Facts read from aanpcert.org and 2 more · last checked Nov 7, 2026
Every screening question turns on two things: whether the person in front of you is a screening candidate at all, and which test and interval the current recommendation names. Everything here applies to adults without symptoms; symptoms move a patient to diagnostic workup.
Practice questions
60 questions written to the FNP-C outline; each choice is explained once you pick.
Cancer: colorectal, breast, cervical, lung, and prostate as a shared decision.
Cardiometabolic: blood pressure, statins for primary prevention, prediabetes and diabetes, abdominal aortic aneurysm.
Infections: HIV, hepatitis B and C, sexually transmitted infections.
Bone and falls: osteoporosis screening, fall prevention in older adults.
Vaccines: zoster, pneumococcal, influenza, Tdap, HPV, hepatitis B.
Behavior: tobacco cessation, including combination nicotine replacement.
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14 adult screening and prevention questions
0 / 14 answered14 questions
Tap an option: why each one is right or wrong appears under it.
Adult screening and prevention
A 68-year-old man who smoked one pack daily for 30 years before quitting presents for preventive care and has never been screened for an abdominal aortic aneurysm. Which one-time screening test is recommended?
USPSTF recommends a one-time abdominal aortic ultrasound for men aged 65 to 75 who have ever smoked; it is accurate, safe, and inexpensive.
A plain radiograph detects an aneurysm only if the wall is calcified and cannot measure it reliably.
The ABI screens for peripheral artery disease, not aortic aneurysm.
CT angiography is used for surgical planning or a symptomatic aneurysm, not for screening, because of radiation and contrast.
A 35-year-old transgender man has taken testosterone for 6 years and has not had gender-affirming pelvic surgery. His last cervical cytology was 5 years ago and was normal. What is the most appropriate recommendation for cervical cancer screening?
Testosterone does not change the screening interval, although atrophy can make cytology harder to read.
Cervical cancer screening is done without symptoms; waiting for symptoms defeats it.
Testosterone does not remove cervical cancer risk; anyone with a cervix needs screening.
A transgender man with a cervix follows the same age-based schedule as cisgender women (USPSTF), with HPV-based testing an option when cytology is hard to obtain.
An 82-year-old community-dwelling man has fallen twice in the past year. He takes lisinopril and atorvastatin, has no orthostatic hypotension, and had his vision corrected last month. His 25-hydroxyvitamin D level is normal. According to USPSTF, which intervention is most appropriate to prevent further falls?
Hip protectors may reduce hip fractures in nursing homes, but they do not prevent falls, and adherence is poor.
USPSTF recommends exercise interventions for community-dwelling adults 65 or older at increased fall risk; strength and balance training lowers falls.
USPSTF recommends against vitamin D to prevent falls in community-dwelling older adults who are not deficient.
Bisphosphonates reduce fracture risk in osteoporosis but do not prevent falls.
A 58-year-old man who currently smokes and has a 30 pack-year history presents for preventive care and feels well. Which screening test is most appropriate to offer him?
Chest radiographs do not lower lung cancer mortality and are not recommended for screening.
Adults 50 to 80 with 20 or more pack-years who smoke now or quit within 15 years should be offered annual low-dose CT (USPSTF 2021).
Sputum cytology has poor sensitivity and is not a screening test.
Screening is meant for people without symptoms; feeling well is the reason to screen, not a reason to skip it.
A 72-year-old woman with type 2 diabetes, COPD, and history of Guillain-Barré syndrome 15 years ago expresses concern about receiving the influenza vaccine. She states, "I've heard the flu shot can cause Guillain-Barré syndrome again, and with my lung problems, I don't know if it's safe." Which of the following responses best applies evidence-based risk communication?
Dismissing her worry as outdated ends the conversation without the numbers she needs to decide, and patients who feel dismissed often decline.
GBS 15 years ago that was not linked to a vaccine is not a reason for specialist clearance; the precaution applies to GBS within 6 weeks of a previous influenza vaccine (CDC).
Giving the absolute risk of vaccine-associated GBS (about 1 to 2 per million doses) next to her higher influenza risk from diabetes and COPD addresses her concern with numbers.
With diabetes and COPD, influenza is a serious risk for her; the benefit of vaccination clearly outweighs a rare vaccine risk.
A 45-year-old man with no symptoms asks for an ECG at his annual visit because a coworker had a heart attack. He does not smoke, his BP is 118/76 mm Hg, his lipids and glucose are normal, and his estimated 10-year cardiovascular risk is under 5%. Which recommendation follows USPSTF guidance?
Calcium scoring is used to refine statin decisions at borderline or intermediate risk, not for a low-risk adult with normal lipids.
USPSTF recommends against screening ECGs in adults at low cardiovascular risk without symptoms (D); a low pretest probability means false positives lead to more testing without benefit, so the visit focuses on risk-factor counseling.
Stress testing is for symptoms suggestive of ischemia; in a low-risk adult without symptoms a positive result is usually a false positive.
A resting ECG in a low-risk adult without symptoms rarely changes management and mostly produces nonspecific findings that prompt further tests.
A 52-year-old woman is due for colorectal cancer screening per guidelines. During the visit, she mentions difficulty affording co-pays and reports unreliable transportation, stating she missed her last two specialist appointments. Which action best addresses social determinants of health while maintaining guideline-based screening?
Deferring screening delays cancer detection with no guarantee that her situation will change.
A list of resources helps, but it does not get her screened at this visit.
Colonoscopy is a valid test, but referring her for it ignores the transport and cost barriers that made her miss specialist visits.
A home FIT keeps her on a guideline-based screening path without travel, and documenting the barriers with a link to resources addresses the social needs.
A 28-year-old patient with history of injection drug use presents reporting recent unprotected sexual encounters with multiple partners. They request 'full STI screening.' Vital signs are normal. Physical exam shows track marks on forearms but no acute findings. Which testing strategy is most appropriate?
An HIV test and counseling are part of the visit, but injection drug use and multiple partners also call for syphilis, gonorrhea and chlamydia NAAT, and hepatitis B and C testing.
Routine HSV serology and HPV testing of exposed sites are not recommended for screening people without symptoms (CDC STI 2021), and this plan leaves out HIV, syphilis, GC/CT, and hepatitis testing.
For a person who injects drugs and has multiple sexual partners, CDC recommends HIV, syphilis, gonorrhea and chlamydia NAAT at exposed sites, and hepatitis B and C testing.
Injection drug use is itself an indication for hepatitis B and C testing; no documented exposure is needed.
A 48-year-old man smokes 25 cigarettes a day and lights his first cigarette within 10 minutes of waking. Two earlier attempts with a 14-mg patch alone failed. He now chooses combination nicotine replacement. Which regimen is most appropriate?
More than 10 cigarettes a day calls for the 21-mg patch, and smoking within 30 minutes of waking calls for the 4-mg strength of the short-acting form.
A 7-mg patch is a tapering step, far below his nicotine dependence.
A 14-mg patch underdoses someone who smokes 25 a day, and it already failed twice; the 2-mg gum is the strength for light dependence.
He chose combination therapy; the short-acting form is what treats breakthrough cravings, and two full patches without it skip that.
A 42-year-old woman with no personal or family history of breast cancer, no known genetic mutation, and no chest radiation asks when she should start screening mammography. Which recommendation follows USPSTF guidance?
USPSTF (2024) recommends biennial screening mammography for women aged 40 to 74 at average risk, so screening starts now and repeats every 2 years.
Starting at 50 ignores the 2024 update that lowered the start age to 40, and USPSTF uses a 2-year interval, not yearly.
MRI screening is for high-risk women, such as BRCA carriers or those with a lifetime risk of 20% or more, not for average risk.
Age 50 was the start age in the 2016 USPSTF statement; the 2024 statement starts at 40.
A 67-year-old woman has never been screened for osteoporosis. She has no fractures, takes no glucocorticoids, and feels well. Which recommendation follows USPSTF guidance?
Drug treatment is decided by DXA results or fracture risk; starting a bisphosphonate without testing exposes her to adverse effects without a diagnosis.
Heel ultrasound can estimate risk, but DXA of the hip and spine is the test used to diagnose osteoporosis and guide treatment, and yearly testing is not recommended.
Waiting for a fracture defeats screening; the point is to treat before the first fracture.
USPSTF (2025) recommends screening for osteoporosis with bone density testing in all women 65 or older, and in younger postmenopausal women at increased risk.
A 39-year-old man with a BMI of 31 kg/m² has a wellness visit. He has no symptoms, his blood pressure is normal, and he has never been tested for diabetes. Which recommendation follows USPSTF guidance?
USPSTF (2021) recommends screening adults 35 to 70 who have overweight or obesity for prediabetes and type 2 diabetes, so he should be tested now.
An OGTT is a valid test, but yearly testing is not recommended; after a normal result the interval is about 3 years.
Age 45 was the older threshold; the 2021 USPSTF statement lowered the start age to 35 for adults with overweight or obesity.
Urine glucose appears only when blood glucose exceeds the renal threshold, so a dipstick misses prediabetes and early diabetes and is not a screening test.
A 58-year-old woman has hypertension that is controlled on medication. She does not smoke and has no diabetes or cardiovascular disease. Her LDL cholesterol is 138 mg/dL, and her 10-year cardiovascular risk is estimated at 11%. Which recommendation follows USPSTF guidance?
An LDL of 190 or higher is a separate indication for statins regardless of risk; it is not the threshold for primary prevention by risk.
USPSTF (2022) recommends a statin for primary prevention in adults 40 to 75 with at least one risk factor (here hypertension) and a 10-year risk of 10% or more.
Lifestyle change is part of the plan, but at an 11% 10-year risk with hypertension she meets the USPSTF threshold, and withholding the statin leaves that risk untreated.
Niacin does not reduce cardiovascular events in statin-era trials and has troublesome adverse effects.
A 62-year-old man had shingles 3 years ago and received the live zoster vaccine (Zostavax) at age 60. He is healthy and asks whether he needs another shingles vaccine. Which recommendation follows the CDC adult immunization schedule?
Shingles can recur, so a past episode is not a reason to skip vaccination.
A single recombinant dose leaves the series incomplete; two doses 2 to 6 months apart are needed for durable protection.
Recombinant zoster vaccine (Shingrix), 2 doses 2 to 6 months apart, is recommended for adults 50 or older, including those who had shingles or received the live vaccine (at least 8 weeks after it).
The live zoster vaccine is no longer available in the United States (since 2020), and it was less effective than the recombinant vaccine.
A running total sits here; it fills in after your last pick.
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What a USPSTF grade asks you to do
A or B: offer or provide the service. Most private insurance must cover A and B services with no cost sharing (Affordable Care Act).
C: offer it selectively, by the patient's circumstances and preferences.
D: recommend against it; harms outweigh benefits.
I: the evidence is insufficient to weigh benefit against harm.
USPSTF writes for people at average risk without symptoms. Hereditary syndromes such as BRCA or Lynch follow other rules, covered on AOCNP cancer continuum.
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Ages and intervals that trip candidates
Colorectal cancer from 45. Ages 45 to 49 became a grade B in 2021, 50 to 75 is grade A, and 76 to 85 is selective. A positive stool test is followed by colonoscopy, not another stool test (USPSTF 2021).
Cervical screening by age band. Cytology every 3 years from 21 to 29; from 30 to 65, high-risk HPV testing every 5 years, co-testing every 5, or cytology every 3; none before 21, and none after 65 with adequate negative prior screening (USPSTF 2018). A December 2024 draft would make primary HPV testing every 5 years, self-collected samples allowed, the preferred test from 30 to 65; the 2018 statement stays in force until it is finalized (checked Nov 2026).
Hepatitis C once, 18 to 79 (USPSTF 2020), and HIV from 15 to 65, younger or older with risk (USPSTF 2019).
Hepatitis B: USPSTF 2020 screens adults at increased risk, while CDC since 2023 recommends testing every adult at least once with a three-test panel.
PSA: an individual decision from 55 to 69 (grade C) and not recommended from 70 (grade D) (USPSTF 2018).
Aspirin for primary prevention: not started at 60 or older; an individual decision from 40 to 59 when 10-year cardiovascular risk reaches 10% (USPSTF 2022).
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Vaccine schedules change faster than screening
ACIP and CDC schedules changed repeatedly between 2024 and 2026: adult pneumococcal and RSV recommendations, and in January 2026 a revision of the childhood schedule that also touched HPV. Study vaccine items from the CDC adult schedule carrying the current date, not from a table in a review book.
Does the FNP-C follow USPSTF or specialty society screening ages?
NPCB does not name the source of its items. This page uses USPSTF, the reference most primary-care guidance is built on; when a stem names another guideline, answer by that one.