1|Page
NRNP 6531: ADVANCED PRACTICE CARE OF
ADULTS ACROSS THE LIFESPAN
Complete Practice Q&A with Verified Detailed
Rationales
High-Yield Exam Review | Graded A+ Content
Updated for 2026-2027 Academic Year
1. HEALTH PROMOTION & SCREENING
Question 1
A 55-year-old African American male with a history of hypertension
presents for an annual physical. According to USPSTF guidelines, which
screening test is most appropriate for this patient?
A. Abdominal aortic aneurysm (AAA) screening with ultrasound
B. Lung cancer screening with low-dose CT
C. Colorectal cancer screening with colonoscopy
D. Prostate cancer screening with PSA
Answer: A. Abdominal aortic aneurysm (AAA) screening with
ultrasound
Rationale: The USPSTF recommends one-time AAA screening with
ultrasound for men aged 65-75 who have ever smoked. However, men
with a family history or other risk factors may be screened earlier. This
,2|Page
patient has hypertension (risk factor) and is African American (higher
risk). Lung cancer screening (B) is recommended for adults aged 50-80
with a 20-pack-year smoking history who currently smoke or quit within
15 years. Colorectal cancer screening (C) begins at age 45. PSA
screening (D) is an individualized decision.
Clinical Pearl: AAA screening is one-time unless new risk factors
develop. Women with no smoking history do not require screening.
Question 2
A 62-year-old female with a 30-pack-year smoking history (quit 10 years
ago) asks about lung cancer screening. Which statement is correct
regarding low-dose CT (LDCT) screening?
A. Screening is recommended for all adults over 50 regardless of
smoking history
B. Screening should continue annually until age 80
C. Screening is indicated if the patient has a 20-pack-year history and
quit within 15 years
D. Chest X-ray is an acceptable alternative to LDCT
Answer: C. Screening is indicated if the patient has a 20-pack-year
history and quit within 15 years
Rationale: USPSTF guidelines for lung cancer screening:
• Age 50-80 years
• 20-pack-year smoking history
• Current smoker or quit within 15 years
• Annual LDCT until age 80 or patient is no longer eligible
,3|Page
This patient meets criteria (quit 10 years ago, within 15 years).
Screening stops at age 80 or if the patient has not smoked for 15 years.
Chest X-ray (D) is NOT recommended for screening.
Clinical Pearl: Shared decision-making is required before initiating
LDCT screening, discussing benefits, limitations, and potential harms
(false positives, overdiagnosis).
Question 3
A 68-year-old male with a history of hypertension and hyperlipidemia
presents for a wellness visit. He has never had colorectal cancer
screening. What is the appropriate recommendation?
A. No screening needed due to age
B. Fecal immunochemical test (FIT) annually
C. Colonoscopy every 10 years
D. Either B or C is acceptable
Answer: D. Either B or C is acceptable
Rationale: USPSTF recommends colorectal cancer screening for
adults aged 45-75. Options include:
• Stool-based tests: FIT annually, guaiac FOBT annually, FIT-DNA
every 1-3 years
• Structural exams: Colonoscopy every 10 years, CT colonography
every 5 years, flexible sigmoidoscopy every 5-10 years
Screening decisions should be individualized for adults aged 76-85
based on health status and prior screening history. This patient has no
prior screening and is healthy, so screening is appropriate.
, 4|Page
Clinical Pearl: Colonoscopy is the gold standard but requires bowel
preparation and has higher risk. Stool-based tests are non-invasive but
require annual adherence.
Question 4
A 48-year-old female with no family history of breast cancer asks about
mammography screening. According to USPSTF guidelines, what is the
appropriate recommendation?
A. Begin screening at age 40 annually
B. Begin screening at age 40 every 2 years
C. Begin screening at age 50 annually
D. Begin screening at age 50 every 2 years
Answer: D. Begin screening at age 50 every 2 years
Rationale: USPSTF breast cancer screening guidelines:
• Age 40-49: Individualized decision
• Age 50-74: Biennial mammography
• Age ≥75: Insufficient evidence
The American Cancer Society recommends annual screening from 45-
54, then biennial from 55 onward. The USPSTF recommends shared
decision-making for ages 40-49. For this 48-year-old with no risk
factors, discussing risks/benefits is appropriate.
Clinical Pearl: High-risk patients (BRCA mutation, strong family
history) require earlier and more frequent screening with MRI.
NRNP 6531: ADVANCED PRACTICE CARE OF
ADULTS ACROSS THE LIFESPAN
Complete Practice Q&A with Verified Detailed
Rationales
High-Yield Exam Review | Graded A+ Content
Updated for 2026-2027 Academic Year
1. HEALTH PROMOTION & SCREENING
Question 1
A 55-year-old African American male with a history of hypertension
presents for an annual physical. According to USPSTF guidelines, which
screening test is most appropriate for this patient?
A. Abdominal aortic aneurysm (AAA) screening with ultrasound
B. Lung cancer screening with low-dose CT
C. Colorectal cancer screening with colonoscopy
D. Prostate cancer screening with PSA
Answer: A. Abdominal aortic aneurysm (AAA) screening with
ultrasound
Rationale: The USPSTF recommends one-time AAA screening with
ultrasound for men aged 65-75 who have ever smoked. However, men
with a family history or other risk factors may be screened earlier. This
,2|Page
patient has hypertension (risk factor) and is African American (higher
risk). Lung cancer screening (B) is recommended for adults aged 50-80
with a 20-pack-year smoking history who currently smoke or quit within
15 years. Colorectal cancer screening (C) begins at age 45. PSA
screening (D) is an individualized decision.
Clinical Pearl: AAA screening is one-time unless new risk factors
develop. Women with no smoking history do not require screening.
Question 2
A 62-year-old female with a 30-pack-year smoking history (quit 10 years
ago) asks about lung cancer screening. Which statement is correct
regarding low-dose CT (LDCT) screening?
A. Screening is recommended for all adults over 50 regardless of
smoking history
B. Screening should continue annually until age 80
C. Screening is indicated if the patient has a 20-pack-year history and
quit within 15 years
D. Chest X-ray is an acceptable alternative to LDCT
Answer: C. Screening is indicated if the patient has a 20-pack-year
history and quit within 15 years
Rationale: USPSTF guidelines for lung cancer screening:
• Age 50-80 years
• 20-pack-year smoking history
• Current smoker or quit within 15 years
• Annual LDCT until age 80 or patient is no longer eligible
,3|Page
This patient meets criteria (quit 10 years ago, within 15 years).
Screening stops at age 80 or if the patient has not smoked for 15 years.
Chest X-ray (D) is NOT recommended for screening.
Clinical Pearl: Shared decision-making is required before initiating
LDCT screening, discussing benefits, limitations, and potential harms
(false positives, overdiagnosis).
Question 3
A 68-year-old male with a history of hypertension and hyperlipidemia
presents for a wellness visit. He has never had colorectal cancer
screening. What is the appropriate recommendation?
A. No screening needed due to age
B. Fecal immunochemical test (FIT) annually
C. Colonoscopy every 10 years
D. Either B or C is acceptable
Answer: D. Either B or C is acceptable
Rationale: USPSTF recommends colorectal cancer screening for
adults aged 45-75. Options include:
• Stool-based tests: FIT annually, guaiac FOBT annually, FIT-DNA
every 1-3 years
• Structural exams: Colonoscopy every 10 years, CT colonography
every 5 years, flexible sigmoidoscopy every 5-10 years
Screening decisions should be individualized for adults aged 76-85
based on health status and prior screening history. This patient has no
prior screening and is healthy, so screening is appropriate.
, 4|Page
Clinical Pearl: Colonoscopy is the gold standard but requires bowel
preparation and has higher risk. Stool-based tests are non-invasive but
require annual adherence.
Question 4
A 48-year-old female with no family history of breast cancer asks about
mammography screening. According to USPSTF guidelines, what is the
appropriate recommendation?
A. Begin screening at age 40 annually
B. Begin screening at age 40 every 2 years
C. Begin screening at age 50 annually
D. Begin screening at age 50 every 2 years
Answer: D. Begin screening at age 50 every 2 years
Rationale: USPSTF breast cancer screening guidelines:
• Age 40-49: Individualized decision
• Age 50-74: Biennial mammography
• Age ≥75: Insufficient evidence
The American Cancer Society recommends annual screening from 45-
54, then biennial from 55 onward. The USPSTF recommends shared
decision-making for ages 40-49. For this 48-year-old with no risk
factors, discussing risks/benefits is appropriate.
Clinical Pearl: High-risk patients (BRCA mutation, strong family
history) require earlier and more frequent screening with MRI.
