CHAPTER LIST
,Chapter 1: Coordination of Care
Chapter 2: Diagnosis and Staging
Chapter 3: Treatment Modalities: Local and Systemic
Chapter 4: Nursing Practice: Symptom Management
Chapter 5: Psychosocial and Spiritual
Chapter 6: Survivorship
Chapter 7: End of Life Care
Chapter 8: Professional Performance and Education
,Chapter 1: Coordination of Care - Test Bank
Question 1
A 48-year-old patient with newly diagnosed Stage II invasive ductal carcinoma expresses
confusion regarding the sequence of her treatment plan involving surgery,
chemotherapy, and radiation. Which action by the breast care nurse best demonstrates
the role of "navigator" in care coordination?
A. Providing the patient with a standard oncology textbook to research treatment
sequences.
B. Scheduling a multidisciplinary team (MDT) meeting and facilitating a session to create
a unified care map for the patient.
C. Advising the patient to follow the surgeon’s instructions exclusively until surgery is
complete.
D. Referring the patient to a local breast cancer support group for peer-led medical
advice.
Answer: B
Rationale: Effective care coordination involves facilitating interdisciplinary collaboration
to ensure a seamless transition between modalities. By organizing an MDT approach and
creating a patient-specific care map, the nurse ensures all providers are aligned and the
patient understands the longitudinal plan, which reduces anxiety and treatment delays.
Keywords: Navigation, Multidisciplinary Team (MDT), Care Mapping.
Question 2
A breast care nurse is reviewing documentation and notices that several patients are
experiencing a delay of >45 days between biopsy and the start of definitive treatment.
What is the most appropriate quality improvement (QI) initiative for the nurse to lead?
A. Increasing the number of hours the surgical suite is open.
B. Implementing a tracking system to identify and mitigate barriers at specific "pinch
points" in the diagnostic-to-treatment continuum.
C. Hiring more administrative staff to handle insurance prior authorizations.
,D. Reducing the number of diagnostic tests required before surgical intervention.
Answer: B
Rationale: Quality improvement in coordination of care focuses on identifying systemic
barriers (e.g., pathology turnaround, scheduling conflicts) that impact patient outcomes.
A tracking system provides data-driven insights into where delays occur, allowing for
targeted interventions to meet evidence-based benchmarks for timely care.
Keywords: Quality Improvement, Barriers to Care, Timeliness.
Question 3
During a survivorship transition visit, a patient reports that her primary care physician
(PCP) is unaware of the long-term cardiac monitoring requirements following her
Herceptin (trastuzumab) therapy. How should the nurse address this gap in
coordination?
A. Instruct the patient to find a new PCP who specializes in oncology.
B. Provide the patient with a copy of her medical records and ask her to explain it to the
PCP.
C. Develop and transmit a comprehensive Survivorship Care Plan (SCP) to the PCP,
detailing the treatment summary and specific follow-up schedules.
D. Tell the patient that the oncologist will handle all care indefinitely to avoid confusion.
Answer: C
Rationale: The Survivorship Care Plan is a critical coordination tool used to bridge the
gap between oncology specialists and primary care. It ensures that the PCP has the
necessary information to monitor for late effects and manage the patient's health within
the context of their cancer history.
Keywords: Survivorship Care Plan (SCP), Transition of Care, Communication.
Question 4
A patient from a rural area is diagnosed with breast cancer but lacks reliable
transportation for the 6-week daily radiation course. Which coordination strategy is most
effective for this patient’s advocacy?
A. Suggesting the patient delay treatment until she can fix her car.
,B. Coordinating with social work to identify local lodging programs (e.g., Hope Lodge)
or community-based medical transport vouchers.
C. Recommending the patient switch to a less effective treatment that requires fewer
visits.
D. Telling the patient it is her responsibility to find a way to the clinic.
Answer: B
Rationale: Patient advocacy involves identifying and addressing social determinants of
health (SDOH) that may prevent access to care. Coordinating with social services to
provide practical resources like lodging or transport ensures that the patient can adhere
to the prescribed treatment plan regardless of geographic or financial barriers.
Keywords: Advocacy, Social Determinants of Health, Access to Care.
Question 5
When managing a patient with a high-risk genetic mutation (BRCA1), the breast care
nurse must coordinate a "high-risk clinic" model. Which of the following represents the
primary goal of this coordinated model?
A. Reducing the cost of genetic testing.
B. Providing psychological counseling only after a cancer diagnosis occurs.
C. Integrating surveillance (MRI/Mammography) and risk-reduction strategies
(chemoprevention/surgery) into a long-term management plan.
D. Ensuring the patient is seen by a different doctor every visit to get multiple opinions.
Answer: C
Rationale: Coordination for high-risk patients involves a proactive, longitudinal approach
that integrates multiple preventive and screening modalities. This ensures that the patient
receives consistent monitoring and can make informed decisions about risk-reducing
interventions over time.
Keywords: BRCA, Surveillance, Risk Reduction.
Question 6
Which element is most critical for a nurse to include in a "care pathway" for patients
undergoing neoadjuvant chemotherapy (NAC)?
,A. A list of all hospital cafeteria hours.
B. Standardized timeframes for re-imaging to assess tumor response before surgery.
C. A mandate that all patients must receive the same chemotherapy dose regardless of
weight.
D. A policy that prevents patients from calling the office between appointments.
Answer: B
Rationale: Care pathways are designed to standardize and optimize the sequence of care.
In neoadjuvant settings, coordinating the timing of re-evaluation (imaging and clinical
exam) is essential to determine if the treatment is effective or if the surgical plan needs to
be adjusted.
Keywords: Care Pathways, Neoadjuvant Chemotherapy, Standardization.
Question 7
A breast care nurse is facilitating a multidisciplinary "tumor board." What is the nurse's
unique contribution to this coordinated effort?
A. Determining the exact radiation dose to be delivered.
B. Interpreting the molecular pathology slides for the group.
C. Representing the patient's holistic needs, psychosocial concerns, and functional status
in the decision-making process.
D. Performing the final surgical verification of the biopsy site.
Answer: C
Rationale: While physicians focus on the technical aspects of diagnosis and treatment, the
nurse provides the holistic perspective. This includes the patient’s ability to tolerate
treatment, their support system, and their personal preferences, ensuring the medical
plan is feasible for the individual.
Keywords: Tumor Board, Holistic Care, Interdisciplinary.
Question 8
A patient with limited English proficiency is scheduled for a complex surgical
consultation. To ensure effective coordination and patient safety, the nurse should:
,A. Ask the patient’s 10-year-old daughter to translate.
B. Use a professional medical interpreter via phone or in person.
C. Use a generic online translation app on a smartphone.
D. Speak loudly and slowly in English to ensure the patient understands.
Answer: B
Rationale: Professional medical interpreters are essential for accurate communication
regarding medical risks, benefits, and instructions. Using family members (especially
children) is inappropriate due to the risk of misinterpretation and the emotional burden
placed on the relative.
Keywords: Cultural Competence, Communication, Safety.
Question 9
In the context of the CBCN® exam, "Coordination of Care" across the "continuum" refers
to:
A. Managing the patient only from the time of surgery to the first follow-up.
B. Oversight of care from screening and diagnosis through treatment, survivorship, and
end-of-life care.
C. Ensuring the patient stays within one specific hospital building.
D. Purely administrative tasks like filing insurance claims and scheduling.
Answer: B
Rationale: The continuum of care in breast nursing is broad, encompassing the entire
journey from healthy screening/risk assessment to terminal care if necessary.
Coordination must be maintained at every transition point in this journey.
Keywords: Continuum of Care, Transitions, Longitudinal Management.
Question 10
A breast care nurse identifies that the clinic has a high rate of "no-shows" for post-
operative follow-ups among minority populations. The nurse organizes a community
outreach program to provide education in local community centers. This is an example
of:
, A. Breach of patient privacy.
B. Addressing healthcare disparities through community-based coordination.
C. Marketing the hospital to increase profits.
D. Unnecessary interference in patient personal lives.
Answer: B
Rationale: Coordination of care extends into the community. By identifying a disparity
and moving education/outreach into the community, the nurse addresses barriers to
follow-up care, which improves overall population health outcomes.
Keywords: Disparities, Community Outreach, Follow-up Care.
Question 11
When documenting a care coordination intervention, which of the following is most
important for the nurse to include to ensure continuity of care?
A. The nurse’s personal opinion of the patient’s personality.
B. A list of all other patients seen that day.
C. Specific education provided, the patient's understanding, and the plan for the next
transition of care.
D. Only the date and time of the visit.
Answer: C
Rationale: Clear documentation of teaching and the "next steps" in the plan is vital for
other members of the interdisciplinary team to provide consistent care. It prevents the
patient from receiving conflicting information and ensures all providers know the current
status of the care plan.
Keywords: Documentation, Continuity of Care, Patient Education.
Question 12
A patient is experiencing severe financial toxicity due to the cost of oral oncologics (e.g.,
CDK4/6 inhibitors). The nurse’s role in coordination is to:
A. Advise the patient to skip doses to save money.
,Chapter 1: Coordination of Care
Chapter 2: Diagnosis and Staging
Chapter 3: Treatment Modalities: Local and Systemic
Chapter 4: Nursing Practice: Symptom Management
Chapter 5: Psychosocial and Spiritual
Chapter 6: Survivorship
Chapter 7: End of Life Care
Chapter 8: Professional Performance and Education
,Chapter 1: Coordination of Care - Test Bank
Question 1
A 48-year-old patient with newly diagnosed Stage II invasive ductal carcinoma expresses
confusion regarding the sequence of her treatment plan involving surgery,
chemotherapy, and radiation. Which action by the breast care nurse best demonstrates
the role of "navigator" in care coordination?
A. Providing the patient with a standard oncology textbook to research treatment
sequences.
B. Scheduling a multidisciplinary team (MDT) meeting and facilitating a session to create
a unified care map for the patient.
C. Advising the patient to follow the surgeon’s instructions exclusively until surgery is
complete.
D. Referring the patient to a local breast cancer support group for peer-led medical
advice.
Answer: B
Rationale: Effective care coordination involves facilitating interdisciplinary collaboration
to ensure a seamless transition between modalities. By organizing an MDT approach and
creating a patient-specific care map, the nurse ensures all providers are aligned and the
patient understands the longitudinal plan, which reduces anxiety and treatment delays.
Keywords: Navigation, Multidisciplinary Team (MDT), Care Mapping.
Question 2
A breast care nurse is reviewing documentation and notices that several patients are
experiencing a delay of >45 days between biopsy and the start of definitive treatment.
What is the most appropriate quality improvement (QI) initiative for the nurse to lead?
A. Increasing the number of hours the surgical suite is open.
B. Implementing a tracking system to identify and mitigate barriers at specific "pinch
points" in the diagnostic-to-treatment continuum.
C. Hiring more administrative staff to handle insurance prior authorizations.
,D. Reducing the number of diagnostic tests required before surgical intervention.
Answer: B
Rationale: Quality improvement in coordination of care focuses on identifying systemic
barriers (e.g., pathology turnaround, scheduling conflicts) that impact patient outcomes.
A tracking system provides data-driven insights into where delays occur, allowing for
targeted interventions to meet evidence-based benchmarks for timely care.
Keywords: Quality Improvement, Barriers to Care, Timeliness.
Question 3
During a survivorship transition visit, a patient reports that her primary care physician
(PCP) is unaware of the long-term cardiac monitoring requirements following her
Herceptin (trastuzumab) therapy. How should the nurse address this gap in
coordination?
A. Instruct the patient to find a new PCP who specializes in oncology.
B. Provide the patient with a copy of her medical records and ask her to explain it to the
PCP.
C. Develop and transmit a comprehensive Survivorship Care Plan (SCP) to the PCP,
detailing the treatment summary and specific follow-up schedules.
D. Tell the patient that the oncologist will handle all care indefinitely to avoid confusion.
Answer: C
Rationale: The Survivorship Care Plan is a critical coordination tool used to bridge the
gap between oncology specialists and primary care. It ensures that the PCP has the
necessary information to monitor for late effects and manage the patient's health within
the context of their cancer history.
Keywords: Survivorship Care Plan (SCP), Transition of Care, Communication.
Question 4
A patient from a rural area is diagnosed with breast cancer but lacks reliable
transportation for the 6-week daily radiation course. Which coordination strategy is most
effective for this patient’s advocacy?
A. Suggesting the patient delay treatment until she can fix her car.
,B. Coordinating with social work to identify local lodging programs (e.g., Hope Lodge)
or community-based medical transport vouchers.
C. Recommending the patient switch to a less effective treatment that requires fewer
visits.
D. Telling the patient it is her responsibility to find a way to the clinic.
Answer: B
Rationale: Patient advocacy involves identifying and addressing social determinants of
health (SDOH) that may prevent access to care. Coordinating with social services to
provide practical resources like lodging or transport ensures that the patient can adhere
to the prescribed treatment plan regardless of geographic or financial barriers.
Keywords: Advocacy, Social Determinants of Health, Access to Care.
Question 5
When managing a patient with a high-risk genetic mutation (BRCA1), the breast care
nurse must coordinate a "high-risk clinic" model. Which of the following represents the
primary goal of this coordinated model?
A. Reducing the cost of genetic testing.
B. Providing psychological counseling only after a cancer diagnosis occurs.
C. Integrating surveillance (MRI/Mammography) and risk-reduction strategies
(chemoprevention/surgery) into a long-term management plan.
D. Ensuring the patient is seen by a different doctor every visit to get multiple opinions.
Answer: C
Rationale: Coordination for high-risk patients involves a proactive, longitudinal approach
that integrates multiple preventive and screening modalities. This ensures that the patient
receives consistent monitoring and can make informed decisions about risk-reducing
interventions over time.
Keywords: BRCA, Surveillance, Risk Reduction.
Question 6
Which element is most critical for a nurse to include in a "care pathway" for patients
undergoing neoadjuvant chemotherapy (NAC)?
,A. A list of all hospital cafeteria hours.
B. Standardized timeframes for re-imaging to assess tumor response before surgery.
C. A mandate that all patients must receive the same chemotherapy dose regardless of
weight.
D. A policy that prevents patients from calling the office between appointments.
Answer: B
Rationale: Care pathways are designed to standardize and optimize the sequence of care.
In neoadjuvant settings, coordinating the timing of re-evaluation (imaging and clinical
exam) is essential to determine if the treatment is effective or if the surgical plan needs to
be adjusted.
Keywords: Care Pathways, Neoadjuvant Chemotherapy, Standardization.
Question 7
A breast care nurse is facilitating a multidisciplinary "tumor board." What is the nurse's
unique contribution to this coordinated effort?
A. Determining the exact radiation dose to be delivered.
B. Interpreting the molecular pathology slides for the group.
C. Representing the patient's holistic needs, psychosocial concerns, and functional status
in the decision-making process.
D. Performing the final surgical verification of the biopsy site.
Answer: C
Rationale: While physicians focus on the technical aspects of diagnosis and treatment, the
nurse provides the holistic perspective. This includes the patient’s ability to tolerate
treatment, their support system, and their personal preferences, ensuring the medical
plan is feasible for the individual.
Keywords: Tumor Board, Holistic Care, Interdisciplinary.
Question 8
A patient with limited English proficiency is scheduled for a complex surgical
consultation. To ensure effective coordination and patient safety, the nurse should:
,A. Ask the patient’s 10-year-old daughter to translate.
B. Use a professional medical interpreter via phone or in person.
C. Use a generic online translation app on a smartphone.
D. Speak loudly and slowly in English to ensure the patient understands.
Answer: B
Rationale: Professional medical interpreters are essential for accurate communication
regarding medical risks, benefits, and instructions. Using family members (especially
children) is inappropriate due to the risk of misinterpretation and the emotional burden
placed on the relative.
Keywords: Cultural Competence, Communication, Safety.
Question 9
In the context of the CBCN® exam, "Coordination of Care" across the "continuum" refers
to:
A. Managing the patient only from the time of surgery to the first follow-up.
B. Oversight of care from screening and diagnosis through treatment, survivorship, and
end-of-life care.
C. Ensuring the patient stays within one specific hospital building.
D. Purely administrative tasks like filing insurance claims and scheduling.
Answer: B
Rationale: The continuum of care in breast nursing is broad, encompassing the entire
journey from healthy screening/risk assessment to terminal care if necessary.
Coordination must be maintained at every transition point in this journey.
Keywords: Continuum of Care, Transitions, Longitudinal Management.
Question 10
A breast care nurse identifies that the clinic has a high rate of "no-shows" for post-
operative follow-ups among minority populations. The nurse organizes a community
outreach program to provide education in local community centers. This is an example
of:
, A. Breach of patient privacy.
B. Addressing healthcare disparities through community-based coordination.
C. Marketing the hospital to increase profits.
D. Unnecessary interference in patient personal lives.
Answer: B
Rationale: Coordination of care extends into the community. By identifying a disparity
and moving education/outreach into the community, the nurse addresses barriers to
follow-up care, which improves overall population health outcomes.
Keywords: Disparities, Community Outreach, Follow-up Care.
Question 11
When documenting a care coordination intervention, which of the following is most
important for the nurse to include to ensure continuity of care?
A. The nurse’s personal opinion of the patient’s personality.
B. A list of all other patients seen that day.
C. Specific education provided, the patient's understanding, and the plan for the next
transition of care.
D. Only the date and time of the visit.
Answer: C
Rationale: Clear documentation of teaching and the "next steps" in the plan is vital for
other members of the interdisciplinary team to provide consistent care. It prevents the
patient from receiving conflicting information and ensures all providers know the current
status of the care plan.
Keywords: Documentation, Continuity of Care, Patient Education.
Question 12
A patient is experiencing severe financial toxicity due to the cost of oral oncologics (e.g.,
CDK4/6 inhibitors). The nurse’s role in coordination is to:
A. Advise the patient to skip doses to save money.
