Author Question: While interviewing a 48-year-old client during her annual physical examination, the nurse learns ... (Read 73 times)

FButt · **on:** Jun 28, 2018

While interviewing a 48-year-old client during her annual physical examination, the nurse learns that she has never had a mammogram. The American Cancer Society recommends annual mammography screening starting at age 40.

Before the nurse encourages this client to begin annual screening, it is important for her to understand the reasons why women avoid testing. These reasons include which of the following? (Select all that apply.)

a. Fear of x-ray exposure
b. Expense of the procedure
c. Reluctance to hear bad news
d. Having heard that the test is painful
e. Belief that lack of family history makes this test unnecessary

Question 2

While performing a self-breast exam, the client notes an area on the right breast that is nodular, with some associated tenderness. This is a new onset finding because the exams were not problematic in the past,.

The left breast examination is unremarkable. The client calls to report her findings to the clinical nurse because this is not her typical result. What action should the nurse take next?

a. Refer the client to an oncologist because the results sound suspicious.
b. Ask the client to come in for an office visit so that the findings can be validated but tell her that this information is within the normal range of presentation.
c. Have the client wear a tight-fitting bra and tell her that the tenderness is associated with ovulation and will pass.
d. Have the client repeat the self-breast exam in 2 weeks and call back with findings to provide a basis for comparison.

meltdown117 · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: A, B, C, D
Fear of x-ray exposure, expense, reluctance to hear bad news, and fear of pain are reasons women avoid having a mammogram done. Although the test is expensive, it is usually covered by health insurance, and many communities offer low-cost or free screening to women without insurance. It is important to acknowledge that some discomfort occurs with screening. Scheduling the test immediately at the end of a period makes it less painful. The risk of radiation exposure is minimal to none. Nurses play a vital role in providing information and reassurance to help women overcome these fears. Even clients with no family history should have a regular screening done. The nurse should emphasize that a combination of breast self-examination and mammography needs to be performed at regular intervals. Women with a family history may need to begin screening at a younger age and have additional testing such as ultrasound performed.

Answer to Question 2

ANS: B
Although these findings are within the normal range of presentation for breast tissue, they are not in the normal presentation for this client. The client has called to express concern; therefore, the nurse should have the client schedule an appointment for assessment and evaluation. There is no need for referral to a specialist at this time. Wearing a tight fitting bra may help provide support but does not address the physical findings and concern of the client. Repeating the self-breast exam may be required but it does not address the client's current concerns; therefore, the client should be seen by a health care provider.