NSG 6020 Final Exam Review/ NSG6020 Final Exam Study Guide (Latest, 2021): South University

$45.00
NSG 6020 Final Exam Review/ NSG6020 Final Exam Study Guide (Latest, 2021): South University

NSG 6020 Final Exam Review/ NSG6020 Final Exam Study Guide (Latest, 2021): South University

$45.00
NSG 6020 Final Exam Review/ NSG6020 Final Exam Study Guide (Latest, 2021): South University

NSG6020 Final Exam Review

Breast and Lymphatics

Statement by the patient would indicate a need for further teaching?

A. "The best time to check my breasts is a week before my cycle."

B. "I will check my breasts in the shower one week after my cycle."

C. "I will exam my breast in a clock-like sequence so that I don't miss any surface area."

D. "I will be sure to check my arm pits."

A

The week before a woman's cycle is not the best time to check for lumps because the breasts

become sore and tender and may also be "lumpy" a week prior to the cycle.

Answer 2 is incorrect because the week after a woman's cycle is the best time to do the

examination, and the shower allows for ease of palpation.

Answer 3 in incorrect because a clock-like sequence is the proper way to perform a BSE.

Answer 4 is incorrect because under the arms houses lymph nodes and the axillary tail of

Spence, which is a common site for breast cancer.

A pregnant woman who has breast implants asks the nurse if she can still breastfeed. What is

the nurse's best response?

A. "You should not have any problems breast feeding because your implants do not affect milk

production."

B. "When the breast implants are inserted they usually affect the milk glands, and

breastfeeding is not possible."

C. "This would depend on which type of implants were placed and which procedure was used

by the surgeon. Check with your surgeon to see if your milk production will be affected."

C

Milk production may vary depending on the procedure. Many women can still breastfeed after

breast augmentation. The surgeon would be able to determine this ability.

Answers 1 and 2 are incorrect because they may not be true. Only the surgeon can determine if

milk production will be affected.

Statement by the patient would indicate a need for further teaching?

A. "The best time to check my breasts is a week before my cycle."

B. "I will check my breasts in the shower one week after my cycle."

C. "I will exam my breast in a clock-like sequence so that I don't miss any surface area."

D. "I will be sure to check my arm pits."

A

The week before a woman's cycle is not the best time to check for lumps because the breasts

become sore and tender and may also be "lumpy" a week prior to the cycle.

Answer 2 is incorrect because the week after a woman's cycle is the best time to do the

examination, and the shower allows for ease of palpation.

Answer 3 in incorrect because a clock-like sequence is the proper way to perform a BSE.

Answer 4 is incorrect because under the arms houses lymph nodes and the axillary tail of

Spence, which is a common site for breast cancer.

A pregnant woman who has breast implants asks the nurse if she can still breastfeed. What is

the nurse's best response?

A. "You should not have any problems breast feeding because your implants do not affect milk

production."

B. "When the breast implants are inserted they usually affect the milk glands, and

breastfeeding is not possible."

C. "This would depend on which type of implants were placed and which procedure was used

by the surgeon. Check with your surgeon to see if your milk production will be affected."

C

Milk production may vary depending on the procedure. Many women can still breastfeed after

breast augmentation. The surgeon would be able to determine this ability.

Answers 1 and 2 are incorrect because they may not be true. Only the surgeon can determine if

milk production will be affected.

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.

ANS: B

The breast is composed of glandular tissue, fibrous tissue (including the suspensory ligaments),

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.

ANS: B

The upper outer quadrant is the site of most breast tumors. In the upper outer quadrant, the

nurse should notice the axillary tail of Spence, the cone-shaped breast tissue that projects up

into the axilla, close to the pectoral group of axillary lymph nodes.

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

ANS: C

The breast has extensive lymphatic drainage. Four groups of axillary nodes are present: (1)

central, (2) pectoral (anterior), (3) subscapular (posterior), and (4) lateral.

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

ANS: B

The breast has extensive lymphatic drainage. Most of the lymph, more than 75%, drains into

the ipsilateral, or same side, axillary nodes.

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."

ANS: D

Adolescent breast development usually begins between 8 and 10 years of age. The nurse

should not belittle the girl's feelings by using statements like "don't worry" or by sharing

personal experiences. The beginning of breast development precedes menarche by about 2

years.

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.

ANS: C

Occasionally one breast may grow faster than the other, producing a temporary asymmetry.

This may cause some distress; reassurance is necessary. Tenderness is common also.

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.

ANS: A

Full development from stage 2 to stage 5 takes an average of 3 years, although the range is 1.5

to 6 years. Pubic hair develops during this time, and axillary hair appears 2 years after the onset

of pubic hair. The beginning of breast development precedes menarche by about 2 years.

Menarche occurs in breast development stage 3 or 4, usually just after the peak of the

adolescent growth spurt, which occurs around age 12 years. See Figure 17-6.

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.

ANS: C

Breasts of the nonpregnant woman change with the ebb and flow of hormones during the

monthly menstrual cycle. During the 3 to 4 days before menstruation, the breasts feel full, tight,

heavy, and occasionally sore. The breast volume is smallest on days 4 to 7 of the menstrual

cycle.

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.

ANS: A

The areolae become larger and grow a darker brown as pregnancy progresses, and the

tubercles become more prominent. (The brown color fades after lactation, but the areolae

never return to the original color). A venous pattern is prominent over the skin surface and

does not need to be reported as it is an expected finding. After the fourth month, colostrum, a

thick, yellow fluid (precursor to milk) may be expressed from the breasts.

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."

ANS: D

After the fourth month, colostrum may be expressed. This thick yellow fluid is the precursor of

milk, and it contains the same amount of protein and lactose but practically no fat. The breasts

produce colostrum for the first few days after delivery. It is rich with antibodies that protect the

newborn against infection, so breastfeeding is importat

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.

ANS: D

After menopause, the glandular tissue atrophies and is replaced with connective tissue. The fat

envelope atrophies also, beginning in the middle years and becoming marked in the eighth and

ninth decades. These changes decrease breast size and elasticity, so the breasts droop and sag,

looking flattened and flabby

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.

ANS: C

Gynecomastia may reappear in the aging male and may be due to testosterone deficiency.

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.

ANS: B

Research has shown that girls with overweight or obese BMI levels have a higher occurrence of

early onset of breast budding (before age 8 years for African-American girls and age 10 years

for white girls) and early menarche.

The nurse is reviewing statistics regarding breast cancer. Which woman, aged 40 years in the

United States, has the highest risk for development of breast cancer?

A)African-American

B)White

C)Asian

D)American Indian

ANS: A

The incidence of breast cancer varies with different cultural groups. White women have a

higher incidence of breast cancer than African-American women starting at age 45 years; but

African-American women have a higher incidence before age 45 years. Asian, Hispanic, and

American Indian women have a lower risk for development of breast cancer (American Cancer

Society, 2009-2010).

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.

ANS: C

African-American women have a higher incidence of breast cancer before age 45 years than

white women, and are more likely to die of their disease. In addition, African-American women

are significantly more likely to be diagnosed with regional or distant breast cancer than are

white women. This racial difference in mortality rates may be related to insufficient use of

screening measures and lack of access to health care.

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."

ANS: B

Breast pain occurs with trauma, inflammation, infection, or benign breast disease. The nurse

will need to gather more information about the patient's pain rather than make statements

that ignore the patient's concerns.

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.

ANS: C

The use of some medications, such as oral contraceptives, phenothiazines, diuretics, digitalis,

steroids, methyldopa, and calcium channel blockers, may cause clear nipple discharge. Bloody

or blood-tinged discharge from the nipple, not clear, is significant, especially if a lump is also

present. In the pregnant female, colostrum would be a thick, yellowish liquid, and it would be

expressed after the fourth month of pregnancy.

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?

ANS: C

It is important for the nurse to determine where the rash first appeared. Paget's disease starts

with a small crust on the nipple apex and then spreads to the areola. Eczema or other

dermatitis rarely starts at nipple unless it results from breastfeeding. It usually starts on the

areola or surrounding skin and then spreads to the nipple. See Table 17-6.

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.

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