Question 4

Question:

A 30-year-old woman whose mother and grandmother have died of carcinoma of the breast refuses to have mammography. She says that she knows she is at risk but states, “I hate having my breasts squashed–it’s uncomfortable.” Her physician would like her to have annual mammograms. Which of the following is most likely to influence her to agree to mammography?

Correct Answer: C.  Offer analgesia prior to mammography

Often when patients refuse to comply with a physician’s recommendations, there is a reason for the refusal. It is important to explore the patient’s reasons for refusal. This woman has explained why she does not want a mammography. She is afraid of the discomfort involved. Therefore offering analgesia (choice C) is a reasonable first option to try to allay her fears, and have her agree to the procedure.
In general, fear tactics (choice A and D), and ultimatums (choice B and E) will not be the correct answer on the USMLE Step 1 exam.