PRACTICE QUESTIONS: Chapter 18 (Exam #2)

Question 1

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
B. Pectoral, lateral, anterior, and sternal
C. Central, lateral, pectoral, and subscapular
D. Lateral, pectoral, axillary, and suprascapular

Answer 1

C. Central, lateral, pectoral, and subscapular

Question 2

In examining a 70-year-old male patient, the nurse notices that he has bilateral gynecomastia. Which of the following describes the nurses best course of action?

A. Recommend that he make an appointment with
his physician for a mammogram.
B. Ignore it. Benign breast enlargement in men is not
unusual.
C. Explain that this condition may be the result of
hormonal changes, and recommend that he see
his physician.
D. Explain that gynecomastia in men is usually
associated with prostate enlargement and
recommend that he be thoroughly screened.

Answer 2

C. Explain that this condition may be the result of hormonal changes, and recommend that he see his physician.

Question 3

The nurse is reviewing statistics regarding breast cancer. Which woman, aged 40 years in the United States, has the highest risk for developing breast cancer?

A. Black
B. White
C. Asian
D. American Indian

Answer 3

A. Black

Question 4

During a breast health interview, a patient states that she has noticed pain in her left breast. The nurses 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.

Answer 4

B. I would like some more information about the pain in your left breast.

Question 5

During a health 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. Immediately contact the physician to report the
discharge.
B. Ask her if she is possibly pregnant.
C. Ask the patient some additional questions about
the medications she is taking.
D. Immediately obtain a sample for culture and
sensitivity testing.

Answer 5

C. Ask the patient some additional questions about the medications she is taking.

Question 6

During a physical examination, a 45-year-old woman states that she has had a crusty, itchy rash on her breast for approximately 2 weeks. In trying to find the cause of the rash, which question would be important for the nurse to ask?

A. Is the rash raised and red?
B. Does it appear to be cyclic?
C. Where did the rash 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?

Answer 6

C. Where did the rash first appearon the nipple, the areola, or the surrounding skin?

Question 7

A patient is newly diagnosed with benign breast disease. The nurse recognizes which statement about benign breast disease to be true? The presence of benign breast disease:

A. Makes it hard to examine the breasts.
b. Frequently turns into cancer in a womans later years.
c. Is easily reduced with hormone replacement therapy.
d. Is usually diagnosed before a woman reaches childbearing age.

Answer 7

A. Makes it hard to examine the breasts.

Question 8

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 correct mammography is a good replacement for BSE.
D. She does not need to perform BSEs as long as a physician checks her
breasts annually.

Answer 8

A. BSEs may detect lumps that appear between mammograms.

Question 9

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

Answer 9

D. 65 year old whose mother had breast cancer

Question 10

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. Asymmetry of breast size and shape is probably due to breastfeeding
and is nothing to worry about.
C. Asymmetry is not unusual, but the nurse should verify that this change is
not new.
D. Asymmetry of breast size and shape is very unusual and means she may
have an inflammation or growth.

Answer 10

C. Asymmetry is not unusual, but the nurse should verify that this change is not new.

Question 11

The nurse is assisting with a BSE 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.

Answer 11

A. Woman whose nipples are in different planes (deviated).

Question 12

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. Unilateral inversion of a nipple is always a serious sign.
C. Whether the inversion is a recent change should be determined.
D. Nipple inversion is not significant unless accompanied by an underlying palpable mass.

Answer 12

C. Whether the inversion is a recent change should be determined.

Question 13

The nurse is performing a breast examination. Which of these statements best describes the correct procedure to use when screening for nipple and skin retraction during a breast examination? Have the woman:

A. Bend over and touch her toes.
B. Lie down on her left side and notice any retraction.
C. Shift from a supine position to a standing position, and note any lag or
retraction.
D. Slowly lift her arms above her head, and note any retraction or lag in
movement.

Answer 13

D. Slowly lift her arms above her head, and note any retraction or lag in movement.

Question 14

The nurse is palpating a female patients breasts during an examination. Which of these positions is most likely to make significant lumps more distinct during breast palpation?

A. Supine with the arms raised over her head
B. Sitting with the arms relaxed at her sides
C. Supine with the arms relaxed at her sides
D. Sitting with the arms flexed and fingertips touching her shoulders

Answer 14

A. Supine with the arms raised over her head

Question 15

A patient states during the interview that she noticed a new lump in the shower a few days ago. It was on her left breast near her axilla. The nurse should plan to:

A. Palpate the lump first
B. Palpate the unaffected breast first.
C. Avoid palpating the lump because it could be a cyst, which might rupture.
D. Palpate the breast with the lump first but plan to palpate the axilla last.

Answer 15

B. Palpate the unaffected breast first

Question 16

The nurse has palpated a lump in a female patients right breast. The nurse documents this as a small, round, firm, distinct, lump located at 2 oclock, 2 cm from the nipple. It is nontender and fixed. No associated retraction of the skin or nipple, no erythema, and no axillary lymphadenopathy are observed. What information is missing from the documentation?

A. Shape of the lump
B. Consistency of the lump
C. Size of the lump
D. Whether the lump is solitary or multiple

Answer 16

C. Size of the lump

Question 17

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.

Answer 17

C. The best time to perform a BSE is 4 to 7 days after the first day of the menstrual period.

Question 18

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.

Answer 18

cC BSE on a monthly basis will help you become familiar with your own breasts and feel their normal variations.

Question 19

A 55-year-old postmenopausal woman is being seen in the clinic for her annual examination. She is concerned about changes in her breasts that she has noticed over the past 5 years. She states that her breasts have decreased in size and that the elasticity has changed so that her breasts seem flat and flabby. The nurses best reply would be:

A. This change occurs most often because of long-term use of bras that do not provide
enough support to the breast tissues.
B. This is a normal change that occurs as women get older and is due to the increased levels
of progesterone during the aging process.
C. Decreases in hormones after menopause causes atrophy of the glandular tissue in the
breast and is a normal process of aging.
D. Postural changes in the spine make it appear that your breasts have changed in shape.
Exercises to strengthen the muscles of the upper back and chest wall will help prevent
the changes in elasticity and size.

Answer 19

C. Decreases in hormones after menopause causes atrophy of the glandular tissue in the breast and is a normal process of aging.

Question 20

A 43-year-old woman is at the clinic for a routine examination. She reports that she has had a breast lump in her right breast for years. Recently, it has begun to change in consistency and is becoming harder. She reports that 5 years ago her physician evaluated the lump and determined that it was nothing to worry about. The examination validates the presence of a mass in the right upper outer quadrant at 1 o’clock, approximately 5 cm from the nipple. It is firm, mobile, and nontender, with borders that are not well defined. The nurse replies:

A. Because of the change in consistency of the lump, it should be further evaluated by a
physician.
B. The changes could be related to your menstrual cycles. Keep track of the changes in the
mass each month.
C. The lump is probably nothing to worry about because it has been present for years and
was determined to be non cancerous 5 years ago.
D. Because you are experiencing no pain and the size has not changed, you should continue
to monitor the lump and return to the clinic in 3 months.

Answer 20

A. Because of the change in consistency of the lump, it should be further evaluated by a physician.

Question 21

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.

Answer 21

C. Examine your breasts shortly after your menstrual period each month.

Question 22

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.

Answer 22

A. On the same day every month

Question 23

While inspecting a patients breasts, the nurse finds that the left breast is slightly larger than the right with the bilateral presence of Montgomery glands. The nurse should:

A. Palpate over the Montgomery glands, checking for drainage.
B. Consider these findings as normal, and proceed with the examination.
C. Ask extensive health history questions regarding the womans breast asymmetry.
D. Continue with the examination, and then refer the patient for further evaluation of the
Montgomery glands.

Answer 23

B. Consider these findings as normal, and proceed with the examination.

Question 24

While examining a 75-year-old woman, the nurse notices that the skin over her right breast is thickened and the hair follicles are exaggerated. This condition is known as:

A. Dimpling.
B. Retraction.
C. Peau d’orange.
D. Benign breast disease.

Answer 24

C. Peau d’orange

Question 25

A new mother calls the clinic to report that part of her left breast is red, swollen, tender, very hot, and hard. She has a fever of 38.3 C. She also has had symptoms of influenza, such as chills, sweating, and feeling tired. The nurse notices that she has been breastfeeding for 1 month. From her description, what condition does the nurse suspect?

A. Mastitis
B. Paget disease
C. Plugged milk duct
D. Mammary duct ectasia

Answer 25

A. Mastitis

Question 26

During a breast examination on a female patient, the nurse notices that the nipple is flat, broad, and fixed. The patient states it started doing that a few months ago. This finding suggests:

A. Dimpling.
B. Retracted nipple.
C. Nipple inversion.
D. Deviation in nipple pointing.

Answer 26

B. Retracted nipple.

Question 27

The nurse is assessing the breasts of a 68-year-old woman and discovers a mass in the upper outer quadrant of the left breast. When assessing this mass, the nurse is aware that characteristics of a cancerous mass include which of the following? Select all that apply.

A. Nontender mass
B. Dull, heavy pain on palpation
C. Rubbery texture and mobile
D. Hard, dense, and immobile
E. Regular border
F. Irregular, poorly delineated border

Answer 27

A. Non-tender mass
D. Hard, dense, and immobile
F. Irregular, poorly delineated border

Question 28

The nurse is examining a 62-year-old man and notes that he has bilateral gynecomastia. The nurse should explore his health history for which related conditions?
Select all that apply.

A. Malnutrition
B. Hyperthyroidism
C. Type 2 diabetes mellitus
D. Liver cirrhosis

Answer 28

B. Hyperthyroidism
D. Liver cirrhosis