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503 > Exam 2: Primary Care Screening [3] > Flashcards

Exam 2: Primary Care Screening [3] Flashcards

1
Q

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

A

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.

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2
Q

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

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

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3
Q

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

A

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)

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4
Q

When is autism screening done?

A

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.

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5
Q

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

A

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

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6
Q

Which of the following is recommended for all adults?

A. Hepatitis C screening
B. Colon cancer screening
C. Obesity screening
D. Osteoporosis screening

A

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.

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7
Q

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

A

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

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8
Q

Which of the following tools are used to screen for drug and alcohol use?

A. PEDS
B. M-CHAT-R
C. CRAFFT
D. CCHD

A

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.

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9
Q

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

A

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.

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10
Q

What is included in the universal screening for a 12-month-old visit?

A

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 *
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11
Q

What is included in the universal screening for a 2-year-old?

A

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
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12
Q

In children, BMI less than 5% is:

A. Underweight
B. Normal
C. Overweight
D. Obese

A

In children, BMI less than 5% is: Underweight

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13
Q

In children, BMI from 5% - 85% is:

A. Underweight
B. Normal
C. Overweight
D. Obese

A

In children, BMI from 5% - 85% is: Normal

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14
Q

In children, BMI from 85% - 94% is:

A. Underweight
B. Normal
C. Overweight
D. Obese

A

In children, BMI from 85% - 94% is: Overweight

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15
Q

In children, BMI of 95% or greater is:

A. Underweight
B. Normal
C. Overweight
D. Obese

A

In children, BMI of 95% or greater is: Obese

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16
Q

When is the dyslipidemia risk assessment completed for children?

A

When is the dyslipidemia risk assessment completed for children?

Ages 2, 4, 6, 8, and then yearly

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17
Q

When is a fasting or non-fasting lipid blood draw completed?

A

Between ages 9-11 and 17-21

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18
Q

What age do we start doing pap smears?

A

21

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19
Q

How often should we do pap smears?

A

Every 3 years with cervical cytology alone in ages 21-29

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20
Q

When do we do high blood pressure screenings in adults?

A

Ages 18 and older; it is recommended to obtain readings outside of the clinical setting prior to initiating treatment.

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21
Q

When do we do obesity screening?

A

Start obesity screening at age 6 and older

22
Q

At what age do we start HPV testing and how often?

A

HPV testing for ages 30-65 done every 5 years along with cervical cytology

23
Q

When are we to screen and ask patients about smoking cessation?

A

On all well-visits and acute visits

24
Q

At what age do we begin depression screenings?

A

Start at age 12 and continue through adulthood

25
Q

What ages do we want to do chlamydia and gonorrhea testing?

A

Anyone sexually active and ages 24 and younger; and in older women who are at risk.

26
Q

Who should take folic acid and when?

A

All women of childbearing age

27
Q

At what ages should a person be screened for HIV infection?

A

Ages 15-65

28
Q

Who should get an AAA screening and when?

A

One-time screening (US) for men ages 65-75 who have ever smoked

29
Q

At what age do we start mammograms if no risk factors and how often do we do them?

A

50-74; biennial

30
Q

If a woman has risk factors what age do we start mammograms?

A

Ages 40-49 on an individualized basis depending on family history

31
Q

Are monthly self breast exams recommended?

A

No, self-breast exam no longer recommended

32
Q

What ages are colorectal cancer screenings completed?

A

Ages 50-75

33
Q

At what age does type II diabetes screenings begin and how often after that?

A

Ages 40-70

Every 3 years if normal

34
Q

Who should be screened for Hep C and at what age?

A

If born between 1945-1965

Newest recommendation is all adults ages 18-79 - updated March 2020

35
Q

Who should have a dexascan and at what age?

A

Postmenopausal women younger than age 65

or

Any woman over the age of 65

36
Q

At what age should we recommend exercise interventions to prevent falls to community-dwelling individuals?

A

65

37
Q

Is cholesterol screening the same for both men and women? If not what are the recommendations?

A

No

Cholesterol screening recommended for ALL men over age 35

38
Q

What age should a PSA be checked on your male patients?

A

55-69

No screen if average risk

39
Q

At what age should we do a lung cancer screening and how much should the patient have smoked?

A

The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.

40
Q

What age range do we screen for iron deficient anemia in children?

A

6-24 months

41
Q

According to the USPST, when should primary clinicians apply fluoride varnish to a child’s teeth?

A

Fluoride varnish should be applied to all primary teeth of infants and children starting with the first tooth eruption through 5-years-old.

42
Q

The USPSTF recommends screening for gestational diabetes mellitus (GDM) in asymptomatic pregnant women when?

A

24 weeks gestation

43
Q

When does the USPSTF recommend screening for hepatitis B virus (HBV) infection in pregnant women?

A

The USPSTF recommends screening for hepatitis B virus (HBV) infection in pregnant women at their first prenatal visit.

44
Q

When does the USPSTF recommend to screen for HIV?

A

The USPSTF recommends that clinicians screen for HIV infection in adolescents and adults aged 15 to 65 years. Younger adolescents and older adults who are at increased risk of infection should also be screened and pregnant women should be screened and those presenting in labor when HIV status is unknown.

45
Q

When should we screen for intimate partner violence?

A

The USPSTF recommends that clinicians screen for intimate partner violence (IPV) in women of reproductive age and provide or refer women who screen positive to ongoing support services.

46
Q

When should we screen for latent tuberculosis infection?

A

The USPSTF recommends screening for latent tuberculosis infection (LTBI) in populations at increased risk.

47
Q

When should pregnant women be screened for preeclampsia?

A

The USPSTF recommends screening for preeclampsia in pregnant women with blood pressure measurements throughout pregnancy.

48
Q

Should we screen for syphilis and if so, when?

A

The USPSTF recommends screening for syphilis infection in persons who are at increased risk for infection and all pregnant women.

49
Q

When should we start screening for misuse of alcohol?

A

The USPSTF recommends screening for unhealthy alcohol use in primary care settings in adults 18 years or older, including pregnant women, and providing persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce unhealthy alcohol use.

50
Q

When should we screen for drug use?

A

The USPSTF recommends screening by asking questions about unhealthy drug use in adults age 18 years or older. Screening should be implemented when services for accurate diagnosis, effective treatment, and appropriate care can be offered or referred. (Screening refers to asking questions about unhealthy drug use, not testing biological specimens.)

51
Q

The USPSTF recommends vision screening at least once in all children aged ____ to ____ years to detect amblyopia or its risk factors.

A

The USPSTF recommends vision screening at least once in all children aged 3 to 5 years to detect amblyopia or its risk factors.

503 (16 decks)

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