So I just learned of these security questions, I canceled out of the prompt yesterday and I managed to download some apps.
Do I absolutely have to add these? If I don't add them is it just going to keep nagging me every time?
Should you want to continue to use Apple services such as the App Store and iTunes then the questions will need to be answered, this prompt will appear periodically until you do so for information this prompt is usually triggered by an OS upgrade or on occasion when Apple changes the terms and conditions in the App, iTunes or iBooks stores.
You don't have to add them until (unless) they change the service to not keep working until you do fill them out.
If you would rather not add that information now, you don't have to do anything but ignore the prompts each time they arrive.
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