NR 509 Advanced Physical Assessment Final Exam
2026 | Actual Exam | Comprehensive Health
Assessment | Advanced Practice Nursing
Standards||Newest Exam!!!
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 F - Answer-c. This patient was in
compliance with the U.S. Preventive Services Task Force
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(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.
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e. Known BRCA1 or BRCA2 mutation is insufficient c -
Answer-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
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e. Prolactinoma - Answer-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 - Answer-b. This patient is more likely to find a
fibroadenoma than a cancer on self-examination.