A client is starting hormonal therapy with tamoxifen (Nolvadex) to lower the risk for breast cancer. What information needs to be explained by the nurse regarding the action of this drug?
a. It blocks the release of luteinizing hormone.
b. It interferes with cancer cell division.
c. It selectively blocks estrogen in the breast.
d. It inhibits DNA synthesis in rapidly dividing cells.
Question 2During dressing changes, the nurse assesses a client who has had breast reconstruction. Which finding would cause the nurse to take immediate action?
a. Slightly reddened incisional area
b. Blood pressure of 128/75 mm Hg
c. Temperature of 99 F (37.2 C)
d. Dusky color of the flap
Question 3What comfort measure can only be performed by a nurse, as opposed to an unlicensed assistive personnel (UAP), for a client who returned from a left modified radical mastectomy 4 hours ago?
a. Placing the head of bed at 30 degrees
b. Elevating the left arm on a pillow
c. Administering morphine for pain at a 4 on a 0-to-10 scale
d. Supporting the left arm while initially ambulating the client
Question 4A client is discharged to home after a modified radical mastectomy with two drainage tubes. Which statement by the client would indicate that further teaching is needed?
a. I am glad that these tubes will fall out at home when I finally shower.
b. I should measure the drainage each day to make sure it is less than an ounce.
c. I should be careful how I lie in bed so that I will not kink the tubing.
d. If there is a foul odor from the drainage, I should contact my doctor.
Question 5A client has just returned from a right radical mastectomy. Which action by the unlicensed assistive personnel (UAP) would the nurse consider unsafe?
a. Checking the amount of urine in the urine catheter collection bag
b. Elevating the right arm on a pillow
c. Taking the blood pressure on the right arm
d. Encouraging the client to squeeze a rolled washcloth
Question 6A 35-year-old woman is diagnosed with stage III breast cancer. She seems to be extremely anxious. What action by the nurse is best?
a. Encourage the client to search the Internet for information tonight.
b. Ask the client if sexuality has been a problem with her partner.
c. Explore the idea of a referral to a breast cancer support group.
d. Assess whether there has been any mental illness in her past.
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