
c.
The best time to perform a BSE is 4 to 7 days after the first day of the menstrual period.
d.
If she suspects that she is pregnant, then the woman should not perform a BSE until her baby is born.
ANS: C
The nurse should help each woman establish a regular schedule of self-care. The best time to conduct a BSE is right after the menstrual period, or the fourth through seventh day of the menstrual cycle, when the breasts are the smallest and least congested. The pregnant or menopausal woman who is not having menstrual periods should be advised to select a familiar date to examine her breasts each monthfor example, her birth date or the day the rent is due.
The nurse is preparing to teach a woman about BSE. Which statement by the nurse is correct?
a.
BSE is more important than ever for you because you have never had any children.
b.
BSE is so important because one out of nine women will develop breast cancer in her lifetime.
c.
BSE on a monthly basis will help you become familiar with your own breasts and feel their normal variations.
d.
BSE will save your life because you are likely to find a cancerous lump between mammograms.
ANS: C
The nurse should stress that a regular monthly BSE will familiarize the woman with her own breasts and their normal variations. BSE is a positive step that will reassure her of her healthy state. While teaching, the nurse should focus on the positive aspects of BSE and avoid citing frightening mortality statistics about breast cancer, which may generate excessive fear and denial that can obstruct a womans self-care actions.
- During a discussion about BSEs with a 30-year-old woman, which of these statements by the nurse is most appropriate?
a.
The best time to examine your breasts is during ovulation.
b.
Examine your breasts every month on the same day of the month.
c.
Examine your breasts shortly after your menstrual period each month.
d.
The best time to examine your breasts is immediately before menstruation.
ANS: C
The best time to conduct a BSE is shortly after the menstrual period when the breasts are the smallest and least congested.
- The nurse is discussing BSEs with a postmenopausal woman. The best time for postmenopausal women to perform BSEs is:
a.
On the same day every month.
b.
Daily, during the shower or bath.
c.
One week after her menstrual period.
d.
Every year with her annual gynecologic examination.
ANS: A
Postmenopausal women are no longer experiencing regular menstrual cycles but need to continue to perform BSEs on a monthly basis. Choosing the same day of the month is a helpful reminder to perform the examination.
