detecting preclinical disease Flashcards
A 51-year-old woman of European ancestry who has had no primary care for more than 10 years presents to your practice. She has a 40 pack-year cigarette smoking history, currently smoking 1 PPD and reports drinking about 1‒2, 12 oz (0.35 L) beers per week. Her history is otherwise unremarkable as is her physical examination. You order the following screening test:
Hemoglobin electrophoresis.
Mammography.
Chest x-ray.
Fasting serum triglycerides.
Mammogram for women of this age, universal recommendation
A 65-year-old man of Native American ancestry presents for a “physical.” He feels well, denies tobacco or alcohol use, and has not seen a healthcare provider in more than 10 years. The patient states, “I am a really healthy person. I would not come in except my wife and daughter told me I should have a checkup.” As part of today’s visit, he should be screened for:
Pancreatic cancer.
Hemolytic anemia.
Hepatic sclerosis.
Visual defect.
Visual defect.
This is universal screening.
There is no screening for pancreatic cancer.
He is not at risk for hemolytic anemias or hepatic sclerosis according to the informationgiven.
Suicide: True or False?
Males represent nearly 80% of all completed suicides.
true
Suicide: True or False?
When compared with male suicide attempts, female attempts at suicide are approximately 2–3 times more common.
true
Suicide: True or False?
The highest rate of completed suicide is found in teenage males
false
Suicide: True or False?
Inquiring about suicidal ideation could precipitate the act.
false
Ms. Kane is a 25-year-old woman who presents with finger-shaped ecchymotic areas on her right shoulder that are an incidental finding during a physical examination. She denies abuse or assault. The NP’s most appropriate response is:
“Your bruises look as if they were caused by someone grabbing you.”
“Was this an accident?”
“I notice the bruises are in the shape of a hand.”
“How did you fall?”
“I notice the bruises are in the shape of a hand.”
this is the best answer because it is an objective statement.
Mr. Jacobs is a 65-year-old man with COPD and a 60 pack-year history who is currently smoking 1.5 packs of cigarettes per day. He is reading a pamphlet in your office about smoking cessation. You ask him if he has any questions and he states, “I don’t plan to quit smoking at my age. I am too old to quit now. Why bother?” The NP’s most appropriate response is:
Since you have COPD, you really should quit smoking.
You know your lungs will get more damaged if you continue to smoke.
Tell me what you mean by, “I am too old to quit.”
I can provide medication that will help you to quit smoking.
Tell me what you mean by, “I am too old to quit.”
this is an open-ended question that evaluates his knowledge and his readiness to quit.
According to the Stages of Change Theory, he is most likely in which of the following stages?
Precontemplation
Contemplation
Preparation
Minimization
Precontemplation
Indicated or not indicated?
Annual digital rectal exam as colorectal cancer screening in a 63-year-old man
not indicated
Indicated or not indicated?
An initial Pap test with HPV co-testing in a 19-year-old woman who is one-year post-coitarche
not indicated
Indicated or not indicated?
Pelvic ultrasound with endometrial biopsy in a 52-year-old woman who is two years post-LMP and who denies vaginal bleeding
not indicated
Indicated or not indicated?
Annual prostate-specific antigen testing in an 81-year-old man who has hypertension and benign prostatic hypertrophy
not indicated
Indicated or not indicated?
Lung cancer screening with low-dose CT (LDCT) for a 60-year-old who is generally in good health who has a 35 pack-year cigarette smoking history who quit smoking 5 years ago
indicated
indicated or not indicated?
A 30-year-old woman of Asian ancestry who presents for a routine health visit and requests BRCA gene mutation testing
not indicated
