# Drag each preventive-care plan to the appropriate screening category for an asymptomatic, average-risk adult. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=568377&lang=en > language: en > subject: Health Screening > category: HPM ## Question Drag each preventive-care plan to the appropriate screening category for an asymptomatic, average-risk adult. **1.** 45-year-old woman: biennial screening mammography Select a category Routinely recommended Not routinely recommended Selective individualized decision **2.** 28-year-old woman: cervical cytology every 3 years Select a category Routinely recommended Not routinely recommended Selective individualized decision **3.** 55-year-old man with 30 pack-year smoking history who currently smokes: annual low-dose CT Select a category Routinely recommended Not routinely recommended Selective individualized decision **4.** 78-year-old man: colorectal cancer screening based on health status and prior screening history Select a category Routinely recommended Not routinely recommended Selective individualized decision **5.** 85-year-old woman: continue colorectal cancer screening regardless of health or prior screening Select a category Routinely recommended Not routinely recommended Selective individualized decision **6.** 60-year-old man with 20 pack-year smoking history who quit 8 years ago: annual low-dose CT Select a category Routinely recommended Not routinely recommended Selective individualized decision ## Explanation Average-risk colorectal cancer screening is routinely recommended from ages 45 through 75; ages 76 through 85 require selective individual decisions. Biennial mammography is recommended from ages 40 through 74. Annual low-dose CT applies from ages 50 through 80 with at least 20 pack-years and current smoking or quitting within 15 years. Cervical cytology every 3 years remains an accepted plan for ages 21 through 29. ## In-depth explanation Quick answer The correct categorization reflects current USPSTF guidance for average-risk adults. Routine recommendations include biennial mammography for ages 40–74, cervical cytology every 3 years for ages 21–29, and annual low-dose CT for ages 50–80 with ≥20 pack-years and current smoking or quitting within 15 years. Selective individualized decisions apply to colorectal cancer screening for ages 76–85. Not routinely recommended includes continuing colorectal screening at age 85 regardless of health or prior screening history. Low-dose CT for a 60-year-old with 20 pack-years who quit 8 years ago is routinely recommended because the client quit within 15 years. Why this is correct USPSTF guidelines define age ranges and risk thresholds for routine screening. For colorectal cancer, routine screening is ages 45–75; ages 76–85 require individual assessment of health and screening history. For breast cancer, biennial mammography is recommended for ages 40–74. For lung cancer, annual low-dose CT is recommended for ages 50–80 with ≥20 pack-years and current smoking or quitting within 15 years. For cervical cancer, cytology every 3 years is recommended for ages 21–29. Clinical picture Nurses must apply age- and risk-specific screening guidelines to individual clients. Misclassifying a selective decision as routine or not recommended can lead to over- or under-screening. For example, a 60-year-old with 20 pack-years who quit 8 years ago is within the 15-year quit window and therefore meets the smoking-history criterion for routine annual low-dose CT. Memory hook Remember the USPSTF age ranges: colorectal 45–75 routine, 76–85 selective; breast 40–74 biennial; lung 50–80 with ≥20 pack-years and quit ≤15 years; cervical cytology 21–29 every 3 years. NCLEX decision rule Categorize each plan based on the client's age, risk factors, and the specific USPSTF recommendation. If the client falls outside the routine age range or risk threshold, classify as selective or not routinely recommended. Why the alternatives are wrong A plan may be selective if the client is in an age range where individual health status and screening history matter (e.g., colorectal 76–85). A plan is not routinely recommended if the client is outside the recommended age range or fails a required risk criterion (e.g., quit smoking >15 years ago). Sources 1NCSBN 2026 NCLEX-RN Test Plan 2USPSTF colorectal cancer screening 3USPSTF breast cancer screening 4USPSTF lung cancer screening 5USPSTF cervical cancer screening ## Clinical scenario Adult preventive screening triage Assume each client is asymptomatic and average risk unless a smoking history is stated. Use current U.S. preventive guidance. Determine whether the plan is a routine recommendation, a selective individualized decision, or not routinely recommended as stated. ## Key concepts - **Routine recommendation** — A preventive service recommended for all individuals in a defined age and risk group without requiring individual decision-making. - **Selective individualized decision** — A preventive service where the decision depends on the individual's health status, screening history, and preferences, often for age ranges where benefits and harms are closely balanced. - **Not routinely recommended** — A preventive service that is not recommended for the general population in that age or risk group, either because the client is outside the recommended age range or fails a required risk criterion. ## Related questions - [A 76-year-old client visits the primary care clinic for an annual wellness exam. 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Always follow current clinical guidelines and your institution’s protocols._