NR509 / NR 509 FINAL EXAM (LATEST 2023 / 2024):
ADVANCED PHYSICAL ASSESSMENT/A+GRADE
CHAMBERLAIN
1. A 44-year-old female mathematician presentsto
... [Show More] 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 Force (USPSTF)
recommendations for her age group and risk factors prior to her current complaint.
d. Mammography is most sensitive and specific for women in their 40s, when breast tissue is
still dense enough to image accurately.
e. Breast cancer screening is extremely well studied, and no controversy exists on the
recommended norms for screening and follow-up.
2. A 44-year-old female mathematician presentsto 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 Force (USPSTF)
recommendations for her age group and risk factors prior to her current complaint.
d. Mammography is most sensitive and specific for women in their 40s, when breast tissue is
still dense enough to image accurately.
e. Breast cancer screening is extremely well studied, and no controversy exists on the
recommended norms for screening and follow-up.
NR509 / NR 509 FINAL EXAM (LATEST 2023 / 2024):
ADVANCED PHYSICAL ASSESSMENT/A+GRADE
CHAMBERLAIN
3. 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
4. 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 patientsthemselves,
and she is very concerned that she may have breast cancer. Which of the following istrue about
BSE and self-detection of breast cancer?
a. Most massesthat women find at home and bri [Show Less]