Ch. 17: Breast & Regional Lymphatics Flashcards
Which of the following statements is true regarding the internal structures of the breast? The breast is:
A) mainly muscle, with very little fibrous tissue
B) composed of fibrous, glandular, and adipose tissue
C) composed mostly of milk ducts, known as lactiferous ducts
D) composed of glandular tissue, which supports the breast by attaching to the chest wall
B) composed of fibrous, glandular, and adipose tissue
In performing a breast examination, the nurse knows that it is especially important to examine the upper outer quadrant of the breast. 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
B) the location of most breast tumors
In performing an assessment of a woman’s axillary lymph system, the nurse should assess which of these nodes?
A) central, axillary, lateral, and sternal nodes
B) pectoral, lateral, anterior, and sternal nodes
C) central, lateral, pectoral, and subscapular nodes
D) lateral, pectoral, axillary, and suprascapular nodes
C) central, lateral, pectoral, and subscapular nodes
If a patient reports a recent breast infection, then the nurse should expect to find _____ node enlargement.
A) nonspecific
B) ipsilateral axillary
C) contralateral axillary
D) inguinal and cervical
B) ipsilateral axillary
A 9-year-old girl is in the clinic for a sports physical. After some initial shyness she finally asks, “Am I normal? I don’t seem to need a bra yet, but I have some friends who do. What if I never get breasts?” The nurse’s best response would be:
A) “Don’t worry, you still have plenty of time to develop.”
B) “I know just how you feel, I was a late bloomer myself. Just be patient and they will grow.”
C) “You will probably get your periods before you notice any significant growth in your breasts.”
D) “I understand that it is hard to feel different from your friends. Breasts usually develop between 8 and 10 years of age.”
D) “I understand that it is hard to feel different from your friends. Breasts usually develop between 8 and 10 years of age.”
A patient contacts the office and tells the nurse that she is worried about her 10-year-old daughter having breast cancer. She describes a unilateral enlargement of the right breast with associated tenderness. She is worried because the left breast is not enlarged. What would be the nurse’s best response?
A) tell the mother that breast development is usually fairly symmetric and she should be examined right away
B) tell the mother that she should bring her daughter in right away because breast cancer is fairly common in preadolescent girls
C) tell the mother that, although an examination of her daughter would rule out a problem, it is most likely normal breast development
D) tell the mother that it is unusual for breasts that are first developing to feel tender because they haven’t developed much fibrous tissue
C) tell the mother that, although an examination of her daughter would rule out a problem, it is most likely normal breast development
A 14-year-old girl is anxious about not having reached menarche. When taking the history, the nurse should ascertain which of the following? The age:
A) she began to develop breasts
B) her mother developed breasts
C) she began to develop pubic hair
D) she began to develop axillary hair
A) she began to develop breasts
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 nurse’s best response?
A) tell her that it is unusual. The breasts of nonpregnant females usually stay pretty much the same all month long
B) tell her that it is very common for breasts to change in response to stress and that she should assess her life for stressful events
C) tell her that, because of the changing hormones during the monthly menstrual cycle, cyclic breast changes are common
D) tell her that breast changes normally occur only during pregnancy and that a pregnancy test is needed at this time
C) tell her that, because of the changing hormones during the monthly menstrual cycle, cyclic breast changes are common
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 report this immediately
D) during pregnancy, breast changes are fairly uncommon; most of the changes occur after the birth
A) she can expect her areolae to become larger and darker in color
The nurse is teaching a pregnant woman about breast milk. Which statement by the nurse is correct?
A) “Your breast milk is present immediately after delivery of the 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 nutrition as breast milk does.”
D) “You may notice a thick, yellow fluid expressed from your breasts as early as the fourth month of pregnancy.”
D) “You may notice a thick, yellow fluid expressed from your breasts as early as the fourth month of pregnancy.”
A 65-year-old patient remarks that she just can’t believe that her breasts sag so much. She states it must be from lack of exercise. What explanation should the nurse offer her?
A) after menopause, only women with large breasts experience sagging
B) after menopause, sagging is usually due to decreased muscle mass within the breast
C) after menopause, a diet that is high in protein will help maintain muscle mass, which keeps the breasts from sagging
D) after menopause, the glandular and fat tissue atrophies, causing breast size and elasticity to diminish, resulting in breasts that sag
D) after menopause, the glandular and fat tissue atrophies, causing breast size and elasticity to diminish, resulting in breasts that sag
In examining a 70-year-old male patient, the nurse notices that he has bilateral gynecomastia. Which of the following describes the nurse’s best course of action?
A) recommend that he make an appointment with his physician for a mammogram
B) ignore it; it is not unusual for men to have benign breast enlargement
C) explain that this condition may be the result of hormonal changes and recommend that he see his physician
D) tell him that gynecomastia in men is usually associated with prostate enlargement and recommend that he be screened thoroughly
C) explain that this condition may be the result of hormonal changes and recommend that he see his physician
During an examination of a 7-year-old girl, the nurse notices that the girl is showing breast budding. What should the nurse do next?
A) ask her if her periods have started
B) assess the girl’s weight and body mass index (BMI)
C) ask the girl’s mother at what age she started to develop breasts
D) nothing; this is a normal finding
B) assess the girl’s weight and body mass index (BMI)
The nurse is preparing for a class in early detection of breast cancer. Which statement is true with regard to breast cancer in African-American women in the United States?
A) breast cancer is not a threat to African-American women
B) African-American women have a lower incidence of regional or distant breast cancer than white women
C) African-American women are more likely to die of breast cancer at any age
D) breast cancer incidence in African-American women is higher than that of white women after age 45
C) African-American women are more likely to die of breast cancer at any age
During a breast health interview, a patient states that she has noticed pain in her left breast. The nurse’s most appropriate response to this would be:
A) “Don’t worry about the pain; breast cancer is not painful.”
B) “I would like some more information about the pain in your left breast.”
C) “Oh, I had pain like that after my son was born; it turned out to be a blocked milk duct.”
D) “Breast pain is almost always the result of benign breast disease.”
B) “I would like some more information about the pain in your left breast.”
During a history interview, a female patient states that she has noticed a few drops of clear discharge from her right nipple. What should the nurse do next?
A) contact the physician immediately to report the discharge
B) ask her if she is possibly pregnant
C) ask her some additional questions about the medications she is taking
D) immediately obtain a sample for culture and sensitivity testing
C) ask her some additional questions about the medications she is taking
During a physical examination, a 45-year-old woman states that she has had a crusty, itchy rash on her breast for about 2 weeks. In trying to find the cause of the rash, which of these would be important for the nurse to determine?
A) Is the rash raised and red?
B) Does it appear to be cyclic?
C) Where did it first appear—on the nipple, the areola, or the surrounding skin?
D) What was she doing when she first noticed the rash, and do her actions make it worse?
C) Where did it first appear—on the nipple, the areola, or the surrounding skin?
A patient is newly diagnosed with benign breast disease. The nurse recognizes that which statement about benign breast disease is true? The presence of benign breast disease:
A) makes it harder to examine the breasts
B) frequently turns into cancer in a woman’s later years
C) is easily reduced with hormone replacement therapy
D) is usually diagnosed before a woman reaches childbearing age
A) makes it harder to examine the breasts
During an annual physical exam, a 43-year-old patient states that she doesn’t perform monthly breast self-examinations (BSE). 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) breast self-examination is unnecessary until the age of 50 years
C) she is correct, mammography is a good replacement for breast self-examination
D) she doesn’t need to perform breast self-examination as long as a physician checks her breasts yearly
A) BSEs may detect lumps that appear between mammograms
During an interview, a patient reveals that she is pregnant. She states that she is not sure whether she will breastfeed her baby and asks for some information about this. Which of these statements by the nurse is accurate with regard to breastfeeding?
A) “Breastfed babies tend to be more colicky.”
B) “Breastfeeding provides the perfect food and antibodies for your baby.”
C) “Breastfed babies eat more often than infants on formula.”
D) “Breastfeeding is second nature and every woman can do it.”
B) “Breastfeeding provides the perfect food and antibodies for your baby.”
The nurse is reviewing risk factors for breast cancer. Which of these women have risk factors that place them at a higher risk for breast cancer?
A) 37 year old who is slightly overweight
B) 42 year old who has had ovarian cancer
C) 45 year old who has never been pregnant
D) 65 year old whose mother had breast cancer
D) 65 year old whose mother had breast cancer
During an examination of a woman, the nurse notices that her left breast is slightly larger than her right breast. Which of these statements is true about this finding?
A) breasts should always be symmetric
B) this finding is probably due to breastfeeding and is nothing to worry about
C) this finding is not unusual, but the nurse should verify that this change is not new
D) this finding is very unusual and means she may have an inflammation or growth
C) this finding is not unusual, but the nurse should verify that this change is not new
The nurse is assisting with a self-breast examination clinic. Which of these women reflect abnormal findings during the inspection phase of breast examination?
A) woman whose nipples are in different planes (deviated)
B) woman whose left breast is slightly larger than her right
C) nonpregnant woman whose skin is marked with linear striae
D) pregnant woman whose breasts have a fine blue network of veins visible under the skin
A) woman whose nipples are in different planes (deviated)
During the physical examination, the nurse notices that a female patient has an inverted left nipple. Which statement regarding this is most accurate?
A) normal nipple inversion is usually bilateral
B) a unilateral inversion of a nipple is always a serious sign
C) it should be determined whether the inversion is a recent change
D) nipple inversion is not significant unless accompanied by an underlying palpable mass
C) it should be determined whether the inversion is a recent change
