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1. A 45-year-old woman comes into the OB/GYN clinic for her yearly check-up. The
woman mentions to the nurse that she has a dimpling of the right breast that has
occurred in the last 2 weeks. She has not performed a self-breast examination. What
assessment would be appropriate for the nurse to make? abirb.com/test
A) Evaluate the patient's milk production
B) Palpate the area for a breast mass
C) Order an immediate mammogram abirb.com/test
D) Call the physician to schedule a biopsy

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2. The nurse is giving an educational event for a local women's group on self-examination
of the breast. The nurse tells the women's group to raise their arms and inspect their
breasts in a mirror. A member of the women's group asks the nurse why she needs to
do this. What is the nurse's best response? abirb.com/test
A) “It will give you greater visibility.”
B) “If you feel pain you will need to inspect it.”
C) “It will help to observe for dimpling.”
D) “Everyone is different in assessing the breast.” abirb.com/test

3. A woman aged 48 years comes to the clinic because she abirb.com/test

has discovered a lump in her
breast. The diagnosis is positive for breast cancer. The woman asks you when her
teenage daughters should begin mammography. What is your best advice?
A) Age 28 years
B) Age 35 years abirb.com/test

C) Age 38 years
D) Age 40 years
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4. A woman, scheduled for a simple mastectomy in one week, is having her preoperative
teaching done by the clinic nurse. What educational intervention will be of primary
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importance to prevent hemorrhage in the postoperative period?
A) Limit her intake of green leafy vegetables
B) Increase her water intake to 8 glasses per day
C) Stop taking vitamin E one week before abirb.com/test
D) Have nothing by mouth for 24 hours before surgery

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5. You are caring for a 52-year-old woman whose sisters and mother died of breast cancer.
The patient states, “My doctor wants me to take tamoxifen to help prevent breast cancer.
What do you think?” What would be your best response?
A) “We call this drug a chemotherapy agent.” abirb.com/test
B) “Tamoxifen prevents osteoporosis.”
C) “I would recommend raloxifene.”
D) “Tamoxifen reduces the incidence of breast cancer.”
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6. A woman has been treated for a tumour of the left breast that has not responded to
chemotherapy. The woman has just found out that she has the BRCA mutations and
discusses her options with her physician. What treatmentabirb.com/test
would be most difficult for this
woman?
A) More aggressive chemotherapy
B) Left mastectomy abirb.com/test
C) Radiation therapy
D) Bilateral mastectomy

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7. During a recent visit to the clinic a woman presents with erythema of the nipple and
areola on the right breast. She states this started several weeks ago and she was fearful
of what would be found. The nurse suspects abirb.com/test
A) Peau d'orange
B) Nipple inversion
C) Paget's disease
D) Acute mastitis abirb.com/test

8. A patient who came to the clinic after finding a mass in her breast is scheduled for a
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diagnostic breast biopsy. What is it important for the nurse to do?
A) Acknowledge the fear the patient is experiencing
B) Refer her to Reach for Recovery
C) Set up a consultation with a breast cancer survivor abirb.com/test
D) Instruct the patient on prosthetic devices

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9. A patient comes to the clinic after finding a lump in her breast. The lump is found to be
a small, well-defined nodule in the right breast. The patient asks the nurse about her
treatment options. Which treatment would be considered best for this patient?
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A) Lumpectomy and radiation
B) Partial mastectomy and radiation
C) Partial mastectomy and chemotherapy
D) Total mastectomy and chemotherapy abirb.com/test

10. A 23-year-old comes to the free clinic stating “I think I have a lump in my breast. Do I
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have cancer?” The nurse instructs the patient that a diagnosis of breast cancer is
confirmed by what?
A) Breast self-examination.
B) Mammography. abirb.com/test
C) Fine-needle aspiration.
D) Chest x-ray.
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11. A 42-year-old female tells the nurse that she has found a painless lump in her right
breast during her monthly self-examination. She says that she is afraid that she has
cancer. Which assessment finding would strongly suggest that this patient's lump is
cancerous? abirb.com/test
A) Eversion of the right nipple and mobile mass
B) Nonmobile mass with irregular edges
C) Mobile mass that's soft and easily delineated abirb.com/test
D) Nonpalpable right axillary lymph nodes

12. A patient in her 30s has two young children and has just abirb.com/test
had a modified radical
mastectomy with immediate reconstruction. The patient shares with the nurse that she's
worried about her future, but she seems to be adjusting well to her diagnosis and
surgery. What nursing intervention is appropriate to support this patient's coping?
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A) Tell the patient's spouse or partner to be supportive while she recovers.
B) Encourage the patient to proceed with the next phase of treatment.
C) Recommend that the patient remain cheerful for the sake of her children.
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D) Refer the patient to the Canadian Cancer Society's Reach to Recovery program or
another support program.

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13. You are caring for a patient who has just had a radical mastectomy and axillary node
dissection. When doing patient education, what should be included regarding hand and
arm care of the affected side?
A) Avoid exercise of the arm abirb.com/test

B) Keep cuticles clipped.

C) Avoid lifting objects greater than 4 kg.
D) Use a sunscreen with an SPF of 4 to 8. abirb.com/test

14. A new mother who is breastfeeding calls the clinic to speak to a nurse. The patient is
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complaining of pain in her left breast and describes her breast as feeling “doughy.” The
nurse tells her to come into the clinic and be checked. The patient is diagnosed with
acute mastitis and placed on antibiotics. What comfort measure should the nurse
instruct the patient to do? abirb.com/test
A) Apply cold compresses as ordered.
B) Do not wear a bra until the infection clears.
C) Do not wash the breasts.
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D) Apply tea bags to nipples.

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15. When planning discharge teaching with a patient who has undergone a total mastectomy
with axillary dissection, the nurse knows to instruct the patient that she should report
what signs or symptoms to the physician immediately?
A) Tightness and tingling across the chest wall abirb.com/test
B) Temperature of 36.9ºC
C) Gross swelling and large amount of output from the drainage device
D) Swelling in the arm on the side of the mastectomy abirb.com/test

16. A newly diagnosed breast cancer patient asks the nurse to explain what kind of breast
cancer she has. She tells the nurse that her tumour is not abirb.com/test
large, but the physician
suspects regional lymph node involvement, and that there are signs of metastatic
disease. From this patient's description the nurse suspects the tumour would be
categorized as what? abirb.com/test
A) Stage I
B) Stage IIB
C) Stage IIIA
D) Stage IV abirb.com/test

17. A nurse is admitting a patient to the unit. When reviewing the patient's history, what risk
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factors increase this patient's risk for breast cancer?
A) Breastfeeding
B) First childbirth after 30 years of age
C) Early menopause abirb.com/test

D) Late menarche

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18. A nurse is examining a patient who has come to the clinic because she thinks she has a
lump in her breast. The nurse notes a fibroadenoma. What question is most appropriate
for the nurse to ask this patient?
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A) How old are you?
B) Have you had a referral for a biopsy?
C) How long have you had a lump in your breast?
D) Do you take birth control tablets? abirb.com/test

19. The nurse is reviewing the physician's notes from the patient who just left. The nurse
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notes that the physician is concerned the patient may have a malignant tumour in the
breast. Based upon assessment data the mass, when palpated, is what?
A) Nontender
B) A regular shape abirb.com/test
C) A soft and regular shape
D) Mobile tissue
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20. A patient has come in for her annual mammogram. The patient voices concerns about
repeated exposure to radiation. What should the nurse teach the patient about a
mammogram?
A) It does not use radiation. abirb.com/test
B) It is a risky procedure and the benefits and risks must be carefully considered.
C) It uses radiation that may cause skin cancer.
D) It is equivalent to an hour of sunlight. abirb.com/test

21. A 42-year-old male has come to the clinic for an annual physical. The nurse notes in the
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patient's history that there is a strong history of male breast cancer in the patient's
family. What should the nurse provide to the patient before he leaves the clinic?
A) A referral for a mammogram
B) Instructions about “Know Your Breasts” (KYB) examination abirb.com/test
C) A referral to a breast surgeon
D) Instructions about when to call the physician about a lump in the arm

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22. You are teaching “Know Your Breasts” (KYB) self-examination to a ladies group at
your church. A participant in the class asks you when the recommended time is to
perform KYB. What is your best reply? abirb.com/test
A) Day 2–4 just before menses
B) Day 1–3 of your menses
C) Day 2–4 after menses
D) Day 5–7 after menses abirb.com/test

23. It is estimated that KYB self-examination is only performed on a routine basis by 25%
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to 30% of women. What is one reason women do not perform KYB monthly?
A) The women feel it is too difficult to differentiate between normal changes and
concerning findings.
B) They might do it at the wrong time of the month. abirb.com/test
C) They would have to call the doctor each month and report what they found.
D) The women would be afraid to go to the doctor if they found something
concerning. abirb.com/test

24. A 60-year-old male presents at the clinic complaining that his breasts are enlarging and
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they hurt. Upon examination the Family Nurse Practitioner finds an enlargement of firm
glandular tissue underneath the areola and immediately surrounding it. She diagnoses
gynecomastia. What would be an appropriate drug to assess if the patient is taking?
A) Gas-X abirb.com/test
B) Zantac
C) Tums
D) Nexium
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25. A patient is to undergo an ultrasound-guided core biopsy. The patient tells the nurse a
friend of hers had a stereotactic core biopsy and wants to know what the difference is.
What would be the nurse's best response? abirb.com/test
A) “An ultrasound-guided core biopsy is faster, less expensive, and does not use
radiation.”
B) “An ultrasound-guided core biopsy is a little more expensive but it doesn't use
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radiation and it is faster.”
C) “An ultrasound-guided core biopsy is a little more expensive, and it also uses
radiation but it is faster.”
D) “An ultrasound-guided core biopsy takes more time,abirb.com/test
and it also uses radiation, but
it is less expensive.”

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26. A patient at high risk for breast cancer is scheduled for an incisional biopsy in the
outpatient surgery department. When the nurse calls to give her preoperative
instructions, the patient asks why an incisional biopsy is being done instead of just
removing the mass. What would be the nurse's best response?abirb.com/test

A) “An incisional biopsy is performed to remove the mass if it is possible and to

confirm the diagnosis.”
B) “An incisional biopsy is performed to confirm a diagnosis and so that special
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studies can be done that will help determine the best treatment.”
C) “An incisional biopsy is performed to see which treatments can be offered the
patient.”
D) “An incisional biopsy is performed so that a frozen abirb.com/test
section can be done and the
information from that be used to determine whether a wide excision is needed.”

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27. A patient is being discharged home from the ambulatory surgery centre after an
incisional biopsy of a mass in her left breast. What are the criteria for discharge for this
patient? (Mark all that apply.)
A) Patient must understand when she can ambulate. abirb.com/test
B) Patient must have someone to accompany her home.
C) Patient must understand activity restrictions.
D) Patient must understand care of the biopsy site. abirb.com/test
E) Patient must understand when she can void.

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28. A 24-year-old mother of a 10-month old has just been told she needs to have an
incisional biopsy of a right breast mass. You are the nurse doing preoperative teaching
with this patient. How could you best assess this patient for specific educational,
physical, or psychosocial needs she might have? abirb.com/test
A) Reviewing her family history and encouraging her to verbalize her questions and
concerns
B) Discussing the possible findings of the biopsy abirb.com/test
C) Discussing possible treatment options if the diagnosis is cancer
D) Reviewing her medical and psychosocial history

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29. Your patient has just returned to the unit from the PACU after breast surgery for
removal of a malignancy. You are planning this patient's care. What would be an
appropriate major nursing diagnosis for you to include inabirb.com/test
this patient's plan of care?
A) Disturbed sensory perception related to nerve irritation in breast
B) Self-care related to fear of moving affected arm
C) Deficient knowledge: care of unaffected breast
D) Undisturbed body image related to loss of the breastabirb.com/test

30. A 52-year-old woman has just been told she has breast cancer and is scheduled for a
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modified mastectomy the following week. As the nurse caring for this patient, you know
that she is anxious and fearful about the upcoming procedure and the newly diagnosed
malignancy. What can you do to best help alleviate this patient's fears?
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A) Provide written material on the procedure that has been scheduled for the patient.
B) Provide the patient with realistic information and expectations about the healing
process and expected recovery.
C) Give the patient current information on breast cancer survival rates.
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D) Offer the patient alternative treatment options.

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31. A patient who has undergone a modified mastectomy with ALND has developed
lymphedema. What specialist would the nurse expect this patient to be referred to?
A) Speech
B) Psychologist abirb.com/test
C) Dietician
D) Rehabilitation
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32. The patient has had a total mastectomy with immediate reconstruction. The patient asks
the nurse when she can take a shower. What should the nurse respond?
A) “Not until the drain is removed.” abirb.com/test
B) “On the second postoperative day.”
C) “Now, if you wash thoroughly with soap and water.”
D) “Seven days after your surgery.”
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33. A patient has been discharged home after a total mastectomy without reconstruction.
The patient lives alone and has a home health referral. When the home care nurse visits
this patient, what does the nurse know to assess? (Mark all that apply.)
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A) Adherence to the exercise plan
B) Overall psychological functioning
C) Surgical drains abirb.com/test
D) Overall physical disability
E) Initiation of pain management

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34. A patient has just been diagnosed with breast cancer, and you are spending time with
her. In assessing this patient's ability to cope with this diagnosis, what would be an
appropriate question for you to ask this patient? abirb.com/test
A) What is her level of education?
B) What coping mechanisms have not helped her in the past?
C) Is there someone she trusts to assist her in making treatment choices?
D) Is she concerned about this diagnosis? abirb.com/test

35. A 35-year-old mother of 3 young children has been diagnosed with stage II breast
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cancer. After discussing treatment options with her physician, the woman goes home to
talk to her husband, later calling the nurse for clarification of some points. The patient
tells the nurse that the physician has recommended breast conservation surgery followed
by radiation, and the husband is asking why his wife does abirb.com/test
not have a modified radical
mastectomy “to be sure all the cancer is gone.” What would be the nurse's best
response?
A) “Modified radical mastectomies are very hard on a patient, both physically and
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emotionally and they really aren't necessary anymore.”
B) “According to the National Institutes of Health, having a modified radical
mastectomy is no longer necessary.”
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C) “Modified radical mastectomies have a really poor survival rate because of
recurrent malignancies. Do you really want to take that chance?
D) “According to the National Institutes of Health, breast conservation combined with
radiation has a survival rate that is the same as if you had a modified radical
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mastectomy.”

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36. A patient who has had a lumpectomy calls the clinic to talk to the nurse. The patient
tells the nurse that she has developed a tender area on her breast that is red and warm
and looks like someone “drew a line with a red marker.” What would the nurse suspect
is the woman's problem? abirb.com/test
A) Mondor disease
B) DVT of the breast
C) Recurrent malignancy abirb.com/test
D) An area of fat necrosis.

37. A woman calls the clinic and tells the nurse she has had aabirb.com/test
bloody drainage from her
right nipple. The nurse makes an appointment for this patient, expecting the physician
or practitioner to order what diagnostic test on this patient?
A) Ultrasound abirb.com/test
B) Mammogram
C) Computer-assisted detection
D) Galactography
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Answer Key

1. B
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2. C
3. C
4. C
5. D abirb.com/test
6. D
7. C
8. A
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9. A
10. C
11. B
12. D abirb.com/test
13. C
14. A
15. C
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16. D
17. B
18. B
19. A abirb.com/test
20. D
21. B
22. D
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23. A
24. B
25. A
26. B abirb.com/test
27. B, C, D
28. D
29. A
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30. B
31. D
32. A
33. A, B, C abirb.com/test
34. C
35. D
36. A
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37. D

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