A nurse is working with a woman who has been diagnosed with severe fibrocystic breast disease. After describing the medications that can be used as treatment, the nurse determines that additional teaching is needed when the client identifies which drug is being used.

Choice A: African American women have the BRCA 1 and BRCA 2 gene is not the correct answer because it is not a fact but a misconception. BRCA 1 and BRCA 2 are genes that normally help prevent breast and ovarian cancer by repairing DNA damage. However, mutations in these genes can increase the risk of developing these cancers. BRCA mutations are not exclusive to African American women, but they can affect any race or ethnicity. According to the National Cancer Institute, about 12% of American white women and 10% of African American women have a BRCA mutation.

Choice B: American white women respond better to breast cancer treatment is not the correct answer because it is not a fact but a disparity. Breast cancer treatment can include surgery, radiation, chemotherapy, hormone therapy, or targeted therapy. The response to treatment can vary depending on various factors such as tumor type, stage, grade, or molecular profile. However, some studies have shown that American white women have better survival rates and outcomes than African-American women after breast cancer treatment. This disparity may be due to differences in access to care, quality of care, socioeconomic status, or biological factors.

Choice C: Breast cancer is more advanced in African American women when found is the correct answer because it is a fact and a disparity. Breast cancer is a disease that occurs when abnormal cells grow and invade the breast tissue or other parts of the body. The stage of breast cancer describes how far the cancer has spread and how serious it is. Breast cancer can be detected by screening tests such as mammograms or clinical exams such as breast self-exams. However, some studies have shown that African American women are more likely than American white women to be diagnosed with breast cancer at later stages. This disparity may be due to differences in screening rates, awareness, symptoms, or tumor biology.

Choice D: More Hispanic women smoke, which increases their risk is not the correct answer because it is not a fact but a misconception. Smoking is a risk factor for breast cancer, as it can damage the DNA of breast cells and increase the levels of hormones that stimulate cell growth. However, smoking rates are not higher among Hispanic women than other racial or ethnic groups. According to the Centers for Disease Control and Prevention, about 14% of Hispanic women smoke cigarettes compared to 16% of American white women and 14% of African American women.

Choice A: Breast milk is not the correct answer because it is not a route of transmission for syphilis. Syphilis is caused by a bacterium called Treponema pallidum, which cannot survive in breast milk. However, breastfeeding mothers with syphilis should be treated with antibiotics to prevent other complications.

Choice B: The birth canal is not the correct answer because it is not a route of transmission for syphilis. Syphilis can be transmitted through sexual contact, but not through vaginal delivery. However, pregnant women with syphilis should be screened and treated before delivery to prevent congenital syphilis in their newborns.

Choice C: Amniotic fluid is not the correct answer because it is not a route of transmission for syphilis. Syphilis cannot cross the amniotic membrane, which protects the fetus from infections in the uterus. However, pregnant women with syphilis should be monitored for signs of fetal distress or premature rupture of membranes.

Choice D: Placenta is the correct answer because it is a route of transmission for syphilis. Syphilis can cross the placenta, which connects the mother and the fetus through blood vessels. This can result in congenital syphilis, which can cause serious problems such as stillbirth, miscarriage, low birth weight, deformities, or neurological damage in newborns.