NCLEX · General

A nurse is teaching a 45-year-old woman about cervical cancer screening. Which schedule is currently recommended?

Correct answer

Pap smear every 3 years (ages 21-65) OR Pap smear with HPV co-testing (co-test) every 5 years (ages 30-65); no Pap needed before age 21 regardless of sexual history

  1. A Annual Pap smear starting at age 21
  2. B Pap smear every 3 years (ages 21-65) OR Pap smear with HPV co-testing (co-test) every 5 years (ages 30-65); no Pap needed before age 21 regardless of sexual history
  3. C Monthly self-examination
  4. D Pap smear only when symptoms occur

Why this is the answer

CERVICAL CANCER SCREENING GUIDELINES (USPSTF/ASCCP): Ages 21-29: Pap smear (cytology) alone every 3 years; HPV testing not recommended in this age group (HPV is common and usually clears spontaneously in younger women); Ages 30-65: OPTION 1: Pap smear every 3 years; OPTION 2: Pap + HPV co-test every 5 years (preferred — most sensitive); OPTION 3: HPV test alone every 5 years (FDA-approved primary screening); Under 21: Do NOT screen regardless of sexual history initiation (normal HPV clearance; colposcopy for abnormal results is harmful in this age group); Over 65: Can discontinue if 3 consecutive negative cytologies or 2 consecutive negative co-tests in past 10 years with last test within 5 years AND no history of CIN2+ or cervical cancer; NURSING ROLE: Correct common misconception that annual Pap smears are needed; explain that longer intervals reflect evidence-based guidelines, not reduced care quality.
Source: NCLEX-RN HP — Cancer Screening, Cervical Cancer Pap Schedule

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