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4.6 Health Screening Guidelines

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NCLEX-RN Registered Nurse

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1 Introduction

About the NCLEX-RN Exam Next Generation NCLEX (NGN) Clinical Judgment Measurement Model (NCJMM) How to Use This Course

2 Chapter 2: Management of Care

2.1 Legal Rights and Responsibilities 2.2 Advance Directives and Self-Determination 2.3 Informed Consent Protocols 2.4 Client Advocacy and Rights (HIPAA) 2.5 Assignment, Delegation, and Supervision 2.6 Five Rights of Delegation 2.7 Scope of Practice (RN vs LPN vs UAP) 2.8 Ethical Practice Principles

3 Chapter 3: Safety and Infection Prevention and Control

3.1 Standard Precautions and Hand Hygiene 3.2 Transmission-Based Precautions (Contact, Droplet, Airborne) 3.3 PPE Donning and Doffing Sequences 3.4 Fall Prevention and Restraints 3.5 Fire Safety (RACE/PASS) 3.6 Disaster Triage and Emergency Response

4 Chapter 4: Health Promotion and Maintenance

4.1 Growth and Development (Erikson/Piaget) 4.2 Developmental Stages: Infancy through Older Adult 4.3 Maternal and Newborn Care (Antepartum) 4.4 Intrapartum Care and Fetal Monitoring 4.5 Postpartum Care (BUBBLE-HE) 4.6 Health Screening Guidelines 4.7 Immunization Schedules

5 Chapter 5: Psychosocial Integrity

5.1 Therapeutic Communication Techniques 5.2 Non-Therapeutic Communication (What to Avoid) 5.3 Anxiety Disorders and Mental Health Concepts 5.4 Schizophrenia: Hallucinations and Delusions 5.5 Depression and Suicide Assessment 5.6 Substance Misuse and Withdrawal 5.7 Grief and End-of-Life Care

6 Chapter 6: Basic Care and Comfort

6.1 Mobility and Hazards of Immobility 6.2 Assistive Devices (Crutches, Canes, Walkers) 6.3 Nutrition and Diet Therapy 6.4 Enteral Nutrition (Tube Feeding) 6.5 Bowel Elimination and Ostomy Care 6.6 Urinary Elimination and Catheter Care

7 Chapter 7: Pharmacological and Parenteral Therapies

7.1 Medication Administration Rights 7.2 Medication Calculations 7.3 High-Alert Medications: Insulins 7.4 High-Alert Medications: Anticoagulants 7.5 High-Alert Medications: Opioids 7.6 High-Alert Medications: Digoxin and Electrolytes 7.7 IV Therapy and Complications 7.8 Blood Product Administration 7.9 Total Parenteral Nutrition (TPN)

8 Chapter 8: Reduction of Risk Potential

8.1 Laboratory Values: Hematology (CBC) 8.2 Laboratory Values: Metabolic Panel (BMP) 8.3 Laboratory Values: Coagulation Studies 8.4 Vital Signs and Trend Recognition 8.5 Perioperative Care (Pre-Op and Post-Op) 8.6 Nasogastric Tubes and Therapeutic Procedures

9 Chapter 9: Physiological Adaptation

9.1 Fluid Imbalances (Hypovolemia and Hypervolemia) 9.2 Arterial Blood Gases (ABGs) and Acid-Base Balance 9.3 Medical Emergencies: Stroke (CVA) 9.4 Medical Emergencies: Myocardial Infarction (MONA) 9.5 Diabetic Emergencies (Hypoglycemia and DKA) 9.6 Respiratory Conditions (COPD, Pneumonia) 9.7 Cardiac Conditions (Heart Failure) 9.8 Neurological Conditions (Seizures)

4.6 Health Screening Guidelines

Key Takeaways Explain This Topic AI

Breast cancer screening: Mammograms start at age 40 (may begin at 50 depending on guidelines), performed annually or biannually based on risk assessment

Cervical cancer screening: Pap smears begin at age 21; every 3 years (21-29), every 5 years with HPV co-testing (30-65), or every 3 years without HPV testing

Colorectal cancer screening: Colonoscopy or alternative begins at age 45; if normal, colonoscopy repeated every 10 years; annual stool tests are an alternative

Blood pressure screening should occur at every healthcare visit for all adults; hypertension threshold is 130/80 mmHg or higher

Lipid screening begins at age 20 for average-risk adults, earlier if risk factors present; fasting lipid panel every 4-6 years

Last updated: January 2026

Health Screening Overview

Health screening detects disease before symptoms appear, enabling early intervention and improved outcomes. Nurses educate clients about recommended screenings and help ensure access to preventive care.

Principles of Screening

Effective screening programs should:

  • Detect conditions where early treatment improves outcomes
  • Use tests that are reliable, valid, and acceptable to patients
  • Be cost-effective at the population level
  • Have treatment available for detected conditions
  • Cancer Screening Guidelines
  • Breast Cancer Screening
  • Age/Risk Recommendation
  • Average risk, 40-44 Option to begin annual mammography
  • Average risk, 45-54 Annual mammography
  • Average risk, 55+ Annual or biennial mammography
  • High risk Earlier screening, may include MRI

High-risk factors :

  • BRCA1/BRCA2 gene mutations
  • Personal history of breast cancer
  • Strong family history (first-degree relatives)
  • Previous chest radiation (e.g., Hodgkin lymphoma treatment)

Clinical Breast Exam : Recommended periodically; patient should know own breasts and report changes.

Breast Self-Awareness : Women should be familiar with how their breasts normally look and feel and report changes promptly.

Cervical Cancer Screening

  • Age Recommendation
  • <21 years No screening
  • 21-29 years Pap smear every 3 years
  • 30-65 years Pap + HPV co-testing every 5 years (preferred) OR Pap alone every 3 years
  • >65 years May discontinue if adequate prior screening
  • Post-hysterectomy No screening if cervix removed for benign reasons

HPV Vaccination : Recommended at age 11-12 (can start at 9); catch-up through age 26.

Key Point : Cervical cancer screening begins at 21 regardless of sexual activity. HPV testing is not recommended before age 30 as a primary screen.

Colorectal Cancer Screening

  • Method Frequency
  • Colonoscopy Every 10 years (gold standard)
  • FIT (Fecal Immunochemical Test) Annually
  • Stool DNA test (Cologuard) Every 1-3 years
  • CT colonography Every 5 years
  • Flexible sigmoidoscopy Every 5 years

Who to Screen :

  • Average risk: Begin at age 45
  • High risk: Earlier screening (personal/family history, IBD, certain genetic syndromes)

If FIT is positive : Colonoscopy is required regardless of any prior colonoscopy.

Lung Cancer Screening

Who qualifies :

  • Age 50-80 years
  • 20+ pack-year smoking history
  • Current smoker OR quit within past 15 years
  • Method : Annual low-dose CT (LDCT)

Discontinue when :

  • Has not smoked for 15+ years, OR
  • Develops health problem limiting life expectancy or willingness to have treatment
  • Prostate Cancer Screening
  • Recommendation : Shared decision-making between patient and provider
  • Age Guidance
  • 50-69 Discuss pros/cons of PSA testing
  • <50 Consider earlier for high-risk (African American, family history)
  • >70 Generally not recommended

Key Point : Routine PSA screening is controversial due to overdiagnosis; emphasize informed decision-making.

  • Skin Cancer Screening
  • No routine screening recommendation for general population
  • Patients should perform self-exams and report changes
  • Clinical skin exam for high-risk individuals

Use ABCDE for melanoma recognition:

  • A symmetry
  • B order irregularity
  • C olor variation
  • D iameter >6 mm
  • E volving (changing)
  • Cardiovascular Screening
  • Blood Pressure
  • Category Systolic Diastolic
  • Normal <120 <80
  • Elevated 120-129 <80
  • Stage 1 HTN 130-139 80-89
  • Stage 2 HTN ≥140 ≥90

Screening : At every healthcare visit for all adults.

  • Lipid Screening
  • When to begin : Age 20 for average-risk adults
  • Frequency : Every 4-6 years if normal; more often if risk factors
  • Component Desirable Level
  • Total Cholesterol <200 mg/dL
  • LDL ("bad") <100 mg/dL
  • HDL ("good") >40 mg/dL (men), >50 mg/dL (women)
  • Triglycerides <150 mg/dL
  • Diabetes Screening

Who to screen :

  • All adults age 35+ (every 3 years if normal)
  • Earlier if overweight/obese with risk factors
  • All adults with hypertension

Methods :

  • Fasting plasma glucose (FPG)
  • HbA1c
  • 2-hour oral glucose tolerance test (OGTT)
  • Test Normal Prediabetes Diabetes
  • FPG <100 mg/dL 100-125 ≥126
  • HbA1c <5.7% 5.7-6.4% ≥6.5%
  • Other Important Screenings
  • Osteoporosis

DEXA Scan Recommendations :

  • Women age 65+
  • Men age 70+
  • Earlier if risk factors present (low body weight, steroid use, smoking, prior fracture)
  • Depression

Screen all adults, especially:

  • Pregnant and postpartum women
  • Chronic disease patients
  • Adolescents
  • Tools : PHQ-2 (initial), PHQ-9 (full assessment)
  • Sexually Transmitted Infections
  • Population Screening
  • Sexually active women <25 Annual chlamydia and gonorrhea
  • Pregnant women Syphilis, HIV, Hep B at first prenatal; others based on risk
  • MSM (men who have sex with men) At least annual HIV, syphilis, chlamydia, gonorrhea
  • HIV-positive individuals Annual screening for STIs
  • Hepatitis C

Who to screen :

  • All adults age 18-79 (at least once)
  • Anyone with risk factors (IV drug use, blood transfusion before 1992)
  • Preventive Care Summary by Age
  • Age Group Key Screenings
  • 18-39 BP, lipids (age 20+), STIs if sexually active, depression
  • 40-49 Add mammography (age 40), diabetes (age 35+)
  • 50-64 Add colonoscopy (age 45+), lung cancer if smoker
  • 65+ Add DEXA, consider discontinuing some screenings
  • Exam Tips
  • Know when to START each screening (age triggers)
  • Know frequency of repeat screenings
  • Recognize high-risk factors that warrant earlier screening
  • Understand shared decision-making for prostate cancer screening
  • Remember colorectal cancer screening now starts at 45 (updated from 50)
  • Cervical cancer screening starts at 21 regardless of sexual activity