NR 509 - FINAL EXAM BATE'S
INTERACTIVE QUESTION BANK EXAM
WITH CORRECT QUESTIONS AND
ANSWERS 2025
1. 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 -
CORRECT-ANSWERSc. 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. 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 c - CORRECT-ANSWERSb.
Sensitivity of screening for breast cancer increases with breast MRI at the expense
of specificity.
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 - CORRECT-ANSWERSe. 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
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 because of very high sensitivity - CORRECT-
ANSWERSb. This patient is more likely to find a fibroadenoma than a cancer on
self-examination.
5. 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 - CORRECT-
ANSWERSd. This patient carries several risk factors that together justify BRCA
testing.
6. A 68-year-old former paleontologist presents to clinic with concerns about her breast
cancer risk. Her mother developed the disease in her 50s and died from it in her 60s. A
younger cousin developed the disease a few years ago before the age of 50 years, but this
individual was not tested for the BRCA1 and BRCA2 genes. In addition, the patient
INTERACTIVE QUESTION BANK EXAM
WITH CORRECT QUESTIONS AND
ANSWERS 2025
1. 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 -
CORRECT-ANSWERSc. 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. 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 c - CORRECT-ANSWERSb.
Sensitivity of screening for breast cancer increases with breast MRI at the expense
of specificity.
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 - CORRECT-ANSWERSe. 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
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 because of very high sensitivity - CORRECT-
ANSWERSb. This patient is more likely to find a fibroadenoma than a cancer on
self-examination.
5. 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 - CORRECT-
ANSWERSd. This patient carries several risk factors that together justify BRCA
testing.
6. A 68-year-old former paleontologist presents to clinic with concerns about her breast
cancer risk. Her mother developed the disease in her 50s and died from it in her 60s. A
younger cousin developed the disease a few years ago before the age of 50 years, but this
individual was not tested for the BRCA1 and BRCA2 genes. In addition, the patient
