Boards Health promotion Flashcards
A 38-year-old female patient comes to the clinic for a routine checkup. She has a body mass index (BMI) of 24 and a 20 pack-year history of smoking. The patient has no family history of cancer. Based on U.S. Preventive Services Task Force (USPSTF) guidelines, what should the patient be screened for?
A.Colorectal cancer
B.Lung cancer
C.Type 2 diabetes
D.Depression
depression
Which of the following factors may decrease the risk for childhood obesity?
A.Early introduction of solid foods
B.Exclusive formula feeding during the first 6 months
C.Young maternal age at birth
D.Breastfeeding
breastfeeding during first 6 months of life is believed to be associated iwth a lower risk of childhood obesity
What information would the nurse practitioner include when discussing recommendations for routine colorectal cancer screening to a men’s wellness group?
A.Patients should have a carcinoembryonic antigen (CEA) test after age 60 years.
B.Beginning at 30 years of age, patients are recommended to schedule a proctosigmoidoscopy.
C.High-sensitivity fecal occult blood test (FOBT) should begin at age 45.
D.Capsule colonoscopy should be used every 10 years starting at age 40.
Solution: C
High-sensitivity fecal occult blood test (FOBT) should begin at age 45.
High-sensitivity fecal occult blood test (FOBT) beginning at age 45 is the correct screening recommendation. The carcinoembryonic antigen (CEA) test can help monitor response to treatment and detect metastasis or recurrence in patients who have received treatment for colorectal cancer. A screening proctosigmoidoscopy would not be appropriate at 30 years of age. If a capsule colonoscopy is selected as the screening tool, it is repeated every 5 years.
The human papillomavirus (HPV) vaccine prevents which strains of HPV?
A.16 and 18
B.6 and 11
C.31 and 33
D.52 and 58
16 and 18
A 11-year-old patient comes to the clinic for a school physical examination. If the patient requires no catch-up immunizations, which of the following vaccinations should the nurse practitioner recommend at this visit?
A.DTaP, IPV, HepB, rotavirus
B.DTaP, Hib, pneumococcal, HepA
C.Tdap, IPV, MMR, varicella
D.Tdap, HPV, meningococca
Answer: D. Tdap, HPV, meningococcal
The Centers for Disease Control and Prevention (CDC) recommend the Tdap, HPV, and meningococcal vaccines at age 11 to 12 years. The patient should also receive an annual influenza vaccine, and the nurse practitioner should assess COVID-19 immunization status to determine whether initial immunization or booster is appropriate.
A 72-year-old female patient is seen by the nurse practitioner (NP) for a routine physical exam. When discussing preventive screenings, which recommendation will the NP make regarding breast cancer screening?
A.Breast cancer screenings are no longer indicated due to patient age.
B.An MRI of the breast should be done every 2 years.
C.A mammogram should be completed yearly.
D.A mammogram should be completed every other year.
Answer: D. A mammogram should be completed every other year.
Current recommendations suggest that patients between the ages of 50 and 74 years should obtain a mammogram to screen for breast cancer every other year. Yearly mammograms are no longer recommended. The age at which screening may cease in the absence of other risk fastors is age 75 years. The evidence is currently insufficient to recommend the use of adjunctive screening methods such as ultrasound or MRI as a routine screening.
The family nurse practitioner is assessing an older adult patient using the Stopping Elderly Accidents, Deaths, & Injuries (STEADI) initiative algorithm called the Algorithm for Fall Risk Assessments & Interventions. Which documentation is representative of moderate risk?
the pt has fallen in teh past year without injury, gait and balance deficits present
Any patient with gait, balance, or sensory deficits is considered moderate or high risk, regardless of fall history. A patient with gait, balance, or sensory deficits who has not fallen, or a patient who has fallen one time without injury is classified as moderate risk. A patient who has fallen once with injury or fallen two or more times is considered at high risk. Only patients without gait and balance issues without a history of falls are classified as low risk and may need further evaluation with other assessment tools. A patient who had concerns about falling but did not exhibit any balance or ambulation problems would be considered at low risk.
Which plan for care will the nurse practitioner discuss with the parent of a 4-month-old infant whose initial dose of rotavirus vaccine is unknown?
A.Restart the dosing series
B.Administer a booster dose
C.Maintain a two-series dose
D.Default to a three-series dose
Default to a three-series dose.
If an infant is receiving Rotarix, a dosage is administered at 2 and 4 months of age. If the infant has received rotavirus live RotaTeq, the infant will receive three doses, one at 2, 4, and 6 months of age. The Centers for Disease Control and Prevention (CDC) recommends that if any treatment in the series of rotavirus vaccination is either RotaTeq or unknown, the practitioner will default to a three-series dose. Restarting the dosing series is not specific to the recommendations of the CDC. Restarting or maintaining a two-dosing series is not recommended.
A patient from eastern Europe presents for follow-up of tuberculosis (TB) exposure. Upon completing the health history, it is revealed the patient received the bacillus Calmette–Guérin (BCG) vaccine as a child. What is the best method to determine if the patient was exposed to TB?
A.Purified protein derivative (PPD) skin test
B.Interferon gamma release assay (IGRA) blood test
C.Chest x-ray
D.Sputum culture
Solution: B
Interferon gamma release assay (IGRA) blood test.
If a patient has been vaccinated with bacillus Calmette–Guérin (BCG), the gold standard to evaluate if they have been exposed to TB is the interferon gamma release assay (IGRA) blood test. A purified protein derivative (PPD) test may cause a false positive reaction. There is no need for a chest x-ray or sputum culture until positive symptoms or a positive test is present.
The nurse practitioner is speaking with the parent of a 10-year-old patient about car safety. What seating position would the NP identify as safest for the child?
A.Front passenger seat
B.Rear seat, center position
C.Rear seat, behind the driver
D.Rear seat, behind the front passenger
Answer: B. Rear seat, center position
Rear seat, center position is the safest seating position for a child in a vehicle. Placing a child in the front passenger seat exposes them to airbag risks. Rear seat positions behind the driver and behind the front passenger may have less protection in the event of a side impact. The center position in the rear seat provides the greatest distance from potential impact areas.
A 5-year-old child has received the DTaP, IPV, and influenza vaccines. What additional immunization is recommended for this child?
A.Hepatitis A
B.Rotavirus
C.MMR
D.PPSV
MMR.
Per the Centers for Disease Control and Prevention (CDC) recommendations, a child between the ages of 4 to 6 years should receive the DTaP, IPV, MMR, varicella, and influenza vaccines. The rotavirus vaccine series must be started by age 6 weeks and completed by age 32 weeks. The hepatitis A vaccine is administered only to individuals who are at a high risk for developing the illness.
A nurse practitioner (NP) received the Bacillus Calmette-Guérin (BCG) vaccine 10 years ago while working in an area with endemic tuberculosis (TB). Which test should the NP undergo for routine TB screening?
A.Chest x-ray
B.Mantoux test
C.Acid-fast bacilli culture
D.Interferon-gamma release assay
Answer: D. Interferon-gamma release assay
Individuals who have received a prior BCG vaccine may have a false-positive TB skin test (Mantoux) and should be screened using an alternate method. The interferon-gamma release assay (TB blood test) is preferred for screening as it does not result in false positives with prior vaccination. Chest x-rays can be completed to follow up on a positive interferon-gamma release assay but are not generally recommended as the preferred screening for latent TB. Acid-fast bacilli cultures are completed from sputum samples of patients with suspected or known TB, but these would not detect latent TB in a screening capacity.
During a well visit, the parent of a 6-year-old patient reports that the child drinks “two to three glasses” of fruit juice per day. What should the nurse practitioner respond?
A.”Stop giving your child juice. It has no nutritional benefit.”
B.”That amount is fine as long as it’s 100% fruit juice.”
C.”At this age, your child shouldn’t drink more than 12 ounces of juice per day.”
D.”I would suggest cutting back to no more than 6 ounces per day.”
Answer: D. “I would suggest cutting back to no more than 6 ounces per day.”
The American Academy of Pediatrics (AAP) recommends that daily consumption of fruit juice be limited to 4 ounces in children age 1 to 3 years, to 6 ounces in children age 4 to 6 years, and to 8 ounces in children 7 years and older. The AAP suggests that fruit juice not be given to any child younger than 1 year. While fruit juice offers no nutritional benefit over whole fruit and usually lacks the fiber provided by the latter, it is not true that it lacks nutritional value. However, juice increases the risk for tooth decay and may promote a preference for sweetened beverages over water. Beverages that are 100% fruit juice are preferred over “juice drinks,” which may contain significant amounts of added sugar, but the patient’s consumption of juice would still be considered excessive.
A 2-month-old patient presents for a scheduled well-child visit. The patient was born at 33 weeks’ gestation and was successfully treated for intussusception shortly after birth. The caregiver mentions that the infant had a mild fever and a runny nose a few days ago but appears better now. Today’s examination reveals a healthy infant with normal vital signs. Which of the following scheduled immunizations would be contraindicated at this visit?
A.Rotavirus vaccine (RV)
B.Diphtheria, tetanus, and acellular pertussis vaccine (DTaP)
C.Haemophilus influenzae type b vaccine (Hib)
Answer: A. Rotavirus vaccine (RV)
The RV is contraindicated for infants with severe combined immunodeficiency or a history of intussusception. Preterm birth and recent mild illness are not contraindications to routine immunizations.
A 5-year-old child has received the DTaP, IPV, and influenza vaccines. What additional immunization is recommended for this child?
A.Hepatitis A
B.Rotavirus
C.MMR
D.PPSV
Solution: C
MMR.
Per the Centers for Disease Control and Prevention (CDC) recommendations, a child between the ages of 4 to 6 years should receive the DTaP, IPV, MMR, varicella, and influenza vaccines. The rotavirus vaccine series must be started by age 6 weeks and completed by age 32 weeks. The hepatitis A vaccine is administered only to individuals who are at a high risk for developing the illness.
