A new breast lump, postmenopausal or abnormal bleeding, rectal bleeding, or unexplained weight loss is reported and worked up promptly.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A nurse at a community wellness fair is teaching adults about colorectal cancer screening. According to standard guidelines, average-risk adults should begin routine screening at what age?
Answer: C. Current guidelines recommend that average-risk adults begin colorectal cancer screening at age 45. Beginning at 30 or 35 is too early for average-risk adults, and waiting until 60 delays detection of a common, screenable cancer.
Question 2 of 5
A client asks when to start mammography screening for breast cancer. The nurse explains that, for average-risk women, screening generally begins around:
Answer: B. For average-risk women, routine mammography commonly begins around age 40–50 (guidelines vary; shared decision-making applies). Earlier or higher-risk clients individualize timing with the provider.
Question 3 of 5
Using current adult clinical guidelines, a clinic nurse reviews a client's averaged readings of 134/82 mmHg. The nurse documents this as which blood pressure category?
Answer: B. A systolic of 130 to 139 or diastolic of 80 to 89 mmHg is classified as Stage 1 hypertension under current ACC/AHA guidelines. Elevated BP is 120 to 129 systolic AND less than 80 diastolic. Normal is below 120/80. Stage 2 is 140/90 or higher.
Question 4 of 5
A client at risk for colorectal cancer asks about screening. Which teaching about screening colonoscopy for average-risk adults is accurate?
Answer: A. Current guidelines recommend average-risk adults begin colorectal cancer screening at age 45, with colonoscopy repeated about every 10 years if results are normal. Screening is not limited only to those with symptoms.
Question 5 of 5
Teaching about safe sun exposure to prevent skin cancer, the nurse includes:
Answer: B. Use broad-spectrum sunscreen (SPF 30+), reapply regularly, avoid peak midday sun, wear protective clothing/hats, and avoid tanning beds. A 'base tan' does not protect skin.
Keep the streak going with more questions like these, each with a full rationale.
What is cancer screening guidelines?
Recommendations are age and risk based for breast, cervical, colorectal, and lung cancer. Earlier and more frequent screening applies with family history or high risk.
Key points to remember
- Breast: mammography is generally recommended every 1-2 years starting around age 40-50.
- Cervical: Pap test every 3 years from age 21-29; Pap plus HPV co-testing every 5 years from age 30-65.
- Colorectal: screening begins at age 45 via colonoscopy (every 10 years) or stool-based tests.
- Lung: low-dose CT is recommended for adults 50-80 with a significant smoking history.
- Prostate screening (PSA) is an individualized shared decision starting around age 50.
- Family history and genetic risk (BRCA, Lynch syndrome) warrant earlier and more frequent screening.
Nursing priorities
- Identify which screenings are due based on the patient's age, sex, and risk factors.
- Educate on screening intervals and the purpose of early detection.
- Prepare and support patients undergoing colonoscopy, mammography, or Pap testing.
- Ensure abnormal or positive results are communicated and followed up promptly.
- Promote modifiable risk reduction: tobacco cessation, sun protection, and HPV vaccination.
Labs & values
Patient teaching
- Know your screening schedule and keep appointments even without symptoms.
- Report warning signs such as a new lump, abnormal bleeding, persistent cough, or changing mole.
Red flags: report now
- A new breast lump, postmenopausal or abnormal bleeding, rectal bleeding, or unexplained weight loss is reported and worked up promptly.
- Abnormal screening results require timely follow-up and must not be lost; ensure the patient is notified.
- A change in a mole (asymmetry, irregular border, color change, growth) is reported for evaluation.
References
Clinical references for this topic
