Mastitis Practice Exam

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1. Which of the following is the primary predisposing factor related to mastitis?

  1. Epidemic infection from nosocomial sources localizing in the lactiferous glands and ducts
  2. Endemic infection occurring randomly and localizing in the peri glandular connective tissue
  3. Temporary urinary retention due to decreased perception of the urge to avoid
  4. Breast injury caused by overdistention, stasis, and cracking of the nipples

2.Which of the following conditions is common in pregnant women in the 2nd trimester of pregnancy?

  1. Mastitis
  2. Metabolic alkalosis
  3. Physiologic anemia
  4. Respiratory acidosis

3.A nurse is providing instructions to a mother who has been diagnosed with mastitis. Which of the following statements if made by the mother indicates a need for further teaching?

  1. “I need to take antibiotics, and I should begin to feel better in 24-48 hours.”
  2. “I can use analgesics to assist in alleviating some of the discomfort.”
  3. “I need to wear a supportive bra to relieve the discomfort.”
  4. “I need to stop breastfeeding until this condition resolves.”

4. A nurse is preparing a list of self-care instructions for a PP client who was diagnosed with mastitis. Select all instructions that would be included on the list.

  1. Take the prescribed antibiotics until the soreness subsides.
  2. Wear supportive bra
  3. Avoid decompression of the breasts by breastfeeding or breast pump
  4. Rest during the acute phase
  5. Continue to breastfeed if the breasts are not too sore.

5. Signs and symptoms of mastitis include all of the following except:

  1. Fever
  2. Elevated white blood count
  3. Diffuse breast tenderness and warmth
  4. Focal breast tenderness and warmth

6.   True or False: Patients with mastitis should temporarily stop breast feeding until the infection clears.

  1. True
  2. False

7. Drug of choice for treatment of mastitis:

  1. Amoxicillin
  2. Clindamycin
  3. Doxycycline
  4. Dicloxacillin
Answers & Rationales

1. D. Breast injury caused by overdistention, stasis, and cracking of the nipples. With mastitis, injury to the breast, such as overdistention, stasis, and cracking of the nipples, is the primary predisposing factor.

  • Options A and B: Epidemic and endemic infections are probable sources of infection for mastitis.
  • Option D: Temporary urinary retention due to decreased perception of the urge to void is a contributory factor to the development of urinary tract infection, not mastitis.

2. C. Physiologic anemia. Hemoglobin and hematocrit levels decrease during pregnancy as the increase in plasma volume exceeds the increase in red blood cell production.

3. D. “I need to stop breastfeeding until this condition resolves.” In most cases, the mother can continue to breastfeed with both breasts. If the affected breast is too sore, the mother can pump the breast gently. Regular emptying of the breast is important to prevent abscess formation.

  • Option A:  Antibiotic therapy assists in resolving the mastitis within 24-48 hours
  • Options B and C: Additional supportive measures include ice packs, breast supports, and analgesics.

 4. B, D, and E. Mastitis are an infection of the lactating breast. Client instructions include resting during the acute phase, maintaining a fluid intake of at least 3 L a day, and taking analgesics to relieve discomfort. Additional supportive measures include the use of moist heat or ice packs and wearing a supportive bra.

  • Option A: Antibiotics may be prescribed and are taken until the complete prescribed course is finished. They are not stopped when the soreness subsides.
  • Option C: Continued decompression of the breast by breastfeeding or pumping is important to empty the breast and prevent formation of an abscess.

5. C. Diffuse breast tenderness and warmth

6. B. False

7. D. Dicloxacillin