TEST INSTRUCTIONS Read the article. The test for this CE activity is to be taken online at www.nursingcenter.com/CE/NP. Tests can no longer be mailed or faxed. You'll need to create (it's free!) and log in to your personal CE Planner account before taking online tests. Your planner will keep track of all your Lippincott Professional Development online CE activities for you. There's only one correct answer for each question. A passing score for this test is 8 correct answers. If you pass, you can print your certificate of earned contact hours and access the answer key. If you fail, you have the option of taking the test again at no additional cost. For questions, contact Lippincott Professional Development: 1-800-787-8985. Registration deadline is June 6, 2025. PROVIDER ACCREDITATION

Lippincott Professional Development will award 2.0 contact hours for this continuing nursing education activity.

Lippincott Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.0 contact hours. Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia, Georgia, West Virginia, New Mexico, South Carolina, and Florida, CE Broker #50-1223. Your certificate is valid in all states.

Payment: The registration fee for this test is $21.95.

Factors impacting quality of life for breast cancer survivors

Learning Outcomes: A majority of participants in this activity will demonstrate knowledge of factors impacting quality of life (QOL) for breast cancer survivors by achieving a passing score on the posttest.

Learning Objectives: After reading the article and completing the posttest, the participant will be able to:

Identify the prevalence, pathophysiology, risk factors, and symptoms of breast cancer. Describe screening and genetic testing for BRCA1 and BRCA2 variants. Explain factors that impact the well-being and QOL among breast cancer survivors. Summarize the practice implications for primary care providers in managing care for breast cancer survivors.

Posttest: Case-based Assessment: Placing yourself in the role of the NP providing care, use the case scenarios below to answer the questions for each applying knowledge and skills learned in the attached article.

Questions #1-#5 are based on the following case scenario: DS is a 35-year-old woman at the primary care clinic for a new patient visit. DS's intake form notes normal vital signs and no past medical history. Her ethnicity is Ashkenazi Jewish. Her height is 5 feet 4 inches and weight is 130 lb. She reached menarche at 10 years of age. She uses oral contraceptives for birth control. Her mother and maternal aunt were both diagnosed with breast cancer in their mid-50s and are alive and well today. DS has been married to her husband for 10 years, and they have two children together. She exercises regularly, eats a healthy diet, and drinks alcohol socially (one or two glasses of wine on weekends). She does not smoke. DS had a mammogram last year with a negative (normal) result.

Nonmodifiable breast cancer risk factors for DS include her exercise regimen and food consumption. menarche onset and ethnicity. smoking history and alcohol consumption. Since her mother was diagnosed with breast cancer, DS has a 0% chance of developing breast cancer. 15% lower risk of developing breast cancer. 50% increased risk of developing breast cancer. Given DS's family history of breast cancer and her ethnicity, you ask her to complete a risk assessment tool to determine if nutritional counseling is needed to prevent obesity. assess for a problem with her alcohol consumption to determine alcohol use disorder. evaluate for a family history of BRCA1 or BRCA2 mutations. DS states that she does not understand the importance of testing for BRCA1 and BRCA2 variants. You explain that these genes are associated with an increased risk of developing breast cancer at a younger age. can only be inherited through the father's side of the family, so DS does not need to be tested. can reduce DS's risk by at least half for a breast cancer diagnosis during her life. DS asks you to describe symptoms of breast cancer. You state that changes in the breast are easily identified by individuals early in the cancer process. all women usually experience the same symptoms with minimal variation. most women are asymptomatic or only experience subtle changes until the cancer is more advanced.Questions #6-#9 will be based on the following case scenario: MG is a 54-year-old female diagnosed with breast cancer 6 months ago who has been receiving cancer treatments with an oncologist. MG arrives in the primary care office for her routine annual exam. MG describes difficulty managing her time between cancer treatments and work responsibilities. She has been married to her husband for 25 years, and they have a son in college. MG has been feeling lonely and emotionally distant from her husband lately, as she has not been sexually active with him since starting cancer treatments due to vaginal dryness and discomfort during coitus. MG indicates that she is experiencing poor QOL.
Based on MG's statements and the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline, you decide to screen MG for depression with the Beck Depression Inventory. reassure her that everything will be fine and to keep following her usual routine. refer MG to someone who can help her learn better time management skills. When MG removes her headscarf during the physical exam, you notice loss of eyebrow hair. The QOL domain that you would assess for this finding is coping. body image. social support. The most appropriate intervention to initiate for MG's vaginal dryness is to advise her that studies have found a higher QOL among patients who do not have partners. prescribe a nonhormonal, water-based vaginal lubricant and assess for other factors causing sexual dysfunction. order long-term hormonal therapy products for estrogen and progesterone replacement. MG notes difficulty coping with body changes since her cancer diagnosis. You consider assessing MG's social support as Ozdemir and Tas Arslan found that for breast cancer survivors there is a positive association between social support and coping. no need to assess social support. a negative association between social support and coping.Knowledge-based Question #10
The authors of the article explain that, in providing care for breast cancer survivors, primary care NPs should avoid using screening tools to assess for depression, QOL, or sexual dysfunction and instead refer patients to their oncologist. regularly screen and assess the physical, mental, and social well-being of patients during treatment and remission. focus on the QOL screening recommended for male breast cancer survivors as identified in the vast amount of available literature on this patient population.