# A nurse is providing healthy-aging counseling to a 68-year-old at a wellness visit. Which recommendations align with current USPSTF and CDC guidelines for older adults? Select all that apply.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=374200&lang=en  
> language: en  
> subject: Health Promotion and Maintenance  
> category: HPM

## Question

A nurse is providing healthy-aging counseling to a 68-year-old at a wellness visit. Which recommendations align with current USPSTF and CDC guidelines for older adults? Select all that apply.

1

Continue colorectal cancer screening at recommended intervals through age 75 routinely; ages 76-85 individualize based on health and prior screening.

2

Optimize bone health with adequate calcium and vitamin D, weight-bearing exercise, and DEXA scan screening per USPSTF guidance for postmenopausal women and at-risk men.

3

Discontinue routine colorectal cancer screening after age 65 because the harms of colonoscopy, such as perforation and bleeding, outweigh benefits in older adults.

4

Continue routine breast cancer screening with mammography every 2 years through age 74 (USPSTF), then discuss benefits and harms beyond age 75.

5

Aim for at least 150 minutes per week of moderate-intensity aerobic activity plus muscle-strengthening at least 2 days per week, AND balance training (such as tai chi) to reduce fall risk.

## Explanation

Healthy aging recommendations: 150+ min/week aerobic + strength + balance training (balance is critical for fall prevention), continued breast cancer screening through 74 (USPSTF), continued CRC screening through 75 routinely, bone health (Ca, vitamin D, weight-bearing, DEXA). Choice 3 is wrong — preventive screening continues into older age and is highly effective; the question shifts to individualizing benefits vs harms beyond 75-85, NOT stopping at 65.

## In-depth explanation

Two highest-yield older-adult healthy-aging traps: (1) "stop screening at 65" — wrong, screenings continue and individualize, not stop; (2) "exercise is too risky for older adults" — wrong, balance and resistance training reduce falls and disability. CDC STEADI initiative also focuses on annual fall risk screening.

## Clinical scenario

**68-year-old at routine wellness visit**, generally healthy with controlled hypertension. The nurse provides **USPSTF and CDC healthy-aging counseling** on physical activity, screening, and falls prevention.

## Key concepts

- **USPSTF older-adult screening** — Mammogram through 74, CRC through 75 routinely, individualize 76-85 based on health and prior screening.
- **Balance training for falls** — Tai chi, yoga, or progressive balance exercises reduce fall risk by 20-30% in community-dwelling older adults.
- **Bone health bundle** — Adequate calcium, vitamin D, weight-bearing exercise, DEXA per USPSTF, fall prevention.

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