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Assignment questions
NursingDiscussion postHealth promotion

NU621 breast screening and PSA counselling guide

Counsel a couple at their annual physicals: give the wife evidence-based recommendations on breast self-exam and mammography and the breast changes she should report, then critique PSA as a diagnostic test and advise the husband accordingly.

Editorial process

Last reviewed · August 13, 2026

01

Two beliefs, each partly right

Both patients arrive with a belief that is partly supported, which is what makes this a counselling exercise rather than a correction. The wife thinks breast self-exam and mammography are not useful. On self-exam she is closer to right than she expects: formal breast self-examination as a screening programme has not shown a mortality benefit and does increase benign biopsies, which is why guidance has shifted towards awareness of one's own breasts and prompt reporting of change. On mammography she is wrong, and the recommendation depends on her age and risk, so give the actual recommendation with its age range and interval and say where it comes from. Handling the two halves differently — conceding the self-exam point while making the mammography case — is more persuasive than treating both as misconceptions, and it is also what the evidence actually supports, which matters in a post graded on evidence.

The changes she should report follow directly from that shift towards awareness, and the list should be concrete: a new lump or thickening, skin dimpling or puckering, nipple retraction or new inversion, spontaneous or bloody nipple discharge, persistent focal pain, or skin changes such as redness, scaling or peau d'orange. The husband's belief is that PSA testing is no longer done, which overstates a real change. Critique PSA as a diagnostic test on its own terms — it is prostate-specific, not cancer-specific, so benign hyperplasia, prostatitis and even recent activity raise it, producing false positives, biopsies and overdiagnosis of disease that would never have harmed him. Then give the current recommendation, which for his age band is shared decision-making rather than a blanket yes or no. Bring at least one reference different from your colleagues', as the prompt requires, and cite current guidelines, research findings and the genuine controversies rather than presenting the area as settled.

Likely learning objectives

Inferred from the brief — check these against your own rubric.

  • 01
    Distinguish screening programme evidence from individual clinical advice.
  • 02
    State current breast cancer screening recommendations with age and interval.
  • 03
    List the breast changes that warrant clinical assessment.
  • 04
    Critique PSA specificity and explain overdiagnosis.
  • 05
    Apply shared decision-making to a screening test with genuine trade-offs.
Assignment instructionsQuoted verbatim

Read the full question

Review every instruction before using the planning guidance that follows.

NU621-8D Unit 3 DQ 2 Discussion Question/Prompt You are seeing a husband and wife for routine yearly physicals. You want to discuss health promotion activities with them, including self breast exam (SBE) and mammography for the wife and prostate self exams for the husband. The wife states she is embarrassed to admit she has never done a breast self exam or had a mammogram and didn’t think they were useful anyway. The husband tells you he read in the magazine in your waiting room that blood tests to check for prostate cancer don’t need to be done anymore. Provide evidence-based information to the wife about the recommendations for SBE and mammography and your recommendations to her based on the evidence. Describe changes in her breasts that should be reported to her health care provider. NU621-8D Unit 3 DQ 2 Critique the use of serum prostate-specific antigen (PSA)to diagnose prostate cancer. Provide your evidenced-based recommendations to the husband for PSA testing. Provide at least one reference source that is different from your colleagues to help expand their knowledge. Cite current research findings, national guidelines, and expert opinions and controversies found in the medical and nursing literature to support your position and suggestions. Discussion Peer/Participation Prompt Please respond to at least 2 of your peer’s posts. To ensure that your responses are substantive, use at least three of these prompts: Do you agree with your peers’ recommended treatment plan? Take an opposing view to a peer and present an alternative plan. Share your thoughts on how you support their opinion and explain why. Present new references that support your opinions. Please be sure to validate your opinions and ideas with citations and references in APA format.
Course-wide instructions that accompany this question

ADDITIONAL INSTRUCTIONS FOR THE CLASS Discussion Questions (DQ) Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses. Weekly Participation Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. APA Format and Writing Quality Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition. Use of Direct Quotes I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. LopesWrite Policy For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score. Late Policy The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. Communication Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

02

Turn the brief into deliverables

  1. 01
    Evidence-based information and recommendations for the wife on SBE and mammography.
  2. 02
    A description of the breast changes that should be reported to her provider.
  3. 03
    A critique of serum PSA for diagnosing prostate cancer.
  4. 04
    Evidence-based PSA recommendations for the husband.
  5. 05
    At least one reference source different from your colleagues', with current guidelines cited.
03

Wife, changes to report, PSA critique, husband

01

Breast self-exam, honestly

Why formal SBE lost its screening recommendation, and what replaced it.

02

Mammography recommendation

The current recommendation with age, interval and source.

03

Changes to report

Lump, skin dimpling, nipple retraction, discharge, focal pain, skin change.

04

Critique of PSA

Prostate-specific not cancer-specific, false positives, biopsy harm, overdiagnosis.

05

Recommendation for the husband

Shared decision-making for his age band, with what the conversation should cover.

04

Task force recommendations and society guidance

Recommended databases

  • U.S. Preventive Services Task Force
  • American Cancer Society
  • National Cancer Institute
  • PubMed
  • Course readings

Search sequence

  1. 1.
    Read the USPSTF breast cancer screening recommendation and note its age range and interval.
  2. 2.
    Read the USPSTF prostate cancer screening recommendation and note the shared decision-making band.
  3. 3.
    Read the NCI PSA fact sheet for what elevates PSA besides cancer.
  4. 4.
    Check the American Cancer Society guidance for where it differs from USPSTF.
  5. 5.
    Pick a reference your classmates are unlikely to have used, as the prompt requires.
05

Reference shortlist

These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.

Nothing here is cleared for citation until you have read it.

  1. 01

    Breast Cancer: Screening

    U.S. Preventive Services Task Force · 2024

    The current recommendation with its age range, interval and grade.

  2. 02

    Prostate Cancer: Screening

    U.S. Preventive Services Task Force · 2018

    The shared decision-making recommendation that corrects the husband's belief without endorsing it.

  3. 03

    Prostate-Specific Antigen (PSA) Test

    National Cancer Institute · 2025

    What raises PSA besides cancer, which is the core of the specificity critique.

  4. 04

    Early Detection and Diagnosis of Breast Cancer

    American Cancer Society · 2025

    Society guidance on breast awareness and where it differs from the task force.

  5. 05

    Benign and Precancerous Breast Conditions

    National Cancer Institute · 2025

    Which breast changes are benign and which warrant assessment, for the reportable-changes list.

06

Review before submission

Common mistakes

  • Telling the wife her self-exam scepticism is simply wrong.
  • Giving a mammography recommendation with no age range or interval.
  • Listing breast changes vaguely instead of naming specific findings.
  • Describing PSA as inaccurate rather than as prostate-specific but not cancer-specific.
  • Telling the husband PSA testing has been abandoned, which is what he already believes.
  • Duplicating a classmate's reference when the prompt asks for a different one.

Submission checklist

  • The self-exam answer distinguishes programme screening from breast awareness.
  • The mammography recommendation states an age range, an interval and its source.
  • Specific reportable breast changes are named.
  • The PSA critique addresses specificity, false positives and overdiagnosis.
  • The husband's recommendation reflects shared decision-making for his age band.
  • At least one reference differs from those your colleagues used.

Use this guide to plan and review your own work. Follow your institution's rules and read our academic-integrity policy.

Written by

Aaron Bishop

MA, Education

assignment interpretation and research-methods coaching across disciplines

Aaron leads the EssayCrackers editorial desk. He works on how assignment briefs are read — what a rubric is actually asking for, and where students most often answer a different question than the one set.

Reviewed by

Dr. Nathan Cole

PhD, Rhetoric & Composition

Argumentation and thesis development

Nathan teaches first-year composition and directs a university writing center. He reviews EssayCrackers guides for argumentative soundness and citation accuracy.

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