CALAMBA DOCTORS’ COLLEGE

Virborough Subdivision, Parian, Calamba City, Laguna

Health Assessment
BSN 1

Home Activity No.3

Direction: Write all your works/answers (handwritten) on short bond paper and send via email –
diosdadomanalotojr@yahoo.com or submit after quarantine period.
Read - Health Assessment Procedure - Breasts and Lymphatic system
A. Collecting subjective and objective data.
B. Self-breast examination
C. Assessment Procedures
 Female Breasts
o Inspect size and symmetry, superficial venous pattern, areolas, nipples, retraction and dimpling
o Palpate for texture and elasticity, tenderness and temperature, masses, nipples, mastectomy or
lumpectomy site
o Palpate axilla
 Male Breasts
o Inspect and palpate the breasts, areolas, nipples, and axillae

Clinical Application
1. Ms. Cruz a 20-year-old college student visits the school clinic because she discovered small, painless, non-tender,
firm and mobile lumps in her right breast. What is the most common cause of breast lumps?
A. Breast cancer C. Fibroadenomas
B. Fibrocystic breast disease D. Intraductal Papilloma
2. A 50 year-old female client seeks consultation at the center for breast mammography examination. The examination
yields negative findings. When will the nurse ask her to return for the next breast examination?
A. After a year C. After 3 years
B. After 2 years D. After 5 years
3. Which of these signs and symptoms is NOT an indication of breast cancer?
A. Orange-peel appearance C. Asymmetric venous pattern
B. Recent retract nipples D. Dark brown nipple discharges
4. Which quadrant of the breast is the most common site for malignant tumors?
A. Upper outer quadrant C. Lower outer quadrant
B. Upper inner quadrant D. Lower inner quadrant
5. Mrs X, 23-year-old has a benign fibrocystic cyst of the left breast. Which of the following is associated with
fibrocystic breast disease?
A. Immobile C. Hard consistency
B. Tender D. Irregular shape
6. Jane, aged 50, a mother of 4 children has discovered a lump in her right breast. As you obtain her health history, you
identify risk factors for breast cancer. Which factor increases the risk for breast cancer?
A. History of fibrocystic breast changes C. Multiparity
B. Breast fed her children D. Her age of 50
7. When palpating patient’s breast, its prepare to used:
A. The whole palm C. Index finger and middle finger
B. Three middle finger D. Thumb, index, and middle finger
8. Normal changes in the breast of a premenstrual woman include:
A. A single hard, fixed mass C. Redness on nipple and breast dimpling
B. Tenderness, firm and mobile cysts D. Redness and scaling over the portion of the breast
9. Mrs Y, aged 55, you are reviewing BSE with her. At what time of the month should she perform BSE?
A. First of every month C. Last day of the month
B. Middle of the month D. Same time every month
10. What is the reason for palpating axillary lymph nodes during a clinical breast examination?
A. Axillary node tenderness is the most common initial sign of breast cancer
B. Axillary nodes are tender in response during monthly menstrual cycle
C. Lymph network in the breast toward the axillary lymph nodes.to detect infections and malignancy
D. This is a matter of convenience because of the close proximity of the axillae to the breasts.

Case Study:
Julie is a 46-year-old woman who came to the clinic because she had discovered a lump in her left breast. The
following data are collected during an interview and examination.

She tells the nurse that she first noticed the lump about 9 months ago. Because it seemed small and didn’t hurt,
she didn’t worry about it that much. Recently she noticed that the lump felt bigger and decided that she should have
someone look at it. She tells the nurse, “I just know it’s not cancer because I’m much too young and healthy. And if it is,
I’m not about to let some doctor mutilate me with a knife. I’d rather die than have my breast cut off.” The nurse asks her
if she has noticed any redness or dimpling of the breast. She tells the nurse, “No, not really, but I don’t pay attention to
those things.” She tells the nurse that she started having regular menstrual cycles at age 11 and has not reached
menopause. She has never been married and has no children.

General survey:
She is alert, well-nourished female; hesitant to expose her breast for examination. Breast Inspection reveals
breasts of typical size with right and left breast symmetry. The skin of both breasts is smooth with even pigmentation.
The nipples protrude slightly with no drainage noted. The left nipple is slightly retracted. Significant dimpling is noted on
left breast in upper outer quadrant when arms are raised over her head. Right breast is firm, smooth, elastic, without
lumps or tenderness. Palpation of the left breast reveals a large, hard lump in the upper outer quadrant. No lumps or
masses are noted in the right breast. The left nipple produces a serosanguineous discharge when squeezed; the right
nipple is unremarkable

Clinical Reasoning
1. Which of the above data requires validation and needs further assessment?
2. Based on above data, What is the contributing factor associated with breast cancer
3. Provide at least 3 nursing diagnoses base on the above data.