A 77-year-old male who is otherwise healthy presents for his routine exam. His last colonoscopy was at age 70 years with no polyps detected. He asks the nurse practitioner when he should have his next colonoscopy. The NP discusses the risk versus the benefits of continued screening with the patient and advises:
He should schedule a colonoscopy now.
The patient that he may decide to stop screening.
He should schedule a colonoscopy at age 80 years.
He no longer needs colonoscopies at his age.
The Correct Answer is B
Choice A reason: While colonoscopy every 10 years is standard for average-risk individuals, continued screening in older adults should be individualized. Automatically scheduling another colonoscopy may not be necessary without considering life expectancy and prior results.
Choice B reason: Guidelines suggest that adults aged 76–85 may choose to continue or discontinue colorectal cancer screening based on overall health, prior screening history, and personal preferences. Since this patient had a normal colonoscopy at age 70 and is otherwise healthy, shared decision-making is appropriate.
Choice C reason: Scheduling a colonoscopy at age 80 is arbitrary and not guideline-based. Screening intervals should be based on prior findings and individualized risk assessment.
Choice D reason: Blanket cessation of screening at age 77 is not recommended. Decisions should be personalized, especially in healthy individuals with a long life expectancy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Structural group therapy may be beneficial for social skills and peer support but is not sufficient for managing medication nonadherence in chronic schizophrenia. It lacks the intensive, individualized outreach needed for this scenario.
Choice B reason: Inpatient hospitalization is appropriate for acute psychiatric crises, such as danger to self or others, but may not be necessary if the patient is stable and simply nonadherent. It is not a long-term solution for chronic management.
Choice C reason: Intensive outpatient programs provide structured treatment but may not offer the level of outreach and flexibility needed for patients who are resistant to care or disengaged from services.
Choice D reason: Assertive Community Treatment (ACT) is a multidisciplinary, team-based approach designed for individuals with severe mental illness who are nonadherent or difficult to engage. It includes outreach, medication management, and support in the community, making it the most appropriate choice for this client.
Correct Answer is B
Explanation
Choice A reason: The amygdala is primarily involved in emotional processing, particularly fear and aggression. While it may influence sleep indirectly through emotional arousal, it is not the central regulator of the sleep-wake cycle.
Choice B reason: The hypothalamus plays a critical role in regulating the sleep-wake cycle. It contains the suprachiasmatic nucleus (SCN), which serves as the body’s master circadian pacemaker. The SCN receives light input from the retina and synchronizes physiological processes, including melatonin release and sleep timing.
Choice C reason: The cerebellum is responsible for coordination of voluntary movements, balance, and motor learning. It does not have a direct role in sleep regulation.
Choice D reason: The frontal lobe is involved in executive functions, decision-making, and personality. Although sleep deprivation affects frontal lobe performance, it is not the primary center for sleep-wake regulation.
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