Chapter 17: Breasts and Axillae

Question 1

1. Montgomery tubercles are most prominent in the breasts of
   a. adult males.
   b. patients with lung disease.
   c. pregnant women.
   d. pubertal females.

Answer 1

c. pregnant women.

Question 2

2. Most women with breast cancer
   a. lack the BRCA1 or BRCA2 gene.
   b. risk increases with aging.
   c. have a aunt who had breast cancer.
   d. continue to menstruate after age 52.

Answer 2

b. risk increases with aging.

Question 3

3. A 50-year-old woman presents as a new patient. Which finding in her personal and social history would increase her risk profile for developing breast cancer?
   a. Drinking three glasses of wine per week
   b. Early menopause
   c. Nulliparity
   d. Late menarche

Answer 3

c. Nulliparity

Question 4

. If your patient has nipple discharge, you will most likely need a
a. Vacutainer tube.
b. glass slide and fixative.
c. specimen jar with formaldehyde.
d. tape strip to test pH.

Answer 4

b. glass slide and fixative.

Question 5

5. While examining a 30-year-old woman, you note that one breast is slightly larger than the other. In response to this finding, you should
   a. note the finding in the patient’s record.
   b. ask the patient if she has ever had breast cancer.
   c. tell the patient to get a mammogram as soon as possible.
   d. tell the patient to get a mammary sonogram as soon as possible.

Answer 5

a. note the finding in the patient’s record.

Question 6

6. A 23-year-old white woman has come to the clinic because she has missed two menstrual periods. She states that her breasts have enlarged and that her nipples have turned a darker color. Your response to this finding is to
   a. instruct her that this is a side effect of birth control injection therapy.
   b. suggest pregnancy testing.
   c. question her use of tanning beds.
   d. schedule an appointment with a surgeon.

Answer 6

b. suggest pregnancy testing.

Question 7

7. In patients with breast cancer, peau d’orange skin is often first evident
   a. in the axilla.
   b. in the upper inner quadrant.
   c. on or around the nipple.
   d. at the inframammary ridge.

Answer 7

c. on or around the nipple.

Question 8

8. A firm, transverse ridge of compressed tissue is felt bilaterally along the lower edge of a 40-year-old patient’s breast. You should
   a. ask the patient if she has a history of breast cancer.
   b. refer the patient to a surgeon.
   c. ask the patient to have a mammogram as soon as possible.
   d. record the finding in the patient’s record.

Answer 8

d. record the finding in the patient’s record.

Question 9

9. When examining axillary lymph nodes, the patient’s arm is
   a. raised fully above the head.
   b. extended at the side.
   c. flexed at the elbow.
   d. crossed over the chest.

Answer 9

c. flexed at the elbow.

Question 10

10. Male gynecomastia associated with illicit or prescription drug use can be expected to
    a. lessen when the body becomes accustomed to the drug.
    b. resolve after the drug is discontinued.
    c. leave permanent breast enlargement when the drug is discontinued.
    d. cause purulent drainage if left untreated.

Answer 10

b. resolve after the drug is discontinued.

Question 11

11. A nursing mother complains that her breasts are tender. You assess hard, shiny, and erythemic breasts bilaterally. You should advise the patient to
    a. massage gently and continue nursing.
    b. apply warm compresses and stop nursing.
    c. monitor her temperature and restrict fluids.
    d. sleep wearing a bra and wash her breasts with antibacterial soap.

Answer 11

a. massage gently and continue nursing.

Question 12

12. You are conducting a clinical breast examination for your 30-year-old patient. Her breasts are symmetric, with bilateral, multiple tender masses that are freely movable and with well-defined borders. You recognize that these symptoms and assessment findings are consistent with
    a. fibroadenoma.
    b. Paget disease.
    c. cancer.
    d. fibrocystic changes.

Answer 12

d. fibrocystic changes.

Question 13

13. Your patient is a nursing mother who asks you to look at a mole she has under her left breast at the inframammary fold. The mole is nontender and soft and has grown in size since she started nursing. There are no other changes to the mole. This mole probably represents an undiagnosed
    a. Montgomery tubercle.
    b. case of Paget disease.
    c. supernumerary nipple.
    d. fat necrosis.

Answer 13

c. supernumerary nipple.

Question 14

14. When conducting a clinical breast examination, the examiner should
    a. forgo the examination if the patient has had a recent mammogram.
    b. keep the patient’s breasts completely covered to respect modesty.
    c. dim the lights to minimize anxiety.
    d. inspect both breasts simultaneously.

Answer 14

d. inspect both breasts simultaneously.

Question 15

1. Mrs. Weber is a 65-year-old patient who has presented at the clinic with a complaint of a tender breast mass that she discovered during breast self-examination. You have completed a physical examination on Mrs. Weber and have palpated a mass of the right breast in the lower outer quadrant. When providing patient education to Mrs. Weber regarding the breast mass, you will explain that the characteristics of a cancerous mass would be which of the following? (Select all that apply.)
   a. Immobile and firm
   b. Pain on palpation
   c. Irregular border edges
   d. Mobile and rubbery
   e. Nontender

Answer 15

A, C, E
a. Immobile and firm
c. Irregular border edges
e. Nontender

Question 16

2. Ms. Lawson is a 41-year-old patient who presents for a routine annual examination. During her breast examination, you are also completing a lymphatic examination. Which of the following lymph nodes are examined during a breast examination? (Select all that apply.)
   a. Supraclavicular
   b. Lateral axillary nodes
   c. Anterior cervical nodes
   d. Anterior axillary nodes
   e. Posterior cervical nodes

Answer 16

A, B, D
a. Supraclavicular
b. Lateral axillary nodes
d. Anterior axillary nodes