Women's Health (APEA) Exam 2026
Questions and Answers Graded A+
which of the following patients is at highest risk for developing breast cancer? -
Correct answer-a. 45 yo F who had 6 pregnancies
b. 61 yo nulliparous F who has dense breast tissue
c. 50 yo F who is obese
d. 32 yo transgender F who has a family hx of breast cancer
*B. 61 yo nulliparous female who has dense breast tissue*
risk factors for breast cancer - Correct answer--female sex
-increasing age
-obesity
-dense breasts
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,-nulliparity
-later in life pregancy
-alcohol, smoking
-no breastfeeding
-Increased estrogen exposure
-family hx/genetic risk
increase estrogen exposure as risk factor for breast cancer - Correct answer--
increased risk:
*estrogen/progestin therapy is postmenopausal with intact uterus
*combined hormonal contraceptives: increased risk during use, decreased 3-5
years of discontinuation
-negligible/reduced risk:
*estrogen-only replacement after hysterectomy
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,-early menarche (< 12 yo)
-late menopause (> 55 yo)
family hx/genetic risk as risk factor for breast cancer - Correct answer--can be
estimated using screening tools: BCRAT, Ontario tool (w/ 1st degree relative hx of
breast cancer)
-BRCA 1, 2 genetic mutations: REFER**
common and *benign* breast masses - Correct answer--fibroadenomas
-cysts
-fibrocystic breasts
breast cancer.. - Correct answer--can mimic benign condition!
-age does NOT rule out cancer
-may be accompanied by change in breast size, symmetry, skin texture, and nipple
inversion or discharge**
©COPYRIGHT 2026, ALL RIGHTS RESERVED 3
, beast cancer workup - Correct answer--complete history and physical
-imaging based on patient characteristics (US or mammography)
breast imaging - Correct answer--ultrasound (US)
*< 30 yo: male, female, or pregnant
*follow-up on mass identified with mammography
-mammography/tomosynthesis (3D)
*> 30 yo: females
*tomosynthesis if dense breasts
a 55 yo female at average risk who has never had breast cancer screening. what
should the NP order? - Correct answer-screening bilateral mammogram
a 28 yo patient reports progressively worsening menstrual pain following her last
pregnancy 2 years ago. prior to the pregnancy, she never had menstrual cramps.
which of the following should the NP tell the patient? - Correct answer-symptoms
suggest that there may be an underlying structural problem (secondary
dysmenorrhea)
©COPYRIGHT 2026, ALL RIGHTS RESERVED 4
Questions and Answers Graded A+
which of the following patients is at highest risk for developing breast cancer? -
Correct answer-a. 45 yo F who had 6 pregnancies
b. 61 yo nulliparous F who has dense breast tissue
c. 50 yo F who is obese
d. 32 yo transgender F who has a family hx of breast cancer
*B. 61 yo nulliparous female who has dense breast tissue*
risk factors for breast cancer - Correct answer--female sex
-increasing age
-obesity
-dense breasts
©COPYRIGHT 2026, ALL RIGHTS RESERVED 1
,-nulliparity
-later in life pregancy
-alcohol, smoking
-no breastfeeding
-Increased estrogen exposure
-family hx/genetic risk
increase estrogen exposure as risk factor for breast cancer - Correct answer--
increased risk:
*estrogen/progestin therapy is postmenopausal with intact uterus
*combined hormonal contraceptives: increased risk during use, decreased 3-5
years of discontinuation
-negligible/reduced risk:
*estrogen-only replacement after hysterectomy
©COPYRIGHT 2026, ALL RIGHTS RESERVED 2
,-early menarche (< 12 yo)
-late menopause (> 55 yo)
family hx/genetic risk as risk factor for breast cancer - Correct answer--can be
estimated using screening tools: BCRAT, Ontario tool (w/ 1st degree relative hx of
breast cancer)
-BRCA 1, 2 genetic mutations: REFER**
common and *benign* breast masses - Correct answer--fibroadenomas
-cysts
-fibrocystic breasts
breast cancer.. - Correct answer--can mimic benign condition!
-age does NOT rule out cancer
-may be accompanied by change in breast size, symmetry, skin texture, and nipple
inversion or discharge**
©COPYRIGHT 2026, ALL RIGHTS RESERVED 3
, beast cancer workup - Correct answer--complete history and physical
-imaging based on patient characteristics (US or mammography)
breast imaging - Correct answer--ultrasound (US)
*< 30 yo: male, female, or pregnant
*follow-up on mass identified with mammography
-mammography/tomosynthesis (3D)
*> 30 yo: females
*tomosynthesis if dense breasts
a 55 yo female at average risk who has never had breast cancer screening. what
should the NP order? - Correct answer-screening bilateral mammogram
a 28 yo patient reports progressively worsening menstrual pain following her last
pregnancy 2 years ago. prior to the pregnancy, she never had menstrual cramps.
which of the following should the NP tell the patient? - Correct answer-symptoms
suggest that there may be an underlying structural problem (secondary
dysmenorrhea)
©COPYRIGHT 2026, ALL RIGHTS RESERVED 4
