# A nurse in a primary care clinic reviews preventive screening recommendations for a 58-year-old man with a 30 pack-year smoking history who currently smokes and has no symptoms. The client's blood pressure is 148/92 mm Hg on initial measurement. Which actions align with current USPSTF recommendations? Select all that apply. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=558417&lang=en > language: en > subject: Health Screening > category: HPM ## Question A nurse in a primary care clinic reviews preventive screening recommendations for a 58-year-old man with a 30 pack-year smoking history who currently smokes and has no symptoms. The client's blood pressure is 148/92 mm Hg on initial measurement. Which actions align with current USPSTF recommendations? Select all that apply. 1 Offer colorectal cancer screening with an accepted strategy such as annual fecal immunochemical testing. 2 Refer for annual low-dose computed tomography of the chest for lung cancer screening. 3 Diagnose hypertension based on this single elevated reading and initiate antihypertensive therapy. 4 Confirm the elevated blood pressure with out-of-office measurements before diagnosing hypertension. 5 Order a screening chest radiograph to evaluate for lung cancer because of the smoking history. 6 Recommend osteoporosis screening with bone mineral density testing based on age and sex. ## Explanation USPSTF recommendations are specific to age, risk factors, and screening modality. Colorectal cancer screening begins at age 45 for average-risk adults, and annual fecal immunochemical testing is an accepted method. Lung cancer screening with annual low-dose computed tomography is recommended for adults aged 50 to 80 years with a 30 pack-year smoking history who currently smoke or quit within the past 15 years. A single elevated office blood pressure reading is not diagnostic; confirmation with out-of-office measurements is required before diagnosing hypertension. Chest radiography is not recommended for lung cancer screening. Osteoporosis screening is not routinely recommended for men at this age. ## In-depth explanation Correct Answer Choices 1, 2, 4 Clinical Reasoning USPSTF recommendations are specific to age, risk factors, and screening modality. Colorectal cancer screening begins at age 45 for average-risk adults, and annual fecal immunochemical testing is an accepted method. Lung cancer screening with annual low-dose computed tomography is recommended for adults aged 50 to 80 years with a 30 pack-year smoking history who currently smoke or quit within the past 15 years. A single elevated office blood pressure reading is not diagnostic; confirmation with out-of-office measurements is required before diagnosing hypertension. Chest radiography is not recommended for lung cancer screening. Osteoporosis screening is not routinely recommended for men at this age. Option Review - Correct — Colorectal cancer screening is recommended for average-risk adults starting at age 45, and annual fecal immunochemical testing is an accepted strategy. - Correct — Annual low-dose computed tomography is recommended for adults aged 50 to 80 years with a 30 pack-year smoking history who currently smoke or quit within the past 15 years. - Incorrect — A single elevated office reading is insufficient to diagnose hypertension; confirmation with out-of-office measurements is required before initiating treatment. - Correct — Out-of-office confirmation with ambulatory or home blood pressure monitoring is recommended to confirm hypertension before diagnosis. - Incorrect — Chest radiography is not recommended for lung cancer screening; low-dose computed tomography is the recommended modality. - Incorrect — Osteoporosis screening is not routinely recommended for men at this age; it is recommended for women aged 65 and older and for younger women at increased risk. Sources 12026 NCLEX-RN Test Plan 2USPSTF: Colorectal Cancer Screening 3USPSTF: Hypertension in Adults Screening 4USPSTF: Lung Cancer Screening 5USPSTF: Osteoporosis Screening ## Clinical scenario A nurse in a primary care clinic reviews preventive screening recommendations for a 58-year-old client with a 30 pack-year smoking history who currently smokes and has no symptoms. The client's blood pressure is 148/92 mm Hg on initial measurement. ## Related questions - [A 76-year-old client visits the primary care clinic for an annual wellness exam. The clien…](https://mymerci.kr/pages/nclex_q.php?qn_id=363451&lang=en) - [A 50-year-old male presents for a routine physical exam. He has no personal or family hist…](https://mymerci.kr/pages/nclex_q.php?qn_id=372688&lang=en) - [Review the colorectal cancer screening timeline and determine the next step after an abnor…](https://mymerci.kr/pages/nclex_q.php?qn_id=393511&lang=en) - [An occupational-health nurse is reviewing tuberculosis screening for U.S. health care pers…](https://mymerci.kr/pages/nclex_q.php?qn_id=396192&lang=en) - [A 46-year-old client with average colorectal cancer risk has no symptoms and no family his…](https://mymerci.kr/pages/nclex_q.php?qn_id=497748&lang=en) - [A woman older than 65 has never been screened for osteoporosis and has no history of a fra…](https://mymerci.kr/pages/nclex_q.php?qn_id=497908&lang=en) - [An adult without diagnosed hypertension has elevated blood pressure at two routine clinic …](https://mymerci.kr/pages/nclex_q.php?qn_id=497909&lang=en) - [An asymptomatic, nonpregnant 46-year-old client has overweight and has never been screened…](https://mymerci.kr/pages/nclex_q.php?qn_id=498094&lang=en) ## Read in another language - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=558417&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=558417&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=558417&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=558417&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=558417&lang=vi) --- More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en) _For study reference only. Always follow current clinical guidelines and your institution’s protocols._