NR509 Final Exam 88 QUESTIONS
AND ANSWERS 2026
A 24-year-old male presents to the office for evaluation of a lump under his left
nipple. He reports no other symptoms, denies trauma or injury, and reports no
known family history of a first-degree relative with breast cancer. On examination,
the NP notes a firm, 2-cm mass under his areola. What is the most likely etiology
for these findings? - ANSWER Breast cancer
A 34-year-old female arrives at the clinic for a prenatal, second-trimester
appointment. During the interview, her behavior is concerning for intoxication, and
she smells of alcohol and cigarettes. She reveals a history of intravenous drug use
"10-years ago". How should the NP counsel this patient? Select all that apply -
ANSWER If a pregnant patient does not intend to quit
tobacco, cutting down is still considered beneficial to the pregnancy and should be
encouraged.
Pregnant women are not routinely screened for hepatitis C, but this test should be
added to the panel of prenatal blood tests for patients with a history of intravenous
drug use
A 27-year-old female presents to the outpatient clinic with acute abdominal pain
and uterine bleeding. Her last menstrual period was 6-weeks ago. She and her
,husband have been trying to conceive for almost one year. On physical
examination, the NP palpates an ill-defined, adnexal
A 35-year-old female with a history of migraines presents to the clinic with
worsening symptoms for the past few weeks. She reports waking up at night with
headaches and nausea. Her only medication history is oral contraceptive pills
(OCPs). Otherwise, she states she is healthy. Which of the following actions if
taken by the NP is the best next step? - ANSWER
Take a further history and perform a very careful neurological exam
A grandmother is accompanying her 9-year-old granddaughter during a routine
physical examination. She asks you privately if her granddaughter has started
puberty yet. During the examination, the NP notes asymmetric projection of the
areola and nipple of the right chest to form a secondary mound above the level of
the breast. The left breast is underdeveloped. These assessment findings are
consistent with which Tanner Stage of development? - ANSWER
IV
A 26-year-old female presents to the Emergency Department with intense
abdominal pain for 6 hours, light-headedness, and a fainting episode that finally
prompted her to seek medical attention. She has a history of gallstones and is
concerned that she is having another gallbladder attack. She denies nausea and
vomiting, and her last normal bowel movement was this morning. She reports that
her LMP was 10 weeks ago. Vital signs: pulse 118; blood pressure, 86/68;
respiratory rate, 20/min; oxygen saturation, 99%; and temperature, 37.3ºC orally.
A β-human chorionic gonadotropin (β-hCG) blood test is pending. The NP
performs an abdominal exam prior to her pelvic exam and, on palpation of her
abdomen, finds involuntary rigidity and rebound tenderness. Which of the
following is the most likely etiology for these assessment findings? - ANSWER
Ruptured ectopic pregnancy
, A 42-year-old female presents to the office for her annual well-woman
examination. She has a history of fibrocystic breast changes since her mid-20s, so
she did not report any new issues except that her right breast feels "heavier" than
usual. After a careful history and physical examination, the NP documents the
following breast findings: Breasts pendulous with diffuse fibrocystic changes.
Single firm 1 × 1 cm mass, mobile, and nontender, with overlying peau d'orange
appearance in the right breast, upper outer quadrant at 11 o'clock, 2 cm from the
nipple. Which of the following is the most accurate interpretation of these
findings? - ANSWER These findings suggest a
cyst
An NP student conducted a clinical breast examination on a 27-year-old female
with a history of fibroadenomas. The NP palpated a rubbery, mobile, nontender
mass in the right breast. The mass was located 3 cm proximal to and 3 cm to the
left of the nipple. Which of the following would be the most appropriate way to
document the physical assessment findings? - ANSWER
rubbery, mobile, nontender mass located in the right breast, in the 10:30 position
from the nipple
Primary prevention is defined as which of the following? - ANSWER
Interventions designed to prevent disease
Based on the U.S. Preventive Services Task Force (USPSTF) recommendations,
which of the following statements is true about screening for breast cancer in
average-risk women? - ANSWER Mammography
is recommended every 2 years for women aged 50-74 with insufficient evidence
for screening women over the age of 75.
AND ANSWERS 2026
A 24-year-old male presents to the office for evaluation of a lump under his left
nipple. He reports no other symptoms, denies trauma or injury, and reports no
known family history of a first-degree relative with breast cancer. On examination,
the NP notes a firm, 2-cm mass under his areola. What is the most likely etiology
for these findings? - ANSWER Breast cancer
A 34-year-old female arrives at the clinic for a prenatal, second-trimester
appointment. During the interview, her behavior is concerning for intoxication, and
she smells of alcohol and cigarettes. She reveals a history of intravenous drug use
"10-years ago". How should the NP counsel this patient? Select all that apply -
ANSWER If a pregnant patient does not intend to quit
tobacco, cutting down is still considered beneficial to the pregnancy and should be
encouraged.
Pregnant women are not routinely screened for hepatitis C, but this test should be
added to the panel of prenatal blood tests for patients with a history of intravenous
drug use
A 27-year-old female presents to the outpatient clinic with acute abdominal pain
and uterine bleeding. Her last menstrual period was 6-weeks ago. She and her
,husband have been trying to conceive for almost one year. On physical
examination, the NP palpates an ill-defined, adnexal
A 35-year-old female with a history of migraines presents to the clinic with
worsening symptoms for the past few weeks. She reports waking up at night with
headaches and nausea. Her only medication history is oral contraceptive pills
(OCPs). Otherwise, she states she is healthy. Which of the following actions if
taken by the NP is the best next step? - ANSWER
Take a further history and perform a very careful neurological exam
A grandmother is accompanying her 9-year-old granddaughter during a routine
physical examination. She asks you privately if her granddaughter has started
puberty yet. During the examination, the NP notes asymmetric projection of the
areola and nipple of the right chest to form a secondary mound above the level of
the breast. The left breast is underdeveloped. These assessment findings are
consistent with which Tanner Stage of development? - ANSWER
IV
A 26-year-old female presents to the Emergency Department with intense
abdominal pain for 6 hours, light-headedness, and a fainting episode that finally
prompted her to seek medical attention. She has a history of gallstones and is
concerned that she is having another gallbladder attack. She denies nausea and
vomiting, and her last normal bowel movement was this morning. She reports that
her LMP was 10 weeks ago. Vital signs: pulse 118; blood pressure, 86/68;
respiratory rate, 20/min; oxygen saturation, 99%; and temperature, 37.3ºC orally.
A β-human chorionic gonadotropin (β-hCG) blood test is pending. The NP
performs an abdominal exam prior to her pelvic exam and, on palpation of her
abdomen, finds involuntary rigidity and rebound tenderness. Which of the
following is the most likely etiology for these assessment findings? - ANSWER
Ruptured ectopic pregnancy
, A 42-year-old female presents to the office for her annual well-woman
examination. She has a history of fibrocystic breast changes since her mid-20s, so
she did not report any new issues except that her right breast feels "heavier" than
usual. After a careful history and physical examination, the NP documents the
following breast findings: Breasts pendulous with diffuse fibrocystic changes.
Single firm 1 × 1 cm mass, mobile, and nontender, with overlying peau d'orange
appearance in the right breast, upper outer quadrant at 11 o'clock, 2 cm from the
nipple. Which of the following is the most accurate interpretation of these
findings? - ANSWER These findings suggest a
cyst
An NP student conducted a clinical breast examination on a 27-year-old female
with a history of fibroadenomas. The NP palpated a rubbery, mobile, nontender
mass in the right breast. The mass was located 3 cm proximal to and 3 cm to the
left of the nipple. Which of the following would be the most appropriate way to
document the physical assessment findings? - ANSWER
rubbery, mobile, nontender mass located in the right breast, in the 10:30 position
from the nipple
Primary prevention is defined as which of the following? - ANSWER
Interventions designed to prevent disease
Based on the U.S. Preventive Services Task Force (USPSTF) recommendations,
which of the following statements is true about screening for breast cancer in
average-risk women? - ANSWER Mammography
is recommended every 2 years for women aged 50-74 with insufficient evidence
for screening women over the age of 75.
