Screenings (cancer, diabetes, lipids) NCLEX-RN Practice Questions

Screenings (cancer, diabetes, lipids) NCLEX-RN Practice Questions strengthen your readiness to counsel, coordinate, and interpret preventive care across the lifespan. In Health Promotion & Maintenance, nurses must know who needs screening, when to begin, how often to repeat, and what follow-up is appropriate after abnormal findings. This set emphasizes evidence-informed recommendations for breast, cervical, colorectal, lung, and prostate cancers, plus diabetes and lipid disorders. You’ll practice selecting client-specific strategies, preparing clients for tests (e.g., mammogram, FIT/FOBT, colonoscopy), and clarifying test limitations. These items mirror real NCLEX-RN complexity: prioritization, risk stratification, interpretation, and client education. Use these to refine clinical judgment and provide safe, equitable, and timely preventive care.

Q1. A 41-year-old woman at average risk asks when to start breast cancer screening. Which nursing recommendation is most appropriate?

• Begin annual screening mammography starting now
• Defer mammography until age 50 and screen every 2 years
• Breast ultrasound annually is sufficient at this age
• Breast MRI screening is recommended for all women starting at age 40

Correct Answer: Begin annual screening mammography starting now

Q2. The nurse provides pre-appointment teaching for a screening mammogram. Which instruction is correct?

• Do not eat or drink after midnight before the test
• Hold metformin for 48 hours prior to the exam
• Schedule the mammogram during heavy menstrual flow
• Avoid deodorants, powders, or lotions under arms/breasts on the day of the exam

Correct Answer: Avoid deodorants, powders, or lotions under arms/breasts on the day of the exam

Q3. A 33-year-old woman with prior normal cervical cytology asks about the best screening plan. Which option is appropriate?

• Cervical cytology alone now and every 3 years if normal
• No cervical screening until age 40 if asymptomatic
• High-risk HPV testing alone every year
• Colposcopy every 5 years regardless of results

Correct Answer: Cervical cytology alone now and every 3 years if normal

Q4. A 22-year-old sexually active woman presents for well-woman care. Which cervical cancer screening plan is recommended?

• Start cytology screening at age 25 and repeat every 5 years
• Start cytology screening now and repeat every 3 years if normal
• HPV test alone annually starting now
• No screening until after first pregnancy

Correct Answer: Start cytology screening now and repeat every 3 years if normal

Q5. A 66-year-old woman has had adequate prior negative screening and no history of CIN2+ in the past 25 years. What should the nurse recommend for cervical cancer screening?

• Continue Pap and HPV co-testing every 5 years
• Discontinue cervical cancer screening
• Switch to annual cytology indefinitely
• HPV genotyping annually

Correct Answer: Discontinue cervical cancer screening

Q6. A 31-year-old has normal cytology but tests positive for HPV-16. What is the best next action?

• Repeat co-testing in 12 months
• Immediate colposcopy
• Defer testing for 3 years
• Start empiric antiviral therapy

Correct Answer: Immediate colposcopy

Q7. A 28-year-old pregnant patient is due for cervical cancer screening. What should the nurse do?

• Defer Pap until 6 weeks postpartum
• Perform cervical cytology during the prenatal visit
• Obtain endometrial biopsy instead of Pap
• Schedule HPV testing only

Correct Answer: Perform cervical cytology during the prenatal visit

Q8. A 52-year-old at average risk asks about colorectal cancer screening. Which is an appropriate option?

• Annual FIT (fecal immunochemical test)
• CT colonography annually
• Colonoscopy every 20 years
• Stool guaiac testing every 10 years

Correct Answer: Annual FIT (fecal immunochemical test)

Q9. A patient’s FIT result is positive. What is the priority next step?

• Repeat FIT in 6 months
• Schedule diagnostic colonoscopy
• Order abdominal ultrasound
• Begin empiric iron supplementation

Correct Answer: Schedule diagnostic colonoscopy

Q10. A 42-year-old has a first-degree relative diagnosed with colorectal cancer at 48. What screening plan is best?

• Start colonoscopy at age 50 and repeat every 10 years
• Begin colonoscopy now and repeat every 5 years
• Annual stool DNA testing only
• Sigmoidoscopy every 10 years

Correct Answer: Begin colonoscopy now and repeat every 5 years

Q11. The nurse teaches colonoscopy preparation for tomorrow morning. Which instruction is most accurate?

• Eat a high-fiber dinner the evening before
• Use a split-dose polyethylene glycol bowel prep and clear liquids the day before
• Start iron supplementation to prevent anemia from bowel prep
• Take loperamide the night before to reduce cramping

Correct Answer: Use a split-dose polyethylene glycol bowel prep and clear liquids the day before

Q12. A patient is preparing for a guaiac-based FOBT. Which statement shows correct understanding?

• “I should avoid red meat and high-dose vitamin C for 3 days before testing.”
• “I can take NSAIDs up to the morning of the test.”
• “I must fast for 12 hours before sample collection.”
• “I will collect a single sample from one bowel movement.”

Correct Answer: “I should avoid red meat and high-dose vitamin C for 3 days before testing.”

Q13. The nurse teaches a client to use an FIT kit at home. Which instruction is correct?

• Collect samples from three separate stools and freeze them
• Collect a single sample using the provided device and avoid urine or toilet water contamination
• Stop all fruits and vegetables for 5 days before sampling
• Add bleach to the toilet to preserve the sample

Correct Answer: Collect a single sample using the provided device and avoid urine or toilet water contamination

Q14. A 58-year-old with a 25 pack-year history quit 10 years ago. What lung cancer screening is indicated?

• No screening; quitting eliminates risk
• Annual low-dose CT scan of the chest
• Annual chest X-ray
• Sputum cytology every 6 months

Correct Answer: Annual low-dose CT scan of the chest

Q15. A 45-year-old current smoker with a 15 pack-year history asks about lung cancer screening. Best response?

• Recommend annual LDCT based on smoking alone
• He does not meet pack-year criteria; focus on smoking cessation and risk reduction
• Order annual chest X-ray for screening
• Schedule LDCT every 5 years

Correct Answer: He does not meet pack-year criteria; focus on smoking cessation and risk reduction

Q16. A 37-year-old with BMI 31 kg/m² has no symptoms. What should the nurse recommend for diabetes screening?

• Defer screening until age 45
• Obtain HbA1c or fasting plasma glucose now
• Random glucose only if symptomatic
• Oral glucose tolerance test only at age 50

Correct Answer: Obtain HbA1c or fasting plasma glucose now

Q17. A 27-year-old with BMI 29 kg/m² and polycystic ovary syndrome presents for preventive care. Best diabetes screening approach?

• Screen now due to risk factors
• Wait until age 35
• Wait until postpartum
• Screen only if HbA1c exceeds 6.5%

Correct Answer: Screen now due to risk factors

Q18. A client had prediabetes (A1c 5.8%) identified last year. When should the nurse plan to repeat testing?

• Every 5 years
• Annually
• Only if symptoms develop
• Every 6 months for life

Correct Answer: Annually

Q19. An asymptomatic adult had normal diabetes screening today. When should rescreening occur if risk remains low?

• Every 3 years
• Every 6 months
• Only after age 60
• Monthly capillary glucose monitoring

Correct Answer: Every 3 years

Q20. A patient with recent gestational diabetes delivered a healthy infant. What postpartum diabetes testing should the nurse plan?

• HbA1c at 6 months postpartum only
• 75-g 2-hour oral glucose tolerance test at 4–12 weeks postpartum
• Fasting plasma glucose immediately after delivery
• No testing is needed if asymptomatic

Correct Answer: 75-g 2-hour oral glucose tolerance test at 4–12 weeks postpartum

Q21. A 48-year-old woman with hypertension and no prior lipid testing presents for care. What is the appropriate action?

• Defer lipid testing until age 65
• Order a lipid panel now for risk assessment
• Order triglycerides only
• No screening because she is asymptomatic

Correct Answer: Order a lipid panel now for risk assessment

Q22. A client asks if fasting is required for a routine screening lipid panel. Best response?

• Fasting is always required for any lipid test
• Nonfasting testing is acceptable; fasting may be needed if triglycerides are elevated
• Only water restriction is required
• Fasting is unnecessary and never used

Correct Answer: Nonfasting testing is acceptable; fasting may be needed if triglycerides are elevated

Q23. A nonfasting lipid panel shows triglycerides of 410 mg/dL. What should the nurse anticipate?

• Start omega-3s and recheck in 1 year without further testing
• Repeat a fasting lipid panel to confirm and further evaluate
• No further action is needed
• Order HDL only

Correct Answer: Repeat a fasting lipid panel to confirm and further evaluate

Q24. A 59-year-old African American man with no urinary symptoms asks about prostate cancer screening. What is the best nursing action?

• Order PSA screening without discussion
• Discuss benefits and harms of PSA screening and engage in shared decision-making
• Perform annual digital rectal exam only
• Advise against any screening before age 70

Correct Answer: Discuss benefits and harms of PSA screening and engage in shared decision-making

Q25. A 28-year-old with numerous nevi asks for routine whole-body skin cancer screening. The nurse’s best response is:

• Recommend annual whole-body CT
• Teach sun protection and skin self-exam; refer if lesions change or risk is high
• Order serum melanoma markers
• Advise monthly dermatologic biopsies

Correct Answer: Teach sun protection and skin self-exam; refer if lesions change or risk is high

Q26. A healthy 44-year-old at average risk asks about colorectal cancer screening. What should the nurse recommend?

• Begin screening at age 45
• Begin screening now at age 44
• No screening is needed if asymptomatic
• Only genetic testing is necessary

Correct Answer: Begin screening at age 45

Q27. A 32-year-old woman with a BRCA1 mutation asks about breast cancer screening. Best plan?

• Begin annual mammography at 50 only
• Annual breast MRI plus mammography starting now
• Ultrasound only every 2 years
• No screening until symptoms develop

Correct Answer: Annual breast MRI plus mammography starting now

Q28. A 35-year-old had a total hysterectomy for benign fibroids and no history of CIN2+. What is the recommendation for cervical cancer screening?

• Continue Pap every 3 years
• HPV testing annually
• Discontinue cervical cancer screening
• Colposcopy every 5 years

Correct Answer: Discontinue cervical cancer screening

Q29. A 31-year-old’s Pap shows ASC-US with positive high-risk HPV. What is the best next step?

• Repeat co-testing in 3 years
• Immediate colposcopy
• No follow-up needed if asymptomatic
• Start HPV vaccination as sole management

Correct Answer: Immediate colposcopy

Q30. A 22-year-old with type 1 diabetes since age 12 presents for preventive care. What is the appropriate lipid screening plan?

• Defer lipids until age 40
• Obtain a lipid panel now and repeat periodically
• Triglycerides only if BMI is over 30
• No lipid testing is required in type 1 diabetes

Correct Answer: Obtain a lipid panel now and repeat periodically

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