# The nurse reviews a preventive-care note for an average-risk adult. Which documented plans require follow-up? Highlight the plans that do not match current colorectal screening guidance.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=564150&lang=en  
> language: en  
> subject: Lifestyle Choices  
> category: HPM

## Question

The nurse reviews a preventive-care note for an average-risk adult. Which documented plans require follow-up? Highlight the plans that do not match current colorectal screening guidance.

Nurses' Notes
1030:
The client is 63 years old and attends a preventive-care visit. The client reports no rectal bleeding, unexplained weight loss, or change in bowel habits. The record shows no inflammatory bowel disease, prior colorectal polyps, or known hereditary cancer syndrome. A normal screening colonoscopy was completed 10 years ago. During shared planning, the client says, I would be comfortable completing a FIT every year. The client adds, if a FIT is positive, I will repeat the FIT next month before deciding about colonoscopy. The nurse reviews the need to complete follow-up after an abnormal stool test. The client says, I could choose colonoscopy every 10 years if each result remains normal. When discussing another stool-based option, the client states, I plan to repeat stool DNA-FIT every 4 years if the result stays negative. The client also says, CT colonography every 5 years is an option I could discuss. After comparing preparation requirements, the client adds, a 7-year interval should be enough if I choose CT colonography. The nurse explains that each accepted strategy has its own interval and follow-up pathway. The client states, I will choose among recommended strategies after discussing benefits, burdens, and follow-up. The client says, I understand that an abnormal stool-based test needs follow-up colonoscopy. The client notes, new rectal bleeding would need diagnostic evaluation rather than waiting for routine screening. The nurse asks about relatives with colorectal cancer and prior abnormal testing. The client responds, my family and personal history should be checked before using the average-risk schedule. The nurse documents the three plans that need clarification before the screening order is placed.

## Explanation

A positive FIT requires colonoscopy, stool DNA-FIT is repeated every 1 to 3 years, and CT colonography every 5 years. The remaining plans match accepted screening or diagnostic pathways.

## In-depth explanation

Quick answer
Highlight the plan to repeat a positive FIT before colonoscopy, the 4-year stool DNA-FIT interval, and the 7-year CT-colonography interval. Each plan is close to a valid pathway but changes the required follow-up or interval.

Why this is correct
For average-risk adults, FIT is performed annually, stool DNA-FIT every 1 to 3 years, CT colonography every 5 years, and screening colonoscopy every 10 years. A positive stool-based screening test requires follow-up colonoscopy to complete the screening process.[1]

Easy analogy or mental picture
Think of each screening method as a route with its own timetable. Choosing a valid route is not enough; the client must also use that route's interval and take the required exit after an abnormal result.

Memory hook
Match the method, interval, and abnormal-result follow-up.

NCLEX decision rule
First confirm that the client is asymptomatic and average risk. Then compare the chosen method, interval, and next step after an abnormal result instead of treating all screening tests as interchangeable.

Why the other choices are wrong
Annual FIT, colonoscopy every 10 years after a normal result, CT colonography every 5 years, informed choice among recommended strategies, colonoscopy after an abnormal stool test, diagnostic evaluation of new bleeding, and risk-history review all fit the stated scenario.References

- [1]USPSTF: Colorectal Cancer Screening—Clinician SummaryU.S. Preventive Services Task Force

- [2]2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing

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