NR 509 - Final Exam
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2026
,A 44-year-old female mathematician presents to clinic with a complaint of a mass in the
right breast. Her partner noticed this mass 2 days ago, and the patient feels guilty
because she has only had one mammogram and does not engage in breast self-
examination (BSE) on any regular basis. She has no family history of breast cancer, and
her prior mammogram was ordered as a routine screening test at age 43 years after a
brief discussion with her primary care provider. After a thorough investigation reveals a
benign cyst, what advice should be given to this patient about screening for breast
cancer in her age group?
a. BSE is well evidenced, and all recommending agencies agree that it should be
taught and reinforced.
b.Clinical breast examination (CBE) is superior to BSE and should be a routine part
of annual examinations starting at age 30 years.
c.This patient was in compliance with the U.S. Preventive Services Task Force
(USPSTF) recommendations for her age group and risk factors prior to her current
complaint.
d. Mammography is most sensitive and specific for women in their 40s, when breast
tissue is still dense enough to image accurately.
e. Breast cancer screening is extremely well studied, and no controversy exists on
the recommended norms for screening and follow-up.
c. This patient was in compliance with the U.S. Preventive Services Task Force (USPSTF)
recommendations for her age group and risk factors prior to her current complaint.
,A 42-year-old female website developer presents for an annual preventive examination
with questions about breast cancer screening. She is concerned about the radiation
exposure associated with mammography and is interested in magnetic resonance
imaging (MRI) as a possible alternative for routine screening. She is otherwise healthy
with no family history of breast, ovarian, or colon cancer. Which of the following is true
about MRI as a screening modality for breast cancer in the general population?
a. Breast cancer screening by MRI has been well studied in the general population.
b. Sensitivity of screening for breast cancer increases with breast MRI at the expense
of specificity.
c.This patient is an ideal candidate for screening via breast MRI based on
current evidence.
d. Women at low lifetime risk of breast cancer (<20%) are recommended to
undergo screening MRI.
e. Known BRCA1 or BRCA2 mutation is insufficient criteria to justify screening with
breast MRI.
b. Sensitivity of screening for breast cancer increases with breast MRI at the expense of
specificity.
A 35-year-old G0P0 woman presents to clinic with a complaint of bilateral nipple
discharge. This discharge started several weeks ago and has occurred at irregular
intervals since that time. She does not complain of local tenderness, redness, fever, or
any other systemic symptoms aside from slightly irregular periods over the last few
months.
On examination, she is able to express a small amount of discharge, which is sent to the
laboratory and found to be consistent with breast milk but without any signs of blood or
pus. Screening laboratories are also sent, which reveal a normal blood count, metabolic
panel, thyroid-stimulating hormone, and human chorionic gonadotropin (HCG) level.
Further laboratories are still pending. Which of the following is the most likely diagnosis?
a. Mastitis
b. Ductal carcinoma in situ
c. Paget disease of the breast
d. Occult pregnancy
e. Prolactinoma
e. Prolactinoma
, A 22-year-old G0P0 undergraduate student presents to clinic after finding a breast mass
on breast self-examination (BSE) at home. The mass is nontender without skin changes,
erythema, or overlying swelling. She has heard that most breast cancers are found by
patients themselves, and she is very concerned that she may have breast cancer. Which
of the following is true about BSE and self-detection of breast cancer?
a. Most masses that women find at home and bring to a provider's attention turn out to
be malignant.
b.This patient is more likely to find a fibroadenoma than a cancer on self-examination.
c.The most likely breast mass this patient is likely to find in herself is an
abscess complicating underlying mastitis.
d. Because of this patient's age, breast masses should not be pursued with imaging
and diagnosis because the risk of cancer is so low.
e. BSE is universally recommended because of very high sensitivity and specificity
for finding cancerous lesions.
b. This patient is more likely to find a fibroadenoma than a cancer on self-examination.
Bate's Exam Questions
Verified and Provided
with A+ Graded
Answers| Latest Updated
2026
,A 44-year-old female mathematician presents to clinic with a complaint of a mass in the
right breast. Her partner noticed this mass 2 days ago, and the patient feels guilty
because she has only had one mammogram and does not engage in breast self-
examination (BSE) on any regular basis. She has no family history of breast cancer, and
her prior mammogram was ordered as a routine screening test at age 43 years after a
brief discussion with her primary care provider. After a thorough investigation reveals a
benign cyst, what advice should be given to this patient about screening for breast
cancer in her age group?
a. BSE is well evidenced, and all recommending agencies agree that it should be
taught and reinforced.
b.Clinical breast examination (CBE) is superior to BSE and should be a routine part
of annual examinations starting at age 30 years.
c.This patient was in compliance with the U.S. Preventive Services Task Force
(USPSTF) recommendations for her age group and risk factors prior to her current
complaint.
d. Mammography is most sensitive and specific for women in their 40s, when breast
tissue is still dense enough to image accurately.
e. Breast cancer screening is extremely well studied, and no controversy exists on
the recommended norms for screening and follow-up.
c. This patient was in compliance with the U.S. Preventive Services Task Force (USPSTF)
recommendations for her age group and risk factors prior to her current complaint.
,A 42-year-old female website developer presents for an annual preventive examination
with questions about breast cancer screening. She is concerned about the radiation
exposure associated with mammography and is interested in magnetic resonance
imaging (MRI) as a possible alternative for routine screening. She is otherwise healthy
with no family history of breast, ovarian, or colon cancer. Which of the following is true
about MRI as a screening modality for breast cancer in the general population?
a. Breast cancer screening by MRI has been well studied in the general population.
b. Sensitivity of screening for breast cancer increases with breast MRI at the expense
of specificity.
c.This patient is an ideal candidate for screening via breast MRI based on
current evidence.
d. Women at low lifetime risk of breast cancer (<20%) are recommended to
undergo screening MRI.
e. Known BRCA1 or BRCA2 mutation is insufficient criteria to justify screening with
breast MRI.
b. Sensitivity of screening for breast cancer increases with breast MRI at the expense of
specificity.
A 35-year-old G0P0 woman presents to clinic with a complaint of bilateral nipple
discharge. This discharge started several weeks ago and has occurred at irregular
intervals since that time. She does not complain of local tenderness, redness, fever, or
any other systemic symptoms aside from slightly irregular periods over the last few
months.
On examination, she is able to express a small amount of discharge, which is sent to the
laboratory and found to be consistent with breast milk but without any signs of blood or
pus. Screening laboratories are also sent, which reveal a normal blood count, metabolic
panel, thyroid-stimulating hormone, and human chorionic gonadotropin (HCG) level.
Further laboratories are still pending. Which of the following is the most likely diagnosis?
a. Mastitis
b. Ductal carcinoma in situ
c. Paget disease of the breast
d. Occult pregnancy
e. Prolactinoma
e. Prolactinoma
, A 22-year-old G0P0 undergraduate student presents to clinic after finding a breast mass
on breast self-examination (BSE) at home. The mass is nontender without skin changes,
erythema, or overlying swelling. She has heard that most breast cancers are found by
patients themselves, and she is very concerned that she may have breast cancer. Which
of the following is true about BSE and self-detection of breast cancer?
a. Most masses that women find at home and bring to a provider's attention turn out to
be malignant.
b.This patient is more likely to find a fibroadenoma than a cancer on self-examination.
c.The most likely breast mass this patient is likely to find in herself is an
abscess complicating underlying mastitis.
d. Because of this patient's age, breast masses should not be pursued with imaging
and diagnosis because the risk of cancer is so low.
e. BSE is universally recommended because of very high sensitivity and specificity
for finding cancerous lesions.
b. This patient is more likely to find a fibroadenoma than a cancer on self-examination.
