A nurse is educating clients about breast cancer at a community health event. Which of the following statements should the nurse include in the training?
Breast cancer can occur in any part of the breast, but ductal breast cancer is most common.
Breastfeeding increases the risk of breast cancer in women over 40 years of age.
Clients who have BRCA1 or BRCA2 gene changes have a decreased risk of breast cancer.
Clients should begin screening mammography annually by the age of 50 years old.
The Correct Answer is A
Choice A rationale
Breast cancer can occur in any part of the breast, but ductal breast cancer is most common. This statement is correct because the majority of breast cancers originate in the ducts that carry milk to the nipple. Ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) are the most common types of breast cancer, accounting for about 80% of all cases.
Choice B rationale
Breastfeeding increases the risk of breast cancer in women over 40 years of age. This statement is incorrect. In fact, breastfeeding is known to reduce the risk of breast cancer. The longer a woman breastfeeds, the greater the protective effect. This is thought to be due to hormonal changes that occur during lactation, which may delay the return of menstrual periods and reduce a woman’s lifetime exposure to hormones like estrogen that can promote breast cancer cell growth.
Choice C rationale
Clients who have BRCA1 or BRCA2 gene changes have a decreased risk of breast cancer. This statement is incorrect. Mutations in the BRCA1 and BRCA2 genes significantly increase the risk of developing breast cancer. Women with these mutations have a 45-65% chance of developing breast cancer by age 70, compared to about 12% for women in the general population. These genes normally help repair DNA damage, but when they are mutated, they can lead to the development of cancer.
Choice D rationale
Clients should begin screening mammography annually by the age of 50 years old. This statement is partially correct but not entirely accurate. The American Cancer Society recommends that women with an average risk of breast cancer should start annual mammograms at age 45 and can switch to biennial screening at age 55. However, women should have the option to start screening as early as age 40 if they choose.
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Related Questions
Correct Answer is B
Explanation
Choice A rationale
An abdominal aortic aneurysm (AAA) is most commonly found infrarenally, below the level of the renal arteries, rather than in the suprarenal aorta. The suprarenal aorta is the section of the aorta above the renal arteries, and while aneurysms can occur there, it is not the most common location for AAAs. Therefore, this statement is incorrect.
Choice B rationale
An abdominal aortic aneurysm is defined as a localized dilation of the abdominal aorta that exceeds 50% of the normal vessel diameter, typically greater than 30 mm in diameter. This dilation occurs due to weakening of the arterial wall, which can result from various factors such as atherosclerosis, hypertension, and genetic predisposition. This statement is correct and should be included in the teaching.
Choice C rationale
An abdominal aortic aneurysm typically occurs due to weakening of the arterial wall, rather than thickening. The weakened wall allows the arterial wall to bulge or balloon out, forming an aneurysm. This statement is incorrect as it misrepresents the pathophysiology of AAAs.
Choice D rationale
Abdominal aortic aneurysms are more likely to rupture when blood pressure is too high, rather than too low. Hypertension increases the pressure within the weakened arterial wall, potentially leading to rupture. Therefore, controlling blood pressure is crucial in managing abdominal aortic aneurysms to reduce the risk of rupture. This statement is incorrect.
Correct Answer is ["C"]
Explanation
Choice A rationale
Hypercyanotic spells, also known as “tet spells,” are typically associated with Tetralogy of Fallot, a congenital heart defect. The child in this scenario has congenital mitral stenosis, not Tetralogy of Fallot, making hypercyanotic spells less likely.
Choice B rationale
A murmur is a sound made by turbulent blood flow within the heart. While the child may have a murmur due to congenital mitral stenosis, it is not a direct risk associated with the exacerbation of heart failure. The primary concern here is the risk of digitalis toxicity due to the administration of furosemide.
Choice C rationale
Digitalis toxicity is a significant risk for this child. Furosemide, a diuretic, can cause electrolyte imbalances, particularly hypokalemia, which increases the risk of digitalis toxicity. Symptoms of digitalis toxicity include nausea, vomiting, dizziness, and arrhythmias.
Choice D rationale
Dependent rubor is a reddish-blue discoloration of the extremities, typically associated with peripheral arterial disease. It is not directly related to heart failure or the administration of furosemide.
Choice E rationale
Fever is not a typical complication of heart failure or the administration of furosemide. It is more commonly associated with infections or inflammatory conditions.
Choice F rationale
Carditis, or inflammation of the heart, is not a direct risk associated with the exacerbation of heart failure or the administration of furosemide. The primary concern remains digitalis toxicity.
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