NR 509 Final Exam: Advanced Physical Assessment Questions and Answ
.
Study online at https://quizlet.com/_hvnqyl
1. A 44-year-old female mathemati- C. This patient was in compliance with the U.S. Preventive
cian presents to clinic with a com- Services Task Force (USPSTF) recommendations for her
plaint of a mass in the right age group and risk factors prior to her current com-
breast. Her partner noticed this plaint.
mass 2 days ago, and the pa-
tient feels guilty because she has The USPSTF recommends that women age <50 years
only had one mammogram and discuss risks and benefits with their provider and decide
does not engage in breast self-ex- on appropriate screening for their individual preferences
amination (BSE) on any regular and needs
basis. She has no family histo-
ry of breast cancer, and her pri-
or 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 re-
veals 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 rein-
forced.
b. Clinical breast examination
(CBE) is superior to BSE and
should be a routine part of annu-
al examinations starting at age 30
years.
c. This patient was in compliance
, NR 509 Final Exam: Advanced Physical Assessment Questions and Answ
.
Study online at https://quizlet.com/_hvnqyl
with the U.S. Preventive Services
Task Fo
2. A 42-year-old female website de- b. Sensitivity of screening for breast cancer increases with
veloper presents for an annu- breast MRI at the expense of specificity.
al preventive examination with
questions about breast can- Rationale: Sensitivity of screening for breast cancer in-
cer screening. She is concerned creases with breast MRI at the expense of specificity. In-
about the radiation exposure creased sensitivity (in this case, higher-resolution imag-
associated with mammography ing to pick up subtler disease) is often traded for reduced
and is interested in magnetic res- specificity (in the form of discovering many small items of
onance imaging (MRI) as a possi- no pathological significance).
ble alternative for routine screen-
ing. She is otherwise healthy with
no family history of breast, ovari-
an, or colon cancer. Which of the
following is true about MRI as
a screening modality for breast
cancer in the general popula-
tion?
a. Breast cancer screening by MRI
has been well studied in the gen-
eral population.
b. Sensitivity of screening for
breast cancer increases with
breast MRI at the expense of
specificity.
c. This patient is an ideal candi-
date for screening via breast MRI
based on current evidence.
d. Women at low lifetime risk
, NR 509 Final Exam: Advanced Physical Assessment Questions and Answ
.
Study online at https://quizlet.com/_hvnqyl
of breast cancer (<20%) are rec-
ommended to undergo screen-
ing MRI.
e. Known BRCA1 or BRCA2 muta-
tion is insufficient cr
3. A 35-year-old G0P0 woman pre- e. Prolactinoma
sents to clinic with a complaint
of bilateral nipple discharge. This Rationale: Prolactinomas are pituitary tumors that secrete
discharge started several weeks prolactin, which causes the production of breast milk and
ago and has occurred at irregu- can suppress menstruation.
lar intervals since that time. She
does not complain of local ten-
derness, redness, fever, or any
other systemic symptoms aside
from slightly irregular periods
over the last few months. On ex-
amination, 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 labo-
ratories are also sent, which re-
veal a normal blood count, meta-
bolic panel, thyroid-stimulating
hormone, and human chorion-
ic gonadotropin (HCG) level. Fur-
ther laboratories are still pend-
ing. Which of the following is the
most likely diagnosis?
, NR 509 Final Exam: Advanced Physical Assessment Questions and Answ
.
Study online at https://quizlet.com/_hvnqyl
a. Mastitis
b. Ductal carcinoma in situ
c. Paget disease of the breast
d. Occult pregnancy
e. Prolactinoma
4. A 22-year-old G0P0 undergrad- b. This patient is more likely to find a fibroadenoma than
uate student presents to clinic a cancer on self-examination.
after finding a breast mass on
breast self-examination (BSE) at Rationale: This patient is more likely to find a fibroade-
home. The mass is nontender noma than a cancer on self-examination. In this patient's
without skin changes, erythe- age range (15-25 years), palpable masses are most likely
ma, or overlying swelling. She to be benign fibroadenomas.
has heard that most breast can-
cers are found by patients them-
selves, and she is very concerned
that she may have breast can-
cer. 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 malig-
nant.
b. This patient is more likely to
find a fibroadenoma than a can-
cer on self-examination.
c. The most likely breast mass this
patient is likely to find in herself is
an abscess complicating underly-
ing mastitis.
.
Study online at https://quizlet.com/_hvnqyl
1. A 44-year-old female mathemati- C. This patient was in compliance with the U.S. Preventive
cian presents to clinic with a com- Services Task Force (USPSTF) recommendations for her
plaint of a mass in the right age group and risk factors prior to her current com-
breast. Her partner noticed this plaint.
mass 2 days ago, and the pa-
tient feels guilty because she has The USPSTF recommends that women age <50 years
only had one mammogram and discuss risks and benefits with their provider and decide
does not engage in breast self-ex- on appropriate screening for their individual preferences
amination (BSE) on any regular and needs
basis. She has no family histo-
ry of breast cancer, and her pri-
or 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 re-
veals 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 rein-
forced.
b. Clinical breast examination
(CBE) is superior to BSE and
should be a routine part of annu-
al examinations starting at age 30
years.
c. This patient was in compliance
, NR 509 Final Exam: Advanced Physical Assessment Questions and Answ
.
Study online at https://quizlet.com/_hvnqyl
with the U.S. Preventive Services
Task Fo
2. A 42-year-old female website de- b. Sensitivity of screening for breast cancer increases with
veloper presents for an annu- breast MRI at the expense of specificity.
al preventive examination with
questions about breast can- Rationale: Sensitivity of screening for breast cancer in-
cer screening. She is concerned creases with breast MRI at the expense of specificity. In-
about the radiation exposure creased sensitivity (in this case, higher-resolution imag-
associated with mammography ing to pick up subtler disease) is often traded for reduced
and is interested in magnetic res- specificity (in the form of discovering many small items of
onance imaging (MRI) as a possi- no pathological significance).
ble alternative for routine screen-
ing. She is otherwise healthy with
no family history of breast, ovari-
an, or colon cancer. Which of the
following is true about MRI as
a screening modality for breast
cancer in the general popula-
tion?
a. Breast cancer screening by MRI
has been well studied in the gen-
eral population.
b. Sensitivity of screening for
breast cancer increases with
breast MRI at the expense of
specificity.
c. This patient is an ideal candi-
date for screening via breast MRI
based on current evidence.
d. Women at low lifetime risk
, NR 509 Final Exam: Advanced Physical Assessment Questions and Answ
.
Study online at https://quizlet.com/_hvnqyl
of breast cancer (<20%) are rec-
ommended to undergo screen-
ing MRI.
e. Known BRCA1 or BRCA2 muta-
tion is insufficient cr
3. A 35-year-old G0P0 woman pre- e. Prolactinoma
sents to clinic with a complaint
of bilateral nipple discharge. This Rationale: Prolactinomas are pituitary tumors that secrete
discharge started several weeks prolactin, which causes the production of breast milk and
ago and has occurred at irregu- can suppress menstruation.
lar intervals since that time. She
does not complain of local ten-
derness, redness, fever, or any
other systemic symptoms aside
from slightly irregular periods
over the last few months. On ex-
amination, 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 labo-
ratories are also sent, which re-
veal a normal blood count, meta-
bolic panel, thyroid-stimulating
hormone, and human chorion-
ic gonadotropin (HCG) level. Fur-
ther laboratories are still pend-
ing. Which of the following is the
most likely diagnosis?
, NR 509 Final Exam: Advanced Physical Assessment Questions and Answ
.
Study online at https://quizlet.com/_hvnqyl
a. Mastitis
b. Ductal carcinoma in situ
c. Paget disease of the breast
d. Occult pregnancy
e. Prolactinoma
4. A 22-year-old G0P0 undergrad- b. This patient is more likely to find a fibroadenoma than
uate student presents to clinic a cancer on self-examination.
after finding a breast mass on
breast self-examination (BSE) at Rationale: This patient is more likely to find a fibroade-
home. The mass is nontender noma than a cancer on self-examination. In this patient's
without skin changes, erythe- age range (15-25 years), palpable masses are most likely
ma, or overlying swelling. She to be benign fibroadenomas.
has heard that most breast can-
cers are found by patients them-
selves, and she is very concerned
that she may have breast can-
cer. 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 malig-
nant.
b. This patient is more likely to
find a fibroadenoma than a can-
cer on self-examination.
c. The most likely breast mass this
patient is likely to find in herself is
an abscess complicating underly-
ing mastitis.
