NR 509: Final Exam Practice Questions With
Complete Solutions
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 Correct
Answers b. This patient is more likely to find a
fibroadenoma than a cancer on self-examination.
CHAPTER 18: Breasts & Axillae
,A 24-year-old graphic designer presents to clinic
with a concern for a breast mass. A rubbery,
mobile, nontender mass is palpated in the right
breast as described by the patient, which is
consistent with a firbroadenoma. In describing the
location of the mass, the examiner notes that it is 3
cm proximal to and 3 cm to the left of the nipple.
Which of the following would be the most
appropriate way to report this finding?
a. "Rubbery, mobile, nontender mass located in
right breast, in the 10:30 position from the nipple"
b. "Rubbery, mobile, nontender mass located in
right breast, in the lower outer quadrant"
c. "Rubbery, mobile, nontender mass located in
right breast, in the upper inner quadrant"
d. "Rubbery, mobile, nontender mass located in the
left breast, upper outer quadrant"
e. "Rubbery, mobile, nontender mass located in
right breast, in the 1:30 position from the nipple"
Correct Answers a. "Rubbery, mobile, nontender
mass located in right breast, in the 10:30 position
from the nipple"
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 Correct Answers e. Prolactinoma
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 Correct Answers b.
Sensitivity of screening for breast cancer increases
with breast MRI at the expense of specificity.
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
Complete Solutions
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 Correct
Answers b. This patient is more likely to find a
fibroadenoma than a cancer on self-examination.
CHAPTER 18: Breasts & Axillae
,A 24-year-old graphic designer presents to clinic
with a concern for a breast mass. A rubbery,
mobile, nontender mass is palpated in the right
breast as described by the patient, which is
consistent with a firbroadenoma. In describing the
location of the mass, the examiner notes that it is 3
cm proximal to and 3 cm to the left of the nipple.
Which of the following would be the most
appropriate way to report this finding?
a. "Rubbery, mobile, nontender mass located in
right breast, in the 10:30 position from the nipple"
b. "Rubbery, mobile, nontender mass located in
right breast, in the lower outer quadrant"
c. "Rubbery, mobile, nontender mass located in
right breast, in the upper inner quadrant"
d. "Rubbery, mobile, nontender mass located in the
left breast, upper outer quadrant"
e. "Rubbery, mobile, nontender mass located in
right breast, in the 1:30 position from the nipple"
Correct Answers a. "Rubbery, mobile, nontender
mass located in right breast, in the 10:30 position
from the nipple"
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 Correct Answers e. Prolactinoma
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 Correct Answers b.
Sensitivity of screening for breast cancer increases
with breast MRI at the expense of specificity.
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
