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Exam 18: Breasts and Axillae

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Question 1

Multiple Choice

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The nurse is assessing a client and confirms the presence of galactorrhea. Which conclusion by the nurse is the most appropriate?

A) It suggests an endocrine disorder.
B) It may indicate a malignancy.
C) It suggests a breast infection.
D) It is usually indicative of lactation.

E) A) and B)
F) A) and C)

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Question 2

Multiple Choice

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A pregnant client expresses concern about performing breast self-examination during pregnancy since her breasts are tender. Which response by the nurse is the most appropriate?

A) "All you need to do is just concentrate on having a healthy baby for now."
B) "You can wait until your breasts are no longer tender, and then resume your self-exams."
C) "It's very important for you to be familiar with the changes in your breasts."
D) "Breast cancer during pregnancy is rare, so don't worry about it."

E) A) and B)
F) A) and C)

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Question 3

Multiple Choice

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While the nurse is counseling a client about fibrocystic breast disease, the client asks if having this disorder will lead to cancer. Which response by the nurse is the most appropriate?

The nurse is performing an assessment on a newborn and notes a thin, milky discharge from the infant's nipple. Which conclusion by the nurse based on this data is the most appropriate?

The nurse is educating a prenatal class about lactation when one of the clients asks how milk is produced. When responding to the client, which structure will the nurse include as being responsible for milk production?

The nurse is asking a client questions regarding lifestyle patterns. Which statement by the client would alert the nurse to possible risk for breast cancer?

The nurse is conducting a breast health workshop for a group of women. Which would the nurse include in this workshop when outlining risk factors for breast cancer?

The nurse is performing a breast assessment of an Asian adult female. Which action should the nurse complete first?

The nurse is conducting a focused interview for an adult female client who is experiencing breast discomfort. The client states that the discomfort has increased over the last 6 months. Upon assessment, the nurse notes that the client has round, mobile masses with smooth borders in all quadrants bilaterally. The client's last mammogram was conducted 6 months ago and the findings support the current assessment findings. Based on this data, which statement by the nurse is the most appropriate?

The nurse is planning to perform a breast examination of a female client. When preparing the client for the examination, the nurse will inform the client to expect which techniques?

The nurse is compiling statistics for a breast cancer awareness presentation for a group of women. Which facts about breast cancer are appropriate for the nurse to include in the presentation?

The nurse is performing a breast examination and is palpating into the tail of Spence. Why is it appropriate to palpate this area of the breast during an examination?

A female client is hospitalized with injury and tissue destruction of the left pectoralis major and serratus anterior muscles due to a motor vehicle accident. The nurse would include which information during the discharge teaching?

The nurse is teaching a childbirth education class. When educating the participants about breast changes during pregnancy, which substance leaking from the breast is anticipated during pregnancy?

The nurse is teaching a client with benign breast disease about symptom relief. Which topic would the nurse include in this session?

The nurse is evaluating the risk for metastasis after a client is diagnosed with breast cancer. Which lymph node involvement would indicate the greatest likelihood of metastasis for this client?

During the breast examination on a client, the nurse palpates a small, subclavicular node on the right side of the client's chest. Which is the priority nursing action at this time?

The nurse is teaching self-breast examination to a client and demonstrates inspecting the breasts with arms over the head. The client asks the nurse why this is necessary. Which response by the nurse is the most appropriate?

The nurse is using inspection to assess the breasts of a female client. Which finding might the nurse obtain using this assessment technique?

The nurse is interviewing a 37-year-old client for breast cancer risks. Which statement by the client indicates an appropriate understanding of the risks associated with breast cancer?