ONCOLOGY CERTIFIED NURSE WITH CORRECT
ACTUAL QUESTIONS AND CORRECTLY WELL
DEFINED ANSWERS LATEST ALREADY GRADED
A+ (2025/2026)
Cancer Prevention, Screening, and Genetic Risk (1–10)
1. A 50-year-old woman with no family history of breast cancer asks about
screening mammography. According to the USPSTF, what is the recommended
screening interval?
A) Annually starting at age 40
B) Biennially (every 2 years) for women aged 50–74
C) Only if there is a palpable lump
D) MRI annually starting at age 30
Answer: B
*Rationale: The USPSTF recommends biennial screening mammography for
women aged 50–74. The decision to start screening before age 50 should be
individualized. High-risk women (BRCA mutation, strong family history) may need
earlier or more frequent screening with MRI.*
2. A 55-year-old patient is diagnosed with colorectal cancer. The patient asks
whether any family members are at risk. Which finding would most strongly
suggest hereditary nonpolyposis colorectal cancer (HNPCC/Lynch syndrome)?
A) One first-degree relative with colon cancer at age 70
B) Endometrial cancer in a first-degree relative
C) Multiple colorectal adenomas (>100)
D) A single colonic polyp at age 60
,Answer: B
Rationale: Lynch syndrome (HNPCC) is associated with colorectal, endometrial,
ovarian, gastric, and other cancers. The Amsterdam criteria or revised Bethesda
guidelines help identify families. Endometrial cancer is a hallmark of Lynch
syndrome. Familial adenomatous polyposis (FAP) presents with hundreds of
polyps.
3. A 60-year-old man with a 40-pack-year smoking history asks about lung cancer
screening. Which of the following meets the USPSTF criteria for annual low-dose
CT screening?
A) Age 50–80 years, 30 pack-year smoking history, current smoker or quit within
15 years
B) Any age with a smoking history of 10 pack-years
C) Age 65 years with a 10-pack-year history
D) Age 70 years with a 50-pack-year history who quit 20 years ago
Answer: A
*Rationale: The USPSTF recommends annual low-dose CT for lung cancer
screening in adults aged 50–80 years with a 20 pack-year smoking history and who
currently smoke or have quit within the past 15 years. Option A is correct (30
pack-years is within the range).*
4. A 35-year-old woman with a strong family history of breast and ovarian cancer
tests positive for a BRCA1 mutation. What is her estimated lifetime risk of breast
cancer?
A) 5–10%
B) 20–30%
C) 45–65%
D) 65–75%
Answer: D
*Rationale: BRCA1 and BRCA2 mutations confer a high lifetime risk of breast
,cancer (up to 70–80%) and ovarian cancer (up to 40–50%). Risk-reducing
mastectomy and salpingo-oophorectomy are options. Annual breast MRI and
mammography are recommended.*
5. Which cancer screening test is recommended for average-risk adults beginning
at age 45?
A) Colonoscopy every 10 years
B) Annual fecal immunochemical test (FIT)
C) Flexible sigmoidoscopy every 5 years
D) All of the above are acceptable options
Answer: D
*Rationale: The American Cancer Society recommends colorectal cancer screening
starting at age 45 for average-risk adults. Multiple options are available, including
colonoscopy every 10 years, FIT annually, flexible sigmoidoscopy every 5 years, CT
colonography every 5 years, and stool DNA testing.*
6. A 25-year-old woman presents with a new diagnosis of cervical intraepithelial
neoplasia (CIN 2) on biopsy. Which human papillomavirus (HPV) types are most
strongly associated with cervical cancer?
A) HPV 6 and 11
B) HPV 16 and 18
C) HPV 31 and 33
D) HPV 45 and 52
Answer: B
*Rationale: HPV 16 and 18 are responsible for approximately 70% of cervical
cancers. HPV 6 and 11 cause genital warts but are low-risk for cancer. The HPV
vaccine (Gardasil 9) protects against HPV 16, 18, and other high-risk types.*
, 7. A 65-year-old man with a history of hepatitis C and cirrhosis is being screened
for hepatocellular carcinoma (HCC). Which test is recommended every 6 months?
A) CT scan of the abdomen
B) Alpha-fetoprotein (AFP) alone
C) Abdominal ultrasound with or without AFP
D) Liver biopsy
Answer: C
*Rationale: The American Association for the Study of Liver Diseases (AASLD)
recommends surveillance for HCC in patients with cirrhosis using abdominal
ultrasound every 6 months, with or without alpha-fetoprotein. CT and MRI are
used for diagnostic confirmation, not routine screening.*
8. A 58-year-old woman with a new diagnosis of breast cancer undergoes genetic
testing and is found to have a CHEK2 mutation. This mutation is associated with an
increased risk of which other cancer?
A) Ovarian cancer
B) Colorectal cancer
C) Lung cancer
D) Pancreatic cancer
Answer: B
*Rationale: CHEK2 mutations are associated with moderate increased risk of
breast cancer and colorectal cancer. Lynch syndrome is more strongly associated
with colorectal and endometrial cancer. BRCA1/2 are associated with breast,
ovarian, pancreatic, and prostate cancers.*
9. A 52-year-old man with a 30-pack-year smoking history has quit smoking. How
long after quitting does the risk of lung cancer decrease significantly?
A) 1 year
B) 5 years
ACTUAL QUESTIONS AND CORRECTLY WELL
DEFINED ANSWERS LATEST ALREADY GRADED
A+ (2025/2026)
Cancer Prevention, Screening, and Genetic Risk (1–10)
1. A 50-year-old woman with no family history of breast cancer asks about
screening mammography. According to the USPSTF, what is the recommended
screening interval?
A) Annually starting at age 40
B) Biennially (every 2 years) for women aged 50–74
C) Only if there is a palpable lump
D) MRI annually starting at age 30
Answer: B
*Rationale: The USPSTF recommends biennial screening mammography for
women aged 50–74. The decision to start screening before age 50 should be
individualized. High-risk women (BRCA mutation, strong family history) may need
earlier or more frequent screening with MRI.*
2. A 55-year-old patient is diagnosed with colorectal cancer. The patient asks
whether any family members are at risk. Which finding would most strongly
suggest hereditary nonpolyposis colorectal cancer (HNPCC/Lynch syndrome)?
A) One first-degree relative with colon cancer at age 70
B) Endometrial cancer in a first-degree relative
C) Multiple colorectal adenomas (>100)
D) A single colonic polyp at age 60
,Answer: B
Rationale: Lynch syndrome (HNPCC) is associated with colorectal, endometrial,
ovarian, gastric, and other cancers. The Amsterdam criteria or revised Bethesda
guidelines help identify families. Endometrial cancer is a hallmark of Lynch
syndrome. Familial adenomatous polyposis (FAP) presents with hundreds of
polyps.
3. A 60-year-old man with a 40-pack-year smoking history asks about lung cancer
screening. Which of the following meets the USPSTF criteria for annual low-dose
CT screening?
A) Age 50–80 years, 30 pack-year smoking history, current smoker or quit within
15 years
B) Any age with a smoking history of 10 pack-years
C) Age 65 years with a 10-pack-year history
D) Age 70 years with a 50-pack-year history who quit 20 years ago
Answer: A
*Rationale: The USPSTF recommends annual low-dose CT for lung cancer
screening in adults aged 50–80 years with a 20 pack-year smoking history and who
currently smoke or have quit within the past 15 years. Option A is correct (30
pack-years is within the range).*
4. A 35-year-old woman with a strong family history of breast and ovarian cancer
tests positive for a BRCA1 mutation. What is her estimated lifetime risk of breast
cancer?
A) 5–10%
B) 20–30%
C) 45–65%
D) 65–75%
Answer: D
*Rationale: BRCA1 and BRCA2 mutations confer a high lifetime risk of breast
,cancer (up to 70–80%) and ovarian cancer (up to 40–50%). Risk-reducing
mastectomy and salpingo-oophorectomy are options. Annual breast MRI and
mammography are recommended.*
5. Which cancer screening test is recommended for average-risk adults beginning
at age 45?
A) Colonoscopy every 10 years
B) Annual fecal immunochemical test (FIT)
C) Flexible sigmoidoscopy every 5 years
D) All of the above are acceptable options
Answer: D
*Rationale: The American Cancer Society recommends colorectal cancer screening
starting at age 45 for average-risk adults. Multiple options are available, including
colonoscopy every 10 years, FIT annually, flexible sigmoidoscopy every 5 years, CT
colonography every 5 years, and stool DNA testing.*
6. A 25-year-old woman presents with a new diagnosis of cervical intraepithelial
neoplasia (CIN 2) on biopsy. Which human papillomavirus (HPV) types are most
strongly associated with cervical cancer?
A) HPV 6 and 11
B) HPV 16 and 18
C) HPV 31 and 33
D) HPV 45 and 52
Answer: B
*Rationale: HPV 16 and 18 are responsible for approximately 70% of cervical
cancers. HPV 6 and 11 cause genital warts but are low-risk for cancer. The HPV
vaccine (Gardasil 9) protects against HPV 16, 18, and other high-risk types.*
, 7. A 65-year-old man with a history of hepatitis C and cirrhosis is being screened
for hepatocellular carcinoma (HCC). Which test is recommended every 6 months?
A) CT scan of the abdomen
B) Alpha-fetoprotein (AFP) alone
C) Abdominal ultrasound with or without AFP
D) Liver biopsy
Answer: C
*Rationale: The American Association for the Study of Liver Diseases (AASLD)
recommends surveillance for HCC in patients with cirrhosis using abdominal
ultrasound every 6 months, with or without alpha-fetoprotein. CT and MRI are
used for diagnostic confirmation, not routine screening.*
8. A 58-year-old woman with a new diagnosis of breast cancer undergoes genetic
testing and is found to have a CHEK2 mutation. This mutation is associated with an
increased risk of which other cancer?
A) Ovarian cancer
B) Colorectal cancer
C) Lung cancer
D) Pancreatic cancer
Answer: B
*Rationale: CHEK2 mutations are associated with moderate increased risk of
breast cancer and colorectal cancer. Lynch syndrome is more strongly associated
with colorectal and endometrial cancer. BRCA1/2 are associated with breast,
ovarian, pancreatic, and prostate cancers.*
9. A 52-year-old man with a 30-pack-year smoking history has quit smoking. How
long after quitting does the risk of lung cancer decrease significantly?
A) 1 year
B) 5 years
