UCY (15)
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School
Western Governors University *
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Course
21
Subject
Health Science
Date
Nov 24, 2024
Type
Pages
3
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25.
A NR is working with a woman who has been diagnosed with severe fibrocystic breast disease. After describing the medications that can be used as treatment, the NR determines that additional teaching is
needed whe
n the client identifie
s
which dru
ab
g
irb
a
.
s
co
b
m
e
/t
i
e
n
s
g
t
A.
tamoxifen B.
bromocriptine C.
danazol D.
penicillin Correct answer: D used? Reason: Treatment of severe fibrocystic breast disease may include the use of tamoxifen, bromocriptine, or danazol. Penicillin would be used to treat an infection such as mastitis. #QSN Format:Multiple Choice #CHP 6: Disorders of the Breasts Cognitive Level: Analyze Client Needs: Physiological Integrity: Pharmacological and Biological parentseral Therapies REF: Page.208 26.
A woman comes to the clinic. Assessment reveals a firm, rubbery, movable mass in the upper outer quadrant of the left brea
s
t. The edge
s
of the ma
ss
are clearl
a
y
b i
d
r b
e
. c
l
o
i n
m
e
/ t
a
e s
t e
t d. The NR interprets these findings as suggestive of which disorder? A.
fibrocystic breast disorder B.
duct ectasia C.
intraductal papilloma D.
fibroadenoma Correct answer: D Reason: Fibroadenoma is characterized by a firm, rubbery, well-circumscribed, freely mobile mass, usually located in the upper outer quadrant of the breast. Duct ectasia occurs when the milk duct
s
become conge
s
ted w
ith s
ecretion
s
and debri
s
, re
su
ltin
a
g
b i i
r b
n
. c
p
o m
e r
/ t
i
e
d
s u
t ctal inflammation. Periareolar infections consist of active inflammation around nondilated subareolar breast ducts
—
a condition termed periductal mastitis. Fibrocystic breast disorder is characterized by lumpy, tender brea
s
t
s
w
ith po
ss
ible clear to yello
w
nipple di
s
charge. Int r
a
a
b
d
i r b
u
. c
c o
t m
a l
/t e
p
s
a
t pilloma is
manife
s
ted by a wart-like growth in the mammary ducts near the nipple that is soft, nontender, mobile, and poorly delineated. A serous, serosanguinous, or watery discharge from the nipple may occur. #QSN Format:Multiple Choice #CHP 6: Disorders of the Breasts Cognitive Level: Analyze Client Needs: Physiological Integrity: Physiological Adaptation REF: Page.211-212 27.
A client with advanced breast cancer, who has had both chemotherapy and radiation therapy, is to start hormonal therapy using a selective estrogen receptor modulator (SERM). Which agent would the NR expect the client to receive?
A.
tamoxifen B.
letrozole C.
exemestane D.
cortison
eCorrect answer: A Reason: Tamoxifen is an example of a SERM used as adjunctive treatment for breast cancer. Letrozole and exemestane are aromatase inhibitors used to treat advanced breast cancer. Cortisone is a steroid and would not be used. #QSN Format:Multiple Choice #CHP 6: Disorders of the Breasts Cognitive Level: Apply Client N
eed
s
: P
hy
s
iological Integrity: P
harmacological and P
aren
a b
t
i
e
r b
r
.
a
c
l
om
T
/ h
t e
e
s t
rapies REF: Page.224 28.
A woman who has undergone a right modified-radical mastectomy returns from surgery. The NR would focus immediate interventions on which area as the
a
p
b
r
ir
i
b
o
.c
r
o
i
m
t
/
y
te
?
st
A.
respiratory function B.
body image C.
lymphedema prevention D.
incisional careCorrect answer: A Reason: Upon return from surgery, the NR's priority would be on the client's respiratory function, encouraging the client to turn, cough, and deep breathe at frequent intervals, at least every 2 hour
s
, to help expand collap
s
ed alveoli, clear inhalation a
a
n
bi
e
rb
s
.c
t h
om
et
/t
i
e
c
st
agent
s
from the body, and prevent postoperative atelectasis and pneumonia. Body image and prevention of lymphedema would be priorities later on in the client's course of care. The client will most likely have a surgical dressing in place that most likely would not be removed in the immediate postoperative period. #QSN Format:Multiple Choice #CHP 6: Disorders of the Breasts Cognitive Level: Apply Client Needs: Physiological Integrity: Physiological Adaptation REF: Page.229 29.
A
client is
diagno
s
ed w
ith fibrocy
s
tic brea
s
t di
s
ea
s
e. After t e a
a
b
c
i h
r b
i
. n
c o
g
m t
/ t
h
e s
e
t client about thi
s condition, the NR determines that the teaching was successful based on which client statement? A.
"I need to cut out drinking coffee like I'm used to doing." B.
"It's important that I stop smoking or my condition will get worse." C.
"I guess I'll have to find a replacement for milk and cheese." D.
"No more cookies and baked goods for me."
Correct answer: A Reason: Caffeine is a stimulant, and eliminating it will help reduce symptoms of fibrocystic brea
s
t di
s
ea
s
e. Thu
s
cutting out coffee from the client
's
intake in d
a b
i c
i r b
a
.
t
c
e
o
s
m /
u
t e
n
s
d
t er
s
tanding of the situation. Although smoking cessation is important for anyone, cigarettes, along with dairy products such as milk and cheese, and sweets, such as cookies and baked goods, are not associated with symptoms of fibrocystic breast disease. #QSN Format:Multiple Choice #CHP 6: Disorders of the Breasts Cognitive Level: Analyze Client Needs: Physiological Integrity: Physiological Adaptation REF: Page.208 30.
A
laboratory technician arrive
s
to dra
w
blood for a complete
a
b
b
l
i r
o
b o
. c
d
o m
c
/ t
o
e u
s t
nt (CBC) for a client who had a left-sided mastectomy 8 hours ago. The client has an intravenous line with fluid infusing in her right antecubital space. The NR enters the room and sees the technician beginning to place a tourniquet on the client's right arm. Which response by the NR would be most appropriate? A.
Stop the technician immediately. B.
Have the technician come back later on. C.
Notify the surgeon to obtain the specimen via a cut-down proc
a
e
bi
d
rb
u
.c
r
o
e
m
. D.
Tell the technician to obtain the specimen from the client's left arm. Correct answer: A Reason: The NR should immediately stop the technician from obtaining the specimen. The left arm cannot be used because the mastectomy was performed on that side. The right arm has an intravenous infusion, so obtaining blood from this arm would a
b
b
e
ir
b
i
.
c
n
o
a
m
p
/
p
t
e
r
s
o
t
priate, most likely leading to inaccurate results. Telling the technician to come back later on does not address the situation at present. Notifying the surgeon may be appropriate, but a cut-down procedure is invasive, and other less invasive options should be attempted first before considering such a procedure. #QSN Format:Multiple Choice #CHP 6: Disorders of the Breasts Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential REF: Page.221-222 31.
A
client is
being di
s
charged after having a right-
s
ided modifi
a
e
b
d
irb
r
.
a
co
d
m
ic
/t
a
es
l
t m
as
tectomy. After teaching the client about ways to minimize lymphedema, the NR determines that the teaching was successful based on which client statement? A.
"I should use lotion on my hands after working in my garden.
a
"
birb B.
"I need to avoid wearing tops that have elastic in the sleeves." C.
"I should have my blood pressure taken in my right arm." D.
"I need to limit my driving to once a week."
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