MSN Exam for Breast Cancer

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1) Can a mammography detect breast cancer before you can even see it.

  1. Yes
  2. No
  3. Sometimes
  4. What is a mammography?

2) Jeovina, with advanced breast cancer is prescribed tamoxifen (Nolvadex). When teaching the client about this drug, the nurse should emphasize the importance of reporting which adverse reaction immediately?

  1. Vision changes
  2. Hearing loss
  3. Headache
  4. Anorexia

3) Noninvasive Breast Cancer is when..

  1. the cancer cells have spread to other parts of your body
  2. the cancer cells have stayed from their origin and have not spread

4) Can family history of breast cancer increase the chances of the family members?

  1. No
  2. Yes
  3. Only from the mother’s side
  4. Only from the dad’s side

5) The nurse is teaching the client about breast self-examination. Which observation should the client be taught to recognize when doing the examination for detection of breast cancer?

  1. tender, movable lump
  2. pain on breast self-examination
  3. round, well-defined lump
  4. dimpling of the breast tissue

6) Which of the following terms is used to describe removal of the breast tissue and an axillary lymph node dissection leaving muscular structure intact as surgical treatment of breast cancer?

  1. Modified radical mastectomy
  2. Segmental mastectomy
  3. Total mastectomy
  4. Radical mastectomy

7) Nurse Meredith is instructing a premenopausal woman about breast self-examination. The nurse should tell the client to do her self-examination:

  1. at the end of her menstrual cycle.
  2. on the same day each month.
  3. on the 1st day of the menstrual cycle.
  4. immediately after her menstrual period.

8) Hormonal agents are used to treat some cancers. An example would be:

  1. Thyroxine to treat thyroid cancer.
  2. ACTH to treat adrenal carcinoma.
  3. Estrogen antagonists to treat breast cancer.
  4. Glucagon to treat pancreatic carcinoma.

9) What does regional refer to in relation to breast cancer?

  1. Metastases
  2. Lymph nodes
  3. A tumor within the breast
  4. A tumor is within both breasts

10) A client with breast cancer is returned to the room following a right total mastectomy. The nurse should:

  1. Elevate the client’s right arm on pillows
  2. Place the client’s right arm in a dependent sling
  3. Keep the client’s right arm on the bed beside her
  4. Place the client’s right arm across her body

11) The community health nurse implemented a new program about effective breast cancer screening technique for the female personnel of the health department of Valenzuela. Which of the following technique should the nurse consider to be of the lowest priority?

  1. Yearly breast exam by a trained professional
  2. Detailed health history to identify women at risk
  3. Screening mammogram every year for women over age 50
  4. Screening mammogram every 1-2 years for women over age of 40.

12) The nurse is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47. Following the American Cancer Society (ACS) guidelines, the nurse should recommend that the women:

  1. perform breast self-examination annually
  2. have a mammogram annually
  3. have a hormonal receptor assay annually
  4. have a physician conduct a clinical evaluation every 2 years

13) What is the purpose of using hormonal therapy for patients with breast cancer cells?

  1. To replace the hormones and add testosterone.
  2. To produce more hormones by adding testosterone along with estrogen and progesterone.
  3. To block the supply of estrogen or pregesterone to the cells.

14) Breast Cancer is most likely to spread to your ____________area.

  1. Face
  2. Stomach
  3. Underarm
  4. Leg

15) Which of the following are used in diagnosing breast cancer?

  1. Mammogram
  2. Ultrasound
  3. MRI
  4. Biopsy
  5. All of the above

16) A female client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a fluid and electrolyte imbalance induced by chemotherapy?

  1. Urine output of 400 ml in 8 hours
  2. Serum potassium level of 3.6 mEq/L
  3. Blood pressure of 120/64 to 130/72 mm Hg
  4. Dry oral mucous membranes and cracked lips

17) Maria refuses to acknowledge that her breast was removed. She believes that her breast is intact under the dressing. The nurse should

  1. call the MD to change the dressing so Kathy can see the incision
  2. recognize that Kathy is experiencing denial, a normal stage of the grieving process
  3. reinforce Kathy’s belief for several days until her body can adjust to stress of surgery.
  4. remind Kathy that she needs to accept her diagnosis so that she can begin rehabilitation exercises.

18) Nina, an oncology nurse educator is speaking to a women’s group about breast cancer. Questions and comments from the audience reveal a misunderstanding of some aspects of the disease. Various members of the audience have made all of the following statements. Which one is accurate?

  1. Mammography is the most reliable method for detecting breast cancer.
  2. Breast cancer is the leading killer of women of childbearing age.
  3. Breast cancer requires a mastectomy.
  4. Men can develop breast cancer.

19) The community health nurse implemented a new program about effective breast cancer screening technique for the female personnel of the health department of Valenzuela. Which of the following technique should the nurse consider to be of the lowest priority?

  1. Yearly breast exam by a trained professional
  2. Detailed health history to identify women at risk
  3. Screening mammogram every year for women over age 50
  4. Screening mammogram every 1-2 years for women over age of 40

20) The 2000 NIH Consensus Development Conference Statement states that what percentage of women with invasive breast cancer should consider the option of systemic chemotherapy, not just women whose tumors are greater than 1cm in size?

  1. 100% (all)
  2. 75%
  3. 50%
  4. 25%

21) The statistics decrease for getting breast cancer as one gets older in age.

  1. True
  2. False

22) Can men get breast cancer?

  1. Yes, always
  2. No, never
  3. Yes, but not likely
  4. I don’t know

23) What does local breast cancer refer to?

  1. Metastases
  2. The chest wall
  3. The breast
  4. Lymph nodes

24) What is the percentage of breast tissue that can be removed and rearranged to have the breast still looking like a breast?

  1. 60%
  2. 15%
  3. 30%
  4. 45%

25) Breast reconstruction is done after_____________surgery.

  1. Lumpectomy
  2. Mastectomy

26) Breast Cancer is the most common reason for death in what ages?

  1. 0-4
  2. 85-99
  3. 55-84
  4. 15-54

27) Ductal lavage is used for

  1. women at higher risk for benign proliferative breast disease.
  2. women at low risk for breast cancer.
  3. screening women over age 65.
  4. women with breast implants.

28) Maria Sison, 40 years old, single, was admitted to the hospital with a diagnosis of Breast Cancer. She was scheduled for radical mastectomy. Nursing care during the preoperative period should consist of

  1. assuring Maria that she will be cured of cancer
  2. assessing Maria’s expectations and doubts
  3. maintaining a cheerful and optimistic environment
  4. keeping Maria’s visitors to a minimum so she can have time for herself

29) What is a symptom of Breast Cancer?

  1. Itchy throat
  2. Lump in underarm or breast area.
  3. Pain in the arm

30) A 37-year-old client with uterine cancer asks the nurse, “Which is the most common type of cancer in women?” The nurse replies that it’s breast cancer. Which type of cancer causes the most deaths in women?

  1. Breast cancer
  2. Lung cancer
  3. Brain cancer
  4. Colon and rectal cancer

31) Is early detection of breast cancer your best chance of survival?

  1. No
  2. Yes
  3. Sometimes
  4. I Don’t Know

32) A 34-year-old female client is requesting information about mammograms and breast cancer. She isn’t considered at high risk for breast cancer. What should the nurse tell this client?

  1. She should have had a baseline mammogram before age 30.
  2. She should eat a low-fat diet to further decrease her risk of breast cancer.
  3. She should perform breast self-examination during the first 5 days of each menstrual cycle.
  4. When she begins having yearly mammograms, breast self-examinations will no longer be necessary.

33) Nurse Amy is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47. Following the American Cancer Society guidelines, the nurse should recommend that the women:

  1. perform breast self-examination annually.
  2. have a mammogram annually.
  3. have a hormonal receptor assay annually.
  4. have a physician conduct a clinical examination every 2 years.

34) The nurse recognizes which of the following statements as accurately reflecting a risk factor for breast cancer?

  1. Mother affected by cancer before 60 years of age
  2. Onset of menses before 14 years of age
  3. Multiparity
  4. No alcohol consumption

35) Only women can get Breast Cancer.

  1. True
  2. False

36) What is Breast Cancer?

  1. A tumor that developes in the breast area
  2. A very common disease among women
  3. A deadly disease
  4. All of the above

37) A male client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the seven warning signs of cancer. What is another warning sign of cancer?

  1. Persistent nausea
  2. Rash
  3. Indigestion
  4. Chronic ache or pain

38)A client receiving chemotherapy for breast cancer has an order for Zofran (ondansetron) 8mg PO to be given 30 minutes before induction of the chemotherapy. The purpose of the medication is to:

  1. Prevent anemia
  2. Promote relaxation
  3. Prevent nausea
  4. Increase neutrophil counts

39) During a breast examination, which finding most strongly suggests that the Luz has breast cancer?

  1. Slight asymmetry of the breasts.
  2. A fixed nodular mass with dimpling of the overlying skin
  3. Bloody discharge from the nipple
  4. Multiple firm, round, freely movable masses that change with the menstrual cycle

40) 1 in ____ women get Breast Cancer.

  1. 7
  2. 2
  3. 8
  4. 4

41) Nurse Lucia is providing breast cancer education at a community facility. The American Cancer Society recommends that women get mammograms:

  1. yearly after age 40.
  2. after the birth of the first child and every 2 years thereafter.
  3. after the first menstrual period and annually thereafter.
  4. every 3 years between ages 20 and 40 and annually thereafter.

42) A female client was diagnosed with breast cancer. It is found to be stage IV, and a modified mastectomy is performed. After the procedure, what behaviors could the nurse expects the client to display?

  1. Denial of the possibility of carcinoma.
  2. Signs of grief reaction.
  3. Relief that the operation is over.
  4. . Signs of deep depression.

43) A 52 yr-old female tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client’s lump is cancerous?

  1. eversion of the right nipple and a mobile mass
  2. nonmobile mass with irregular edges
  3. mobile mass that is oft and easily delineated
  4. nonpalpable right axillary lymph nodes

44) Nurse April is teaching a group of women to perform breast self-examination. The nurse should explain that the purpose of performing the examination is to discover:

  1. cancerous lumps.
  2. areas of thickness or fullness.
  3. changes from previous self-examinations.
  4. fibrocystic masses.

45) Nurse April is teaching a client who suspects that she has a lump in her breast. The nurse instructs the client that a diagnosis of breast cancer is confirmed by:

  1. breast self-examination.
  2. mammography.
  3. fine needle aspiration.
  4. chest X-ray.
Answers and Rationales
  1. A. Yes 
  2. A. Vision changes . The client must report changes in visual acuity immediately because this adverse effect may be irreversible. Tamoxifen isn’t associated with hearing loss. Although the drug may cause anorexia, headache, and hot flashes, the client need not report these adverse effects immediately because they don’t warrant a change in therapy.
  3. B. the cancer cells have stayed from their origin and have not spread 
  4.  B. Yes 
  5. D. dimpling of the breast tissue . The tumor infiltrates nearby tissue, it can cause retraction of the overlying skin and create a dimpling appearance.
  6. A. Modified radical mastectomy. A modified radical mastectomy leaves the pectoralis major and minor muscles intact. In a segmental mastectomy, varying amounts of breast tissue are removed, including the malignant tissue and some surrounding tissue to ensure clear margins. In a total mastectomy, breast tissue only is removed. Radical mastectomy includes removal of the pectoralis major and minor muscles in addition to breast tissue and axillary lymph node dissection.
  7. D. immediately after her menstrual period. Premenopausal women should do their self-examination immediately after the menstrual period, when the breasts are least tender and least lumpy. On the 1st and last days of the cycle, the woman’s breasts are still very tender. Postmenopausal women because their bodies lack fluctuation of hormone levels, should select one particular day of the month to do breast self-examination.
  8. C. Estrogen antagonists to treat breast cancer. Estrogen antagonists are used to treat estrogen hormone-dependent cancer, such as breast carcinoma. A well-known estrogen antagonist used in breast cancer therapy is tamoxifen (Nolvadex). This drug, in combination with surgery and other chemotherapeutic drugs reduces breast cancer recurrence by 30 percent. Estrogen antagonists can also be administered to prevent breast cancer in women who have a strong family history of the disease. Thyroxine is a natural thyroid hormone. It does not treat thyroid cancer. ACTH is an anterior pituitary hormone, which stimulates the adrenal glands to release glucocorticoids. It does not treat adrenal cancer. Glucagon is a pancreatic alpha cell hormone, which stimulates glycogenolysis and gluconeogenesis. It does not treat pancreatic cancer.
  9. B. Lymph nodes 
  10. A. Elevate the client’s right arm on pillows . A total mastectomy involves removal of the entire breast and some or all of the axillary lymph nodes. Following surgery, the client’s right arm should be elevated on pillows, to facilitate lymph drainage. Other options are incorrect because they would not help facilitate lymph drainage and would create increased edema in the affected extremity.
  11. B. Detailed health history to identify women at risk . Because of the high incidence of breast cancer, all women are considered to be at risk regardless of health history.
  12. B. have a mammogram annually. According to the ACS guidelines, “Women older than age 40 should perform breast selfexamination monthly (not annually).” The hormonal receptor assay is done on a known breast tumor to determine whether the tumor is estrogen- or progesterone-dependent.
  13. C. To block the supply of estrogen or pregesterone to the cells. 
  14. C. Underarm 
  15. E. All of the above
  16. D. Dry oral mucous membranes and cracked lips . Chemotherapy commonly causes nausea and vomiting, which may lead to fluid and electrolyte imbalances. Signs of fluid loss include dry oral mucous membranes, cracked lips, decreased urine output (less than 40 ml/hour), abnormally low blood pressure, and a serum potassium level below 3.5 mEq/L.
  17. B. recognize that Kathy is experiencing denial, a normal stage of the grieving process. A person grieves to a loss of a significant object. The initial stage in the grieving process is denial, then anger, followed by bargaining, depression and last acceptance. The nurse should show acceptance of the patient’s feelings and encourage verbalization.
  18. D. Men can develop breast cancer. Men can develop breast cancer, although they seldom do. The most reliable method for detecting breast cancer is monthly self-examination, not mammography. Lung cancer causes more deaths than breast cancer in women of all ages. A mastectomy may not be required if the tumor is small, confined, and in an early stage.
  19. B. Detailed health history to identify women at risk . Because of the high incidence of breast cancer, all women are considered to be at risk regardless of health history.
  20. A. 100% (all). The 2000 Consensus Development Conference Statement states that all women with invasive breast cancer should consider the option of systemic chemotherapy, not just women whose tumors are greater than 1 cm in size.
  21. B. False 
  22. C. Yes, but not likely
  23. C. The breast
  24. C. 30% 
  25. B. Mastectomy 
  26. D. 15-54
  27. A. women at higher risk for benign proliferative breast disease. Performed in the doctor’s office, a microcatheter is inserted through the nipple while instilling saline and retrieving the fluid for analysis. It has been shown to identify atypical cells in this population and has been found to be adept at detecting cellular changes within the breast tissue.
  28. B. assessing Maria’s expectations and doubts . Assessing the client’s expectations and doubts will help lessen her fears and anxieties. The nurse needs to encourage the client to verbalize and to listen and correctly provide explanations when needed.
  29. B. Lump in underarm or breast area. 
  30. B. Lung cancer . Lung cancer is the most deadly type of cancer in both women and men. Breast cancer ranks second in women, followed (in descending order) by colon and rectal cancer, pancreatic cancer, ovarian cancer, uterine cancer, lymphoma, leukemia, liver cancer, brain cancer, stomach cancer, and multiple myeloma.
  31. B. Yes
  32. B. She should eat a low-fat diet to further decrease her risk of breast cancer. A low-fat diet (one that maintains weight within 20% of recommended body weight) has been found to decrease a woman’s risk of breast cancer. A baseline mammogram should be done between ages 30 and 40. Monthly breast self-examinations should be done between days 7 and 10 of the menstrual cycle. The client should continue to perform monthly breast self-examinations even when receiving yearly mammograms.
  33. B. have a mammogram annually. The American Cancer Society guidelines state, “Women older than age 40 should have a mammogram annually and a clinical examination at least annually [not every 2 years]; all women should perform breast self-examination monthly [not annually].” The hormonal receptor assay is done on a known breast tumor to determine whether the tumor is estrogen- or progesterone-dependent.
  34. A. Mother affected by cancer before 60 years of age . Risk for breast cancer increases twofold if first-degree female relatives (sister, mother, or daughter) had breast cancer. Increased risk is associated with early menarche (i.e., menses beginning before 12 years of age). Nulliparity and later maternal age for first birth are associated with increased risk for breast cancer. Alcohol use remains controversial; however, a slightly increased risk is found in women who consume even one drink daily and doubles among women drinking three drinks daily.
  35. B. False
  36. D. All of the above
  37. C. Indigestion . Indigestion, or difficulty swallowing, is one of the seven warning signs of cancer. The other six are a change in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge, a thickening or lump in the breast or elsewhere, an obvious change in a wart or mole, and a nagging cough or hoarseness. Persistent nausea may signal stomach cancer but isn’t one of the seven major warning signs. Rash and chronic ache or pain seldom indicate cancer.
  38. C. Prevent nausea. Zofran is given before chemotherapy to prevent nausea. Answers A, B, and D are not associated with the medication; therefore, they are incorrect.
  39. B. A fixed nodular mass with dimpling of the overlying skin . A fixed nodular mass with dimpling of the overlying skin is common during late stages of breast cancer. Many women have slightly asymmetrical breasts. Bloody nipple discharge is a sign of intraductal papilloma, a benign condition. Multiple firm, round, freely movable masses that change with the menstrual cycle indicate fibrocystic breasts, a benign condition.
  40. C. 8 
  41. A. yearly after age 40. The American Cancer Society recommends a mammogram yearly for women over age 40. The other statements are incorrect. It’s recommended that women between ages 20 and 40 have a professional breast examination (not a mammogram) every 3 years.
  42. B. Signs of grief reaction. It is mostly likely that grief would be expressed because of object loss.
  43. B. nonmobile mass with irregular edges. Breast cancer tumors are fixed, hard, and poorly delineated with irregular edges. Nipple retraction —not eversion—may be a sign of cancer. A mobile mass that is soft and easily delineated is most often a fluid-filled benigned cyst. Axillary lymph nodes may or may not be palpable on initial detection of a cancerous mass.
  44. C. changes from previous self-examinations. Women are instructed to examine themselves to discover changes that have occurred in the breast. Only a physician can diagnose lumps that are cancerous, areas of thickness or fullness that signal the presence of a malignancy, or masses that are fibrocystic as opposed to malignant.
  45. C. fine needle aspiration. Fine needle aspiration and biopsy provide cells for histologic examination to confirm a diagnosis of cancer. A breast self-examination, if done regularly, is the most reliable method for detecting breast lumps early. Mammography is used to detect tumors that are too small to palpate. Chest X-rays can be used to pinpoint rib metastasis.

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