MCCQE Part I Prevention and screening Questions: 10 Free Practice MCQs
Prevention and screening questions test population logic applied to one patient. The MCC objectives expect the Canadian Task Force on Preventive Health Care recommendations, including the age ranges and intervals for colorectal, breast and cervical screening, and the honest discussion of benefits and harms. They also expect brief intervention for smoking, alcohol and inactivity, and an understanding of why some tests are recommended against.
Where candidates lose marks
- Screening outside the recommended age range or interval because the patient asked.
- Treating a screening result as a diagnosis without confirmatory testing.
- Ignoring the task force recommendation against a test that has no proven benefit.
- Forgetting to offer brief intervention and follow-up for smoking or alcohol use.
Guideline to follow: The MCCQE Part I follows the Canadian Task Force on Preventive Health Care and the Canadian Immunization Guide, with provincial screening programme standards.
Ten MCCQE Part I-style prevention and screening questions with the answer and the reasoning behind it. They come from the CA.med bank, which has 60 prevention and screening questions and many more across every topic.
1 / 10
A 60-year-old woman is scheduled for an elective open right colectomy. The surgical team is reviewing preoperative measures that reduce the risk of a surgical site infection.
According to the Ontario Health surgical site infection quality standard, which preoperative measure is recommended?
Show answer
Answer: D. Advise a shower, bath or bed bath on the day before or the day of surgery
Why: The Ontario Health surgical site infection quality standard advises that people having surgery are advised to have, or are helped to have, a shower, bath or bed bath on the day before or the day of surgery, and that hair removal, if required, is performed immediately before surgery. Nasal decolonization may be performed if indicated, and antibiotic prophylaxis is given at the appropriate time, dose and postoperative duration rather than as a prolonged course.
- A. The standard says nasal decolonization may be performed if indicated, rather than routinely for people having surgery.
- B. Antibiotic prophylaxis is given at the appropriate time, dose and postoperative duration, with repeat intraoperative doses when indicated, and a 7 day course is not part of that advice.
- C. If hair removal is required it is performed immediately before surgery, and the previous evening is not the recommended timing.
Sources: Surgical Site Infections Quality Standard, Ontario Health
2 / 10
A 45-year-old woman reports that her father was diagnosed with colorectal cancer at the age of 52. She is asymptomatic and has not had a colonoscopy before.
What screening strategy does the BC Guidelines document recommend for her?
Show answer
Answer: A. Colonoscopy every five years starting at age 40
Why: One first-degree relative with colorectal cancer diagnosed before age 60 calls for colonoscopy every five years starting at age 40 or ten years younger than the relative's age at diagnosis. Stool testing is inadequate for this level of family history, a single examination with symptom-triggered follow-up is insufficient, and waiting until 50 ignores the earlier onset of disease in the family.
- B. A first-degree relative diagnosed before age 60 calls for colonoscopy rather than stool testing.
- C. A single examination with symptom-triggered testing does not match the recommended five-yearly surveillance for this level of family history.
- D. One first-degree relative affected before age 60 removes her from the average-risk group and brings screening forward.
Sources: Government of British Columbia. BC Guidelines: Colorectal Cancer Part 1, Screening (2022).
3 / 10
A 58-year-old man asks whether a blood test for a tumour marker could be used to screen for colorectal cancer instead of a stool test.
Which statement reflects the BC Guidelines on tests not recommended for colorectal cancer screening?
Show answer
Answer: D. Carcinoembryonic antigen testing is not supported for screening
Why: Carcinoembryonic antigen testing, barium enema and the combined use of stool testing with flexible sigmoidoscopy are all listed as not recommended for primary screening in asymptomatic patients. Treating a tumour marker as a first-line screen, using barium enema, or combining the two tests are therefore all inconsistent with the guideline.
- A. Blood tumour markers are not validated for detecting colorectal cancer in asymptomatic people and are not recommended as a screen.
- B. Barium enema is one of the tests the guideline states should not be used as a primary screening tool.
- C. Adding flexible sigmoidoscopy to stool testing for primary screening is explicitly not recommended.
Sources: Government of British Columbia. BC Guidelines: Colorectal Cancer Part 1, Screening (2022).
- Like these? CA.med has a bank of 1500 questions, plus timed mock exams. Free to start: App Store · Google Play
4 / 10
A 53-year-old man mentions that his mother was diagnosed with colorectal cancer at the age of 66. He is otherwise well and has no bowel symptoms.
How should his colorectal cancer screening be managed according to the BC Guidelines?
Show answer
Answer: B. Fecal immunochemical testing every two years from age 50
Why: A first-degree relative diagnosed after age 60 does not increase risk, so standard screening with fecal immunochemical testing every two years from age 50 is appropriate. The five-yearly colonoscopy schedule applies to relatives diagnosed before 60, annual colonoscopy is far more intensive than recommended, and some screening is still warranted rather than none.
- A. The five-yearly colonoscopy schedule applies when a first-degree relative is diagnosed before age 60, not after.
- C. Annual colonoscopy is far more intensive than any recommended schedule and is not justified by this history.
- D. A relative affected after age 60 still leaves him eligible for routine average-risk screening.
Sources: Government of British Columbia. BC Guidelines: Colorectal Cancer Part 1, Screening (2022).
5 / 10
A 24-year-old woman in her first pregnancy is at term and about to deliver vaginally. Her pregnancy and labour have been uncomplicated. She asks her family physician what will be done routinely after the baby is born to reduce the chance of heavy bleeding.
According to the SOGC postpartum haemorrhage guideline, what does active management of the third stage of labour consist of?
Show answer
Answer: C. A uterotonic agent given after delivery of the baby
Why: Guideline No. 431 states that active management of the third stage of labour should be offered to all women, and it defines that management as the use of a uterotonic after delivery of the baby. Delayed cord clamping has replaced early clamping because it improves neonatal outcomes without increasing bleeding, and controlled cord traction adds little benefit, so both have been dropped from the definition. Routine manual removal is not performed, and if the placenta has not delivered by 30 minutes the guideline advises measures to expedite it rather than immediate surgery.
- A. Delayed cord clamping has become standard of care, and controlled cord traction shortens the third stage by only a few minutes while removing little blood.
- B. Manual removal is reserved for a retained placenta, and the guideline advises expediting placental delivery only after 30 minutes have passed.
- D. Massage on its own is not the recommended definition; the uterotonic is the element that the guideline identifies as active management.
Sources: SOGC Clinical Practice Guideline No. 431: Postpartum Haemorrhage and Haemorrhagic Shock (2022)
6 / 10
A 62-year-old man with no symptoms and an average risk of colorectal cancer tells his family physician that he would prefer a colonoscopy every ten years rather than a stool test for colorectal cancer screening.
Which screening approach does the Canadian Task Force on Preventive Health Care recommend for adults aged 60 to 74?
Show answer
Answer: B. Fecal occult blood testing every two years or flexible sigmoidoscopy every ten years
Why: For adults aged 60 to 74 the Task Force recommends screening with fecal occult blood testing every two years or flexible sigmoidoscopy every ten years. Colonoscopy is explicitly not recommended as a screening test, computed tomography colonography is not a recommended modality, and this age group is precisely the one the guideline targets rather than excludes.
- A. Colonoscopy is not recommended as a screening test by the Task Force, although it remains the follow-up test after a positive stool result.
- C. Computed tomography colonography is not one of the modalities the Task Force recommends for this age group.
- D. Adults between 60 and 74 years fall within the group for whom screening is recommended, not excluded.
Sources: Canadian Task Force on Preventive Health Care. Colorectal Cancer (2016).
7 / 10
A 76-year-old woman has been admitted to hospital with pneumonia and reduced mobility. She is at high risk of a pressure injury and lies in bed for most of the day.
According to the Ontario Health pressure injury quality standard, which intervention should be provided?
Show answer
Answer: B. An appropriate support surface based on her assessment, plus help with regular repositioning
Why: The Ontario Health pressure injury standard provides people who are at risk of a pressure injury with appropriate support surfaces based on their assessment and with interventions that enable repositioning at regular intervals, helping them to reposition or repositioning them when they cannot. Options A and D withhold or delay the appropriate surface, and option C substitutes symptom-driven turning for regular repositioning.
- A. A standard mattress does not match the standard's advice to provide support surfaces chosen on the basis of the patient's assessment.
- C. The standard asks for repositioning at regular intervals, so waiting for the patient to report discomfort does not meet it.
- D. The standard provides support surfaces to people who are at risk as well as those who already have a pressure injury, so waiting for one to develop is too late.
Sources: Ontario Health - Pressure Injuries Quality Standard
8 / 10
A 34-year-old woman reports longstanding constipation. She has no rectal bleeding, weight loss, anaemia or family history of colorectal cancer.
According to Choosing Wisely Canada, is colonoscopy indicated?
Show answer
Answer: C. No, colonoscopy is not warranted without alarm features or family history
Why: Below age 50, without family history of colon cancer or alarm features such as anaemia or weight loss, the risk of colorectal cancer with constipation is very low and the risks of colonoscopy usually outweigh the benefits. Constipation alone, a barium enema, or youth are not indications for endoscopy.
- A. Constipation is not an accurate symptom for diagnosing organic disease, so a blanket policy of colonoscopy is not supported.
- B. Barium enema does not substitute for the recommended approach of withholding colonoscopy in the absence of alarm features.
- D. Being younger than 50 lowers rather than raises the likelihood of colorectal cancer in this presentation.
Sources: Choosing Wisely Canada. Canadian Association of Gastroenterology recommendations (2026).
9 / 10
A 3-year-old boy is brought to hospital after being found face down in a backyard inflatable pool. He was resuscitated and is now stable. His parents ask how they can prevent this from happening again and mention that he has started swimming lessons.
Which counselling point fits Canadian injury prevention guidance for a child of this age?
Show answer
Answer: D. Drowning is a leading cause of injury death in early childhood, and young children need constant close supervision around water
Why: The CPS injury prevention framework reports that in children aged 1 to 14 years drowning is the leading cause of death, and that water depth and conditions are hazardous for young children and place them at high risk of drowning if unsupervised. It also notes that leading causes of injury mortality are generally unrelated to free play and are often linked to hazards rather than intentional risk taking. Counselling and environmental measures such as pool fencing are designed to eliminate those hazards.
- A. Lessons do not replace supervision, because water depth and conditions remain hazards a toddler cannot manage.
- B. Even shallow water is hazardous for a young child, and the framework treats water depth and conditions as hazards.
- C. Drowning is the leading cause of injury death in children aged 1 to 14 years in Canada, so this age group is very much affected.
Sources: Canadian Paediatric Society. Children and youth injury prevention in Canada: Preventing harm, protecting futures. Position statement (2026).
10 / 10
A 77-year-old woman attends her family physician for a routine visit. She has no gastrointestinal symptoms, no personal or family history of colorectal neoplasia, and her last screening colonoscopy eight years ago showed no lesions. She asks whether she should continue colorectal cancer screening.
According to the Canadian Task Force on Preventive Health Care, what should be recommended for this patient?
Show answer
Answer: A. Discontinue colorectal cancer screening
Why: The Task Force recommends against screening adults aged 75 years and over, so a 77-year-old woman with no history of colorectal neoplasia should stop screening. Continuing stool testing, ten-yearly colonoscopy or one-time flexible sigmoidoscopy all fall outside the recommended age range, and colonoscopy is not endorsed as a screening modality at all.
- B. Stool testing every two years applies to adults aged 50 to 74, and she is beyond that upper age threshold.
- C. Screening colonoscopy is not recommended by the Task Force at any age, and specifically not from age 75 onwards.
- D. Flexible sigmoidoscopy every ten years is an option only for adults aged 50 to 74, which this patient exceeds.
Sources: Canadian Task Force on Preventive Health Care. Colorectal Cancer (2016).
Explore the 1500-question bank in CA.med
Timed practice, spaced repetition and AI clinical simulations that grade you like an examiner. Free to start.
More topics
- Surgery190 questions in the app
- Obstetrics & Gynaecology202 questions in the app
- Paediatrics201 questions in the app
- Colorectal cancer12 questions in the app
- Psychiatry150 questions in the app
Free MCCQE Part I Practice Questions by Topic · Free timed mock exam
How Canadian licensure works, province by province
Exam-style questions written by MedHub for practice. They are not official exam questions.