NURS5220 EXAM 2 EXPLORE 340
ESSENTIAL QUESTIONS AND
ANSWERS
Which part of the brain contains the Wernicke speech area, which permits speech and
comprehension of written language?
A. Frontal lobe
B. Parietal lobe
C. Temporal lobe
D. Limbic system - Answer-C: CorrectThe temporal lobe is responsible for perception
and interpretation of sounds as well as localizing their source. It contains the Wernicke
speech area, which allows a person to understand spoken and written language. It is
also involved in the integration of behavior, emotion, and personality, as well as long-
term memory. Answers a, b, and d regulate other characterisitics.
Long-term memory is associated with which area of the brain?
A. Frontal lobe
B. Parietal lobe
C. Temporal lobe
D. Limbic system - Answer-C; CorrectThe temporal lobe not only contains the Wernicke
speech area, it is also involved in the integration of behavior, emotion, and personality,
as well as long-term memory. Answers a, b, and d regulate other characterisitics.
A patient reports spontaneous discharge from her left nipple. How would you determine
if the discharge was from one or multiple ducts?
A. Order an ultrasound.
B. Order a mammogram.
C. Compress the nipple and examine with a magnifying glass.
D. Depress the nipple into the well behind the areola and observe discharge. - Answer-
C: CorrectDetermine whether the discharge is bilateral or unilateral. Use a magnifying
glass to look closely at the nipple to determine whether the discharge is from a single
duct or multiple ducts. Characteristics of concern include spontaneous discharge that is
unilateral and from a single duct.
Mrs. Harris presents to your office with a complaint of a red rash on her breast
suggestive of either Paget disease or eczema. Which is a distinguishing factor between
these two problems?
,A. Location of the lesion on the nipple
B. Presence or absence of crust
C. Response to cortisone
D. Pattern of fever - Answer-C: CorrectPaget disease is a surface manifestation of
underlying ductal carcinoma. Unlike eczema, it does not respond to steroids. Cortisone
is a steroid.
Mrs. Ulman is a 56-year-old patient who presents to your office for her routine follow-up
after having a mastectomy of the right breast 2 years ago. Which statement applies to
your examination of this patient?
A. Swelling, thickening, and small lumps at the mastectomy site are expected.
B. The mastectomy site is inspected but not palpated because of pain.
C. If malignancy recurs, it may be at the scar site.
D. There is no need to examine the mastectomy site. - Answer-C: CorrectThe patient
who has had a mastectomy has special examination needs. In addition to examining the
unaffected breast in the usual manner, you must examine the mastectomy site, with
particular attention to the scar. If malignancy recurs, it may be at the scar site. Be aware
that a woman who has had a mastectomy may feel uncomfortable removing her bra and
prosthesis if she wears one.
Mrs. Yates is a 58-year-old patient who presents to your office for her yearly physical
examination. She asks you if she really needs to have mammograms. Which is a
correct response?
A. Breast cancer mortality is reduced with mammography screening.
B. After age 63, there is no benefit from mammography.
C. You don't need mammograms unless you have a family history of breast cancer.
D. If you have fewer than three risk factors, you are safe to stop having mammograms
after age 60. - Answer-A; CorrectBreast cancer screening recommendations for women
at average risk vary by authority. Breast cancer mortality is reduced with mammography
screening, although estimates are of borderline statistical significance. The magnitudes
of effect are small for younger ages, with most of the benefit of mammography resulting
from screening during ages 50 to 74 years.
Mrs. Harold is a 37-year-old patient who presents for her yearly physical examination.
Which statement made by Mrs. Harold would make the examiner suspect fibrocystic
changes?
A. "I have a lump in my breast that is not tender."
B. "My right breast is larger than the left breast."
C. "My nipples are darker than before my baby was born."
D. "I feel lumps before my period." - Answer-D: CorrectFibrocystic changes are benign
fluid-filled cyst formation caused by ductal enlargement usually associated with a long
follicular or luteal phase of the menstrual cycle.
,Mrs. Black brings her 12-year-old daughter in with a complaint of a breast mass. On
examination, you note unilateral breast enlargement with associated tenderness but no
mass. Which action do you take?
A. Refer for mammogram.
B. Refer for biopsy.
C. Ask the mother about her own breast development.
D. Explain that this is an expected finding. - Answer-D: CorrectBreast examination is
important in children for Tanner staging and as part of an evaluation regarding
premature or delayed puberty. Thelarche (breast development) represents the first sign
of puberty in girls. The developmental process can be classified using Tanner's five
stages of physical sexual maturity. Breast tissue of the adolescent female feels
homogeneous, dense, firm, and elastic. Breasts develop at different rates in the
individual, which can result in temporary asymmetry.
Mrs. Newer brings her young child in for a yearly physical examination. On examination,
you note a supernumerary nipple. For which other finding do you need to be alert?
A. Papillomatosis
B. Duct ectasia
C. Renal anomalies
D. Ambiguous sex organs - Answer-C: CorrectSupernumerary nipples, which are more
common in African-American women than in white women, appear as one or more extra
nipples located along the embryonic mammary ridge (the "milk line"). These nipples and
areolae may be pink or brown, are usually small, and are commonly mistaken for moles.
In some cases, supernumerary nipples may be associated with congenital renal or
cardiac anomalies, particularly in whites.
Mrs. Wolf is a 68-year-old patient who presents to your office with a complaint of breast
mass. On examination, you note an irregular hard, fixed breast mass and an inverted
nipple. Which of the following would you suspect?
A. Fibroadenoma
B. Intraductal papilloma
C. Fat necrosis
D. Carcinoma - Answer-D; CorrectMalignant breast tumors are ductal carcinomas that
arise from the epithelial lining of ducts or lobular carcinomas that originate in the
glandular tissue of the lobules. Mrs. Wolf is displaying the characteristic objective signs
of carcinoma.
Mrs. Bower, a 56-year-old patient, presents for a yearly physical examination. On
examination, you note a fixed mass in the left breast. Given this finding, which area
would you palpate for sentinel nodes?
A. Supraclavicular fossa
B. Inner aspect of the upper arm
, C. Posterior chest wall along the border of the scapula
D. Anterior chest wall along the pectoral muscles - Answer-A: CorrectPalpate the
supraclavicular and infraclavicular areas for the presence of enlarged nodes. These
nodes are considered to be sentinel nodes (Virchow nodes), so any enlargement is
highly significant. Sentinel nodes are indicators for invasion of the lymphatics by cancer.
Mrs. Jones brings her newborn infant daughter in for a routine office visit. On
examination, you express a clear to milky white fluid from the breast bud. Which term is
used to describe this fluid?
A. Witch's milk
B. Witch hazel
C. Infant's milk
D. Neonate excretion - Answer-A; CorrectThe breasts of many well newborns, male and
female, are enlarged for a relatively brief time as a result of passively transferred
maternal estrogen. If you squeeze the breast bud gently, a small amount of clear or
milky white fluid, commonly called "witch's milk," is sometimes expressed.
What is the cause of a peau d'orange appearance to the skin of the breast?
A. Vascular stasis
B. Destruction of stromal tissue
C. Infiltration with immune cells
D. Edema from blocked lymph drainage - Answer-D: CorrectA peau d'orange (orange
skin) appearance of the skin indicates edema of the breast caused by blocked lymph
drainage in advanced or inflammatory breast cancer. The skin appears thickened with
enlarged pores and accentuated skin markings.
Which is a similarity between fibroadenoma and fibrocystic disease?
A. Both involve fluid-filled cysts.
B. Both are usually tender to touch.
C. Both are nonmalignant breast problems.
D. Both fluctuate with the menstrual cycle. - Answer-C: CorrectFibroadenomas are
benign tumors composed of stromal and epithelial elements that represent a
hyperplastic or proliferative process in a single terminal ductal unit. Fibrocystic disease
is a benign fluid-filled cyst formation caused by ductal enlargement. Both are
nonmalignant breast conditions.
When examining a 34-year-old mother of two who is a new patient in for a routine
physical, you notice that the right nipple is inverted. Which question would you
immediately ask?
A. "Did you breast feed your children?"
B. "How long has your right nipple been inverted?"
C. "Is there any history of breast cancer in your family?"
ESSENTIAL QUESTIONS AND
ANSWERS
Which part of the brain contains the Wernicke speech area, which permits speech and
comprehension of written language?
A. Frontal lobe
B. Parietal lobe
C. Temporal lobe
D. Limbic system - Answer-C: CorrectThe temporal lobe is responsible for perception
and interpretation of sounds as well as localizing their source. It contains the Wernicke
speech area, which allows a person to understand spoken and written language. It is
also involved in the integration of behavior, emotion, and personality, as well as long-
term memory. Answers a, b, and d regulate other characterisitics.
Long-term memory is associated with which area of the brain?
A. Frontal lobe
B. Parietal lobe
C. Temporal lobe
D. Limbic system - Answer-C; CorrectThe temporal lobe not only contains the Wernicke
speech area, it is also involved in the integration of behavior, emotion, and personality,
as well as long-term memory. Answers a, b, and d regulate other characterisitics.
A patient reports spontaneous discharge from her left nipple. How would you determine
if the discharge was from one or multiple ducts?
A. Order an ultrasound.
B. Order a mammogram.
C. Compress the nipple and examine with a magnifying glass.
D. Depress the nipple into the well behind the areola and observe discharge. - Answer-
C: CorrectDetermine whether the discharge is bilateral or unilateral. Use a magnifying
glass to look closely at the nipple to determine whether the discharge is from a single
duct or multiple ducts. Characteristics of concern include spontaneous discharge that is
unilateral and from a single duct.
Mrs. Harris presents to your office with a complaint of a red rash on her breast
suggestive of either Paget disease or eczema. Which is a distinguishing factor between
these two problems?
,A. Location of the lesion on the nipple
B. Presence or absence of crust
C. Response to cortisone
D. Pattern of fever - Answer-C: CorrectPaget disease is a surface manifestation of
underlying ductal carcinoma. Unlike eczema, it does not respond to steroids. Cortisone
is a steroid.
Mrs. Ulman is a 56-year-old patient who presents to your office for her routine follow-up
after having a mastectomy of the right breast 2 years ago. Which statement applies to
your examination of this patient?
A. Swelling, thickening, and small lumps at the mastectomy site are expected.
B. The mastectomy site is inspected but not palpated because of pain.
C. If malignancy recurs, it may be at the scar site.
D. There is no need to examine the mastectomy site. - Answer-C: CorrectThe patient
who has had a mastectomy has special examination needs. In addition to examining the
unaffected breast in the usual manner, you must examine the mastectomy site, with
particular attention to the scar. If malignancy recurs, it may be at the scar site. Be aware
that a woman who has had a mastectomy may feel uncomfortable removing her bra and
prosthesis if she wears one.
Mrs. Yates is a 58-year-old patient who presents to your office for her yearly physical
examination. She asks you if she really needs to have mammograms. Which is a
correct response?
A. Breast cancer mortality is reduced with mammography screening.
B. After age 63, there is no benefit from mammography.
C. You don't need mammograms unless you have a family history of breast cancer.
D. If you have fewer than three risk factors, you are safe to stop having mammograms
after age 60. - Answer-A; CorrectBreast cancer screening recommendations for women
at average risk vary by authority. Breast cancer mortality is reduced with mammography
screening, although estimates are of borderline statistical significance. The magnitudes
of effect are small for younger ages, with most of the benefit of mammography resulting
from screening during ages 50 to 74 years.
Mrs. Harold is a 37-year-old patient who presents for her yearly physical examination.
Which statement made by Mrs. Harold would make the examiner suspect fibrocystic
changes?
A. "I have a lump in my breast that is not tender."
B. "My right breast is larger than the left breast."
C. "My nipples are darker than before my baby was born."
D. "I feel lumps before my period." - Answer-D: CorrectFibrocystic changes are benign
fluid-filled cyst formation caused by ductal enlargement usually associated with a long
follicular or luteal phase of the menstrual cycle.
,Mrs. Black brings her 12-year-old daughter in with a complaint of a breast mass. On
examination, you note unilateral breast enlargement with associated tenderness but no
mass. Which action do you take?
A. Refer for mammogram.
B. Refer for biopsy.
C. Ask the mother about her own breast development.
D. Explain that this is an expected finding. - Answer-D: CorrectBreast examination is
important in children for Tanner staging and as part of an evaluation regarding
premature or delayed puberty. Thelarche (breast development) represents the first sign
of puberty in girls. The developmental process can be classified using Tanner's five
stages of physical sexual maturity. Breast tissue of the adolescent female feels
homogeneous, dense, firm, and elastic. Breasts develop at different rates in the
individual, which can result in temporary asymmetry.
Mrs. Newer brings her young child in for a yearly physical examination. On examination,
you note a supernumerary nipple. For which other finding do you need to be alert?
A. Papillomatosis
B. Duct ectasia
C. Renal anomalies
D. Ambiguous sex organs - Answer-C: CorrectSupernumerary nipples, which are more
common in African-American women than in white women, appear as one or more extra
nipples located along the embryonic mammary ridge (the "milk line"). These nipples and
areolae may be pink or brown, are usually small, and are commonly mistaken for moles.
In some cases, supernumerary nipples may be associated with congenital renal or
cardiac anomalies, particularly in whites.
Mrs. Wolf is a 68-year-old patient who presents to your office with a complaint of breast
mass. On examination, you note an irregular hard, fixed breast mass and an inverted
nipple. Which of the following would you suspect?
A. Fibroadenoma
B. Intraductal papilloma
C. Fat necrosis
D. Carcinoma - Answer-D; CorrectMalignant breast tumors are ductal carcinomas that
arise from the epithelial lining of ducts or lobular carcinomas that originate in the
glandular tissue of the lobules. Mrs. Wolf is displaying the characteristic objective signs
of carcinoma.
Mrs. Bower, a 56-year-old patient, presents for a yearly physical examination. On
examination, you note a fixed mass in the left breast. Given this finding, which area
would you palpate for sentinel nodes?
A. Supraclavicular fossa
B. Inner aspect of the upper arm
, C. Posterior chest wall along the border of the scapula
D. Anterior chest wall along the pectoral muscles - Answer-A: CorrectPalpate the
supraclavicular and infraclavicular areas for the presence of enlarged nodes. These
nodes are considered to be sentinel nodes (Virchow nodes), so any enlargement is
highly significant. Sentinel nodes are indicators for invasion of the lymphatics by cancer.
Mrs. Jones brings her newborn infant daughter in for a routine office visit. On
examination, you express a clear to milky white fluid from the breast bud. Which term is
used to describe this fluid?
A. Witch's milk
B. Witch hazel
C. Infant's milk
D. Neonate excretion - Answer-A; CorrectThe breasts of many well newborns, male and
female, are enlarged for a relatively brief time as a result of passively transferred
maternal estrogen. If you squeeze the breast bud gently, a small amount of clear or
milky white fluid, commonly called "witch's milk," is sometimes expressed.
What is the cause of a peau d'orange appearance to the skin of the breast?
A. Vascular stasis
B. Destruction of stromal tissue
C. Infiltration with immune cells
D. Edema from blocked lymph drainage - Answer-D: CorrectA peau d'orange (orange
skin) appearance of the skin indicates edema of the breast caused by blocked lymph
drainage in advanced or inflammatory breast cancer. The skin appears thickened with
enlarged pores and accentuated skin markings.
Which is a similarity between fibroadenoma and fibrocystic disease?
A. Both involve fluid-filled cysts.
B. Both are usually tender to touch.
C. Both are nonmalignant breast problems.
D. Both fluctuate with the menstrual cycle. - Answer-C: CorrectFibroadenomas are
benign tumors composed of stromal and epithelial elements that represent a
hyperplastic or proliferative process in a single terminal ductal unit. Fibrocystic disease
is a benign fluid-filled cyst formation caused by ductal enlargement. Both are
nonmalignant breast conditions.
When examining a 34-year-old mother of two who is a new patient in for a routine
physical, you notice that the right nipple is inverted. Which question would you
immediately ask?
A. "Did you breast feed your children?"
B. "How long has your right nipple been inverted?"
C. "Is there any history of breast cancer in your family?"
