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Exam (elaborations)

NR509 Final Exam & Practice Test: The Ultimate Clinical Judgment Builder

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Stop guessing and start mastering your NR509 final! This comprehensive question bank gives you two full versions of the final exam and practice tests, complete with detailed, verified answers to explain the why behind every diagnosis. Covering everything from breast cancer screening and abdominal pain to neurological assessments and pediatric milestones, this resource is designed to sharpen your clinical reasoning and ensure you're prepared for any scenario on exam day. If you want to go into your final feeling confident and ready to ace it, this is your essential study companion.

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NR509 Final TEST FINAL EXAM AND PRACTICE EXAM
20262027 BANK 2 VERSIONS QUESTIONS WITH DETAILED
VERIFIED ANSWERS EXAM QUESTIONS WILL COME
FROM HERE (100% CORRECT ANSWERS A+ GRADED




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
F - ANSWERS--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.

,2|Page


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 BRCA2 mutation is insufficient cr - ANSWERS--b.
Sensitivity of screening for breast cancer increases with breast MRI at
the expense of specificity.


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

,3|Page


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 - ANSWERS--e. Prolactinoma


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.

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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 because of very high sensitivity -
ANSWERS--b. This patient is more likely to find a fibroadenoma than a
cancer on self-examination.


A 48-year-old female psychologist presents to clinic with concerns
about her breast cancer risk after an age-matched cousin was recently
diagnosed with this disease. This cousin is the third family member on
her father's side in as many years to be diagnosed with breast cancer,
including the patient's own father, who had surgery and subsequent
treatment 3 years ago for breast cancer. The patient has little other
knowledge of her family history, only that her grandparents
independently arrived from Eastern Europe near the end of World War
II and were among very few members of their family that survived the
war. The patient has read about testing for the breast cancer genes
(BRCA1 and BRCA2) and desires further information about whether this
would be appropriate for her. Which of the following is true about this
patient's indications for BRCA testing?


a. Her familial lineage is irrelevant to her risk of BRCA genes and -
ANSWERS--d. This patient carries several risk factors that together
justify BRCA testing.

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