The following sample questions are representative of actual test content, difficulty level, and question format. The answer key follows the set of questions.
Directions: Each question or incomplete statement below is followed by four suggested answers or completions. Select the one that is best in each case.
Male patients with breast cancer demonstrate a higher risk of exhibiting which genetic mutation?
Skin dimpling and retractions are accentuated on which of the following positions?
- Pectoral muscle flexion
- Arm resting on examiner’s shoulder
- Arms behind the back
Which baseline laboratory value is indicated for a patient with clinical stage I (T1c N0 Mx) breast cancer?
- Alkaline phosphatase
- Carcinoembryonic antigen
- Lactate dehydrogenase
Which of the following organizations looks at quality measures for breast care programs?
- American College of Surgeons
- The Joint Commission
- Centers for Medicare and Medicaid Services
- Susan G. Komen for the Cure
A colleague asks about the benefit of nursing certification. The certified breast care nurse (CBCN®) responds:
- “I have met predetermined standards for specialty practice.”
- “I am able to perform biopsies.”
- “It takes the place of state licensure.”
- “It will increase reimbursement for services.”
Rationale: Population-based studies show a range of BRCA2 mutations in men with the highest prevalence reported from Iceland. Men with BRCA2 mutation may present at a younger age and have a high grade tumor
Reference: Babiera, G.V., Skoracki, R.J, & Esteva, F.J. (Eds.). (2012). Advanced therapy of breast disease (3rd ed.). Shelton, CT. People's Medical Publishing House-USA, pp 1257-1258.
Rationale: Inspection of the breast is part of the clinical breast examination. By the patient placing her hands on her hips and pressing down, the pectoralis muscle is flexed and this action shows skin dimpling, retractions, or masses.
Reference: Ignatavicius, D.D., & Workman, M.L. (Eds.). (2013). Medical-surgical nursing: Patient-centered collaborative care (7th ed.). St. Louis, MO: Elsevier Saunders, p 1596.
Rationale: General work-up includes liver function test, alkaline phosphatase, CBC, and platelets. Carcinoembryonic antigen is a tumor marker that has low specificity for breast cancer. CA-125 is a tumor marker for ovarian cancer.
Reference: National Comprehensive Cancer Network. (2011). NCCN Clinical Practice Guidelines in Oncology: Breast cancer screening and diagnosis [v.1.2011]. Retrieved from http://www.nccn.org.
Rationale: The American College of Surgeons monitors quality measures and grants accreditation. The Joint Commission certifies clinical programs focused on a variety of disease states. The Centers for Medicare and Medicaid Services awards agreements to implement randomized trials. Susan G. Komen for the Cure provides grant support for funding opportunities.
Reference: Mahon, S.M. (Ed.). (2011). Site-specific cancer series: Breast cancer (2nd ed.). Pittsburgh, PA: Oncology Nursing Society, pp 219-224.
Rationale: Certification is the formal recognition of specialized knowledge, skills, and experience in nursing by which a nongovernmental agency or association certifies an individual licensed to practice in a profession has met certain predetermined standards specified by that profession for specialty practice.
Reference: Yarbro, C.H., Wujcik, D., & Gobel, B.H. (Eds.). (2011). Cancer nursing: Principles and practice (7th ed.). Sudbury, MA: Jones and Bartlett, p 1852.