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Advanced Physical Assessment NR 509 Final Exam
Prep Test Bank Newest 2025 With 260 Questions
with Correct Detailed Answers / NR509 Final Exam
Practice Questions with Answers
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 Fo - ...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.
The USPSTF recommends that women age <50 years
discuss risks and benefits with their provider and decide
on appropriate screening for their individual preferences
and needs
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.
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d. Women at low lifetime risk of breast cancer (<20%) are
recommended to undergo screening MRI.
e. Known BRCA1 or BRCA2 mutation is insufficient cr -
...ANSWER...✓✓ b. Sensitivity of screening for breast
cancer increases with breast MRI at the expense of
specificity.
Rationale: Sensitivity of screening for breast cancer
increases with breast MRI at the expense of specificity.
Increased sensitivity (in this case, higher-resolution
imaging to pick up subtler disease) is often traded for
reduced specificity (in the form of discovering many small
items of no pathological significance).
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
, 4|Page
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
e. Prolactinoma - ...ANSWER...✓✓ e. Prolactinoma
Rationale: Prolactinomas are pituitary tumors that
secrete prolactin, which causes the production of breast
milk and can suppress menstruation.
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.
Advanced Physical Assessment NR 509 Final Exam
Prep Test Bank Newest 2025 With 260 Questions
with Correct Detailed Answers / NR509 Final Exam
Practice Questions with Answers
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 Fo - ...ANSWER...✓✓ C. This patient was in
compliance with the U.S. Preventive Services Task Force
,2|Page
(USPSTF) recommendations for her age group and risk
factors prior to her current complaint.
The USPSTF recommends that women age <50 years
discuss risks and benefits with their provider and decide
on appropriate screening for their individual preferences
and needs
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.
,3|Page
d. Women at low lifetime risk of breast cancer (<20%) are
recommended to undergo screening MRI.
e. Known BRCA1 or BRCA2 mutation is insufficient cr -
...ANSWER...✓✓ b. Sensitivity of screening for breast
cancer increases with breast MRI at the expense of
specificity.
Rationale: Sensitivity of screening for breast cancer
increases with breast MRI at the expense of specificity.
Increased sensitivity (in this case, higher-resolution
imaging to pick up subtler disease) is often traded for
reduced specificity (in the form of discovering many small
items of no pathological significance).
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
, 4|Page
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
e. Prolactinoma - ...ANSWER...✓✓ e. Prolactinoma
Rationale: Prolactinomas are pituitary tumors that
secrete prolactin, which causes the production of breast
milk and can suppress menstruation.
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.
