Mammogram

The exam loves to use a mammogram as the textbook example of secondary prevention: the disease may already exist, so you are detecting it early, not preventing it. The classic trap is choosing “primary prevention” because the woman feels healthy—remember that screening an asymptomatic person is always secondary, while primary prevention would be a measure like limiting alcohol or maintaining a healthy weight to lower risk. Expect age-cutoff items and a date-of-last-exam “tell”: the answer usually hinges on whether the client is due under the recommended interval.

Teaching points are high-yield. Before the test the client should avoid deodorant, powder, and lotion on the breasts and underarms (aluminum mimics calcifications), and schedule it for the week or two after menses starts, when breasts are least tender. A frequent distractor confuses mammography with breast self-awareness or clinical breast exam—those are not the gold-standard screen (ACS no longer recommends routine CBE/self-exam). A BRCA-positive or strongly family-historied client warrants earlier screening plus a yearly MRI alongside the mammogram, not a routine mammogram alone.