# The public health nurse reviews lung cancer screening plans. Which plans require follow-up? Highlight the plans that do not match current screening guidance.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=495945&lang=en  
> language: en  
> subject: Lifestyle Choices  
> category: HPM

## Question

The public health nurse reviews lung cancer screening plans. Which plans require follow-up? Highlight the plans that do not match current screening guidance.

| Client profile | Screening plan |
| --- | --- |
| Age 49 | Current smoker with 30 pack-years plans annual low-dose CT now |
| Age 52 | Current smoker with 22 pack-years plans annual low-dose CT |
| Age 55 | Former smoker with 25 pack-years who quit 16 years ago plans CT |
| Age 64 | Former smoker with 40 pack-years who quit 8 years ago plans CT |
| Age 70 | Current smoker with 20 pack-years also accepts cessation counseling |
| Age 79 | Former smoker with 35 pack-years who quit 10 years ago plans CT |
| Age 60 | Current smoker with 28 pack-years plans annual chest radiography |
| Age 80 | Current smoker with 25 pack-years discusses annual low-dose CT through shared decision-making |
| Age 76 | Eligible smoker unable to accept curative treatment plans continued screening |

## Explanation

Screening before age 50, screening after 15 smoke-free years, substituting chest radiography, and continuing when curative treatment cannot be accepted require follow-up. Eligible adults receive annual low-dose CT after shared decision-making.

## In-depth explanation

Quick answer
Highlight the plan at age 49, the former smoker who quit 16 years ago, the plan for chest radiography, and continued screening when curative treatment cannot be accepted. Each misses an eligibility, modality, or stopping criterion.

Why this is correct
USPSTF recommends annual low-dose CT for adults aged 50 through 80 with at least 20 pack-years who currently smoke or quit within 15 years. Screening stops after 15 smoke-free years or when health limits life expectancy or the ability or willingness to undergo curative surgery. Chest radiography is not the recommended screening test.[2]

Easy analogy or mental picture
Think of a screening doorway with four checks: age, smoking exposure, time since quitting, and ability to benefit from treatment. Low-dose CT is the correct doorway, while chest radiography is a different door. The picture organizes criteria but does not replace shared decision-making.

Memory hook
Age and smoking exposure define the screening window: 50 to 80, 20 pack-years, within 15 years, low-dose CT.

NCLEX decision rule
When reviewing lung cancer screening, think benefit requires both high risk and treatment readiness; check age, pack-years, quit date, low-dose CT, and whether curative treatment remains a realistic option.

Why the other choices are wrong
The adults aged 52, 64, 70, 79, and 80 meet the listed age, exposure, and quit-time criteria, and low-dose CT is the intended method. Smoking-cessation support accompanies rather than replaces appropriate screening.References

- [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing

- [2]USPSTF: Lung Cancer Screening RecommendationU.S. Preventive Services Task Force

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