Certified Breast Care Nurse (CBCN)Proctored
Exam with NGN –Screenshot Questions & 100%
Verified Answers
Domain I: Coordination of Care
1. A patient with a new diagnosis of invasive lobular carcinoma is scheduled for a bilateral MRI. She asks, "My
friend had an ultrasound, why do I need this?" The CBCN's best response is based on the knowledge that:
,- A. Invasive lobular carcinoma has a higher incidence of being multifocal, multicentric, or bilateral.
- B. MRI is a standard replacement for mammography in all newly diagnosed patients.
- C. An ultrasound is only useful for evaluating benign breast cysts.
- D. The MRI is needed to definitively rule out bone metastases before surgery.
Answer: A
Rationale: Invasive lobular carcinoma (ILC) is known for its diffuse growth pattern and a higher propensity to be
multifocal (multiple tumors in the same quadrant), multicentric (tumors in different quadrants), or bilateral (in both
breasts) compared to invasive ductal carcinoma. MRI is more sensitive for detecting this extent of disease,
which is critical for surgical planning. MRI does not replace mammography, ultrasound has broader uses, and
bone metastases are evaluated with bone scans or PET/CT.
2. During a preoperative education session, which topic is most critical to discuss to prevent post-surgical
lymphedema in a patient scheduled for an axillary lymph node dissection (ALND)?
- A. The importance of immediate breast reconstruction.
- B. Avoiding blood pressure readings and venipuncture on the ipsilateral arm.
- C. Starting passive range-of-motion exercises on postoperative day 1.
- D. The use of compression sleeves 24 hours a day, starting immediately after surgery.
,Answer: B
Rationale: Lifetime precautions for the at-risk arm after ALND include avoiding blood pressure readings,
venipuncture, and constrictive jewelry to reduce the risk of trauma and infection, which can trigger lymphedema.
Active, not passive, ROM is started gradually. Compression sleeves are for managing confirmed lymphedema,
not universal prophylaxis.
3. A patient is scheduled for a stereotactic breast biopsy. The CBCN explains that this procedure uses which
imaging modality for guidance?
- A. Ultrasound
- B. MRI
- C. Mammography
- D. CT scan
Answer: C
Rationale: Stereotactic biopsy uses mammographic images taken from two different angles to generate three-
dimensional coordinates, precisely guiding the needle to the lesion. Ultrasound-guided and MRI-guided biopsies
are distinct procedures.
4. A 38-year-old patient with a BRCA1 mutation is discussing risk-reducing strategies. She states she wants a
bilateral prophylactic mastectomy but refuses oophorectomy. The CBCN should:
, - A. Insist she consult a gynecologic oncologist immediately.
- B. Acknowledge her choice, but educate that her risk of ovarian cancer remains significantly elevated.
- C. Explain that the mastectomy is pointless without the oophorectomy.
- D. Tell her that a mastectomy also eliminates her ovarian cancer risk.
Answer: B
Rationale: A shared decision-making approach requires respecting the patient's autonomy after ensuring she
has complete information. A prophylactic mastectomy significantly reduces breast cancer risk but has no impact
on ovarian cancer risk. The nurse's role is to educate, support, and coordinate the appropriate follow-up care
(e.g., periodic transvaginal ultrasound/CA-125), even if it deviates from the optimal medical recommendation.
5. A patient with breast cancer is starting letrozole. Which pre-existing condition should be reported to the
medical oncologist immediately?
- A. Well-managed hypertension
- B. Osteopenia
- C. Osteoporosis with a history of a pathologic fracture
- D. Mild, diet-controlled diabetes
Answer: C
Exam with NGN –Screenshot Questions & 100%
Verified Answers
Domain I: Coordination of Care
1. A patient with a new diagnosis of invasive lobular carcinoma is scheduled for a bilateral MRI. She asks, "My
friend had an ultrasound, why do I need this?" The CBCN's best response is based on the knowledge that:
,- A. Invasive lobular carcinoma has a higher incidence of being multifocal, multicentric, or bilateral.
- B. MRI is a standard replacement for mammography in all newly diagnosed patients.
- C. An ultrasound is only useful for evaluating benign breast cysts.
- D. The MRI is needed to definitively rule out bone metastases before surgery.
Answer: A
Rationale: Invasive lobular carcinoma (ILC) is known for its diffuse growth pattern and a higher propensity to be
multifocal (multiple tumors in the same quadrant), multicentric (tumors in different quadrants), or bilateral (in both
breasts) compared to invasive ductal carcinoma. MRI is more sensitive for detecting this extent of disease,
which is critical for surgical planning. MRI does not replace mammography, ultrasound has broader uses, and
bone metastases are evaluated with bone scans or PET/CT.
2. During a preoperative education session, which topic is most critical to discuss to prevent post-surgical
lymphedema in a patient scheduled for an axillary lymph node dissection (ALND)?
- A. The importance of immediate breast reconstruction.
- B. Avoiding blood pressure readings and venipuncture on the ipsilateral arm.
- C. Starting passive range-of-motion exercises on postoperative day 1.
- D. The use of compression sleeves 24 hours a day, starting immediately after surgery.
,Answer: B
Rationale: Lifetime precautions for the at-risk arm after ALND include avoiding blood pressure readings,
venipuncture, and constrictive jewelry to reduce the risk of trauma and infection, which can trigger lymphedema.
Active, not passive, ROM is started gradually. Compression sleeves are for managing confirmed lymphedema,
not universal prophylaxis.
3. A patient is scheduled for a stereotactic breast biopsy. The CBCN explains that this procedure uses which
imaging modality for guidance?
- A. Ultrasound
- B. MRI
- C. Mammography
- D. CT scan
Answer: C
Rationale: Stereotactic biopsy uses mammographic images taken from two different angles to generate three-
dimensional coordinates, precisely guiding the needle to the lesion. Ultrasound-guided and MRI-guided biopsies
are distinct procedures.
4. A 38-year-old patient with a BRCA1 mutation is discussing risk-reducing strategies. She states she wants a
bilateral prophylactic mastectomy but refuses oophorectomy. The CBCN should:
, - A. Insist she consult a gynecologic oncologist immediately.
- B. Acknowledge her choice, but educate that her risk of ovarian cancer remains significantly elevated.
- C. Explain that the mastectomy is pointless without the oophorectomy.
- D. Tell her that a mastectomy also eliminates her ovarian cancer risk.
Answer: B
Rationale: A shared decision-making approach requires respecting the patient's autonomy after ensuring she
has complete information. A prophylactic mastectomy significantly reduces breast cancer risk but has no impact
on ovarian cancer risk. The nurse's role is to educate, support, and coordinate the appropriate follow-up care
(e.g., periodic transvaginal ultrasound/CA-125), even if it deviates from the optimal medical recommendation.
5. A patient with breast cancer is starting letrozole. Which pre-existing condition should be reported to the
medical oncologist immediately?
- A. Well-managed hypertension
- B. Osteopenia
- C. Osteoporosis with a history of a pathologic fracture
- D. Mild, diet-controlled diabetes
Answer: C
