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Difficulty: HardHealth Screening

A primary care nurse is reviewing the health records of four clients to determine their need for annual lung cancer screening with low-dose computed tomography (LDCT). Based on current evidence-based screening guidelines, which client should the nurse identify as meeting the criteria for this screening?

  1. A
    A 48-year-old client who currently smokes one pack of cigarettes per day and has a 25 pack-year smoking history
  2. B
    A 56-year-old client who has a 15 pack-year smoking history and quit smoking 4 years ago
  3. A 68-year-old client who has a 30 pack-year smoking history and quit smoking 10 years agoAnswer
  4. D
    A 76-year-old client who has a 45 pack-year smoking history and quit smoking 16 years ago

Answer

The 68-year-old client who has a 30 pack-year smoking history and quit smoking 10 years ago is the correct candidate for LDCT screening.
The correct answer identifies the client who meets all three criteria established by current preventive health guidelines for annual low-dose computed tomography (LDCT) lung cancer screening. To qualify, a client must be between 50 and 80 years old, possess a smoking history of 20 pack-years or greater, and either currently smoke or have quit within the past 15 years. The 68-year-old client with a 30 pack-year history who quit 10 years ago perfectly matches this risk profile.

Step-by-Step Solution

1
Identify the current age criteria for LDCT lung cancer screening.
The client must be between 50 and 80 years of age.
Screening outside this age range lacks evidence of a mortality benefit that outweighs the risks of false positives and unnecessary invasive procedures.
2
Determine the required smoking history threshold.
The client must have a smoking history of at least 20 pack-years.
This threshold specifically identifies individuals at a high enough statistical risk for lung cancer to benefit from secondary prevention measures.
3
Evaluate the smoking status and quit-time limits.
The client must be a current smoker or have quit within the past 15 years.
After 15 years of smoking cessation, the risk of lung cancer drops significantly, and the risks of routine LDCT screening begin to outweigh the benefits.
4
Analyze each client profile against all three established criteria.
Only the 68-year-old client meets the age, pack-year, and timeframe-since-quitting requirements.
Accurate application of screening guidelines requires satisfying every component of the inclusion criteria.

Key Concept

Secondary prevention criteria require precise application of multiple demographic and historical variables (age, pack-years, years since quitting) to correctly identify candidates for annual LDCT lung cancer screening.
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Topics

Health Screening

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