AANPCB Family Nurse Practitioner (FNP) Exam

A 67-year-old man asks about lung cancer screening. He smoked 1 pack per day for 25 years and quit 9 years ago. He has no symptoms and would accept surgery if cancer were found. Which screening plan matches the current USPSTF recommendation?

1. ANo screening, because he has already quit smoking
2. BA single low-dose CT now, then stop if it is negative
3. CAnnual posteroanterior chest radiograph
4. DAnnual low-dose CT of the chestCorrect

Why: The 2021 USPSTF recommendation (grade B) covers adults 50 to 80 years old with at least a 20 pack-year history who currently smoke or quit within the past 15 years; he has 25 pack-years and quit 9 years ago, so annual low-dose CT applies. Chest radiography is not the recommended screening test. Quitting does not end eligibility until 15 years have passed, and the recommendation is for yearly screening, not a single scan.

A 23-year-old nonpregnant woman has a positive urine NAAT for Chlamydia trachomatis. She has no drug allergies. Which regimen does CDC recommend?

1. ADoxycycline twice daily for 7 daysCorrect
2. BMetronidazole twice daily for 7 days
3. CSingle-dose oral azithromycin as preferred therapy
4. DCeftriaxone as a single intramuscular dose

Why: The CDC 2021 STI treatment guidelines list doxycycline 100 mg twice daily for 7 days as the recommended regimen for chlamydia in adolescents and adults; azithromycin moved to an alternative regimen because of concern about its effectiveness for rectal infection. Ceftriaxone treats gonorrhea, and metronidazole treats trichomoniasis and bacterial vaginosis.