Exam 2: Primary Care Screening [3] Flashcards
When providing well child care for an infant in the first year of life, the NP demonstrates an understanding of current guidelines when taking what action?
A. Focusing less on development and more on illness prevention and nutrition
B. Following guidelines established by the Bright Futures publication
C. Scheduling well-baby visits to coincide with key developmental milestones
D. See the infant at ages 2, 4, 6, and 12 months when immunizations are due
In the most recent AAP Recommendations for Preventative Pediatric Health Care, there is a greater emphasis on behavioral and developmental issues and a recommendation that well child care be based on child and family development rather than the periodicity of immunization schedules.
A sexually active adolescent asks the school nurse about prevention of STDs. What is the most appropriate recommendation?
A. Use condoms
B. Abstain from sex
C. Any type of contraception method will prevent STDs
D. The withdrawal method of contraception will prevent STDs
A. Use condoms
Condoms provide the best available barrier to STDs
The nurse needs to be open, forthright, and respectful of the decisions the student made about sexual activity
Which lead level is considered normal?
A. Below 5 mcg/dL
B. 5-9 mcg/dL
C. 10-19 mcg/dL
D. 20-44 mcg/dL
Answer: A
Normal lead levels are < 5 mcg/dL
Levels > 5 are abnormal and need repeated and monitored
For levels > 69 - requires chelation (old literature; now 45)
When is autism screening done?
Autism surveillance occurs at every visit (through direct observation and asking parents if they have any concerns about their child’s learning, development, or behavior)
Formal autism screening is routine and recommend for all children at 18 and 24 months, or at other ages with parental concerns.
Which of the following are A screening recommendations for a healthy 24-year-old woman with no family history of cardiovascular disease and a body mass index (BMI) of 23 kg/m2?
A. Hypertension screening
B. Cholesterol screening
C. Diabetes screening
D. Abdominal aortic aneurysm (AAA) screening
Answer: A
HTN screening: > 18 YO
Cholesterol screening: > 45 YO; C recommendation for > 20 YO with no risk factors
Diabetes screening: Recommended w/additional risk factors such as HTN, HLD, or elevated BMI
AAA screening: Once for men with smoking history ages 65-75
Which of the following is recommended for all adults?
A. Hepatitis C screening
B. Colon cancer screening
C. Obesity screening
D. Osteoporosis screening
Answer: C
Obesity screening with BMI is recommended for all adults.
One-time hepatitis c screening recommended for adults born between 1945 and 1965.
Colon cancer screening is recommended from ages 50-75 and is not recommended for average-risk adults younger than 50.
Osteoporosis screening is recommended for women over the age of 65 and women younger than 65 with similar risk factors of women older than 65.
Which of the following patients should be screened for an abdominal aortic aneurysm (an A or B USPSTF recommendation)?
A. A 45-year-old man who has smoked 1 pack of cigarettes per day for the past 20 years
B. A 70-year-old man who smoked 1 pack of cigarettes per day for 30 years and quit 10 years prior
C. A 55-year-old man with hypertension who has never smoked cigarettes
D. A 68-year-old woman who smoked 2 packs per day for the past 40 years
Answer: B
The USPSTF recommends one-time screening for abdominal aortic aneurysm in men between the ages of 65 and 75 who have ever smoked
Which of the following tools are used to screen for drug and alcohol use?
A. PEDS
B. M-CHAT-R
C. CRAFFT
D. CCHD
Answer: C (CRAFFT)
CRAFFT is a mnemonic (Car/Relax/Alone/Forget/Friends/Trouble) screening tool that assesses for drug and alcohol use and can be used in 11- to 21-year-old patients.
PEDS is a developmental screen for children between the ages of 6 months and 8-years-old.
The M-CHAT-R is an autism screening tool for children
CCHD (critical congenital heart disease) is a pulse oximetry screening for newborns.
Which of the following adolescents should have instrument-based hearing screening, even if they do not have concerns about their hearing?
A. An 11-year-old girl with no medical problems
B. A 17-year-old boy with well-controlled asthma
C. A 19-year-old sophomore in college with acne
D. All of the above
Answer: D (all of the above)
In 2017, the American Academy of Pediatrics (AAP) updated recommendations to include screening for all adolescents once between 11 and 14 years, once between 15 and 17 years, and once between 18 and 21 years. Use standard frequencies (500, 1000, 2000, 4000 Hz) at 4-, 5-, 6-, 8-, and 10-years-old. High frequencies (6000 and 8000 Hz) should be added for adolescents.
What is included in the universal screening for a 12-month-old visit?
12-month-old well visit:
Comprehensive history Unclothed physical exam Weight, length, head circumference Vision Hearing Immunizations Health education and anticipatory guidance Oral health * Hemoglobin (if not performed at 9-months) * TB risk assessment * Lead level *
What is included in the universal screening for a 2-year-old?
2-year-old well visit:
Comprehensive history Autism screening for second time * Unclothed physical exam Weight, length (standing- BMI), head circumference * Vision screening Hearing screening Lead level * Dyslipidemia risk assessment * Immunizations Health education and anticipatory guidance
In children, BMI less than 5% is:
A. Underweight
B. Normal
C. Overweight
D. Obese
In children, BMI less than 5% is: Underweight
In children, BMI from 5% - 85% is:
A. Underweight
B. Normal
C. Overweight
D. Obese
In children, BMI from 5% - 85% is: Normal
In children, BMI from 85% - 94% is:
A. Underweight
B. Normal
C. Overweight
D. Obese
In children, BMI from 85% - 94% is: Overweight
In children, BMI of 95% or greater is:
A. Underweight
B. Normal
C. Overweight
D. Obese
In children, BMI of 95% or greater is: Obese
When is the dyslipidemia risk assessment completed for children?
When is the dyslipidemia risk assessment completed for children?
Ages 2, 4, 6, 8, and then yearly
When is a fasting or non-fasting lipid blood draw completed?
Between ages 9-11 and 17-21
What age do we start doing pap smears?
21
How often should we do pap smears?
Every 3 years with cervical cytology alone in ages 21-29
When do we do high blood pressure screenings in adults?
Ages 18 and older; it is recommended to obtain readings outside of the clinical setting prior to initiating treatment.