NSG 6020 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.
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