NR 509 Final Exam Practice UPDATE
VERIFIED QUESTIONS & DETAILED
EXPLANATIONS GRADED A+
Professional Academic Assistance Services
CHAPTER 18: Breasts & Axillae
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 - Answer: c. 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.
CHAPTER 18: Breasts & Axillae
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.
d. Women at low lifetime risk of breast cancer (<20%) are
recommended to undergo screening MRI.
e. Known BRCA1 or B - Answer: b. Sensitivity of screening for
breast cancer increases with breast MRI at the expense of
,specificity.
CHAPTER 18: Breasts & Axillae
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 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
CHAPTER 18: Breasts & Axillae
, 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.
b. This patient is more likely to find a fibroadenoma than a
cancer on self-examination.
c. The most likely breast mass this patient is likely to find in
herself is an abscess complicating underlying mastitis.
d. Because of this patient's age, breast masses should not be
pursued with imaging and diagnosis because the risk of cancer is
so low.
e. BSE is universally recommended b - Answer: b. This patient is
more likely to find a fibroadenoma than a cancer on self-
examination.
CHAPTER 18: Breasts & Axillae
A 48-year-old female psychologist presents to clinic with
concerns about her breast cancer risk after an age-matched
VERIFIED QUESTIONS & DETAILED
EXPLANATIONS GRADED A+
Professional Academic Assistance Services
CHAPTER 18: Breasts & Axillae
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 - Answer: c. 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.
CHAPTER 18: Breasts & Axillae
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.
d. Women at low lifetime risk of breast cancer (<20%) are
recommended to undergo screening MRI.
e. Known BRCA1 or B - Answer: b. Sensitivity of screening for
breast cancer increases with breast MRI at the expense of
,specificity.
CHAPTER 18: Breasts & Axillae
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 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
CHAPTER 18: Breasts & Axillae
, 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.
b. This patient is more likely to find a fibroadenoma than a
cancer on self-examination.
c. The most likely breast mass this patient is likely to find in
herself is an abscess complicating underlying mastitis.
d. Because of this patient's age, breast masses should not be
pursued with imaging and diagnosis because the risk of cancer is
so low.
e. BSE is universally recommended b - Answer: b. This patient is
more likely to find a fibroadenoma than a cancer on self-
examination.
CHAPTER 18: Breasts & Axillae
A 48-year-old female psychologist presents to clinic with
concerns about her breast cancer risk after an age-matched
