1
NR 509
NR 509/ NR509 Final Exam Guide: Advanced
Physical Assessment | Q/A | Grade A| 100%
Correct (Verified Answers) (2026/ 2027) -
Chamberlain
1. A 44-year-old female mathematician presents to clinic with a
complaint of a mass in the right breast... What advice should be given
to this patient about screening for breast cancer in her age group?
Correct Answer: This patient was in compliance with the U.S.
Preventive Services Task Force (USPSTF) recommendations for her
age group and risk factors prior to her current complaint.
Rationale: For average-risk women, the USPSTF recommends
biennial mammography screening starting at age 50. Screening in the
40s is an individual decision. She had one mammogram at 43, which
aligns with the option to begin individualized screening before 50.
2. A 42-year-old female website developer presents for an annual
preventive examination with questions about breast cancer
NR 509
, 2
NR 509
screening... Which of the following is true about MRI as a screening
modality for breast cancer in the general population?
Correct Answer: Sensitivity of screening for breast cancer
increases with breast MRI at the expense of specificity.
Rationale: Breast MRI has very high sensitivity (detects more
cancers) but lower specificity, leading to more false positives,
unnecessary biopsies, and patient anxiety. It is not recommended for
routine screening in average-risk women.
3. A 35-year-old GOPO woman presents to clinic with a complaint of
bilateral nipple discharge... Which of the following is the most likely
diagnosis?
Correct Answer: Prolactinoma
Rationale: Bilateral, non-bloody, milky nipple discharge
(galactorrhea) in a non-pregnant, non-lactating woman, especially
with menstrual irregularities, is classic for hyperprolactinemia, often
caused by a pituitary prolactinoma.
4. A 22-year-old GOPO undergraduate student presents to clinic after
finding a breast mass on breast self-examination (BSE)... Which of the
following is true about BSE and self-detection of breast cancer?
Correct Answer: This patient is more likely to find a
fibroadenoma than a cancer on self-examination.
NR 509
, 3
NR 509
Rationale: In a 22-year-old, a discrete, mobile, non-tender
breast mass is most commonly a fibroadenoma, a benign tumor.
Breast cancer is extremely rare in this age group.
5. A 48-year-old female psychologist presents to clinic with concerns
about her breast cancer risk... Which of the following is true about this
patient's indications for BRCA testing?
Correct Answer: This patient carries several risk factors that
together justify BRCA testing.
Rationale: Strong family history indicators for BRCA testing
include: breast cancer in a male relative (her father), multiple
relatives with breast cancer (especially if diagnosed <50), and
Ashkenazi Jewish ancestry (implied by Eastern European heritage).
This combination warrants genetic counseling and testing.
6. A 68-year-old former paleontologist presents to clinic with
concerns about her breast cancer risk... Which of the following is true
regarding magnetic resonance imaging (MRI) screening of this
patient?
Correct Answer: Regardless of recommendations, the high
sensitivity of breast MRI comes at the expense of markedly decreased
specificity.
NR 509
, 4
NR 509
Rationale: This repeats a core concept: Breast MRI is highly
sensitive but has low specificity, leading to more callbacks and benign
biopsies. Her personal history of chest radiation places her at high
risk, making supplemental MRI screening a consideration despite its
drawbacks.
7. A 66-year-old female museum curator presents for a routine annual
examination. On examination, a notably enlarged supraclavicular
lymph node is appreciated on the right side... Which of the following is
true about this presentation of lymphadenopathy?
Correct Answer: Metastatic breast cancer cells may spread
directly into the infraclavicular and then supraclavicular nodes
without first causing notable changes in the axillary nodes.
Rationale: An isolated, firm, non-tender supraclavicular node
(Virchow's node) is a red flag for malignancy. Metastases from breast
(or lung, GI) cancer can drain directly to these nodes. Her unopposed
estrogen use also increases breast cancer risk.
8. A 24-year-old graphic designer presents to clinic with a concern for
a breast mass... Which of the following would be the most appropriate
way to report this finding?
Correct Answer: Rubbery, mobile, nontender mass located in
right breast, in the 10:30 position from the nipple.
NR 509
NR 509
NR 509/ NR509 Final Exam Guide: Advanced
Physical Assessment | Q/A | Grade A| 100%
Correct (Verified Answers) (2026/ 2027) -
Chamberlain
1. A 44-year-old female mathematician presents to clinic with a
complaint of a mass in the right breast... What advice should be given
to this patient about screening for breast cancer in her age group?
Correct Answer: This patient was in compliance with the U.S.
Preventive Services Task Force (USPSTF) recommendations for her
age group and risk factors prior to her current complaint.
Rationale: For average-risk women, the USPSTF recommends
biennial mammography screening starting at age 50. Screening in the
40s is an individual decision. She had one mammogram at 43, which
aligns with the option to begin individualized screening before 50.
2. A 42-year-old female website developer presents for an annual
preventive examination with questions about breast cancer
NR 509
, 2
NR 509
screening... Which of the following is true about MRI as a screening
modality for breast cancer in the general population?
Correct Answer: Sensitivity of screening for breast cancer
increases with breast MRI at the expense of specificity.
Rationale: Breast MRI has very high sensitivity (detects more
cancers) but lower specificity, leading to more false positives,
unnecessary biopsies, and patient anxiety. It is not recommended for
routine screening in average-risk women.
3. A 35-year-old GOPO woman presents to clinic with a complaint of
bilateral nipple discharge... Which of the following is the most likely
diagnosis?
Correct Answer: Prolactinoma
Rationale: Bilateral, non-bloody, milky nipple discharge
(galactorrhea) in a non-pregnant, non-lactating woman, especially
with menstrual irregularities, is classic for hyperprolactinemia, often
caused by a pituitary prolactinoma.
4. A 22-year-old GOPO undergraduate student presents to clinic after
finding a breast mass on breast self-examination (BSE)... Which of the
following is true about BSE and self-detection of breast cancer?
Correct Answer: This patient is more likely to find a
fibroadenoma than a cancer on self-examination.
NR 509
, 3
NR 509
Rationale: In a 22-year-old, a discrete, mobile, non-tender
breast mass is most commonly a fibroadenoma, a benign tumor.
Breast cancer is extremely rare in this age group.
5. A 48-year-old female psychologist presents to clinic with concerns
about her breast cancer risk... Which of the following is true about this
patient's indications for BRCA testing?
Correct Answer: This patient carries several risk factors that
together justify BRCA testing.
Rationale: Strong family history indicators for BRCA testing
include: breast cancer in a male relative (her father), multiple
relatives with breast cancer (especially if diagnosed <50), and
Ashkenazi Jewish ancestry (implied by Eastern European heritage).
This combination warrants genetic counseling and testing.
6. A 68-year-old former paleontologist presents to clinic with
concerns about her breast cancer risk... Which of the following is true
regarding magnetic resonance imaging (MRI) screening of this
patient?
Correct Answer: Regardless of recommendations, the high
sensitivity of breast MRI comes at the expense of markedly decreased
specificity.
NR 509
, 4
NR 509
Rationale: This repeats a core concept: Breast MRI is highly
sensitive but has low specificity, leading to more callbacks and benign
biopsies. Her personal history of chest radiation places her at high
risk, making supplemental MRI screening a consideration despite its
drawbacks.
7. A 66-year-old female museum curator presents for a routine annual
examination. On examination, a notably enlarged supraclavicular
lymph node is appreciated on the right side... Which of the following is
true about this presentation of lymphadenopathy?
Correct Answer: Metastatic breast cancer cells may spread
directly into the infraclavicular and then supraclavicular nodes
without first causing notable changes in the axillary nodes.
Rationale: An isolated, firm, non-tender supraclavicular node
(Virchow's node) is a red flag for malignancy. Metastases from breast
(or lung, GI) cancer can drain directly to these nodes. Her unopposed
estrogen use also increases breast cancer risk.
8. A 24-year-old graphic designer presents to clinic with a concern for
a breast mass... Which of the following would be the most appropriate
way to report this finding?
Correct Answer: Rubbery, mobile, nontender mass located in
right breast, in the 10:30 position from the nipple.
NR 509
