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Test Blueprint

  1. Breast Health: Risk Assessment and Reduction, Screening, Early Detection (15%)
    1. Breast development and changes across the life span
    2. Hormonal influences
    3. Benign conditions and anomalies
    4. Infection/inflammatory breast conditions
    5. High risk lesions
    6. Elements of clinical breast exam and lymph node examination
    7. Abnormal physical findings
    8. Epidemiology (population-based risk factors)
    9. Process of carcinogenesis (genetic/genomic, somatic versus germline mutations)
    10. Risk reduction, screening, and early detection (including clinical trials)
    11. Issues related to special populations (e.g., male, elderly, disabled, adolescent, pregnant, cultural, ethnicity, healthcare disparities)
    12. Regulatory requirements related to mammography (e.g., MQSA)
    13. Breast cancer risk prediction models (e.g., Gail Model)
  2. Diagnosis and Staging (18%)
    1. Diagnostic procedures and tests
    2. Pathology/tumor characteristics
    3. Staging and prognosis: AJCC staging criteria
  3. Treatment Modalities: Local and Systemic (20%)
    1. Local treatment modalities
    2. Systemic treatment modalities (e.g., hormonal, chemotherapy, targeted therapy)
    3. Complementary, alternative, integrative modalities
    4. Treatment consideration for special populations (e.g., male, elderly, disabled, adolescent, pregnant, cultural, ethnicity, healthcare disparities)
    5. Treatment preparations
    6. Modifiers of therapeutics efficacy (e.g., metabolism genes, CYP2D6 inhibitors)
  4. Symptom Management (risk factors, pathophysiology, prevention, education, and management) (17%)
    1. Surgical
    2. Medical
    3. Oncologic emergencies
    4. Radiation (e.g., skin changes)
  5. Psychosocial and Spiritual (8%)
    1. Influence of culture, spirituality, gender, sexual preference, age and healthcare disparities on psychosocial response across the continuum of breast care
    2. Psychosocial components accompanying hereditary predisposition to cancer (e.g., survivor guilt, transmitter guilt, family conflict)
    3. Altered body image
    4. Sexual dysfunction
    5. Emotional distress (e.g., anxiety, depression, fear of recurrence, family conflict)
    6. Socioeconomic considerations related to screening, diagnosis, treatment, and follow-up
    7. Coping strategies
    8. Principles of stress response and crisis management
    9. Psychosocial assessment techniques (e.g., spiritual, sexual, distress, coping, family function)
    10. Communication strategies and issues (e.g., active listening, clarification, family dynamic
  6. Survivorship (8%)
    1. Long-term effects (occurring from diagnosis to two years after treatment)
    2. Late effects (treatment-related organ toxicity)
    3. Surveillance for recurrence (e.g., breast cancer screening, symptom-directed work-up, physical exams)
    4. Second primaries (e.g., uterine, colon, ovary, skin, thyroid, breast)
    5. Employment and insurance issues
    6. Quality of life (physical, spiritual, cultural, emotional)
    7. Familial risk assessment and implications for genetic counseling
    8. Rehabilitation (e.g., pain, ROM, lymphedema, cognitive impairment)
    9. Components of a survivorships care plan (e.g., summary of treatments, side effects, late effects, surveillance, health promotion)
  7. End of Life Care (4%)
    1. Advance care planning and advance directives
    2. Palliative care services/settings
    3. Comfort measures and symptom management (non-pharmacologic and pharmacologic)
    4. Legal and ethical issues
    5. Pathophysiology of the dying process
    6. Insurance and reimbursement issues
    7. Spirituality, grief, and bereavement
  8. Professional Performance and Education (10%)
    1. Clinical trials (e.g., phases, assessing trials, elements of informed consent)
    2. Scope and standards of nursing practice
    3. Special populations and diverse needs (e.g., cultural, race, age, disabilities, underserved)
    4. Telephone assessment and triage
    5. Program planning and implementation
    6. Professional practice guidelines (e.g., ONS, NCCN, ASCO, ACR)
    7. Resources (e.g., local, state, federal, institutional, internet)
    8. Case management/patient navigation
    9. Evidence-based practice
    10. Advocacy and legislative issues impacting breast care delivery and access